September, 2007 Archive

September 27, 2016, 11:00 am

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

Average Rating: 4.6 out of 5 based on 233 user reviews.

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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, zoloft 100mg pills $113.00 if you come in with pain in your calf with redness and heat, zoloft 100mg pills $113.00 a doppler study is done to determine if a deep vein thrombosis (DVT) is present. Zoloft 100mg pills $113.00 If you complain that your other calf is also sore, zoloft 100mg pills $113.00 we will do a doppler study of that leg to make sure you don’t have bilateral DVTs.

In my ER, zoloft 100mg pills $113.00 if you present with bilateral calf pain, zoloft 100mg pills $113.00 redness and heat and you happen to mention you had burning in your chest that morning and jaw pain the night before, zoloft 100mg pills $113.00 you get all of the above and (a) an EKG, zoloft 100mg pills $113.00 (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, zoloft 100mg pills $113.00 if you present with all this and you are a status/post trauma patient of four-and-a-half-months with bilateral fused ankles, zoloft 100mg pills $113.00 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, zoloft 100mg pills $113.00 you would be admitted for observation.

At least. Zoloft 100mg pills $113.00

 

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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, zoloft 100mg pills $113.00 they did a doppler study of one leg, zoloft 100mg pills $113.00 despite the presence of pain in both. Zoloft 100mg pills $113.00 What do you know? There’s a DVT there!

Then, zoloft 100mg pills $113.00 they gave an anticoagulant and sent the patient home.

No doppler on the second leg. Zoloft 100mg pills $113.00 No EKG. Zoloft 100mg pills $113.00 No CT of the chest despite the presence of transient chest burning and jaw pains earlier in the day.

You see, zoloft 100mg pills $113.00 if you have a simple DVT, zoloft 100mg pills $113.00 you can take oral anticoagulants and follow up as an outpatient with your doctor.

But…the patient didn’t have a simple DVT. Zoloft 100mg pills $113.00 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, zoloft 100mg pills $113.00 shortness of breath and bilateral leg pain.

She was throwing pulmonary embolisms.

This facility gave a damn. Zoloft 100mg pills $113.00 This facility did not brush off her complaints. Zoloft 100mg pills $113.00 This facility did the tests. Zoloft 100mg pills $113.00 This facility made the diagnosis. Zoloft 100mg pills $113.00 And this facility will treat her appropriately.

Just like they did last May.

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You know that HMO, zoloft 100mg pills $113.00 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, zoloft 100mg pills $113.00 pardon the language, zoloft 100mg pills $113.00 but I’m pissed.

This patient nearly died last May. Zoloft 100mg pills $113.00 What the hell was “Brand X ” HMO thinking when they saw this constellation of symptoms?

“Let’s finish the job?”

Health maintainence, zoloft 100mg pills $113.00 my derriere.

Idiots.

Average Rating: 4.9 out of 5 based on 268 user reviews.

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September 27, 2016, 1:59 am

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What the hell was I thinking when I signed up for ten semester units???

I told myself I would take classes slow and easy and enjoy the process. Viagra-aurochem 25mg $138.00 Of course, viagra-aurochem 25mg $138.00 the first chance I get I sign up for pretty near full time units. Viagra-aurochem 25mg $138.00 I always do that.

Now I work nursing, viagra-aurochem 25mg $138.00 I study nursing and I blog nursing. Viagra-aurochem 25mg $138.00 I’m a nursing machine!

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. Viagra-aurochem 25mg $138.00 After the shock of having my brain still functioning after three hours of Statistics, viagra-aurochem 25mg $138.00 I asked myself…

How could this be done?

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

I’m not talking registry here. Viagra-aurochem 25mg $138.00 I’m talking a company that contracts with a hospital to provide unit staffing. Viagra-aurochem 25mg $138.00 Any unit. Viagra-aurochem 25mg $138.00 Any floor. Viagra-aurochem 25mg $138.00 Long term. Viagra-aurochem 25mg $138.00 One year, viagra-aurochem 25mg $138.00 perhaps more…

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I’ll use the emergency department as an example. Viagra-aurochem 25mg $138.00 Suppose I brought together a group of nurses with experience in emergency nursing. Viagra-aurochem 25mg $138.00 All of them CEN certified with ACLS, viagra-aurochem 25mg $138.00 TNCC, viagra-aurochem 25mg $138.00 PALS and ENPC certifications. Viagra-aurochem 25mg $138.00 We form a company – just for fun we’ll call it “EmergiNurse, viagra-aurochem 25mg $138.00 Inc.”

EmergiNurse, viagra-aurochem 25mg $138.00 Inc. Viagra-aurochem 25mg $138.00 contacts Hotel Hospital and says, viagra-aurochem 25mg $138.00 “For ‘x’ amount of money, viagra-aurochem 25mg $138.00 we will staff your department full time for the next year.” That includes charge nurses and a manager.

If an EmergiNurse is sick, viagra-aurochem 25mg $138.00 another EmergiNurse will take their place. Viagra-aurochem 25mg $138.00 The hospital doesn’t worry about providing health insurance, viagra-aurochem 25mg $138.00 benefits, viagra-aurochem 25mg $138.00 sick leave, viagra-aurochem 25mg $138.00 vacation or scheduling. Viagra-aurochem 25mg $138.00 They don’t have to worry about paying overtime. Viagra-aurochem 25mg $138.00 Twenty-four hours a day, viagra-aurochem 25mg $138.00 seven days a week there will be enough EmergiNurses in the department to staff the floor at least at minimum staffing levels. Viagra-aurochem 25mg $138.00 More staff if the acuity is up. Viagra-aurochem 25mg $138.00 Less if the acuity is down. Viagra-aurochem 25mg $138.00 We adhere to all hospital policies regarding Joint Commission requirements and patient care/procedures.

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For a price. Viagra-aurochem 25mg $138.00 We contract with the hospital to provide nursing service on a unit for a set fee. Viagra-aurochem 25mg $138.00 One fee negotiated for the year. Viagra-aurochem 25mg $138.00 If the census drops the fee stays the same. Viagra-aurochem 25mg $138.00 If the census increases and more EmergiNurses are needed, viagra-aurochem 25mg $138.00 the fee stays the same.

We would provide documentation of all licenses, viagra-aurochem 25mg $138.00 certifications, viagra-aurochem 25mg $138.00 inservices and competencies. Viagra-aurochem 25mg $138.00 We would provide the health insurance, viagra-aurochem 25mg $138.00 vacation, viagra-aurochem 25mg $138.00 sick time, viagra-aurochem 25mg $138.00 educational leave and malpractice insurance for ourselves. Viagra-aurochem 25mg $138.00 We would pay ourselves a set monthly salary.

None of this clock punching, viagra-aurochem 25mg $138.00 standing by the time clock waiting for the minutes to pass before you can leave without getting docked in pay. Viagra-aurochem 25mg $138.00 We are professionals. Viagra-aurochem 25mg $138.00 We show up and we work. Viagra-aurochem 25mg $138.00 If we finish our work before change of shift is over, viagra-aurochem 25mg $138.00 we leave. Viagra-aurochem 25mg $138.00 If the unit is quiet, viagra-aurochem 25mg $138.00 we decide whether to leave or staff in case of admissions. Viagra-aurochem 25mg $138.00 If we have to stay over one day, viagra-aurochem 25mg $138.00 it’s not a big deal and we don’t quibble over 20 minutes of overtime. Viagra-aurochem 25mg $138.00 We set our own schedules.

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We are professionals who own our own practice, viagra-aurochem 25mg $138.00 and we own the company. Viagra-aurochem 25mg $138.00 If we make money we keep it. Viagra-aurochem 25mg $138.00 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. Viagra-aurochem 25mg $138.00 They don’t have to worry about union contracts because they are not our employers. Viagra-aurochem 25mg $138.00 We would manage ourselves, viagra-aurochem 25mg $138.00 bound only by hospital policies and state laws regarding breaks and overtime. Viagra-aurochem 25mg $138.00 We hire only the best nurses who meet our high standards. Viagra-aurochem 25mg $138.00 Magazine readers, viagra-aurochem 25mg $138.00 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.

Look, viagra-aurochem 25mg $138.00 doctors do this all of the time. Viagra-aurochem 25mg $138.00 They contract with hospitals to provide care for the patients. Viagra-aurochem 25mg $138.00 Yes, viagra-aurochem 25mg $138.00 that generates money for the hospital but the hospital is going to have to provide nursing care no matter what for those patients.

So we make it easy for them. Viagra-aurochem 25mg $138.00 They are still paying (big time – nurses don’t come cheap), viagra-aurochem 25mg $138.00 but with less administrative hassles to deal with.

Imagine hiring a nursing company to staff your facility.

Travel nurses do it as individuals. Viagra-aurochem 25mg $138.00 Registries do it per shift.

Why not entire units?

Average Rating: 5 out of 5 based on 196 user reviews.

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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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