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egg122 NP

egg122 NP MSN, APRN

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  1. egg122 NP

    Ghosts of the ER (Clerks)

    My original post also clearly stated that if it is a true emergency that the registrar needs to wait. You can be EMTALA compliant and have the clerk collect information in the room once the case has been screened and deemed not emergent.
  2. egg122 NP

    Ghosts of the ER (Clerks)

    This is your scenario 4: "4. Your actual care is prioritized and the business end of things is taken care of efficiently without interrupting or delaying any other aspect of your hands-on care." Then it should be addressed issue with their manager or your manager and treating front line co-workers with respect. Or communicating with the registration staff about how to handle scenarios for the shift directly. There are ways of doing this without degrading or being passive aggressive to coworkers.
  3. egg122 NP

    Ghosts of the ER (Clerks)

  4. egg122 NP

    Ghosts of the ER (Clerks)

    Your co-workers are jerks. One is not required to be friends with everyone at work (and frankly sometimes it better not to since it can bring unnecessary drama) but everyone should be treating all of their co-workers with a basic courtesy and respect. And unless it is an true emergency (which will happen more often than in other settings given it is the ER), the medical and nursing staff can wait for you to finish your transaction with the patient before busting in like that. I don't walk in and interrupt the RN or MD who is speaking to a patient or doing a procedure in order to examine a patient just because I am an NP. I politely wait for them to finish and my expectation would be that they do the same. Their frustration with the registration process does not given them a pass to be rude to their co-workers. And they most certainly should not be tossing other people's possessions on the floor, repeatedly bumping into co-workers, refusing to make eye contact or talking about registration staff as if they are not present under any circumstances. Ultimately though, every job has it's hang ups and issues. You seem to like the job overall and it has the best pay and benefits so far so this may just be an annoying part of the job. You can also see if there is a lateral move to another department or shift but the grass isn't always greener. It's unfortunate in healthcare that we frequently don't treat each other as humans given that the vast majority of us went into the field to help others. We tear each other apart over conditions created by employers.
  5. egg122 NP

    Family Practice or SNF

    I'm not clear if the SNF has stated their expectations that you will work as an RN as well or of you are concerned about this. As the other posters have stated, make sure the expectations are clear. You can also advise that it will be impossible for you to bill for 15 patients a day if you are working two jobs (and their bottom line will be negatively impacted). If they expect you to work as an RN, they are not a great employer and do not understand the NP role and I would run from that job as fast as possible (and be thankful that they were open and honest in the interviews as so many employers are not). Also, SNFs can be a good way to get both acute and primary care experience. Depending on the capability of your SNF you can be managing sepsis, acute respiratory failure, etc in house in a way that may not happen in private practice.
  6. That's really unfortunate.
  7. I started at a FQHC and had a patient with epigastric pain with nausea who ended up coming back with a hemoglobin between 4-5 but was hemodynamically stable at the time of the appointment. I got the results on a Saturday night and called the patient and sent them to the ER. ER confirmed the level but discharged.... No insurance. America is a very tiered health system.
  8. egg122 NP

    Keep asking full time staff to do overtime

    I agree with this X 1000. Set boundaries. Too many in our profession do not feel empowered enough to do so. It does not make you less of a nurse to not pick up shifts at your own expense so that administrators improve their bottom line by not hiring enough full time staff.
  9. egg122 NP

    Would this be considered abandonment?

    This is actually state dependent. CT Board of Nursing has declared that if your shift is over and you have made it clear that you are not accepting the next shift, then the employer cannot charge you with abandonment for not accepting mandatory overtime (it also said in the statement that it is an employer- employee issue and that the employer fire you). Staffing is the facility's responsibility, not the individual RN.
  10. egg122 NP

    To kill or not to kill... another person dream?

    ...Wow... Have you considered pressing charges?
  11. egg122 NP

    Return to NP Practice

    I agree with KatieMI. North Carolina's board of nursing has a NP refresh course packet that you might be able to model your proposal after: https://www.ncbon.com/vdownloads/continuing-competence/refresher-course.pdf If that doesn't work consider doing a post masters in Adult-Gero and certify/license that way.
  12. egg122 NP

    Leaving before 1 year? Don't know what to do..

    10 to 12 is too many but the sad reality in many NYC hospitals, public or private (particularly in Brooklyn for some reason). Stick out the year if you can then look for hospitals in Westchester or LI.
  13. egg122 NP

    Potentially Hypochondriac Sister

    This X 1000. Set boundaries. You will likely get push back in the beginning since people generally do not like it when people do set them, but in the end the extra attention may be escalating the behavior like kp2016 wrote.
  14. egg122 NP

    Who Can Supervise Nurses?

    So, she could be a supervisor in the sense of scheduling, hiring and firing capability, non-clinical disciplinary issues (like lateness), managing workflow, give feedback on customer service type issues and non-clinical training the same way in which an administrator might be the head honcho (but not clinical) in a nursing home. They should have already had the RN lead in place when she was hired to review clinical issues though. In most states unlicensed personnel cannot give shots, however, some states do allow MDs to delegate this to unlicensed staff- that is the sketchy part and is typically only done in the outpatient setting. I'd say overall if she was not doing the shots, it may be totally legit but the injection part is a little messed up.
  15. egg122 NP


    No, you did not abandon the residents. You were clear that you were not accepting the second shift, signed out and when you left there were 3 staff members in the building. If management suggests that to you, then they are ridiculous. Don't feel guilty about setting limits- it is the manager's responsibility to ensure staffing is in place, not your's. Also, you are not responsible for ensuring the training of new staff (particularly if they come on after your shift)- management is, but it was kind of you to give them your number in case they had questions.
  16. egg122 NP

    RN's skipping vital signs

    You've done what you can. Just keep following up on the high risk patients like you have been and focus on obtaining the vitals/info needed for safe psych practice (whether that is orthostatics, etc). You are not responsible for the fact that the facility does not want to follow it's own P&P or change it to reflect the actual practice. Your medical director needs to buck up and do his job instead of pushing it on you (It's interesting that he has no concern about the liability that occurs when the P&P isn't followed but he feels less than daily vitals policy is a liability). Plus, like you said, there is a medical NP is responsible for the medical management, including diabetes regimens etc and should be following up with that. Also, keep a notebook with a record of the dates, times and people your voiced your concerns with just to cover yourself.

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