June 30, 2016, 12:59 am

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Viagra uit india Anne Jamison, viagra uit india RN, viagra uit india of the Super Secret Assessment Squad!

Viagra uit india Secretly and with deft precision, viagra uit india she feels for enlarged lymph nodes while dancing with her target.

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Viagra uit india Her diagnosis?

Viagra uit india Coordination, viagra uit india impaired, viagra uit india manifested by an inability to dance secondary to klutzemia and exacerbated by ETOH intoxication.

Viagra uit india Recommendation: no second date.


Viagra uit india jeffscottsoto

Viagra uit india Ahhhhh….the statistics test has been uploaded. Viagra uit india The literary narrative has been finalized and sent to my professor in Wisconsin.

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Viagra uit india That’s Jeff Scott Soto on the right, viagra uit india just in case you were wondering who was who. Viagra uit india You know, viagra uit india I’d look a hell of a lot better if I had Photoshop. Viagra uit india My image correction software just doesn’t cut it.


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

Let me put it this way.

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

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

At least. Viagra uit india



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

Well, viagra uit india they did a doppler study of one leg, viagra uit india despite the presence of pain in both. Viagra uit india What do you know? There’s a DVT there!

Then, viagra uit india they gave an anticoagulant and sent the patient home.

No doppler on the second leg. Viagra uit india No EKG. Viagra uit india No CT of the chest despite the presence of transient chest burning and jaw pains earlier in the day.

You see, viagra uit india if you have a simple DVT, viagra uit india you can take oral anticoagulants and follow up as an outpatient with your doctor.

But…the patient didn’t have a simple DVT. Viagra uit india The patient had bilateral DVTs.

That wasn’t all she had.


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, viagra uit india shortness of breath and bilateral leg pain.

She was throwing pulmonary embolisms.

This facility gave a damn. Viagra uit india This facility did not brush off her complaints. Viagra uit india This facility did the tests. Viagra uit india This facility made the diagnosis. Viagra uit india And this facility will treat her appropriately.

Just like they did last May.


You know that HMO, viagra uit india 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, viagra uit india pardon the language, viagra uit india but I’m pissed.

This patient nearly died last May. Viagra uit india What the hell was “Brand X ” HMO thinking when they saw this constellation of symptoms?

“Let’s finish the job?”

Health maintainence, viagra uit india my derriere.


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Average Rating: 4.5 out of 5 based on 261 user reviews.


  • Sean

    September 30, 2007 at 5:36 am

    ugh! Sorry to sound controversial, but thank GOD I live in Canada! Here, it wouldn’t matter who you were, you would have received the best treatment. No messing around with this crap…ugh.

  • Mae

    September 30, 2007 at 9:04 am

    Thank God for E.R.s. I happen to work in one as an RN. There are many issues concerning overcrowding in ER’s, but one of them is certainly the fact that patients cannot get in to their HMO doctors office(the wait is sometimes 3 weeeks and up) and even if they do, they have to wait for “approvals” for that CT scan. If you have bilat DVT’s and go to your HMO Doctors office, your screwed and very possibly dead. Get ready to wait even longer in the lobby, since we have to now house Drunks (no more drunk tanks, they come to the ER)all night long (I work night shift) and we have to house the homeless all night long. We are the social backbone of America. The ER is the frontline. So, get ready to wait longer and longer for that CT scan you can’t get at your doctors office for 3 months. You can wait 3 months or wait 8 hours.

  • AlisonH

    September 30, 2007 at 11:19 am

    Oh, Kim! I’m so sorry! Give her my best, and I’m so glad she made it to the better facility!

  • Nurse K
    Nurse K

    September 30, 2007 at 5:01 pm

    With all due respect, Ms. Kim, the “HMO” didn’t treat the patient, a doctor and nurse did.

  • Mother Jones RN
    Mother Jones RN

    October 1, 2007 at 11:21 am

    I hate HMOs. I’m glad that your story has a happy ending.


  • Candy

    October 1, 2007 at 2:02 pm

    It’s very scary (and WRONG) that the nurse who obviously saw her in said HMO facility wasn’t a stronger advocate for her patient, but so fortunate for her that SMF (and you) were close enough to save her AGAIN.

    If this poor woman developed bilat DVTs only a few months apart, what kind of treatment plan must she be on? It seems her physician didn’t do his due diligence on her case…and will be fortunate that the woman (and her family) don’t sue their pants off.

  • beastarzmom

    October 1, 2007 at 7:12 pm

    And also with all due respect to Nurse K and many of the other very fine people I know who work at that same HMO, I have some horror stories to tell and will never work somewhere that only allows me that choice for health coverage. There must be something in the culture or policies that cuts too many corners. Not that tragic or near tragic mistakes don’t happen everywhere – It just happens too much there.
    Glad this patient was able to get to another provider.

  • Jen

    October 2, 2007 at 7:27 am

    Kim,I’m glad to hear the lady ended up being ok. My Dad wasn’t quite so lucky. He went into his doctor at the same HMO (slogan that rhymes with “Drive”) on a Wednesday. He presented with radiating chest pain, “heart burn”, and nausea. He was 56 yrs. old, a life long smoker, on meds for hypertension, and high cholesterol. What did the doc do? An EKG, a prescription for Zantac, and see you later. By Saturday morning 9 a.m. my Dad was dead. Do you think they could have done a little more workup on Wed?? I wish so much that my Mom or Dad had called me on Wednesday or the days after. I didn’t get a call until Saturday 7:30 a.m. when he was in the ER. By then it was too late. Too much heart damage had been done and he died. With all that said, I’m a firm believer in when God says it’s your time to go it’s your time to go. Still, I will never have that HMO, ever. I agree with you.

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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