minurse

As a Katrina volunteer, I found that the local law enforcement in SE LA kept us all safe and sound. We did have attempts from some to have refills of narcotics (we just said NO) We did have many that saved seemingly trivial items and not "important" things- but who are we to decide how these people were to think during a catastrophic event. Remember all...post traumatic stress?

Hello all. Just thought I would start a new thread to let everyone know how thankful I am that I was able to spend a week in LA helping with medical relief efforts. Thanks to the help of "glascow" (here on these message boards) I spent a week in Jenning, LA setting up a free medical clinic for evacuee's. We saw 30-60 patients a day for various problems. The local community was responsible for initiating this response- not Red Cross, FEMA, or Public Health Services- in fact they wanted to shut down our little operation! The local sherrif threatened them with jail time!! BTW- The local medical community had mixed feelings regarding our efforts. The clinic was staffed with myself and a fabulous FNP from Delaware for the last week- she was staying for another week and had been there 5 days before I arrived! Local nurses and doctors had spent some time and sent great amounts of medicines and supplies for our use! However, they did think that they would be able to 'absorb' the evacuees into their practices. Problem being $$$- we provided FREE service- didn't take insurance information, and handed out as much sample medicine- prescription and OTC- that we could. There were many horific stories, many heroic stories, and plenty of tears! As RITA moves into the area I pray for the safety of my new friends and the people of the area that will be once again affected by a killer storm. I hope that I have the opportunity to help again! Lauren

TheKing is absolutely correct- not all states require a license. MI is non- licensure state. You only need to hang you shingle out on the porch. However, if you expect to provide care to Medicare clients and bill Medicare, you must be ceritified by CMS and this requires you be certified thru the state. In addition, some insurance companies will only work with agencies that are Medicare certified- they believe this is a judgement of quality. Tennessee is a licensure state and also a Certificate of Need State. Not only does the state license ALL agencies, but you also have to prove a need exists for the service area. A whole other ballgame.

there are many programs that do point of service charting, the problem is the cost. try a search at NAHHC, or google it. The last agency I worked with had a system with the acronym GLMY- great lakes..... Sorry, I'm in private duty and we don't do OASIS, etc.--- Much easier on the nurses. The Agency nurse had laptops that had oasis loaded and they had a pen that they used to fill the dot. They uploaded to the office computer server,and data was sent to CMS and intermediary each day/ week/ whatever. They did not maintain paper charts, so when survey time came they had to retrieve and print all the medical records, the surveyors won't look at a computer screen!!!

My theory deals with management. check out http://www.laurenbrasile.com for more details.

Everything on my list, perfume, sewing machine, jewlry, gloves and a hat and low carb candy in the stocking!!!:chuckle

I have taken care of many celebrities. Country music's queens and kings, members of Saudi royal families, and local celebs.

We have a closed unit---on paper--- when the need arises nurses float in and out--apparenty nobody reads! BTW we are ICU/IICU.

MOM is a nurse in a max. security prison at 68. I don't think she'll ever retire. She even works tons of OT...

report them to the state licensing board.

Our hospital H.R. V.P. was recently quoted in the local paper that we "...got no bang for our buck" regarding sign on bonuses and that he hoped area hospital would quit offering them! The hospital has started offering a "referal bonus" to anyone (including the community at large) if a referal is made and an employee is hired! Our raises have been poor--thank goodness more than 5 cents.

as staff working within the same facility, I don't see the problem. Provided that one nurse knows that the other nurse is employed at the facility and isn't just on the phone, saying "Im a nurse...". Also, conversations regarding patients must be conducted confidentially--not in hall, elevator, etc. I recently was called by a man who had been at the scene of an accident, had called the EMS and wanted the patient's condition. I had the patient's wife come to the phone to speak to the man. Now- that would be unethical- to give him information.

we've had a few interesting ones lately. we had a vent dependant (home vent) patient that insisted all day that she was dying. there were no changes in her assessment from previously, in fact there was discharge planning in place for the next day. however, at 6p during end of shift I/O rounds, the patient was cold, cyanotic, hypotensive, and with a rapidly decreasing loc. the doctors were notified, the vent was working properly and and ekg showed nsr. while standing at the bedside the patient coded. asystole. code proceded as usual. pulses came and went, never saw any fibrillation. (patient was allready trached) code was called by the Intensivist attending. Myself and another nurse proceded to postmortem care, pulled IV's, foley and was placing patient into a clean gown. when the other nurse lifted the arm she palpated a distinct brachial pulse. we then noted faint breath sounds and heart tones. the attending was called back into the room (he was speaking to the family) and a code was called again. this occured over a 20 minute time period. this time, the patient did not resume breathing and have a return of pulse. we were all quite perplexed. the doctors have not been able to explain. the equate the resumption of breathing to an "apnea test", but the pulse is unexplained. too long to be "drug effect."

Hey guys, I just needed to get it out, the hubby is non-medical and can't understand. I work IICU, only Sat. Sun. and Mon. and just had a bad week. It began with a co-worker and friend's dad going bad 5th post-op day and my telling her we have to intubate. It progressed to intervening with the family of a 3 month IICU vented patient circling the drain, and trying to facilitate a no CPR order. The week was so draining--I woke up today to find that I had cried in my sleep so much I couldn't get my contacts in!! I'm still very fragile and teary eyed. I think that I'm most disturbed at the fact that I lost control (even if it was in my sleep).

There is an article in a recent AJN that describes all the awfull effects of demerol.(very informative). We rarely ever use it on our intermediate ICU.