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OC_An Khe

OC_An Khe

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  1. OC_An Khe

    Sticky Politics

    Yes healthcare is a business always has been in this country. Yes change is inevitable, both good and bad, therefore we must be the change agents for our own profession. Instead of eating our young we need to unite and protect our fellow competent nurses who speak out against the bad changes that are being imposed on our profession by those who are not members of the profession.
  2. OC_An Khe

    Calling all Military nurses

    Yes a day to toast ABSENT COMRADES.
  3. OC_An Khe

    Male Nurses/female Patients

    Very interesting points made throughout this thread. And some that made me shiver. Bottom line is that it is THE PATIENTS CHOICE. That choice should be honored whenever practical. It doesn't matter the reason, whether it be gender issues, religious practices or just cultural beliefs. In my over 40 years of patient care, at multiple levels of preparation, I have been asked not to care for a patient of both genders. More so in the past then recently. In fact more male patients have asked not to be cared for me (especially during the 80's during the initial HIV epidemic) then female patients. Is there a double standard, of course just as the is a double standard in all of American society. It is fading now as opposed to years ago. Hopefully it will continue to fade.
  4. OC_An Khe

    Universal Heath Care - Lessons from Massachusetts

    Is it a real shortage of PCP or not enough of the who will see patients at the price the insurance co. are willing to pay. Or is their a poor distribution of PCP across the state (more in the richer suburbs and only a few in the poorer areas of the state)? Status of NP in MA? If MDs refuse to take on new patients, it will always result in more frequent ER visits as long as the ER can't refuse to at least eval and treat the patient.
  5. OC_An Khe

    Medicare Debate and Nursing

    Medicare, Medicaid and private insurance are not the problem. We as a nation will figure out how to finance it just as all other developed nations have. The main problem is fee for service without regard to the quality, efficacy, necessity, or outcome of the procedures performed. This leads to unwarranted costs. The changing of medicare to a voucher system IMHO will never happen.
  6. OC_An Khe

    A Nurse CAN be both sexy & smart

    There is a time and place for being sexy, whatever your profession is. But your place of employment isn't one of them.
  7. OC_An Khe

    What do you consider to be nursing's biggest setback?

    See my Kudos on above posts. Historically and going forward, Nursings problem has been it is a female dominated profession.
  8. OC_An Khe

    Mandatory Overtime-- what do you think?

    Mandatory OT used as a routine method of staffing doesn't work in the long run. In the long run it drives up costs more then the cost of hiring appropriate numbers of RNs. As for calling in sick, when you are too tired while helps the individual RN, only causes another to be mandated. Of course it also drives the cost of Mandatory OT up faster as they are now paying 2 RNs @ 2.5x plus benefits instead of one RN with benefits if they hired adequate staff.
  9. OC_An Khe

    Patients Are Not Consumers

    We are consumers. There are two types of consumers, those that have no choice due to illness/injury and those that are consuming because the want to out of a perceived need as opposed to necessity. They are, however, lumped together in the same system. Krugman's point, I believe, is that health care should not be treated the same as other products. It should be removed from complete free market control. If you philosophically believe that the free market is the cure for everything then you will disagree with Krugman. If not then you will be accepting a governmental role in health care. By the way, not even Adam Smith believed in a complete free market.
  10. OC_An Khe

    Tufts nurses vote 70% to authorize strike

    $5200/week IMO is not obscene, just a little bit closer to what an RN is really worth. What is obscene is taking any amount of money to cross a picket line.
  11. OC_An Khe

    do you get paid more for certifications?

    Get an annual bonus for certifications, by the way also get extra salary for BSN.
  12. OC_An Khe

    Medical Malpractice and Tort Reform

    Not trying to provoke a debate. Medicine/ health care is a business. A business that has certain fixed and variable costs. These costs must be met in order to stay in business. If an income stream is taken away from a business then either the costs need to be cut/ eliminated or the income stream has to be replaced. Yes there are MDs that would like to give up defensive medicine, but those that are in private practice or independent LLC's wouldn't like to give up a significant portion of their income. To the OP, explore states that have passed tort reform laws and see if it has had a significant decrease in costs, improved quality or access. An area that wasn't relatively apparent in your foot notes. There is the possibility that tort reform could have positive effect of lowering costs, but it is only a possibility. A lot of other factors have to fall into place for that potential to be realized. As an example, after tort reform, would insurance companies fully reduce mal practice premiums in order for MD's to have a cost reduction or would they try and maintain the premiums as high as possible thus maintaining their profits for the share holders? To over simplify, one business cost is another business' income or an employee salary. This is a very complex area with many variables, many varied opinions and no single correct answer.
  13. OC_An Khe

    Medical Malpractice and Tort Reform

    Remember defensive medicine is also a significant part of the MDs income. Do you think they will voluntarily give up that income stream even if there is tort reform? Does any business voluntarily give up a lucrative income stream?
  14. OC_An Khe

    parking at Vanderbilt

    Don't work at Vandy but know people that do and I believe it is not a problem and it is free. The pay on the other hand is problematic depending on where you are relocating from. Heard it is a fun town though.
  15. OC_An Khe

    We may need fewer nurses in the hospital...

    As heath care is changing, some would say evolving, nursing has to change and adapt as well. Hospital centered care as been the mainstay of health care for most of the 1900's and as a result it was the main employer of nursing. As health care is evolving away from the hospital so to must nursing. There will always be a need for hospitals and bedside care but the numbers have been shrinking for decades and will continue to shift away from the hospital. However those patients that are in the hospital are more complex and require far more RN time then has been the historical norm. See the studies linked on previous posts with regard for the number of patients a RN can safely care for. Administrators do not get this or if they do can't figure how to pay for it.(maybe they don't want to as it increases marginal costs thus decreasing profits). The nurses at Tuft's are correct and need our support. But we do need to address the acuity mix of patients. There is a difference in caring for 6 patients that will be discharged as compared to 6 that are being admitted in acute distress. (just took the number 6 at random not advocating that number or any number).