Nurses just do it

WiseOldRN stopped by my office today. Actually, he/she is on a schedule and comes by regularly. WORN has worked in an administrative job for over 15 years, but WORN is a proud diploma nurse licensed for many years, who could work "any service on any shift, leave and come back for more".

We have chats regularly and this week's was a doozy. WORN goes all over our hospital system so he/she has some tales. While I'm sure some are peppered with hyperbole, I know some of the characters involved so I'm aware that there is truth.

WORN started ranting when I brought up training. As a diploma nurse, WORN regularly went all over the hospital and worked everywhere. His/her last assignment (as a nurse) was in risk management and quality, but as WORN noted, the only place he/she didn't regularly work was case management. WORN figured being a registered nurse made him/her a case manager every day.

When nurses feel they don't have the skills, I remind them what the overall goal of the day is: managing their assignment. This can vary on the status of the patient, but in our world, bowel, bladder and skin are very important. When we forget about the little things: helping someone with a 4-5 day old beard shave (like I did on my lunch hour while visiting our satellite unit while his nurses charted) and comb his hair, it reminds us all that we are taking care of people, not just completing a task list.

Sure, we have plenty of tasks, but when we can't put care at the top of our task list, are we slowly but surely degrading the importance of having an RN care for each patient?

As WORN says, nurses just do it, if the patient needs it. We don't wait for a million other things, like policies, procedures, or unlicensed personnel.

We see what's in front of us, and do the work. We use that nursing process AND we care.

That's all for now. Gotta leave and take care of my patients. Hope you have a great day with yours, wherever you are.

The perils of rehab

While I was at my rehab conference, I talked to lots of folks. One of the biggest issues was reimbursement.

Now I know why there are issues. If companies only hire for a bare minimum set of qualifications for their staff (see below), it's no wonder why all the case managers in the audience said they were coloring their hair due to it turning white prematurely.

Clinical Appeals Reviewer 
Job Description:

Primary Responsibilities:

    Provide expertise or general support in reviewing, researching, investigating,and resolving all types of appeals.
    Communicate issues, implications, and decisions with appropriate parties.
    Analyze and identify trends for Appeals.


Job Requirements:
Required Qualifications:

    High School Diploma/GED.
    1+ year of Telephonic Customer Service experience.
    1+ year of Healthcare Insurance experience.
    Proficiency with Microsoft Outlook, Word, and Excel, including the ability to create spreadsheets and filter data.

Preferred Qualifications:
    Familiarity with Medical Terminology

Funny, but no where did it say this person ought to be a nurse. You get what you pay for...just sayin'

More to come...