clandestine2

Ok, so why are you glazing over the portion of the story where the other nurse lied? I made an error in regards to HIPAA violation. OK. ADDRESSED. Moving on to the point of the post regarding infighting, and you did not answer the other questions regarding report. My actions certainly were not inappropriate.

Not true. I answer the phone with my name. The point was that report was not being given. I, the OP, have the right to call into question when an attempt at legal transfer of authority and responsibility is taking place inappropriately. And nurses should be able to have a conversation that doesn't result in sending an email, largely falsified to elicit a response, due to an emotional response. Susie2310, the conversation was not heated, and the scenario outlined in the email was not accurate by any means. My response was completely respectful and appropriate, actually if it were a legal RN-to-RN report i still have the right to refuse it. So where exactly to you see my behavior to be inappropriate? Asking for my name merely triggered me to clarify that report is not being given, I could care less if the other nurse knew my name.

touche!

Duplicate post

Good points, I absolutely will not correct the other moving forward. The intention of the original communication with the "other" nurse was to ensure that was an understanding that there was not a legal transfer of care. Yes the HIPAA is less likely to be acted upon, but despite the common place activities you refer to above, in a technical sense, and legal relies on the black and white nature of technicalities, HIPAA is being violated here. If the care provider who discharged the patient called and did a DOC-2-DOC, then no there would not be a violation as this is covered under PHI as permitted uses and disclosures, but between two nurses this is not appropriate or permitted "Treatment is the provision, coordination, or management of health care and related services for an individual by one or more health care providers, including consultation between providers regarding a patient and referral of a patient by one provider to another.". Refer here Summary of the HIPAA Privacy Rule | HHS.gov As common place as it may be, violations do occur and HIPAA is not a "in the spirit of" it has rigid definitions in order to protect the publics PRIVATE information. The reality is that I, the nurse, do not have a need to know until the patient walks through the door to seek care, unless a health care provider has done a consultation before hand, which did not happen in my scenario. According to Health and Human Services: Protected Health Information. The Privacy Rule protects all "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information "protected health information (PHI)."12 "Individually identifiable health information" is information, including demographic data, that relates to: •the individual's past, present or future physical or mental health or condition, •the provision of health care to the individual, or •the past, present, or future payment for the provision of health care to the individual, Permitted Uses and Disclosures Permitted Uses and Disclosures. A covered entity is permitted, but not required, to use and disclose protected health information, without an individual's authorization, for the following purposes or situations: (1) To the Individual (unless required for access or accounting of disclosures); (2) Treatment, Payment, and Health Care Operations; (3) Opportunity to Agree or Object; (4) Incident to an otherwise permitted use and disclosure; (5) Public Interest and Benefit Activities; and (6) Limited Data Set for the purposes of research, public health or health care operations.18 Covered entities may rely on professional ethics and best judgments in deciding which of these permissive uses and disclosures to make. * (1) To the Individual. A covered entity may disclose protected health information to the individual who is the subject of the information. (2) Treatment, Payment, Health Care Operations. A covered entity may use and disclose protected health information for its own treatment, payment, and health care operations activities.19 A covered entity also may disclose protected health information for the treatment activities of any health care provider, the payment activities of another covered entity and of any health care provider, or the health care operations of another covered entity involving either quality or competency assurance activities or fraud and abuse detection and compliance activities, if both covered entities have or had a relationship with the individual and the protected health information pertains to the relationship. See additional guidance on *Treatment, Payment, & Health Care Operations. Treatment is the provision, coordination, or management of health care and related services for an individual by one or more health care providers(this is not referring to RNs as we are not providers), including consultation between providers regarding a patient and referral of a patient by one provider to another.

So very frustrated at a recent experience that I had at my job. I work in a busy ED and occasionally we receive patients who are "referred" from an outside urgent care. I have personally received phone calls from a particular urgent care informing us that there is a patient coming over and they continue on by providing ALL protected information about this patient, after they have discharged them, and why they cannot treat them there. It is important to note that the urgent care completes their care of the patient and then discharges them from their system, the patient leaves and may or may not elect to come to our emergency department. The last phone call that I received from this urgent care went about the same as usual but at the end of the conversation the nurse on the other end of the phone call says and what is your name. I paused, as this is not a common request and stated, I have no problem providing my name, heck I answer the phone stating my name, but I must clarify that there is no RN-to-RN report occurring here as this is not a transfer and there is no transfer of medical authority and/or medical accountability between facilities, additionally providing all of the protected information about the patient could constitute a violation of HIPAA as we do not have a need to know since it is not a transfer. I brought this up to the nurse due to her requesting my name as it made me think she was charting it somewhere, which really seems like a bad idea for HER and HER ORGANIZATION to be documenting an inappropriate release of patient information. So... you can probably imagine how this was received. The nurse didn't say anything to me regarding the issue, but was actually agreeable stating oh yes we are just providing info on the patient (smiles and warm fuzzies here), phone hangs up no big deal, and by the way the patient never came to our ED. Fast forward about two weeks I receive a phone call from my director stating she has a disturbing email about a phone call that occurred with an urgent care. For the sake of the readers time I will summarize, the email stated I did not want to give my name in addition to me be terse and maybe rude (can't remember), and the final sentence stated "should we not be sending patients to your ed any longer as you don't want info on them", a basic threat to pull business away. You, the reader, should know that I work for a for profit hospital and this last sentence had all the teeth to ensure my director would act, and act she did. I get a call, she is super matter of fact, basically telling me to just listen and don't say anything back to those who are calling us regardless of appropriateness as customer service is our goal and... well you can fill in the rest. I am disturbed to my nursing core. I have been a nurse now for about 6 years, to some thats nothing and others thats a good amount of time. I haven't seen a lot of malicious behavior like this and I think it is why I am struggling with it. I guess my issue is when nurses cannot listen to constructive criticism without personalizing it and making it about the person communicating it. I get my directors response, she MUST act on this as it is threat to community business relationship and thats to be expected. What I don't get is the fabrication of scenario to elicit a response from my leadership, it really feels icky. I do know that the nurse I was speaking with has been a nurse for about two years, I offer this for context. I assure you that I was nice and pleasant in my conversation with the nurse, and cannot understand why she would paint our conversation in such a way. I can only assume her intellect was offended and she "reacted", instead of considering what she was actually doing, violating protected information (albeit trying to be helpful). I read a post on here by Riseupandnurse that stated due to nurses having to take whatever is dished out by admin, physicians, patients, families, etc, that there is a great deal of free floating anxiety and hostility and sometimes finds its release valve on an unsuspecting victim. Additionally, I feel that there is a great deal of insecurity that we all deal with and sometimes instead of recognizing this and overcoming how it makes us feel then learning from it, we fall victim to self preservation and restructure reality in order to ensure we are righteous and the other, perceived adversary, is wrong and we demonize them and their actions or intended message. When this occurs it is a hugely flawed weakness in psyche, that ultimately is self defeating and greatly inhibits personal growth. I guess I am posting this for therapeutic purposes, and maybe some stimulating conversation can result.

Yes, because mine changed today to not accepted at 0900. So if yours has not changed then you're still being considered

Decisions are being posted right now, you may want to look at app status

Yes... GOING CRAZY!

Update. I spoke with the FNP program coordinator earlier this week to get a pulse on the progress (and because my nerves are getting frayed). I was told that ALL applicants will hear a determination at the same time and that will be in a few weeks from now (before May 1st). She also shared that they will email a decision and that we could follow via app status online (you probably have an email about this). Let May 1st get here already!

@kkad22 Unfortunately I won't hear anything from Otterbein until after OSU makes their decision, I would prefer Otterbein honestly. Also I am working on the OU app now and am basically done. Whichever I get into first is the the one Im going with. OSU tuition is redonkulous, OU and Otterbein are about 25K and I would rather go either of those directions. Also, my spouse works at The James and I can tell you there is a great deal of bureaucracy at OSU, but hey when in Rome and thats why I applied to OSU. At the end of the day it really doesn't matter where you go. Nonetheless I am still nervous and really just want to hear one way or the other. Good luck to everyone

Totally agree! how can one make an insightful decision about "who" you are with 4min of recorded video. palm on face! Im surprised OSU is utilizing this form of interviewing, Im not sure how well a human connection can be made with my webcam. BTW I really did not like the interview process, Im definitely a meet and greet person.

Totally agree! how can one make an insightful decision about "who" you are with 4min of recorded video. palm on face! Im surprised OSU is utilizing this form of interviewing, Im not sure how well a human connection can be made with my webcam. BTW I really did not like the interview process, Im definitely a meet and greet person.

Thank you for posting this kkadd22. I also applied for the 2017 FNP program. I feel you! I am also super nervous. I was disappointed to read that EVERYONE got an interview . I can share that there were 64 applicants for the 50 spots between the MSN-FNP and the BSN to DNP. I got this info from a good source but dont think I should list who as I wouldn't want to jeopardize their position. Anyway, my cumulative is a 3.8, my BSN is a 3.92, science is a 3.90 as I was also a biology major and some programs calculate sciences independently, coming up on 5 years as a nurse, varied experience med/surg ortho/neuro, ED, acute psych and IP psych, I get around :) . SO NERVOUS! I also applied to Otterbein and OU as backups. Good luck. Ill update if I hear anything. I guess we will all know by May 1st!

One major advantage to working in healthcare, especially the areas of healthcare that require higher levels of education is demand. I have worked in administration in other industries where six figure salaries were the norm, however I must stress the volatility of other” industries and demand. In my experience the value of a moderate income over extended time has more inherent value and security versus very high paying jobs and shorter more volatile time periods, not to mention the emotional stress that accompanies those industries. Also, nursing is one of the only professions I know of that one can double income (or at least increase 50%) with each level of education, i.e LPN to BSN to MSN. Nursing is in a very significant period now, and looking back we will recognize the pioneering strives made as it relates to salary equity and practice scope. If you want to make more money, and that is totally acceptable as a motivation, further you nursing education and expand your scope and the increased responsibilities will reflect in your pay.

2013 National Salary Survey Results This data is current as of 2013, I know there is 2014 data out there somewhere. 2013 NP Salaries over vs PA Salaries Avg FT salary for NP 98,817 Avg FT salary for PA 107,268 ​

Probably half way through my BSN program I knew that I wanted to pursue becoming a midlevel practitioner. To keep my options open I decided to take PA/Med School prereqs while finishing my final year of nursing school. I graduated nursing school and continued to take my prereqs while working between neuro and ortho med/surg floors. Fast-forward a few semesters and upon completing the core 9 prereqs (Chem I & II, Biology I & II, genetics, Physics I & II, Ochem I & II), approximately 18 months after graduating nursing school, I decided to go ahead and begin the journey of applying to PA school. I mean I had done all this work, so I must go ahead and apply… Right?!? So CASPA… let me say it again CASPA! So just a little information on the application process, CASPA is well organized, but it costs quite a bit to get your package ready through CASPA. Additionally, each school costs to apply to even if they are linked to CASPA. To make it short, I applied to 15 PA schools, fees ended up being about 2K when all is said and done. Fortunately, I was a first round invite to three schools in my top 5 and I accepted my first offer. Everything falling into place as planned. Now I waited about 10 months before the first semester began. If you are keeping track I've now been a practicing nurse about 2.5 years at the start of the PA program. Ahh… PA school (as an RN), starting the first semester felt familiar and what I expected, actually it felt too familiar. I had an odd feeling about the material, so much of it felt completely like a repeat of nursing school. After the first semester (which I got all As), I had a strong feeling that this was not for me”; I arranged a meeting with the program director and withdrew from the PA program (in excellent standing, with the option of returning the following year). So I'm feeling lost at this point, I revisited what my motivations and desires were for pursuing becoming a midlevel, and why I chose PA. Sadly, in hind site I think I chose PA because I was, and I know many nurses have been, insecure about the level of knowledge I had as a nurse. It came to my attention, while in the PA program, the education nurses receive in their programs in addition to practical clinical experience is so very valuable, and I realized that I had not appreciated this. If one types in PA vs. NP vs. MD vs. DO etc. into Google you will undoubtedly run across posts (especially on studentdoctor.com) really bashing NPs. I had done the same searches a few years ago and was easily swayed by the brutal attacks on NPs at which time for me, the NP pathway was not even a consideration. It is so important to note that I am coming specifically from the point of view of a nurse, as I do believe that the PA education and practice is excellent and they do indeed provide excellent service, BUT they are not anymore educated or prepared than NPs. That is something that became so obvious, as a PA student the assumption in the curriculum is that the student has null medical knowledge and experience, this is where the fish out of water” came for me personally. NURSES LEARN THE MEDICAL MODEL! Although our focus is on the nursing model the medical model and the nursing model interweave in the sense of the science and it has to do so in order for nurses to know when and why to reach out to the PCP. This is KNOWLEDGE gained through clinical practice, as I have never worked with a nurse who did not share the inquisitive nature of any other scientist and was not greatly interested in new disease processes or treatments, even researching and reading on their super short breaks or on lunch (yes they do exist). My point here is that knowingly or not, nurses learn the medical model, nurses learn treatments, nurses learn diagnostic methods, and nurses can often times anticipate interventions. THIS IS VALUABLE KNOWLEDGE, learned in the clinical setting. Reflect back on the education curriculum of the PA and the assumption that they have null experience and knowledge medically. So… I started an NP program, I am wrapping up my first semester and it feels like hand in glove for me. The approach to the education and curriculum incorporate the existing knowledge of the nurse. I feel like I am building on the knowledge I already have, versus starting from a null position. In many ways my insecurities led me down a road that cost me time and money and in the end I realize that it is essential to recognize when that is occurring, and not to allow it to take over. So, if you are considering PA or NP as a nurse, I would highly recommend going the NP route, as it is designed to build on what you already know, and YOU KNOW A LOT.