September, 2007 Archive

August 29, 2016, 11:00 am

Cialis Prices

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Cialis prices Oh, cialis priceswhat I would have given to have one of these sets when I was little!

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Lots of things going on in the blogosphere, cialis prices so I thought I’d dedicate a post to some of the happenings!

First of all, cialis prices the iPhone contest is still going on over at Nursing Voices! You have until October 15th to register and post for a chance at not one, cialis prices but two iPhones. Cialis prices Follow the link and if you win, cialis prices I’ll be totally jealous!

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surgeXperiences

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Cialis prices Radiology Grand Rounds is now up over at Sumer’s Radiology Site.

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Our good friend and fellow blogger, cialis prices Doctor Anonymous is a talk show host! A BlogTalkRadio host, cialis prices that is! His latest interview is with Dr. Cialis prices Rob of Musings of a Distractible Mind. Cialis prices His BlogTalkRadio site has all the info!

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I was honored to be a guest blogger over at MedFriendly.com. My post is about “Five Suggestions for Visiting the Emergency Department”, cialis prices and can be found here.

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Cialis prices Change of Shift will be hosted by GirlVet at Madness: Tales of an Emergency Room Nurse this coming Thursday. Cialis prices Submissions can be sent to mj.finn at hotmail dot com or through Blog Carnival.

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12:59 am

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I am appalled at a certain HMO whose slogan rhymes with “Drive”.

Let me put it this way.

In my ER, glucophage 1000mg pills $205.00 if you come in with pain in your calf with redness and heat, glucophage 1000mg pills $205.00 a doppler study is done to determine if a deep vein thrombosis (DVT) is present. Glucophage 1000mg pills $205.00 If you complain that your other calf is also sore, glucophage 1000mg pills $205.00 we will do a doppler study of that leg to make sure you don’t have bilateral DVTs.

In my ER, glucophage 1000mg pills $205.00 if you present with bilateral calf pain, glucophage 1000mg pills $205.00 redness and heat and you happen to mention you had burning in your chest that morning and jaw pain the night before, glucophage 1000mg pills $205.00 you get all of the above and (a) an EKG, glucophage 1000mg pills $205.00 (b) a big ass IV in your left antecubital space for the contrast you will get when you go for the (c) CT scan of your chest to rule out pulmonary embolism.

In my ER, glucophage 1000mg pills $205.00 if you present with all this and you are a status/post trauma patient of four-and-a-half-months with bilateral fused ankles, glucophage 1000mg pills $205.00 a cast on one leg and a halo on the other leg with explicit instructions to keep your legs elevated since the accident until you began weight bearing two weeks ago, glucophage 1000mg pills $205.00 you would be admitted for observation.

At least. Glucophage 1000mg pills $205.00

 

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Take the same patient with the same chief complaint and let’s see how one particular HMO facility decided to handle the case.

Well, glucophage 1000mg pills $205.00 they did a doppler study of one leg, glucophage 1000mg pills $205.00 despite the presence of pain in both. Glucophage 1000mg pills $205.00 What do you know? There’s a DVT there!

Then, glucophage 1000mg pills $205.00 they gave an anticoagulant and sent the patient home.

No doppler on the second leg. Glucophage 1000mg pills $205.00 No EKG. Glucophage 1000mg pills $205.00 No CT of the chest despite the presence of transient chest burning and jaw pains earlier in the day.

You see, glucophage 1000mg pills $205.00 if you have a simple DVT, glucophage 1000mg pills $205.00 you can take oral anticoagulants and follow up as an outpatient with your doctor.

But…the patient didn’t have a simple DVT. Glucophage 1000mg pills $205.00 The patient had bilateral DVTs.

That wasn’t all she had.

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How did the patient finally get the correct diagnosis? She was taken by ambulance late last night to a decent facility; one that was not affiliated with the HMO.

She had chest burning, glucophage 1000mg pills $205.00 shortness of breath and bilateral leg pain.

She was throwing pulmonary embolisms.

This facility gave a damn. Glucophage 1000mg pills $205.00 This facility did not brush off her complaints. Glucophage 1000mg pills $205.00 This facility did the tests. Glucophage 1000mg pills $205.00 This facility made the diagnosis. Glucophage 1000mg pills $205.00 And this facility will treat her appropriately.

Just like they did last May.

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You know that HMO, glucophage 1000mg pills $205.00 the one that has the slogan beginning with “Be Well….”? They should change it to “Go to Hell…” because that is how they treat their members.

Yeah, glucophage 1000mg pills $205.00 pardon the language, glucophage 1000mg pills $205.00 but I’m pissed.

This patient nearly died last May. Glucophage 1000mg pills $205.00 What the hell was “Brand X ” HMO thinking when they saw this constellation of symptoms?

“Let’s finish the job?”

Health maintainence, glucophage 1000mg pills $205.00 my derriere.

Idiots.

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August 29, 2016, 1:59 am

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Somehow that didn’t come out right…

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I believe that as long as nurses are employees of a hospital and not private contractors they will not have power in an organization.

I started to brainstorm ideas. Mirapex 0.5mg pills $386.00 After the shock of having my brain still functioning after three hours of Statistics, mirapex 0.5mg pills $386.00 I asked myself…

How could this be done?

What if nurses started their own staffing companies? Companies that the nurses themselves would own.

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I’ll use the emergency department as an example. Mirapex 0.5mg pills $386.00 Suppose I brought together a group of nurses with experience in emergency nursing. Mirapex 0.5mg pills $386.00 All of them CEN certified with ACLS, mirapex 0.5mg pills $386.00 TNCC, mirapex 0.5mg pills $386.00 PALS and ENPC certifications. Mirapex 0.5mg pills $386.00 We form a company – just for fun we’ll call it “EmergiNurse, mirapex 0.5mg pills $386.00 Inc.”

EmergiNurse, mirapex 0.5mg pills $386.00 Inc. Mirapex 0.5mg pills $386.00 contacts Hotel Hospital and says, mirapex 0.5mg pills $386.00 “For ‘x’ amount of money, mirapex 0.5mg pills $386.00 we will staff your department full time for the next year.” That includes charge nurses and a manager.

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For a price. Mirapex 0.5mg pills $386.00 We contract with the hospital to provide nursing service on a unit for a set fee. Mirapex 0.5mg pills $386.00 One fee negotiated for the year. Mirapex 0.5mg pills $386.00 If the census drops the fee stays the same. Mirapex 0.5mg pills $386.00 If the census increases and more EmergiNurses are needed, mirapex 0.5mg pills $386.00 the fee stays the same.

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We are professionals who own our own practice, mirapex 0.5mg pills $386.00 and we own the company. Mirapex 0.5mg pills $386.00 If we make money we keep it. Mirapex 0.5mg pills $386.00 We aren’t going to lose money because the hospital still has to provide for nursing services to the patients – they would be paying this money anyway. Mirapex 0.5mg pills $386.00 They don’t have to worry about union contracts because they are not our employers. Mirapex 0.5mg pills $386.00 We would manage ourselves, mirapex 0.5mg pills $386.00 bound only by hospital policies and state laws regarding breaks and overtime. Mirapex 0.5mg pills $386.00 We hire only the best nurses who meet our high standards. Mirapex 0.5mg pills $386.00 Magazine readers, mirapex 0.5mg pills $386.00 internet surfers and all ’round lazy attitudes need not apply.

We would be paid for our service and not have our professional services hidden in room fees and miscellaneous hospital costs.

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So we make it easy for them. Mirapex 0.5mg pills $386.00 They are still paying (big time – nurses don’t come cheap), mirapex 0.5mg pills $386.00 but with less administrative hassles to deal with.

Imagine hiring a nursing company to staff your facility.

Travel nurses do it as individuals. Mirapex 0.5mg pills $386.00 Registries do it per shift.

Why not entire units?

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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