Archive for the ‘Nursing’ Category

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what do you do with a fractured leg?

Sunday, September 6th, 2009

earlier this year i fractured my right leg. and then due to imbalance, i fell and fractured my right shoulder. what wonderful luck! but:

when i saw the orthopedist who diagnosed my leg fracture, he said that my right leg was now 5.5 mm shorter than the left leg. i asked what could be done. the answer “nothing”. so i was to hobble around with this limp for the rest of my life. i guess so. adjust.

i spoke with the orthopedist, the nurse in his office, the sociall worker. no one had any advice or resources to recommend. why? are they irresponsible? is it the state of health care today? why are they working in this specialty. so, as usual, i had to be my own resourceful advocate. and if it weren’t for my status and experience as a health care professional, i would be lost, having expected comptetant “professionals” to help me through this.

what i found: Feet Relief. com. they provide “in soles” for your shoes that can provide a “lift” and support. that, for me, was a temporary correction. and now i have found a company that makes all kinds of orthotics. they say that they can make for me shoe inserts that accomodate my right leg shortening, and can be purchased for all kinds of shoes. (i find athletic shoes to be comfortable and provide the best support.) well i need different kinds of support. i don’t want to wear athletic shoes to that “little black dress” occasion. so this company will apparently also create orthotics to accomodate sandals and dress shoes.

so why am i complaining? the orthotic company cannot make an appliance without an rx from my primary care md or the orhtopedist. try getting a message to them, and request that they fax an rx to the orthotic company. round and round we go. till i suppose i get furious this week and walk sweetly into their offices and ask for the referral (just please make a copy of the damned initial referral) while i wait, thank you.

Posted in Exercise, Health, Lifestyle, Nursing | No Comments »

What is an RN? Really Nothing.

Sunday, November 23rd, 2008

What is an RN? Really Nothing.

Yesterday I had a call from an old friend who was disappointed that her nephew’s wife dropped out of nursing school. I think it was the best decision she could have made. Health care in this country is in such chaos right now; no funding for anything meaningful. I was looking at the ads in the Sunday paper today. I find it interesting that they all say “RN or LPN or CNA”. So they are interchangeable now? One of my reasons for being unemployed is that people see my resume and laugh. I have a bachelors and two masters from three of the best universities in the country. Nobody wants somebody like me anymore. They want technicians, not people who think and are creative and innovative. So I guess I have to keep looking for work at grocery stores and flower shops to supplement my social security checks. As you know, there is no work out there.

Posted in Education, Employment, Health, Nursing | No Comments »

Finding Work; Declining Work

Saturday, January 5th, 2008

My premise is that there is less expected of health care professionals today. Is it just in this state, that I moved to 3 years ago? I think not. Professional positions that not long ago required at least a bachelors degree, if not a masters, now require an associate degree, or any educational level that provides the person with some very basic education and the employer can pay a LOT LESS in salary.

I see this trend not just in my profession, but in many, many professions. Yet we are told  that our economy is strong and there are lots of jobs! Sure, for slightly more than minimum wage, very limited or no benefits, and no job security. More and more I see contracts for a limited time vs. the days of longevity meaning you can invest in a retirement plan and your position is relatively secure. I live in an “at will” state which means you sign a paper,  a contract, which states that you can be terminated, at any time, without notice, with no warning and no reason given. On the other hand, you, the employee, have the same privilege. And I have exercised this right twice this year. Why?

 Now employers are looking for “technicians” or “specialists” which in health ”professions”  in this state, means a student, or an entry level worker,  who wants to earn a few dollars, with no higher goals, ambitions for professional growth.

 In support of my observations, I must say that I have found that the attitudes of those doing the hiring and firing has become very vindictive and demeaning. Perhaps because the ones “in charge” who have been promoted to the role of supervisor or manager are not qualified, educated, nor experienced for their role. Their communication skills seem to be nonexistent. ?the old “peter principle” at work again?

Posted in Certifications, Contracts, Education, Employment, Firing, Health, Hiring, Nursing | No Comments »

Do We Really Need These Drugs?

Wednesday, November 28th, 2007

Until I was hospitalized 1 1/2 years ago for a perforated ulcer,  I was only on one daily Rx medication: the  one pill for keeping my hereditary “borderline” blood pressure under control. However, my “provider” felt she needed to add a calcium supplement to prevent osteoporosis and aspirin to prevent a heart attack and a decongestant, in lieu of just standing upright and blowing my nose. And then, during the hospitalization, Protonix was added (I can live with that). As was Norvasc which resulted in severe hair breakage and loss. I just dumped that one. And a bunch of drugs that caused fluid retention and more drugs to cope with constipation (which I never experienced). Lots of drugs prescribed; few that I took.

Now why did I need all these drugs, and even more that I just didn’t take? Well you know my bandwagon about the pill pushers in this country. And why did I even have a perforated ulcer? Too many inappropriate drugs prescribed for back pain., osteoporosis, nasal congestion!  (I have idiopathic scoliosis and a spinal fracture which didn’t bother me at all for many years when I lifted heavy  bags of books).

So now, without health insurance (yes; one of the 47 million Americans), I am trying more and more to reduce any of this junk, these chemicals, that I put into my body. Why? The side effects. And the cost!  Maybe it is my BP med that is making me a little tired , not the aging process? By the way, the insurance company DID NOT PAY FOR ALL OF MY HOSPITALIZATION AND MEDICAL CONSULTANT EXPENSES.  Surprised? I had to. After a “lay off” due to downsizing at work, with no income, and no insurance. (even though I had worked as a manager for a HEALTH insurance company!). Who pays for all these medications? I go to a local neighborhood clinic that is low cost, for the blood pressure med. But anything else? Well check into Partnership for Prescription Assistance (PPA). They have been most helpful with the drug that will prevent another ulcer.

 As a health professional, I have encountered patients/clients/members who are on as many as 21 medications each day. This is incredible. Who is monitoring this regimen? How can  people keep this straight? How do you do this? And what is really necessary? And what interacts with what other medications?   Contraindications? And what are the side effects? And who is helping to monitor this? No one. Does your doctor/provider/”prescriber” have time to do this? Of course not. And what if all these medications have the resultant side effect of confusion?

 Oh! The answer! Health insurance companies are now providing programs like healthy living support programs that  have nurse case managers who give advice to “members”. The nurse case managers are the gate keepers who help the “members” manage their medications (often from many states away) and keep costs down for the insurance companies (don’t go back to your doctor’s office! that will be a bill that the insurance company will be expected to pay). Just call me, your case manager. the nurse case manager  can talk with you after he/she enters your data into 47 computer  screens.

 So what to do? Think about who you vote for in the next election, and why. No; we don’t need another layer of bureaucracy. We need a WELL THOUGHT OUT PROGRAM FOR NATIONAL HEALTH INSURANCE. So that we can be as progressive as other developed countries. This is just one little step. Think about this.  Don’t just go along with a candidate who says she/he supports health care. You need to look way beyond that kind of statement. What is really in mind? What kind of program? Managed by whom? Who will be in charge? Who will do the oversight? THINK!

Posted in Drugs, Education, Health, Insurance, Nursing, Pharmaceuticals | 2 Comments »

The Nursing Profession: Is this one that you would want for your children?

Monday, November 19th, 2007

I am sure this article, and I will try to keep it brief and not too inflammatory, could really upset some folks. But I make my statements following 39 years in my profession, with a lot of observation, experience, and education.

There is nursing education, and then there is nursing education. I happened to be an undergrad student in nursing at one of the leading universities  in the country in the 60s. We worked at being professionals, taking courses along with med students. We wanted to be the best of the best. And those that didn’t succumb to organic chemistry and anatomy and physiology persevered. Our class diminished from 300 to 99 over four grueling years! But as the years have gone by, I have observed the disintegration of this professional education.

In the state where I now reside, continuing professional education for nurses is not even required. How embarrassing to the profession. Just send in your 50 bucks each year. It wouldn’t take much science to figure out where I live. Not that it matters. My first position in this state was to spend 2 months teaching maternal and child health, because if I had not been hired that summer, the students would not have been able to graduate in the spring. This was an LPN to RN program. I had 12 students (4 men; 8 women). I tried so hard to motivate them to look toward higher education, to think about what opportunities they might have in their careers. But their sole motivation seemed to just make a few more dollars in the hospital. I found this most disappointing.

And maternal and child health? I was to follow a rigid curriculum and monitor clinical practice. The curriculum was labor and delivery, with clinicals in the hospital. No curricula about maternal health. No curricula about child growth and development.

In my work since then, I have met some young nurses who are truly enthusiastic, motivated, wanting to grow professionally, hopefully into a specialty. I would do anything to help them, even if all it means is a great letter of reference and a lot of support. It is of interest that they came from major universities, but not in this state.

I am still trying to make sense of this state that I have been living in for 3 years. Is it the education in this state? Is it the value system of this state? Or is it a more systemic problem that I have lost track of, despite my staying on top of professional literature. The political climate? At any rate, would you really, in good faith, encourage your child to study for the nursing profession? Is it even a “profession” anymore?

 Well here is my arm chair diatribe, and again, I would like to say, I have no intent of offending anyone, but I am very disappointed in most of my nursing colleagues. Which explains, to a degree, why I left 3 positions this year. I was embarrassed to work for colleagues that I could not respect.

Posted in Certifications, Education, Employment, Health, Nursing | No Comments »

More About Diagnoses And Pharmaceuticals

Friday, November 16th, 2007

To those of you who have read my blog, I apologize for repetition. But some issues just don’t go away.

I just heard an ad on tv for health insurance plans to supplement what medicare offers. First of all, just what does medicare offer? And what about the 47 million of us who have no health insurance and are not yet ready for medicare? The ad was about a certain supplemental insurance company, and it was recommended that you discuss this plan with your “doctor” who will help you decide if this plan it right for you. Yah sure! Since when do “doctors” recommend health insurance plans? Well, someone is getting a kick back here from an insurance company. You need to count on your friends and colleagues for this kind of advice: not your “doctor” and not the insurance companies!

All research must be taken with a grain of salt. I was recruited, years ago, for the Nurses’ Health Study. After filling out their questionnaire, I received a letter informing me that I was ineligible as a participant since I had taken steroids. I had  never taken steroids in my life! I didn’t write back because I didn’t have the time (full time working mom, grad student, with two little boys). So now I look at all health care research with more acute skepticism.

As for HRT (Hormone Replacement Therapy), I did that for about 5 years, then quit cold turkey because my gynecologist told me she could not in good faith prescribe it anymore. I have a friend who has been “tapering off” HRT for the 3 years I have known her. Tapering off HRT? No need to. Doing this will not affect your blood pressure and heart rate, and will probably do nothing except have you discontinuing HRT.  I can only suspect that her gynecologist is her age as well, and the looks of skin and hair are more important than the total health picture? Or maybe not? Maybe it doesn’t matter if we do HRT or not? Once again, conflicting conclusions from research.

There is a lot of spurious, and confounding, information in these studies…I am a medical professional, but also a skeptic. I have attended prestigious universities, have worked at prestigious universities. But that doesn’t mean anything. What is important is the integrity of their representatives,  their scientists, of their reporting of results of their studies. They need to be honest, not just writing what the public wants to hear.

So now we need drugs to fall asleep, drugs to stop restless leg, drugs to make us “regular”? Soon we will need drugs to wake up, get our legs going, and be able to use the bathroom normally?

Have we forgotten to eat a normal, well balanced diet, with fiber,  that would prevent some of these “problems” in the first place? Have we forgotten to just go to sleep to some nice music at 10pm after walking the dog in fresh air? And though I am lax myself about taking vitamins, popping a pill or two each day, if it doesn’t burn up your stomach (drink plenty of water), you won’t have legs that fly around or get stiff and achy, most likely.

Posted in Diet, Drugs, Education, Exercise, Health, Insurance, Lifestyle, Nursing, Nutrition, Pharmaceuticals | 1 Comment »

New position: Week 1

Monday, October 29th, 2007

 This entry is about orientation of new staff, etc.   The moral of this story: it is really important to ask all the questions, have a contract, and don’t do a thing, don’t commit to anything until you meet with Human Resources, which should happen on your first morning, if not before you start.  And, if you are a manager or supervisor, please spend your first week telling your staff (or providing them with) your history, their rights, their challenges, commonly used acronyms, an organization chart, a list of necessary phone numbers and email addresses, how to use the phone and the computer, the politics, not to mention introducing them to other staff, providing them with a CLEAN equipped working environment, and a vase of fresh flowers.

 I have had a week from hell. First week in my new position. The incompetence and the accusatory style of communication amazes me. The worst I have experienced in my 39 year career. I still don’t know what my salary is, don’t know benefits, don’t know about my 1 yr contract. Will find out at 3 on Halloween. Bad omen? Good omen? I SHOULD NEVER HAVE STARTED without knowing salary. Why can’t anyone tell me? Well, if it is not livable, I will just have to decide not to sign the contract and walk out the door. 

And on the way to work on Tuesday, I could not avoid some metal debris on the freeway (typical highway shlocky maintenance where I live) and blew out 2 tires and bent a rim. For almost $1000. Didn’t report to insurance cuz my deductible in 1k. So I hear “you were late!”. Yah; well I am alive! Went out to my car for 5 minutes one day to change my contact lens and was told “you never came back”. What!?  And the week before I even started I was asked by my “mentor” how I planned to allocate my time between my job sites.  What? I didn’t even know what sites I would have assigned to me. Most staff have 1 or 2 sites. And I already get the picture. They “drive” between their sites, presenting the fiction they are working when indeed they are not. I was given 17 sites! I will spend 2 days a week at an ethnic academy. Was told they are hard to work with. Nice intro, huh? But I find them VERY pleasant. Cuz I am not naive. I have been around the block a few times. I think THAT site will work out fine, if I ever get paid.

Are you expected to use your personal cell phone and not be reimbursed for mileage? I will just keep my cell phone off. Why should I pay for this service for them?

Take care of you, because often your employer will not….

Posted in Contracts, Education, Employment, Evaluations, Health, Hiring, Interviewing, Nursing, Reimbursement | No Comments »

Research Results, Including HRT

Sunday, September 16th, 2007

A national newspaper printed an article today about health care issues, including HRT.   All research must be taken with a grain of salt. I was recruited, years ago, for the Nurses’ Health Study. After filling out their questionnaire, I received a letter informing me that I was ineligible as a participant since I had taken steroids. I have never taken steroids in my life! I didn’t write back because I didn’t have the time (full time working mom, grad student, with two little boys). So now, even though public health is my love, I look at all research with more acute skepticism

As for HRT, I did that for about 5 years, then quit cold turkey because my gynecologist told me she could not in good faith prescribe it anymore. I have a friend who has been “tapering off” HRT for the 3 years I have known her. Tapering off a relatively innocuous drug? I can only suspect that her gynecologist is her age as well, and the looks of skin and hair are more important than the total health picture? Or maybe not? Maybe it doesn’t matter if we do HRT or not?

There is a lot of spurious, and confounding, information in these studies…I am a medical professional, but also a skeptic. I have attended prestigious universities, have worked at prestigious universities. But that doesn’t mean anything. What is important is the integrity of their representatives, their scientists, of their reporting of results of their studies. They need to be honest, not just writing what the public wants to hear.…

Posted in Drugs, Health, Nursing | No Comments »

Balancing Job Offers

Saturday, September 8th, 2007

Finally, after a lay off happened to me in October of 2006, my applying and interviewing has paid off, or just about. Looking for work can be harder than working. I have been offered two positions: one with a great salary, a 2 year contract, with NO benefits; the other with a lower salary, with a 1 year contract (open for renewal) with great benefits.

Which one do you think I decided to accept?

 Since last October, I have been one of those Americans with no health insurance, a very precarious and scary place to be, especially as I am getting older. Maybe that would be okay if I was 21 and in my prime. I have no major health problems, am not old enough for medicare, don’t have a spouse whose benefits I can share, and suppose someone decides to run me over as I cross the street? Or shoot me? A real possibility in this city where, from my observation. drivers do not seem to know the rules of the road. (they speed through yield signs, brake going up hill, lose track of the width of lanes, have no clue what to do if two or more cars come to an intersection at the same time) So I liquidate all my assets to pay medical and dental bills, and ask my sons to buy me a shopping cart for Mother’s Day!

 This is an issue to think seriously about in our next presidential election. I have worked as a health professional for 39 years, paid my taxes, paid into social security. It seems like I have a right to a relatively comfortable life, with health insurance. Or don’t we have rights anymore? I might do better moving to a foreign country where there is national health insurance. We are LONG OVERDUE for this here.

 When I was an undergrad student in the 60’s, I had a professor who said that we would have  a national health insurance program by the time we graduated in 1968. What a dreamer…I hope, if she is still teaching, that she has become jaded and doesn’t say this anymore…

Posted in Employment, Health, Nursing, Unemployment | No Comments »

Admitting Mistakes

Monday, August 27th, 2007

I believe, from my years of experience, that health professionals, more specifically supervisors, educators, mentors, and managers have a very hard time admitting mistakes.

In how they handled a difficult client/patient. In how they handled strife in staff relationships. In how they handled their supervisory role when they should have been more inquisitive, supportive, rather that critical and demeaning.

In how they handled staff meetings. Staff meetings to me, are for sharing new information, but more importantly for team building. The more the staff talks and shares, the better. You will learn a lot! I have found that frequent staff meetings are extremely important. And the longer the agenda, the shorter the meeting. And the shorter the agenda, the longer the meeting. Staff is often very pleased to have a forum to be heard and respected.

A good manager, supervisor, mentor always gives the benefit of the doubt, and then shares similar experiences in order to help the staff persons grow, rather than become angry and disillusioned.

This concept leads somewhat to evaluations of staff. Why not allow “self evaluations” on which you can comment. Do not make these events a crisis and frightening. Make them a growth experience for both of you. Don’t make them long and tedious. See if you can prepare a somewhat brief, and to the point, evaluation. Just as your initial interviews should be. Let the staff talk. You will learn a lot more that way. Generally forget exit interviews. When that time comes, egos might be so bruised that you don’t hear the truth. I have occasionally left before the exit interview. I knew I would not be heard anyway. And I once had a lengthy interview, trying to be honest about the management style, and after I left several staff were laid off and/or fired and/or left because they couldn’t stand the place.

So what kind of manager/supervisor/mentor do you want to be?  One who is rigorously honest and willing to listen, grow, be even more supportive of your staff? Do you want your former staff to not fear asking you for references? Do you want to be respected and respectful?

Posted in Employment, Evaluations, Firing, Health, Hiring, Interviewing, Meetings, Nursing | No Comments »

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