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PamelaAlfordRN@aol.com's Latest Activity

  1. PamelaAlfordRN@aol.com

    Job Hopping...again

    I changed jobs several jobs last year, before I finally settled into a non-clinical job at an insurance co. It was either that or quit nursing alltogether. I miss the patient contact, but not wearing beepers around my neck 24/7!
  2. PamelaAlfordRN@aol.com

    Catching Hell

    I am a Nurse Case Manager fo a major Medicare HMO, and caught the wrath of GOD yesterday afternoon from a Member's son, even though I had nothing to do with our Medical Director's decision to deny placement for her in a skilled facility.I was told to discuss Home Health Care for her with him, and he informed me, among other things, that I was a f----idiot. Every other word was marked with expletives, even though I was trying to help him. It just goes to show that we're blamed for everything..
  3. PamelaAlfordRN@aol.com

    Let's play I Remember When.....

    What a hoot. I remember working as a nurses aide and having to do "enemas until clear" at 5AM for all the BE preps..whether our patients wanted them or not. One morning, when I was the ONLY aide working 11-7, I had FIFTEEN of them! How times have changed.....
  4. PamelaAlfordRN@aol.com

    Babyboomer RN

    Hey, msdttob: Just wanted to let you know that I was offered a Senior Case Manager position with a major insurance company this week. They're even going to give me eighteen months, to obtain my CCM designation! There IS hope for us babyboomers, and if I can do it, so can you!
  5. PamelaAlfordRN@aol.com

    Cover Your Rear

    Wow, thanks to all of you, for your input and advice....especially for the information about Nurseprotect. I will pass along this information to this nurse, who can certainly use it at such a horrible time.
  6. PamelaAlfordRN@aol.com

    Should families, etc. be held accountable for participating in patient care?

    Sure, they should be held accountable. When I used to work in home health, there were families who would wait on the aide or nurse, to come and "clean up" their loved ones...after the patient had laid in his/her own excretement ALL night. "I'm paying YOU to take care of Him/Her, I was rather arrogantly told many times. Well, some eighteen years later, as Medicare has cut reimbursement, resulting in the closing of thousands of home health agencies, this has resulted in beneficiaries and families being FORCED to doing things that they once relied on the nurse to do...or put their loved ones in a nursing home....
  7. PamelaAlfordRN@aol.com

    Cover Your Rear

    Thanks for your responses. I do not know what kind of treatments were ordered, or what the client's diagnoses was. This happened at a facility I do not work at. I do know that the physician was the medical director of the facility, and even though he had signed the treatment orders after the fact, he refused to acknowledge responsibility, and the nurse who had written the orders was fired, and her license revoked. The buck stopped there. Who else do you think, if any, should share the responsibility for the fact that the client lost a foot? I did not know this nurse personally, but nurses who do know her state that she was an excellent practictioner, and are very frightened and and angry...angry enough, to want to throw in the towel and surrender their licenses. "It's just not worth it anymore", a nurse told me today. I'm beginning to think that, too.....
  8. PamelaAlfordRN@aol.com

    Cover Your Rear

    I learned today that a fellow nurse had her license revoked after it was discovered that she had been writing orders to cover treatments in a skilled facility. The doctor refused to accept responsibility for these orders, and the Board served her on toast. NO matter how good our intentions are, in trying to provide the best of care for our patients, the moral is: cover your rear, and call that doctor...NO matter how many times we get cussed out..or hung up on.
  9. PamelaAlfordRN@aol.com

    Angry Nurse

    In this business, it's damned if you do, damned if you don't. You can't slice yourself up into a thousand pieces and be everything to your patients, their families, the doctors AND hospital administration. You were just telling the simple truth, as bad as it sounded...and what your supervisor didn't want anyone ELSE to know.
  10. PamelaAlfordRN@aol.com

    Bit of humor

    What a hoot. How many times have we fallen into bed after the shift from hell, only to be awakened by the phone, and answer it: "4-West, Miss Martin", like Pavlov's dog?
  11. PamelaAlfordRN@aol.com

    Where do burned out nurses go ?

    Dear Burnedout: I don't think there are any easy cures. In the case where I was working for a home health agency 16-20 hours a day, which enabled the owners to take their Administrators to lavish sabbaticals in New York City (that agency is one of over 3,000 agencies which have been put out of business by PPS), I simply put my house on the market, sold it and moved back to North Georgia where the grass was greener (or so I thought). Anyway, I'm looking into utlization review and case management, before I decide to quit this business and move on. Somewhere out there, there HAS to be something for us for the industry which has fried its nurses to a crisp in exchange for chump change. Good luck--we're ALL going to need it!
  12. PamelaAlfordRN@aol.com

    Babyboomer RN

    I'm 49, and have been through burnout more times that I care to mention. For this reason, I am looking into Utilization Review/Case Management, which closely parallels my eighteen years of experience in home health. The only problem is, that it's a tough field to get into, unless you have CCM designation. So, I'm joining the American Case Management Association, and start learning what I need to know, to be able to take the exam. After all, it's all about cost containment, so if you can't beat 'em, join 'em. Good luck!