Revisiting Complications of a Cure

images-30Curing a disease need not cure the patient.

The patient’s letter was short and angry. I had not helped her; she did not plan to return to see me. And, she didn’t; she might as well have moved to Australia, such was her silence.

Six months earlier, she had undergone a temporal lobectomy for epilepsy, present since her teens, usually manifested by episodes of being disconnected from her surroundings, and only partially controlled by medication. I had been her epileptologist for a dozen years, guided her through two successful pregnancies and assuaged her nervousness about her condition several times a year. Her brain scans showed a stable cystic lesion. We had often discussed surgery, but she was not ready until she had a major motor seizure at age 35, almost 20 years since one other similar event had heralded the onset of her condition.

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Giving Up Patient Care for a Non-Clinical Career

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While clinical practice has worn me down, will I feel lost if I abandon it for a non-clinical career?

On a day when there’s been one snafu after another in the OR, a four hour clinic lasted six, several patients were unhappy, and an administrator 20 years your junior made you feel like you were 12 years old, you start thinking of those far away evergreen hills where there are no patients, you wear a business suit and everyone is cordial. Nirvana; no dictations to tack on to the end of a stressful day, no risk of calls coming to home or worse yet waking you from sleep. Beam me up?

If you have a lot of those days you may head for Nirvana and to your dismay find a hell. A hell of deadlines, budgets, quarterly numbers, job insecurity, hyper-competitiveness, stress because it’s new, stress because it’s stressful – and, if all that wasn’t bad enough, you’re feeling like you really miss taking care of patients, even the depressed, angry, non-compliant ones who may have caused you to head for the hills in the first place.

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Careers in Medicine

goalsetting-300x227Good Goal Setting

There are all sorts of mnemonics out there to help you achieve your goals. SURE for specific, understand what’s involved, realistic, and enthusiastic. Or, SMART for specific, measurable, attainable, realistic and tangible. Somehow these don’t cut it if you’re after bigger fish than a better exercise schedule. So, I, less sure and smart, offer the following formed from my own school of hard knocks.

1. Never set out alone. Share – it lightens the load and adds incentive to not quitting easily.
2. Being vulnerable and humble are winning qualities off of Wall Street. Our educational programs, requiring one big goal every few years, are not necessarily great training for the real world.
3. Pick reasonable timelines. I like goals in the 3-9 month range.
4. Stick to a few goals.
5. Try to be both practical and inspirational.
6. Make your goals considerate of others at home and at work.
7. Have at least one goal that incorporates unhinging yourself from your past.
8. Take a chance.
9. Expect and embrace the unexpected. Great things can come along, if you’re open to the possibilities.
10. Revisit your goals regularly to avoid the perils of aimless drifting.

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Lessons Learned from Allina’s EMR Implementation

northfield250x130Allina Hospital and Clinics went live in 2007 with Excellian, its landmark electronic medical record (EMR) system. Allina, the largest health system in Minnesota with 11 hospitals and 65 clinics, has achieved its vision of “one patient, one record” with the completion of the project, integrating Epic Systems products at the core with other biomedical, administrative, bed management, and picture archiving and communication systems.

Excellian was implemented on time and within 2.5 percent of its original $250 million budget. The project has been heralded as the first of its kind and as an example for other organizations to follow. And it would seem that Healthcare Information and Management Systems Society (HIMSS) agreed – the organization selected Excellian to receive its prestigious 2007 Davies Award for healthcare organizations.

Kim Pederson, former Allina vice president over the Excellian implementation, who now heads her own consulting firm, KP Healthcare Consultants, shares some tips for hospitals undertaking a similarly challenging implementation.

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The Big Deal

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The Big Deal is….who gets to establish the nurse-staffing ratio?

Really.  That is what all the fuss is about.  Control.  The patients have none.  The hospital has all.  The practicing nurses want some.  …And the nurses want the state’s legislature to make the hospitals give them some because there has been no effort on the hospital’s part to do so without this threat.

Patients do not want to be involved in this decision.  They want, expect and deserve proper patient care (a la 1:1 nurse-staffing ratios) and customer service (a la Disney).  Hospitals and nurses that can provide this seamless type of care to patients (not the 1:1 part; maybe 1:4-5?) throughout their facility will not have negative patient satisfaction comments and ratings.  Patients will love this!

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Registered Nurse

nursing21210 THINGS YOU SHOULD KNOW ABOUT BEING A NURSE

Have you been wondering what the perks of a career in nursing are? You may be surprised at the answers! Although it can vary from nurse to nurse, the answers are usually similar. If you think nursing is a field you are interested in, do not go in without all the information you can get! Here I have compiled a list of ten things you should know about nursing! Enjoy!

Number 10:  It Pays better than fast food! (though the hours aren’t as good)

Yes, the pay is what some may think is quite good! But if you take into account the long shifts and crazy hours you put in, it can be debated that it is not enough! Also, the worse the hours the better the pay! If you like working nights you can look forward to making a little more than the day shift!

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3 Sneaky, Wallet-Leeching Items and How to Eliminate Them

online-rn-to-bsn-programs2If you’re like me, then you’ve likely wondered what happened to all your money at the end of the month at least a time or two. Sure, times are hard and bills are always there demanding payment, but it seems like there should be more left over than there usually is.

At this moment I’m working towards my RN credential (I actually got my GED last year by following a free online GED course), and when I secure a good job I may change my mind, but for now I really have to think about how to keep my little money inside my wallet!

Here are a few tips that may appear to come in handy when it comes down to spending your hard-earned dollars not clumsily so you cam pay for you education and life costs easier without missing the essentials in life.

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Walt Disney Hospital

images-12Oh, if only! Right?  I’d definitely apply to work there!  The wage would barely cross my mind because I know it would be researched, fair, balanced and the job would come with unimaginable perks and benefits for me and my family.

The staff would be held accountable for the same level of service throughout the facility.  The management would be incredibly qualified and spectacular.  The workplace would be filled with safety and fun.  The colleagues would be genuine.

I would travel any distance whatsoever to receive medical treatment there.  The cost would not be an issue.  I would save, take a loan, purchase private insurance that only covered WDH inpatient care …whatever it took, I would do it.  Talk about Tourist Healthcare!  I’d be there.

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…No “I” in “Team”

images-13It is true.  There is no “I” in the word “Team”.

There is also no “Team” in the words “Responsibility”, “Lawsuit”, “Assignment”, “Medication Error”, “Patient Safety”, “Holiday Shifts”, “Experience”, “Benefits” and “Income”, “Patient Load”, “Professional”, “License” or “Certification.   – There are only “I”s.

All this to say, it is time we quit teaching our young that “We are a Team!”

We are not.

We are individually practicing professionals with our own patient assignments and patient care assistants (sometimes) to delegate and direct.  We ultimately carry the personal responsibility for each individual patient assignment we agree to take.

Additionally, while we are not “responsible” and therefore not “liable” for another practitioner’s care (unless we are assigned as their preceptor), we are quite willing to provide simple coverage when needed for a break, give and receive help in a crisis, and lend a hand when we are not busy with something else.

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…Hospitals Can Set Own Staffing Ratios?

download-16The hospitals back a proposal (S 876), filed by Sen. Richard Moore (D-Uxrbidge, Massachusetts) and co-sponsored by 20 lawmakers, that would establish committees of nurses and other staff at every Massachusetts hospital to develop individualized staffing plans. Such plans would govern “nurse-to-patient staffing guidelines” that take the acuteness of patient illness into account. (Read the full article here.)

Individual hospitals have proven themselves incapable across-the-board of implementing this type of control. This is a fluff-measure offered by the hospital interest groups and lobbyists on behalf of our employers and meant to appease the bureaucrats’ good, but misguided (sarcasm mine), intentions to help the clamoring staff nursing base.

Elected Official, please remember you are in office because of the clamoring and voting base. We are appealing to you for help, not because we are whiners or ignorant of the ways of business, but because we care deeply for our patients.

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