descendingdaphne


Nurse practitioner costs in the ED

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  1. I wonder if NP programs realize how they are focusing all their efforts on all the wrong topics. Surely there is enough evidence of this and enough testimonials from NPs who report being absolutely inundated with classes which don't help whatsoever in their clinical practice but yet we see this perpetuating in NP programs. One has to wonder where the federal and state regulators are in this equation. I can't imagine they would be happy if medical schools focused entirely on statistics and the history of medicine at the expense of actual medical education.

  2. Well, think about who teaches theory in NP programs - it’s probably not MDs.

  3. I don’t know, man…I’ve never seen admin tell the docs, pharmacists, or ST/PT/OT staff to start mopping patient rooms because they cut EVS coverage 🤷🏻‍♀️

  4. Ffs, my point is that bedside nursing is a dirty, physically demanding, thankless job with a public that has become increasingly self-entitled, disrespectful, and downright abusive. Nurses take the brunt of this while simultaneously being treated like unskilled warm bodies by admin, who expect us to tolerate the abuse and shitty working conditions in exchange for cold pizza and lip service.

  5. Get the CEN Review Manual from ENA. Do one or two of the practice tests. Those are all from the same question bank as the real exam and are a good representation of what you can expect. If you can reliably score above passing, just go ahead and take the real exam.

  6. The tax implication is that, if you’re not truly duplicating your living expenses while on a contract, you’re not eligible to receive a portion of your pay untaxed (the stipend). Instead, all of your pay should be fully taxed, just like it would be if you were a staff nurse.

  7. The board of nursing doesn’t want to endorse the compact because they will lose money from licensing fees, plain and simple.

  8. The hospital can decide against it. I’m in WA and only do local travel. A hospital in Olympia and Gig Harbor have said you must live 50 miles away to be considered for a travel opportunity.

  9. Is it just the Gig Harbor CHI or all of them that prohibit local contractors?

  10. Is it just the Gig Harbor CHI or all of them that prohibit local contractors?

  11. I like to get name, age, code status, PMH, allergies, and admitting reason written down before report if I have time in that five minutes I show up early. I don’t need you to feel like you have to tell me every ailment this 73 yo COPDer has ever had because Nicole the anal retentive nurse insists on knowing the dates and results of every CT scan ever done and now you feel like an inadequate nurse if you don’t because of her.

  12. Explain the allergies to me - can you really remember multiple patients’ random allergies on the fly?

  13. Pre-COVID, the elective procedural areas usually posted the highest pay packages - OR (esp CVOR), cath lab, L&D. Those areas make the hospital the most money, so they’re typically willing to pay to keep them staffed.

  14. Stuff like this should be allowed and encouraged imo so long as the dog is potty trained and calm. My dachshunds unfortunately, well my female anyways, would be super protective in this situation and likely be a straight bitch to anyone that’s not me or my wife.

  15. I’m all for it, so long as it’s someone else’s responsibility to feed, water, walk, and poop scoop after it.

  16. Jeez, I'd hate to know what kind of nursing assessments are/aren't happening if you don't notice a dog in her bed

  17. Guess you’ve never had a fatty hide her teacup chihuahua under her folds in her muumuu…

  18. If your department has no throughput, it’s either increase ratios or increase waiting room times.

  19. I always did an unfurnished 3-month apartment lease (including western WA) and bought some basic furnishings off Facebook marketplace and such, then sold everything the same way before leaving. Just a thought.

  20. Or…have the same conversation and simply discharge them with whatever prescriptions/referrals are warranted.

  21. You did fine! Your patients did stuff, you reacted appropriately, nobody died. Strong work 👍

  22. How in the actual holy hell can medical care be so incompetent that you let a DKA patient get a phos of 0.1???????? That is insanely incompetent.

  23. You’re not wrong, but we sure as shit don’t learn how to expertly manage DKA in nursing school.

  24. Thanks! I got it primarily for my newborn niece that I get to meet for the holidays; should be perfect timing. It did occur to me that it was late for the season in general, tho

  25. Friendly reminder that RSV is spreading like crazy, there’s no vaccine for it (for adults), and it can kill a newborn. Don’t kiss the baby!

  26. Please consider staying home instead - it doesn’t really matter whether you’ve got the flu, COVID, RSV, or any of the dozens of viruses that cause colds.

  27. Or tPA lol goodbye to all of my patients for at least 2 hours while I do an NIH q15 and can't leave the room until that time is up. Then still need to do one q1h until Neuro ICU can open a bed. Nevermind if my other 3 patients are septic or on BiPap or need blood or whatever.

  28. Stroke patients are the worst if you’re in a shitty department with no teamwork. It’s basically crossing your fingers that nothing bad happens in your other rooms while you’re pointing to pictures of a feather and chair 😂

  29. Neuro striding arrogantly into the room demanding their NIHSS while you’re simultaneously hooking the patient up to the monitor, starting the IV, and getting an EKG…as the patient lies slumped toward a flaccid side, drooling, with a deviated gaze.

  30. As a long time ED nurse, currently doing a travel assignment in an internal medicine office, I now have a better understanding on the ‘go to the er’ mentality.

  31. Triage/front of house - so satisfying to have an organized WR on the track board with everyone triaged and work-ups started.

  32. im ed and like a good sepsis workup as long as im not swamped. its satisfying to do everything piv,ekg,cath,fluids,abx,cultures all at once. and finding the source of infection!

  33. I’ve found it’s much more satisfying when they’re really sick, like just-lie-in-the-stretcher-and-stay-quiet, family-stays-out-of-your-way sick.

  34. I assume we’re talking ED? Well appearing otherwise healthy no indication for paxlovid or tamiflu get discharged from the room. I do not swab as it doesn’t change management. I do not offer tylenol or ibuprofen in the ED for people getting discharged; it’s a waste of nurses’ time you can go home and take medication. If they’re puking everywhere oral zofran and discharge. I diagnose clinically and typically as “viral illness”. Here’s your work note see you next time.

  35. “I do not swab as it doesn’t change management. I do not offer tylenol or ibuprofen in the ED for people getting discharged; it’s a waste of nurses’ time you can go home and take medication.”

  36. Honestly social work is half the reason why I left ER lol. I hate having to organize discharge transportation and disposition for patients, hate having to attempt to connect resources, calling family, you name it. Fuckin drove me nuts.

  37. Happy swabbing!! We’re doing three (at least) swabs on everyone since we don’t have a single swab to do it all. RSV and Covid PCR both take two days to come back.

  38. Honestly, shame on your ER docs for even ordering them for non-admitted patients!

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