paramedic-RN

So I work in an ED with mostly amazing docs, I fully trust their judgement for the most part and feel lucky to have their expertise and support when I have a question however there's this one doc who's just bad....we all know at least one bad doc and he's that one (I'll spare you all the examples). Anyway he also is the only doc who meddles in the midlevel's patient's excessively. He'll cancel your orders, put in new one, etc. Well it's akwkard when I disagree with him because he acts as if I have to do what he says on MY patient. According to our policy if there's a disagreement between a midlevel and doc about how to manage a patient then the doc has to take over that patient I don't think they can just force the midlevel to do what they want. So what's everyone take on this? What do ya'll do when a disagreement comes up about how to manage your patient? Can a doc force you to do/not do something with your patient?

Is that honestly what you thought I was suggesting? Clearly I was making a point that this isn't isolated to an America black/white thing. What about that statement makes you think I'm okay with racism?

So there are plenty of physicians that say it's a legitimate treatment. I certainty am not an expert on either of those drugs and I'm assuming you aren't either so my thought is listen to the experts, but why not the experts on both side? You listen to physicians on the left but not the right? There are ID physicians and vaccine experts on the right that have opinions, why is there opinion less valid than a physician on the left?

Oh I'm well aware of the political implications of this medication, I'm not pretending anything, it's not necessary for me to proclaim that knowledge just to ask a question. But the post he's replying to a post filled objective data with no facts and data, it's wasn't some well formulated response that addressed each point. The original post said nothing about politics and suddenly he brought in politics.

These are quotes from Biden not me. And these quotes are Google-able.

This has nothing to do with trump! If you had a landscaper would you constantly be comparing them to your old landscaper? No! We're in the present, why do liberals keep comparing to a past president. And if so why stop there? Why not compare to Washington? Or Lincoln? Do you assess everyday of your life in comparison to previous days? Even if you think Trump was awful, that has NOTHING to do with Biden's cognitive capacity and efforts to compare are clearly efforts to minimize his cognitive decline https://news.Yahoo.com/biden-t-flashed-ihcue-card-104115491.html Even a liberal sites like Yahoo just posted an article about Biden's cue cards that instruct him things like "you take your seat". Also let's say Biden is better than Trump does that mean your happy with a president that clearly has dementia? Because that's what you're implying.

Here's some actual quotes from Biden, as a nurse would you seem this person to have 'good cognitive health'? You're in denial if you don't think a bumbling elderly man who tries to shake hands with invisible people is not loosing it. Also do not compare to Trump, I'm not talking about Trump, he's in the past, this has nothing to do with Trump, I'm talking about the cognitive capacity of the current president. You can find many Youtube video clips of just utter word salad gibberish that's not even translate-able into sentences to paste here. But below is a few that are actually some what readable. "The number one job facing the middle class. And it happens to be, as Barack says, a three-letter word: Jobs. J-O-B-S." When quoting the declaration of independence “All men and women, created by the, you know, you know the thing.” Following the high profile death of Rep. Jackie Walorski at a White House conference “Representative Jackie — are you here? Where’s Jackie?” the president asked from the podium, peering futilely about the room. “I think she was going to be here,” he added. “I’m also sending to Congress a comprehensive package of — that will enhance our underlying effort to accommodate the Russian oligarchs and make sure we take their — take their, their ill-begotten gains,” Biden began. “Ha, we’re going to ‘accommodate’ them,” he said, snorting at his own mistake. “We’re going to seize their yachts, their luxury homes, and other ill-begotten gains of Putin’s kleptocrac- — yeah …” he said, blinking hard and looking to aides for help. “Kleptocracy and klep- — the guys who are the kleptocracies,” he finished with a chuckle. “But these are bad guys.” “I remember spending time at the, you know, going to the, you know, the Tree of Life synagogue, speaking with them,” Biden said. The next day, the White House had to admit that Biden made the story up. He has also said many racist things toward African Americans which I won't even paste here because it would probably get taken down, not to mention really creepy quotes about children. Well I'll post one "Poor Kids Are Just as Bright and Just as Talented as White Kids" - Biden

Almost every country has a long history of racial inequity, not just white on black, rather (fill in the blank vs fill in the blank) and ongoing in many third world and developing countries. Are you really suggesting that the only harm done throughout history in all cases has been a result of conservative beliefs?!

What do you think he brought up that was political? I mean he mentioned the quote from some republican but this is a medication, not a political issue.

So I'm a new NP and ENP and I'm struggling to pick up the standard 2 patient's per hours, granted I'm probably only 10 shifts in since starting. I know eventually I'll get faster, but just wondering what other's experiences have been? Were you as slow a me in the beginning?! ha and how long until you got up to speed? What's weird is I feel like I am picking up two per hour but then I look back at how many I've picked up in my 8 hour shift and it will only be like 9-12, so clearly I'm not.

I know we could all go back and fourth debating the science there but just kinda taking a poll wondering who's prescribing them, seems taboo in my workplace.

Oh no, not at either program sorry.

"politically conservative white males"??????? Has society convinced you it's okay to make implications about one groups race and political affiliation but not another? how would you feel if someone said "liberal black females" would that be any more/less discriminatory? Do you think a politically conservative white male may take offense to your statement in the same way that a liberal black female may take offense to an equivalent statement? It's two sides of the same coin.

Wow that Conway health paper is so passive aggressive especially parts like your "sincerely held beliefs". I can't believe a document that comes across so passive aggressive was sent into circulation. My guess is that it was written by one occupational health nurse and released rather than a large department where more then one person would be reviewing it. As for the religious exemption yea lets call a spade a spade, plenty of people are just claiming it because it's a loophole. Although I'm sure for a small percent of people it's actually due to their religion. However, this isn't new to vaccines, even schools allow religious exemptions for common childhood vaccines. I see your point in the sense of why not just have an option for "personal objections" if you can't even validate their religious claim but as right now that's not really an option anywhere, at least not that I'm aware of.

Has anyone ever heard of not getting paid to chart? Every nurse I've ever worked with doesn't clock out until they finish charting. So if you had a crazy shift and have 2 hours of charting at the end you basically clock 14 hours. Are there places that don't allow this?

Wait you don't ever give Zofran because you saw a rare scenario one time where somebody had an adverse reaction to it?

Hi Kooky Korky, Of course there's no NEED to start every sentence with "so" there's no NEED to start your sentence with any particular word. But I chose to use the word "so" in a couple sentences (didn't realize anyone was counting). I'm curious why you felt the need to point that out? What do you get out of pointing out irrelevant things to strangers online? Are you looking to put someone down? Are you looking for confrontation? What do you get out of that? You should ask yourself SO I could point out that your post was just filled with sentence fragments, but why would I do that? I'm not trying to get some ego fix on a nursing forum.

Not sure if you're referencing me but I'm not concerned about loosing my skills. That's not why I was considering helping them with their RN shortage. It's a long explanation as to why I've been considering it (I'll spare you the details) but my main concern has been the legality of it which OhioNP touched on pretty well.

I do work as an NP two days per week at the clinic but they've offered that if I want more hours I can have them but it's for a nurse position doing infusions. In other words I could pick up a third day as strictly an RN. Their argument is that it's not justified for them to paying an NP to do an RN job when an NP is not required for that job. Which I understand, I don't fully agree but as I mentioned I lost that argument. My concern is flip-flopping on that third day, so for instance if I did a medical intake in the morning as an NP and then the next hour did an infusion as an RN.

I work at a place where I was originally employed as an RN and then when I became and NP I was hired for that role as well. I mostly work in my NP role but will occasionally work a shift as an RN there. Now I know those roles cannot mix for example I know I can't clock in as an RN and then be ordering labs or adjusting meds because in that moment I'm working as an RN, not an NP. However what about switching throughout the day, is that allowed? For instance let says I come in in the morning to do infusions strictly as an RN (it's an infusion clinic) but then I have two medical intakes mid-day (where I then step into my NP role) and then at the end of the day I have a couple infusions strictly as an RN. I've already told my employer I would like to get NP rate across the board and just do infusions as an NP but I lost that argument so now I'm here deciding if it's legally okay to be going back and forth in my roles throughout the day. My employer is not requiring this but is offering the option if I want more hours.

Hm okay thanks what about if you're a 1099 (independent contractor) employee, does that make a difference?

But if someone was doing that with your name, how would you know? Is there any database you can check to see what prescriptions "you" have called in? I realize this is unlikely but medication fraud does happen still.

Any NP's that work in a clinic setting (who are not salaried) that get paid to chart? For example if your day is 8-5 but it was packed with no time to chart and you have to spend time charting after.

Right, I forgot about that, that now all scheduled meds have to be electronically sent anyway. But what about non-scheduled meds? Couldn't someone easily use your name and info to call in a Lexapro script or something like that? I mean they'd probably have to have some kind of healthcare background so that they knew what to say and a pharmacist wouldn't get suspicious. But how would you even find out if someone was doing that with your name?

So as a newly graduated NP something just crossed my mind. If someone knew my name, NPI #or license # and DEA # which I'm sure anyone could easily find out all of those online what would stop them from just fraudulently calling in a narcotic prescription under your name just claiming they're a nurse or something?