pkapple

pkapple

er/icu/neuro/trauma/pacu

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All Content by pkapple

  1. ER billing--which level to charge?

    pkapple posted a topic in Emergency

    need some help, trying to find a web site or better yet the actual requirements per cms or whomever for billing er visits. I need to know what constitiutes a level I charge on up to a levelV charge....

  2. ER billing--which level to charge?

    pkapple replied to pkapple's topic in Emergency

    Thanks David--I think the E&M codes are the provider codes, right? Well our docs bill their own fees. We have to charge the er part of the visit.It doesn't matter if a lac is 2cm or 6 cm, it...

  3. Taking floor orders in the ED?

    pkapple replied to sorefeet's topic in Emergency

    This is a problem everywhere! One ER I worked at had a pretty good system. The ER doc would write basic admit orders-and i mean basic; Admit to sleepy doc DX:whatever routine vs,activity and...

  4. Anyone have to call back patients who have left without being seen.

    pkapple replied to JessicRN's topic in Emergency

    SAme as Taz--our mgmt really wants to know why they left as much as if they are ok. We have a refusal form for those who leave after triage or who leave before completing care-we try to get it signed....

  5. Nutmeg high?

    pkapple replied to occc2010rn's topic in Emergency

    Nutmeg, eh? Revisiting the wonder drugs from the 70's..actually nutmeg is used medicinally in some cultures, but not in high enough doses to get high. It takes like half a little tin box to do that,...

  6. turning non-emergent pts away

    pkapple replied to Jennifer, RN's topic in Emergency

    Just remember it is NOT the patients choice to leave once they present as one poster suggested. of course they can walk out, leave AMA refuse further care, etc. BUT if an employee even remotely...

  7. Could this be a hippa violation???

    pkapple replied to krsrn2005's topic in HIPAA Challenges

    My husband is a PA-c and this stuff happens a lot more often than you might think. Any one could be trying to get a script in your name--just think of all the people you are acquainted with..at...

  8. Is FL nursing really all that bad?

    pkapple replied to UM Review RN's topic in General Nursing

    Angie- you must be working for pretty good hospital. I have worked in many FL hopitals and tho I usually work ICU or ER, the floors regularly carry a heavier load than you are now. Tele or step-downs...

  9. Nursing (free tuition) vs. OT (many loans)

    pkapple replied to tencents's topic in General Nursing

    I would reapply to OT school, get a job, maybe take a pre-req or two and stay in AL near your mom. You don't say why you are going back to NY,other than you were taking pre-reqs there. If you don't...

  10. writing up another LPN for med error

    pkapple replied to luvmy2angels's topic in General Nursing

    an incident report or variance is to alert the facility of actual or potential occurrences that may or may not cause harm to a patient. if meds were not given or given inncorrectly--write the report...

  11. Visiting hours, whose job to enforce them???

    pkapple replied to pink2blue1's topic in General Nursing

    The biggest problem we get with visiting is the fact that every nurse has a dif opinion of enforcement--so if auntie stayed all night last night, why not tonight? or days says its ok but nocs has...

  12. Disfunctional RN's

    pkapple replied to Rnandsoccermom's topic in General Nursing

    Wish I knew the answer....you can't shame a lazy person into doing a good job, can't help or guide a know-it-all with crappy skills or lack of compassion into doing a carring job. Then of course is...

  13. What can unlicensed personnel do?

    pkapple replied to Cattitude's topic in General Nursing

    Having just given an inservice on scope of practice i can tell you that an RN can delegate to uap's. Now the uap must have demonstrated competentcies for whatever task they are given. They may not do...

  14. Need help w/ careplan....

    pkapple replied to CocoChanel's topic in Nursing Student Assistance

    Daytonite--you are awesome! I've been doing this for over 20 years and your concise yet thorough answer to the OP was outstanding!!!! Keep up the "mentoring". Every student,new grad and old fogey will...

  15. Can nurses suture?

    pkapple replied to amanda sue's topic in General Nursing

    It's all scope of practice. If not specifically forbidden by the BON, the nurse is trained and can demonstrate competancy, and the facility p&p is in place, then yes a nurse can suture-its a...

  16. Florida Nursing Jobs & Traveling Nursing

    pkapple replied to MsMorningGlory's topic in Florida Nursing

    Like FAMU and Tweety said, its culture shock! I moved back to FL from WA, cut my pay exactly in half!!!! My car payments, loans and creditcards didn't change, groceries are a bit cheaper, gas is ever...

  17. Help!!

    pkapple replied to b eyes's topic in Patient Safety Issues

    Leave it alone..if she starts in on you then don't apologize just tell her the DON asked and you said it was working out and leave it at that. Ive been on both sides of this...any 15 year nurse can...

  18. RPA's? The new midlevels?

    pkapple replied to sunnyjohn's topic in General Nursing

    Nope, not midlevels in the general sense. http://www.jvir.org/cgi/content/full/15/3/221?ck=nck "There are several important differences between PAs and RPAs that result from the fact that the RPA’s...

  19. EMTALA question

    pkapple replied to hogan4736's topic in General Nursing

    Potentially EMTALA violation. The first hospital had an OC surgeon, the surgeon did not respond-he may very well have to answer to Emtala violation. If a OC doc refuses to come in it is a def...

  20. Would you put your family member in a LTC facility?

    pkapple replied to Cattitude's topic in General Nursing

    Never ever thought we would put a family member in LTC, despite having 2 sisters who are life long LTC workers (a nurse and an aide). But... My 92yo granfather was getting confused - showing up for...

  21. Would you put your family member in a LTC facility?

    pkapple replied to Cattitude's topic in General Nursing

    Balder- sure hope you are kidding. Might better leave everything to the kiddo that keeps you! Besides the Boy Scouts only help little old ladies to cross the street, not

  22. emtala- judgement call- HELP!

    pkapple posted a topic in General Nursing

    long story short...I need to find a class, lecture, conference- some educational program that addresses "ways to improve nursing judgement and practice within scope" preferably live and in person, and...

  23. paramedics in the ER

    pkapple replied to blufoxtrot's topic in Emergency

    Any body know the actual state regs re these issues? Seems Joint commission requires an Rn to triage and also to do initial assessment in a hospital. Any Nurse practice act folks know if an RN can...

  24. Dismissed from nursing school...appeal denied

    pkapple replied to beeenieweeenie, RN's topic in General Students

    Re-apply for next semester, good students have bad days (or semesters). An LPN I work with worked an extra day shift, then her young son kept her up all night with a GI bug (translate-puky,whiny,messy...

  25. When is it ethical to talk about religion with a patient?

    pkapple replied to GardenDove's topic in General Nursing

    Well, if you don't believe in baptism, or are of any other persusion...then the baptising of an infant doesn't mean anything more than if the nurse sang a lullaby or spoke in spanish. If however...