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The combination of various forms of therapy is used to treat lymphedema; Lymphedema use products such as apparel compression bandaging, manual lymph drainage, exercise and skin care are some of the treatments that may follow. Lymphedema various products need to exercise so that the treatment is effective. These are compression bandages and garments, special shoes, accessories like fasteners, hooks and wear aids, compression devices, foams and padding, pneumatic pumps, etc. Manual lymphatic drainage and bandaging the affected limb is the first step in the process of treatment of lymphedema.

An important component of lymphedema treatment ustilization compression garments. Compression garments must be worn by the patient at all times. They can be purchased at the counter or you could have them tailor-made for you. Lymphedema products for the upper body include compression sleeves, gloves, bras and gauntlets. Clothing for the lower body include compression stockings, knee-high or thigh-high stockings, compression devices and compression pantyhose. Patients must consult their doctors before purchasing a compression garment to suit the patient’s condition can be evaluated. Compression garments should also be replaced regularly as they lose their activity after some time.

Band Aging is an important part of the treatment of lymphedema. Compression bandages provide resistance required for muscle tissue to the fluid to prevent fluid retention and swelling. The lessons and even activities of daily living, it is necessary to bandage the affected limb to encourage the lymph flow. Short stretch bandages are preferred as they provide the necessary tension to the supersonic pumping action of the lymph vessels. Tubular stockinettes, tapes, adhesive bandages, finger and toe bandages are some of the lymphedema products that are used in accordance with the qualifications for the patient.

The Lymphedema Lymphedema pump is another product that is important in the treatment process. Two types of pumps are used: the Sequential Gradient Pump and Flex Touch Pump. Pumps are very advantageous for those who do not have easy access to a therapist to perform the decongestive therapy for them. The pump can be bought or it could even be rented from a supply store. Another aspect of treatment the patient needs to follow is skin care. Various skin creams, oils and ointments can be used so that the skin may be kept moisturized and lubricated.

The current internet age of online shopping, it is very convenient for patients to buy specific lymphedema products that may be required. Some of the online stores have qualified therapists who help patients with a choice of products. New products are available in the market so many patients lymphemema are used to thinking of inflammation and tissue fibrosis. For example, a special Elastic Therapeutic Tape is now used by therapists to soften Edemaina. Lymphedema other products like special footwear, wear or doffing aids and bandage rollers try to ease the life of lymphedema patient.

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Source by Peter Hodges

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Having rounded teeth and you would prefer the square, or perhaps you’ve got a tooth chip area and would like chip fixed? Well, if this is the case then you should know about dental bonding. Dental bonding can fix many problems with your teeth but one of the main purposes of the procedure is to fix or improve the shape of the teeth that can be naturally rounded, chip, or succumb to any stage of decay. If you have a chipped tooth, or any of the other conditions of the said dental bonding may be the solution you’ve been looking for to restore your confidence in your smile.

If you have ever thought that your teeth are less than perfect due to imperfections then dental bonding may be the answer for you. Bonds can correct the appearance of many flaws in the teeth. Of course, rounded teeth, chipped teeth, decayed teeth, and minor gaps can all be corrected or improved significantly with the addition of cosmetic dental bonding. In addition, do much to restore confidence in the body to which the bond, the work is quite simple and painless and really not as drastic method you might be thinking. In fact there are so many choices and so few drawbacks to bond it has become a very popular method.

Dental bonding is actually material that covers the front of the tooth and coatings that can be used to shape and fill the missing areas in your teeth. When materials are present light is used to make rock hard materials before they are polished to a perfect shine. What is incredibly natural looking area “tooth” where there was none before. On a personal level I can relate information about a good friend who had some dental bonding done out his teeth. incisors my friend was rather rounded inside and not very “square off” look when seen from the front. After he got dental bonding area took on a natural square look that created the appearance of a normal tooth. The process did much to improve the confidence of my friend and I’m sure it can do the same for you.

The best thing to do when considering this type of procedure is to order a cosmetic dentist. cosmetics your dentist will be able to tell you if the bond is the right choice for you and will be able to provide you with all the relevant information you need to know before undertaking the procedure. If you and your dentist decide to go ahead with the procedure, I think you’ll like my friend, be very pleased with the results. Bonds looks incredibly natural and creates a surface that is durable and resilient as well as create a beautiful smile you’ve always wanted.

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Source by Patrick Boswell

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What if someone very close to you was on the fast track toward death, perhaps through illness, perhaps with a sudden illness, or perhaps they were just falling off in old age. What would you do? What can anyone do when all else has failed, and the end is near?

Nobody gets out of here alive! It is a fact. We all are going to die
one day or another. And as uncomfortable fact is, must be pre
compared for this day to come, either sooner or later.

What if you had a terrible accident in a permanent vegetative state?
Would your family know your wishes, or they would be left arguing
the loose shell party that once housed up, man? It has happened before, as we were all pathologically fascinated watching the fate of a young woman in Florida, to know who would win this last battle of her life: parents or husband.

Granted, this was the most difficult situations that the average person will not have to decide, but still, the discussion of end of life issues is
necessity.

The Hospice patients volunteer for many years, I have witnessed the end of
issues of life with many people. I consider it a special gift to be
incorporated into a person’s life in the most sensitive and effective time,
administration to be present on the edge crosses. I am also a Reiki
expert, which is a form of hands-on healing that channels chi, or
life force energy in my patients. I have used this in many cases
to facilitate the process of death, creating a protective, quiet environment
their bodies.

Although all deaths are not what could be considered a “good death” I
was fortunate enough to assist at the bedside of patients who died good
death, family members present, the pain managed to a level of endurance and
attitude approval inevitable.

No one wants to die.

Even patients who are medicated with large morphine or other narcotics are aware of their surroundings, be hearing the last impression that
dies. One should approach the deathbed with a sense of quiet reverence, as if the child was sleeping in a crib. When you are preparing to leave this earth,
their senses are enhanced by the feel of the energy in the room, the smell,
and sound. These are the last input into their body in this life.

As people get closer to their final departure, the curtain that separates the “real”
world and the spiritual world will be lighter and more transparent. I
had patients tell me about dead relatives and angels visit them in their
tunnel, waiting for their transition. It gives great comfort to know that it is not
only family members on one side looking over them, but others of
spirit side are also watching over them.

Most people have gone of their food in recent days. their breathing will become what is called a “death rattle” … a heavy labored breathing. If they
are able to some patients curl into a fetal position on the right side, called the “sleeping lion” position, which will help the spirit to exit through the top of their head.

Patients respond, even under the cloud of drugs, to touch. limbs will feel cold, as if the withdrawal has already begun to pull out his life force in the middle of their bodies.

I visited once father friend as he lay dying in the hospital. While he was seemingly asleep, the nurse was trying unsuccessfully to draw blood, but not to
extract enough blood due to lack of blood pressure. He was fidgety and uncomfortable as she poked and prodded his arm. I sat quietly down beside him, and put his hands on his head, the flow of energy immediately began to move him. He turned to me, trying to talk, but only moaned and effects of morphine were too strong to defeat. I thought he knew I was there to help and did not want any more treatment from nurse. I asked the nurse to stop poking him with needles while I worked on it, she was kind enough to do. The meeting lasted about an hour and a half. At the time, it left an uneasy state of extreme restlessness to fall into a peaceful slumber. I was a few more hours, watching him sleep, keep your hand.

Finally, I went to the hospital, but said the family I would return first thing in the morning, to check on him. There was no need. I was called for 8 with news that he had passed very peacefully at 6:30 Apparently, one son had sat up with him all night, and when the son got up to use the bathroom, his father died breath. So familiar is the son of the room that he did not want to have his son see him die. Not an uncommon thing,
on the way, that parents protect their children until the end.

People die the way they live.

I’ve been witness to people suffering from end-stage cancer and ALS have been adamant about not taking painkillers. These brave and special patients felt that they would be coherent and make up to
moment their final departure. While this choice seems incomprehensible to most, I was truly amazed by their ability to be true to their ideals. It is probably as difficult to support a person close to you but to observe this
process, the desire of a dying man to keep control of their situation is one of the last condition. And who are we to set a standard for the end of their life? Crossing over is extremely unique process, not unlike being born into the world.

With great advances in medical technology today, we are blessed to be the recipients of the covered lives. However, we’d be wise to talk to our loved ones long as we are ready to go to prolong our lives … what is the quality of life going to be, both for ourselves and those committed to our care. Most do not pay be hooked up with many tubes in hospital
Room, but prefer to die at home, in their own familiar environment.

Death is not an end but a means. It is not the failure to survive, the doorway to the spiritual realm. Often, death is the end of suffering and individual relief for those who take care of them.

I used to believe that diseases like cancer that can rob the body of life
were terrible fate. I have been witness to the gift of time that cancer can give
her patients: time to make amends, time to put things right, time to spend together, the final time where each moment feels. It is a good time well spent that will carry the survivors to grieve days.

We all have only so many days here on earth to live our lives. If we could only realize how fast that time slips away, we may live more joy-filled life for
precious moments of togetherness.

Life is short, be happy.

Difficult as it is to be a manager of a loved one on the verge of departure, it is
final act of love and compassion. The simple act of being there, keep
A hand is really all that is needed.

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Source by Nancy Nylen

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This is an article that everyone needs to read. The facts are these, sometimes nursing home will actually teach and train new resident or patient to be water. How does it work? How can something like this happen in this day and age? I will strike here elucidated by examples of forty-five year old female patients taking short-term nursing home care for treatment.

Here’s the story:

At the hospital, the patient was not incontinent, never had an accident and was able to sleep and live without wearing diapers, just like in the regular world. The hospital performed a patient in a good nursing home so that she could get short-term treatment for injury to her left foot. She needed therapy, physical therapy to learn to walk again. She had now use only one leg.

Immediately when she got to the nursing home nurse who would be caring for her, asked if she would be diaper. The patient hesitated to answer because she thought the question was odd. After all, she did not need a diaper, nor did she want to wear a diaper. Nurse continue to say things like, well, if you have an accident. The patient was, in fact, politely spoken wearing diaper than in a nursing home, even though it was against her better judgment to start wearing diapers of her age as she does not need diapers.

As in all nursing homes and hospitals when patients are wearing diapers, they are told to go in their diapers. After all, that is what the diaper is for, right? So this patient, sometimes, would just go in diapers, use up to defecate, where she was wearing a diaper. What it amounted to was that it was easier to copy in the diaper, but there was a nurse to come to help her out of bed, then help her to the bathroom. The patient became increasingly afraid of falling and the diaper or think that would stop the collapse and diaper would also stop the patient from calling the nurse to help her to the bathroom. After all, a nurse happy because she is the one who will be most, emergencies and all.

but from the beginning with this particular nurse who spoke patient wearing a diaper, patient and probably many other patients were placed in diapers for the convenience of the nursing home, not for the convenience of patients. The patient was in her diaper a day and a nurse was a little upset about what happened, and the nurse convinced the patient that she had an accident. When in fact the patient was not an accident, but the patient dropped the diaper because she was wearing a diaper and when patients call for help, they had to wait and wait for someone to come and help them. Family members witnessed how long it took the nurse to come in one day, just to change a diaper. So nursing home gave so many mixed messages to patients, patients eventually became confused as to why the heck they were diapers to begin with.

So often, patients nursing are automatically placed in diapers for convenience. Homes make patients lose their dignity – they do not need diapers yet they are emotionally forced to wear diapers. This is a big, important issue that city officials need to look into. And when looking at what they need to realize that patients are reluctant to disagree with nurses who give them daily care. So if a nurse even hints that the patient should be diapers, guess what? The patient will be wearing diapers before you know it.

First, the diaper was put on for one enjoy the nursing home, and the patients were talked into wearing diapers if they have an accident. So patients respected by saying, okay, put me in a diaper. But what some patients may not realize was wearing diapers, giving staff more to bring quickly when the bell is rung because the staff knows the patient in a diaper and they will not have to clean the blades if there is an accident. In other words, the accident passed by, rather than having the patient in no diaper and rather than having the need for a patient to be followed back and forth to the bathroom that takes more time for nurses to do, encourage those patients to wear diapers .

By wearing diapers, ambulatory patients just need help going to the bathroom, are encouraged to be less independent. They are now encouraged to stay in bed more simply because they are wearing diapers. The smaller bathroom trips, the more time space and less bathroom trips, the less patient walking does. After a week or so, a patient why they are not as strong as they were when they were in the hospital and no one makes connecting the diaper is actually make them weaker and weaker because they are out of bed, often LESS . As each day passed in a diaper, the patient will be less independent and more dependent on staff to change diapers.

This procedure is wrong. There are some patients who need diapers because of medical reasons, but mostly, many patients simply talk in wearing diapers for convenience. It is suggested that if they are wearing a diaper they will not have sheets accident and it is implied and hinted that the staff will be happier with the patient if the patient is wearing a diaper. Happy staff equals happy patient, right? False. Just because employees are happy they have so many less trips to the bathroom, it does not mean patients are happier. Patients are taught and trained to be no water and they are taught and trained to be happy that they are wearing diapers just in case.

What happened to relatives in nursing homes? They were put in diapers for convenience? They are still wearing diapers? Do they seem less independent now they are wearing diapers?

I am not talking about regular patients in need, who are medically required to wear diapers because they are not water, I’m talking about patients who have not been and are not incontinent, and these patients are politely convinced, convinced by staff to wear diapers. And all the while the staff is polite tight they wear diapers just in case, the nurse says, if you want, it’s your choice. It’s your choice if you want diaper. She says to the patient and also indicate if you have an accident. Basically, it is instilling an idea in a patient she will have an accident and it is better for the patient to have a diaper. The patient agrees just to please staff.

Yet while the patient agrees to please these workers, it is time that the patient will be less independent. And is not the purpose of rehab patient more independent? So nursing administering to the patient mixed messages. The first message is that you are there for short-term treatment, and yet, you’ll need a diaper just in case.

What about your relatives? If you relative to short-term treatment and your relative is NOT a medical need diapers, then your relative should be in diapers? Definitely not. If there is no medical need for a diaper, why the patient is wearing a diaper? Other reasons, yes, Virginia, the staff wants to patients in diapers to avoid collapse.

Why are more covered with patients who do not wear diapers? There are more falls when the bell rings, when a patient rings the bell for the nurse to come to the aid of someone to follow someone to the toilet, the patient has to wait and wait and wait, and frustratingly, some patients decide to get up on their own and go to the bathroom instead of waiting so long for the nurse to come. So patients learn that they will wait and wait and wait, so they have a better diaper. It is implied message and it is the reality of the situation.

Patients wait. Those patients wearing diapers can finally dump the diaper rather than having wet or soaked sheets or poop in the press. So patients are taught systematically taught that they need diapers even though it is their choice, it is their decision; these places make it so that the patient really has no choice in the matter. What real choices are the following:

1. They may be waiting and waiting and waiting and wait when they need to have a bowel movement or urination . And wait and wait and then accident on sheets, on their clothing, all the or
2. They can wait and wait and wait and wait they ring the bell and then they can try to get to the toilet on their own because they are waiting so long, and then stop falling or actually fall or
3. they can choose a diaper and if they wait too long, they can just thrown in the diaper.

If you were patient and you knew that you were there as temporary option would be to take? Would you stop falling when you could be in it because you need help to make? Or quit pooping or urinating over your clothes or sheets and those who nurse very upset with you? Or would you say, okay I will have diaper just in case? This is what patients and employees do. Staff, some staff, train patients to become not just water to facilitate staff because there is no time for them to help patients to the bathroom. Remember some patients, staff may need to do some lifting, and other patients, it may take a long time to make the patient to the rest room and staff do not have time. These nursing provided by these policies tell patients to wear diapers if only to do harm to patients. They teach patients becoming less independent, but the main goal for most short-term therapy patients is becoming more independent not less independently.

If you ever have a patient who has this condition, tell them you do not want to be a diaper. And then record how long it takes for staff to come to the aid of your call in the help of the bell for assistance to go to the bathroom. Document each time so that you are not made to wait and wait and wait and wait and then mess your sheets. When they let you wait and wait, they just train you to be in diapers and training you become like a child and become more dependent on them to change your diaper.

Here is advice for patients who are able to go to the bathroom with them, just say that you do not medically need diapers and that when they come to your aid when they should come to the aid, there will be no accident. And best of all, if there is an accident, staff will handle it and not let you wait and wait and wait and wait while you lay in an accident.

only time patients should be in diapers for comfort is when patients are traveling outside, or take short or long trips by ambulance, ambulette or access-a-trip. In these cases, it makes sense for patients to use diapers. The reason? When you are outside the toilets are usually so far away and some are not wheelchair accessible. And you just never know if there will be a bathroom anywhere. So, it is important to use diapers only for travel because you go out and have an accident on the clothes, you will be outside in wet clothes, especially in winter, you are putting yourself at risk for illness with a stay in wet or soiled clothing for the duration of the trip outdoors. However, when indoors in a nursing facility, and once inside the residence, if you are not medically needed diapers, you should not be wearing diapers at all.

Just because a man has an accident because they were waiting too long for help, there is no reason why people need to be in diapers inside nursing homes. Lets help make things better not worse for our relatives and patients inside these nursing homes.

Any less bathroom trip makes the patient less independent and makes them more dependent on you, the staff and when they get home they will be in worse condition than they were when they arrived at the nursing home for healing.

What do you think about this. I want to hear from patients who were convinced the staff to be in diapers when not medically required to wear diapers. Did staff do this to you too? Please leave a comment or send confidential information by email. The connection is important. Through unity, we can change the system. All patients, residents and families have to combine to get better and quicker services inside a nursing home so that people are not required to wear diapers when they are not medically required to wear diapers.

Yes, of course, if your disease you do medically to be in diapers then you should. No one is telling you to go against orders clinics. All I’m saying is that you should not be in diapers for only the convenience of staff. And hundreds if not thousands of patients are placed in diapers every day for only the convenience of staff.

Disclaimer: This article is written by writer, observer, researcher, and author. I do not advocate walking around in a nursing home if you need help. I advocate that patients do not wear diapers if they do not medically need to be in diapers. I advocate that patients do not speak in wearing diapers for a comfort staff or in their own words, just in case! No patient needed a diaper only if the patient never was and is not incontinent. It is absurd to have a diaper just in case!

There is wearing diapers just in case that makes patients less independent and more dependent on it really teaches and trains the patient to poop in their pants and pee in your pants when no medical need to do so. Let us give these patients back their dignity, and instead, let’s run to help them, run them on the toilet instead of letting them wait and wait and wait and wait. It makes more sense. All patients who are medically required to wear diapers should be diapers. All patients have the doctors orders to wear diapers for medical reasons, should be diapers. That’s all I’m saying. Please reply with your comments.

Did you hear about the woman who was naturally glued to toilet her boyfriend. They argue that it would have been for more than two years and her skin grew around the toilet to make it semi-permanently in a bowl. Why in the world did this woman sitting there for two years? Here is a suggestion. Maybe she had been in a nursing home. In some nursing homes, the practice is to let them sit on the bowl almost forever. Patients waiting as time passes by, until someone has the time to help them return to their beds. And patients know this. That is why so many residents and patients are literally afraid to enter nursing homes and physical rehabilitation and care centers. They are afraid of losing their respect. They know they will be asked to either sit on the bowl forever without help to get up or they will lose their respect by having to wear diapers when they are not medically required to wear diapers.

This is news, yes NEWS history of the toilet bowl caper. This is probably bad and bad nursing rehabilitation and care centers are making our men. They are making people so afraid to go to a nursing home, people say they would rather die than go to a nursing home, and some would sit in their homes taped toilet bowls for fear of nursing homes have put into them.

I need your input here. I need to hear from you. And you need to share your experiences so that everyone else know what is really going on inside of the nursing homes. The goal of personnel, personal nursing staff usher people to the bathroom contrary to the objectives of the patients have become more independent.

Please, I beg you to answer and let us hear your thoughts on this issue. input is greatly appreciated.

I updated this article on May 20, 2008.

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Source by Melinda Thomas

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adult Oral Sedation dental office

adult Oral Sedation as part of dentistry can be a wonderful addition to the services provided to your patients. This article is not intended to provide any training in oral sedation, you are encouraged to take such approved courses.

The ability to treat patients that otherwise go without proper care can be very rewarding for you, your team and your patients. Currently, California, licenses acquired through the Dental Board is required. Part 1004 defines an adult as conscious in all patients over the age of 13, although I personally just treat patients over 18 This permission is only needed if the dentist is going to give medication doses that exceed FDA daily recommended dose. A dentist can apply either by submitting 10 board approved sedations completed before Dec. 31, 2005, have 25 hours of classroom instruction and examination of the patient first live experience of a Board approved CE provider. The license must be renewed every 2 years to a minimum of 7 hours of CE in sedation. Just training the whole dental team, monitoring equipment, emergency training and equipment is required.

Usually in our work, our sedation patients fall into two categories- fear based and time based. Patients fear base are just as you would think, they usually have some previous dental experience that has kept them form a dental office. It is not uncommon for us to see a patient who has not had a dental visit for 10, 20, 30 years in some cases. Typical concerns are bad childhood experience, pain treatment, fear of needles, sound, smell, difficulty getting numb, gag reflex or bad rapport with the dentist. Time based patients usually have at least some fear, but also want to have as few commands as possible to get back to maintenance visit. Patients with hectic work schedules and frequent business travel are examples of patients based on time. The entire dental team must be highly skilled, compassionate, well trained and have excellent communication skills to properly handle patient sedation. Increased patient fears or needs require the team go the extra mile to put the patient at ease.

As before, we treat only patients 18 years or older. Generally, ASA I or ASA II are good candidates and advanced training ASA III can be treated. We consult with each patient a doctor for treatment. Also, a complete medical history and pre-op vitals taken. Oral sedation is very safe, but there are some contraindications – pregnancy, allergy medicine is used, the interaction of some drugs the patient is already taking – I will not go into all that now. Triazolam is the main drugs we use for sedation mouth. Triazolam is a benzodiazepine sedative-hypnotic in the family. Amnesia is natural and welcomed side effect for my patients. Usually the patient takes a small dose of diazepam sleep and we can also complement triazolam with hydroxyzine. We also, quite often, additional sedative with a low dose of nitric oxide during the administration of local anesthetic and oral. Typical sedation appointment is 5-6 hours. We can carry out the treatment of simple restorative, crown and bridge and periodontal treatment (with one trained Hygienists our) full mouth reconstruction, endodontic treatment, oral and laser gum treatment. Our patients are constantly monitored by a pulse oximeter / pulse / blood pressure monitor. We do not put our patients to sleep. They are in a relaxed state that allows them to complete the requested treatment. We can communicate with patients about their appointments as needed. At the conclusion of the appointment, escort the patient is given after surgery and teaching the patient will return home to nap the rest of the afternoon. Patients appreciate amnesiac effect of triazolam. I’ve had patients call the office later in the day, upset that they have slept through and missed their appointments only to be told they were in the office from 7:30 to 1:00 pm.

I hope this give you a brief insight into adult sedation intake and how this can be a wonderful service to provide your patients.

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Source by Craig Johnson DDS

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When you can sue the hospital or its employees for negligence?

A hospital can be sued for negligent mistakes that harm or kill the patient. When an employee of the hospital is guilty of negligence, you can sue the hospital. When a physician working for the hospital makes mistakes, both personal doctor and the hospital as a whole can be sued. However, doctors can only be sued if they were available and could have prevented the failure. You can not sue every doctor in the emergency room or surgical floor, only the one who is or oversaw treatment. Hospitals can also sue the doctor with a history of medical negligence and mistakes were kept on the payroll, thus enabling them to continue to harm patients.

What constitutes neglect?

Neglect occurs when someone is not doing his job as a normal and competent professional would. Failure does not establish guidelines, not a checklist, not to assist patients in need and do not take immediate action in an emergency. There is more tolerance for mistakes made in life-threatening emergencies and general conditions care. Malpractice and negligence can arise from failure to properly diagnose a condition or injury. Neglect can occur when someone is given inappropriate treatment or appropriate treatment is given incorrectly. Nurses administer the wrong medication and treatment protocols are following the wrong example.

Failing to stop patients from the negative results of the medical treatment or side effects of treatment is also negligent. Recommend surgery to cure cataracts that can also leave the patient blind is an example of this concept. To sue for negligence, the risk to be significant enough that the patient could have chosen to have the procedure or treatment if they had known and must have suffered a negative result.

Can Sue professionals other than physicians in the hospital?

Yes. Every medical professional connected with a hospital can be sued for negligence. This includes nurses, physical therapists, medical technicians and pharmacists. First responders such as paramedics and firefighters have a high level of protection against medical negligence claims, because of the difficulty in acting during emergencies, unless they are employees of the hospital and provide care at the facility. Good Samaritans are rarely sued for negligence unless their actions are reckless.

What types of damage are available when someone sues hospital for negligence?

There will be a specific injury as well as actual damages to sue for negligence. You can not sue the hospital because you were unhappy with the level of service.

• The physical pain and suffering
• Medical bills with other primary care or specialists in treating conditions due to the negligence of the hospital, injuries hospital or analyzing what hospital failed to find.
• Lost revenue due to inability to work or lost income of the person who died
• Medical bills for further treatment in a hospital if the patient had received a proper course of treatment.
• The cost of physiotherapy or assisted care while level

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Source by Michael Krillman

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automated appointment reminder system can safely send large amounts of personal appointment reminders to patients with little effort and in a fraction of the cost of manual methods. The effortful part of the process is extracting patient appointment information and send it to the seller. For some practices, reminder system can automatically extract patient appointment information from the job management system, forming appointment reminders, send reminders, and track responses. In other practices, staff need to create a file with patient appointment information. This is usually easy. If practices do not store appointment information electronically, they can send this information by inputting command information online.

Advantages of sending automatic appointment reminders

more comfort for patients. Since the front Office is limited to call the office, they usually reach an answering machine. Automatic reminder system can make reminder calls at night and on weekends, when patients are more likely to be home. While the message left on the answering machine can serve as effective reminders, this message lacks an important feature: interactivity. By reaching the patient, the patient can easily confirm or cancel the appointment during a call.

Reliable, effortless, consistent reminders. Making reminder call for a reminder call is tedious chore for the staff. Fatigue make the routine reminder call can adversely affect the other person’s tone of voice. However, a reminder call is consistent in tone and content. The messages are pre-recorded in the studio with professional voice actors. The recipient can easily repeat the message and call the office if further assistance is required.

Relying on staff to call or send out reminder postcards are burdened not only staff but also have other projects they may or may not get around to complete. Certainly a few days, they forget to take all alerts or calls they just run out of time to do it. However, this is not the case for automatic reminder system.

releases time for other tasks. Other but the time it takes for an employee to a command system information and to view reports, good automatic reminder system requires little interaction and minimal training. Although practices are naturally hesitant to adopt a new tool that can disrupt current workflow, automated appointment reminder system very easy to use and can save hours a day.

Small manual process to make reminder calls. Someone needs to call the number, track responses, keep track of those who need to be called back, try again a few numbers, spending time in answering other questions that come up in conversation, etc. Automated alerts are much more efficient.

Tips for using the automatic appointment reminders

Although most practices that accept appointment reminders are satisfied with the results, there are some potential pitfalls to use Automatic reminder. To avoid these pitfalls, consider setting expectations and ask for feedback.

Set expectations. It is important that staff and patients know what to expect when you switch to automatic reminder system. Explain how reminders work for all employees so that they can field questions from patients. At least, the use of signs and handouts to explain the new reminder services to patients. Most patients are used to receive automatic messages and will appreciate the service.

Ask for feedback. If you are concerned that your patients will not like to receive automatic appointment reminders, do not sign long-term contract with a service provider. Consider the first months of service as a trial period. Ask staff how they feel about the service reminder and whether they have had a positive and / or negative comments from patients. You might want to ask patients directly, especially if you already sent out patient satisfaction surveys.

Listen carefully to feedback. If the majority are happy with the service, you should continue to send automatic reminders. If many express dissatisfaction with the service, it may be time to consider another reminder service.

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Source by Susan Linton

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Healthcare practice owners and managers are often astounded to realize that it can cost as much as $ 6 or $ 7 to successfully collect payment patients with traditional accounts through email. Based employee time, plus postage paid envelopes, the cost adds up truly already sending dozens of accounts each week. Working hours preparing accounts also reduces other efforts around the office – valuable time that could be focused on improving patient flow, document management, etc. – not to mention that most patients are sent two or even three accounts before they return payment. Establishing formal payment policies with your patients can improve collections and reduce training costs.

Design Patient Payment Policy:
When designing a payment strategy, spend some time talking to staff, responsible for the collection and colleagues in other practices. These resources often provide insightful information from direct personal experience of what works and what does not. Consider the history of your job to define how far you should pick a payment policy; there are variations from one locale to the next in terms of age, economic status, and so on. In some areas a written statement that insurance policies you agree and that “payment is due in full at the time services” may be sufficient. Other areas may need detailed information about payment plans, minimum payments and your use of collection agencies to set appropriate expectations.

Just remember to keep it simple. The more simple strategy, the more effective it will be. Be upfront about your rules, explain how you will handle free of charge, and driving with enforcement. Too many practices have found out the hard way it is much easier to offer a well-written policy in advance but it is shocked to calm the patient down when asked to make a large payment on site.

some items
The simple, direct payment policy would require all patient obligations are met at the time of service, but it is not always an option. What about patients “forget” their defense? How about those patients who just do not have enough money to cover expensive process? Below are several options that you might want to consider.

collect fees
Some practices offer to send out patient accounts instead of payment in the office, but add a “collection fee” for each mailed statement. These fees often range anywhere from $ 1 $ 5 per statement and help cover some costs, but rarely less than that. While billing charges can be effective in getting patients to render payment of the first bill, they can reflect negatively in a saturated market with strong competition between practices, not to mention the new practices seek to build a patient base.

Payment Plans:
Payment plans can be a good alternative for patients who can not meet the full obligations at the time service, but the exact parameters are important. Keep in mind payment plans that run too long, increase the risk of default. Some practices have found the best approach is to limit the terms of six months or less.

For some practices, an example payment plan strategy could bring a minimum of say $ 100 due at the time of service, with the balance divided in equal installments over the next 6 months. Or, you could change the overall balance in six monthly installments, with the first installment due at the time of service.

Regardless of how the payment plan is built, it should focus on two equally important goals. First, keep it simple to avoid confusion. Second, to find a reasonable balance between collecting as much as possible up front, at the time of visit, and what the patient can bear. If patients too far upfront, they may not be able to make payments for the next period, resulting in a worst case scenario for everyone – the default.

Interest:
Most offices offer payment plans do not charge interest, but it is not unheard of practice. Interest charges, such as billing charges may be negative determining factor in competitive markets, and new routines. Charging interest also requires more staff time to calculate bills for mailing rarely offset the added cost. Another important factor to remember with interest is to follow the principles of truth in lending law. This can add a few more layers of requirements for administrative training, creating further unnecessary complications.

Gallery Agencies
team with a collections agency can provide you with some recourse if patients fall into arrears, but consider your options carefully and collection agencies can charge anywhere from 15% to 50 % of receivables. Any such cooperation should be carefully studied in advance, described in detail in the policy, including the establishment Contact information for your patients.

No Shows:
Patients who fail to attend a visit without notice is true, annoying and rude. But the collection of no show can turn patients from future visits, not to mention they usually reach very low rate. If you’re collecting no show, keep both these things in mind that the overhead costs of collection can give you enough reason to write it off completely.

Alternate Payment Methods:
Consider that offer as many payment options as possible. In recent years, a reduction in credit card processing fee, which makes them more attractive even for practices with modest traffic patient. Credit cards can also be used to bill monthly installments and payment plans if signed authorization. This will also help circumvent the proverbial ‘check in the mail, “and you will know immediately if the bid is rejected.

Communication
What parameters are defined in the policy of payment, communication is key to ensure smooth implementation. Remember that office staff is on the front line when it comes to dealing with policies to patients and should give clear instructions on all aspects. office wide meeting can benefit all, offer the opportunity for employees to ask questions before implementation. Provide front office with “internal” copy of the policy recommendations on when and how to remind patients of policy.

the relaying new strategy for patients sign the check-in counter stating “Any patient responsibilities must be resolved at the time of service” is an easy first step. Second, create a detailed flyer outlining policy and keep a stack visible in the waiting area, and for the first few months, each patient should to have a copy of your pilot check. The front office staff should advise patients when they call for an appointment and remind them verbally when we came. If steps are necessary, you may need one patient sign a “contract Payment Policy” and keep it in their records.

Some practices now even send “new information patient package” command is planned far in advance. This is an excellent opportunity to include billing policy with other information about the exercises. Practice could also basic information providers, healthy living suggestions intended to practice specialty, or information on how patients should prepare for an office visit.

Implementation:
Create your strategy is the first step to improve the pockets museums, but it will only be as effective as implementation and follow-through. A few small changes to procedures office will ensure this is carried out successfully.

First, it should be standard procedure for employees to obtain prior authorization from the insurance carriers – before the appointment, not just the time the claim is filed. Create a list of steps in relation to the timing of patient visit that includes investigating co-pays, deductibles, the time benefits, etc. directly to the carrier. While pre-authorizations can be done over the phone, “self-serve” online with many airlines is much quicker. Common carrier websites might even be bookmarked on workstations for easy access.

Second, the state staff to take advantage of information from pre sources and in patients obligations age. All parties should be fully aware of their responsibilities and patients are expected to advise how they will render payment.

Third, to ensure patients do not “get away” without paying everyone should be required to check out, and check. All your workers – doctors, nurses, aides, who is the last to visit with the patient – should clearly remind them to cancel the receipt or cashier to handle co-pays on the way out, and get detailed instructions on balance that will be charged to them.

Finally, review the performance strategy. Allow one to two weeks for changes to take effect and begin the evaluation of the results. Arm yourself with detailed information about the collections rates for the weeks and months before the change and bear against the weeks immediately after. Take note of what is happening around the office; assess staff to manage the new policy and make changes as necessary. If something does not seem to be working, make sure that you have given enough time to fully measure the performance, and not be afraid to make another change. Remember, maximizing the pocket portfolios is an ongoing task, but if done properly it can yield improvements in the overall profitability of your practice.

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Source by K Allen

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Receivables management is the art of keeping track of how much credit the company has given its customers, and the company can expect to return. Typically these include the amount the customer owes the company for the sale of any product or service. Doctors provide patients with the best care possible and expect to pay for their services from insurance companies and patients. The healthcare insurance system works in curious ways in which hand carry services and re-imbursed at a much later date.

Whether we like it or not, the insurance model is here to stay and it is important for both small providers like doctors offices and physician groups and large providers like large hospitals to diligently follow up the payments that are due. The receivables management has developed in the most important department in this organization as they help in recovering money from patients and insurance companies and help to keep the business running.

Projects standard payment management has evolved from a mere head of department activities of specialized skill center by itself and requires professionals so that doctors can focus on providing the best care to their patients. These activities have become an important and integral part of the total collection of services that are offered by Medical Billing companies. The process of accounts receivable follow-up is before the entry charge, verification and claim status. The process to enter a charge code in healthcare claim sheet is called charge transfer. This includes determining the procedure codes and diagnosis codes based on the treatment performed by a doctor. There are special rules defined by the insurance companies on what constitutes a valid claim and there are hundreds of rules some simple and others complex to determine the value of the claim. The audit team reviews usually claim based on the rules and accept the requirement of submission. This is a very important step as this significantly lowers the risk of claim denials. Claims are then submitted to the insurance company for processing. Insurance claim processes and sends the remittance of the billing company’s response time is unpredictable and there is a need separate accounts team. This year the team takes the requirements and the insurance payments.

The AR team analyzes the requirement of denial, payment and non-payment if the claim has been filed incorrectly, the claim is adjusted and re-submitted. The AR team constantly develops communication system with the insurance company, patient and physician office and meticulously follow to ensure prompt and full payment. The skill sets and qualities expected from members accounts receivable management team are good analytical skills, attention to detail, hard work and above all, patience. Team members with these characteristics are valuable assets to the organization and will ensure that the medical office receives payments instead.

The aging report is the most common tool for measuring the efficiency of accounts receivable team. This shows the amount that is due to hand and is broken down into different periods – 0 to 30 days, 31 to 60 days, 61 to 90 days and more than 90 days. An aging report that less than 5% of the total amount pending for more than 30 days is considered very efficient.

Finally, accounts receivable management is an important service offered by Medical Billing companies and the performance of this team will determine the financial health of the company as well as the collection of medical practice. If you have any questions regarding accounts receivable and how to receive prompt payment from insurance companies.

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Source by Ryan Wayne

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I’ve stopped with pre-shift religious meditation parked my car along with soothing piece of music. No more prayers to God the way to work asking for more patience, more humanitarian, more understanding. I have noted the fact that it will be no different than any other night in the emergency department, whether I blare Rancid piano YANNI’s Etudes or make a promise to God to go beyond their own body parts to release my patients as they go. Nothing will change. I used to look forward to making a difference in someone’s life, help the poor soul that the body has issued. Those moments are few and far between now. Instead, I tell myself that in the next 12 hours will be spent fake smile pasted on a tired body, going through the motions concern, repeating lines ready false concern and issue medical falling on deaf ears. I used to feel important in my role as a Charge Nurse in the main by the inner-city charity hospitals. Now, as I sit in my car at 6:45 in the evening, gangster rap blaring, I sent out a quick impromptu message to God ….. “Please God, allow me the opportunity to be gainfully employed for 12 hours from now. “

7:02 PM-

I get a quick report on clingons and leftovers that have not made it out of the department with the change of shift and no surprise to me and the night crew, some names all too familiar and the latest reports of “illness” recitable easily from memory. The usual apologies from the day the crew to get them out before we get to go unnoticed. A shrill Shri from one of psych beds startles no. We all look just within “safe” limits of the nursing station from, confirm that obesity safety of our force is camped out next to the room, shaking his head briefly in and go about our business. We go through the ritual take our own baseline vital signs, some popping Xanax and remove sharp objects from our pockets. patient safety is important and we would not want to accidentally stab one of them repeatedly in the chest.

7:17 PM-

main my job aside from direct patient care is Triage. Initial interview, vital signs, short medical history, current medical problems, current medications, height, weight etc etc my first 35 or so matches the typical information on this or any other in the country. 40 years old, female, morbidly obese, diabetes, hypertension, multiple Psych meds, very little Enska, less common sense, no way to pay. She complains of the usual nausea, vomiting, diarrhea and general pain. She has already spent thousands of dollars of other people’s money last week for the same complaint. She did not complete her manuscripts, not monitor gastroenterologist her request and was not at this 300 + £, truffle hunting leech going to change their diet one iota in order to prevent another attack of diverticulitis. her idea of ​​”Clear Liquid Diet” was a bucket of chicken and a bowl of Menudo hour for her arrival. So here she is, totally unaware of why she is still weak. Non-compliant with its meds, non-compliant with discharge instructions, or follow the dietary guidelines, which included gentle, low-fat, liquid diet for a few days until she was able to endure the semi-solid / or solid food.

She bitches profusely when it is brought straight back and put to bed, instead it is sent back out to the waiting area for the long wait. We are very busy and the truly “floating” patients, but she can not seem to fathom this. She barrels through the exit door in the waiting area calling me every name in the book (in Spanish) and swearing never to return. “Pendejo!”, She mutters. Oh, she’ll be back.

“NEXT”!

7:31 PM-

3 My patient is a 23 year old mother of three, the oldest being 10. She has somehow mistaken our “emergency unit” for children clinic and wants her young “checked out “because they feel” hot “. No heat ever taken home, no Tylenol or Motrin given before the decision was made to spend $ 1,500.00 on other people’s money and spend our time Babysitting 3 snot-nosed, unkempt Ankle-Biters are not more sicker than a man in the moon. I usher them one by one on the scale of the plot and is not surprised that anyone is twice the size they should be limited to their age. One, I have to pry finger foods and “Big Gulp” from their stubborn little mitts before the weight so as not to inadvertently add 5 lbs to the triple-digit reading his. Electronic scale beeps incessantly and says: “one at a time, PLEASE.” (Ok, not quite) With all their vitals are normal they are started out of the hold where they eagerly jump on the furniture and run around like defense for attention deficit.

I verbally assault obese stomach pain my wife, who has “been waiting time” (uh, how about 20 minutes). I immediately took the “Cheetos positive signal” on her fingers and around her lips and remind her of the sickest are seen first and to have a seat. She throws me “Pinch pendejo” and rumbles back to his or her seat. I sneak in a quick call to God, praying that he makes sure she looks before she plops back down in his chair (s). I hear intercom announcer now, “CODE BLUE trauma, ER waiting room.” I mentally picture the scenario of the code team spend the next hour remove the child Julio rectal 300-lb verbally abusive Hispanic woman.
“NEXT” !!

9:21 PM-

I’ve lived dinner crowd with my work intact and make my way back to the treatment area to assist the rest of my team in the treatment of patients who were lucky enough to do it again before non-liquid riff-raff. I make my way to EMS radio station when I hear ….. “Unit 842 number 2 patients report” …. we have 102 years of nursing home patient, …. found unresponsive on the floor .. ..not IV .. .. she is now awake, combative, confused, falling into a chair, urinary incontinence, bla, bla, bla … “the report from the nursing home before its EMS transport reveals that this patient had a tendency to” dig out stool rectal when their constipation. “” Oh, it’s just friggin lovely “

9:25 PM-

waiting room intercom buzz ……” I beeen waiting for 10 hours, pendejo you … you piece of …. “click!

9:33 PM

wonderful our elderly finger painter comes, covered in poop from head to toe. EMS personnel that smirk they wheel her in, updating us that any change in the way. no, no changes, except that now she has given up the fight and return unresponsive and her breathing shallow. an instant her breathing stops and immediately rushed to the trauma 1 where CPR is started. “CODE BLUE IS-1, CODE BLUE IS-1.”

9:57 PM-

“Time of death, 9:55” is belted out by the code team leader. “She never stood a chance.” “It was her time.” “She had a long and good life.” Bla bla bla bla. She had a horrendous death. Born fall into the amniotic fluid, but certainly proud parents can be sure of. She died, however, covered in shit, piss and bedsores. Nursing home where she spent her remaining days in perpetual anguish and loneliness must be burned to the ground. No family, no attention, nowhere near as prominent and proud as she once was. Left to spend while understaffed employees Mary Perpetual petri dish were able fraction of them and plundered through her personal belongings. A courtesy call to the nursing home is placed to tell them that Mrs. Mullins will not come back and have been transferred to the ECU (Eternal Care Unit). I hear, “Whew, thank God ….. CLICK.”

10:22 PM-

our usual group of drug-seeking, bipolar disorder, depression, suicidal thoughts, Xanax, Vicodin, Demerol dogs arrive as scheduled with many and varied complaints, migraine, chronic back pain , stress, anxiety, fibromyalgia, bla, bla, bla .. ..!
They are easy to spot, almost always familiar with the history Same Ole ‘. Most people we know on a first name basis. They are all, incidentally, the same allergy medications; Tylenol, Motrin, will save, Toradol, Aspirin or other drugs or not harmless placebo we have tried to quell the “pain” of the past. The only thing that works is “Demerol” and they must have a large supply of Vicodin in the form of a prescription when they leave. (Vicodin have Tylenol in it but does not seem to cause severe allergic reactions when mixed with euphoria, …. go figure!)

Security is usually called, to tell them “no drugs Tonight” is just asking for fighting. $ 1,000.00 later other peoples money and they usually go with their noise and their script for Vicodin. But usually not before asking for “shots for the road” or more scripts for anxiety (preferably Xanax) or sleep aids. 30 pills are often given the number of pills, depending on the frequency of the prescribed dose. This typically last a few days for typical agents found and then they usually return with more “pain” and hungry monkey.

In an age when doctors are sued for both the treatment of pain or to prescribe too many drugs and “get them addicted”, the medical personal are caught up in the proverbial “Catch 22”. More often than not, I’ve been written up several times and was a place where my work was in danger because I challenge sad their lies when the low life drug addicts undertaken is ours. Now I just shut up, shaking his head and asking for overdose.

11:12 PM

Waiting Room PTT ring in the wall. “… How long will I ……. can you tell me where I am on the list …… Donde esta su Doctor ……. I can not find my baby … ….. is Dingo ate my baby ….. pinche PEDEJO, I have been Heer goes for two days and my ASS feel like someone poured salsa right up my ………. click.

midnight in the garden of good (good for nothings) and evil (doers) –

After a flurry of non triage liquid, (sore toe, “shakes”, anal abscess, foreign body in the nose, ears and stomach of 2 years, blah, blah) I call the astute, well-dressed, middle-aged white male, who is walking quite gingerly and refuse to sit. Differential diagnoses race through my head, back pain, abdominal pain, rectal abscess or ,. maybe …. no! …. No! …… NOOOOOOOOOOO!

Yes!

story goes (and it is common) that he and his wife were “attempts “in bed (against his wishes, no doubt) when the vibrator was stuck in his keester and is now painfully out of reach. Given the nature of “injury” he is whisked back private room, put on his side, Kent like a 57 Chevy, and valiant efforts are required to attend 12-inch “perpetrator with ribs” from his colon. All to no avail. At one point we had to keep the foreign body (actually, it was done in the US) colon would not let go of it’s new found friend cylindrical. We pulled, twisted, yanked, pulled, all efforts prove futile. Finally, the doctor stopped, exhausted by the tug-o-war game, with forceps, commonly used to remove large headed children, protruding from prominent lawyers butt, he made the decision to call the surgery team. All efforts to be a professional, however, fell by the wayside when in a moment of silence, the low noise found in the room. Had the blood pressure cuff inflated? Incandescent lights were buzzing? Was on TV?

No, no and no. We looked at the tongs and took them were vibrating uncontrollably, instead realize at the time that this article was still on. A mad rush of nearly crew to close the door of the private room was not trying to humiliate this local experts with boisterous laughter us. No dice.

We will all end up writing and apologies made for “unprofessionalism and disregard for the privacy of the patient and mental well-being” our.
It’s okay. We had to preserve their own spiritual welfare. Still true that laughter is still the best medicine.

1:02

Ten triage and later dinner time for this mentally worn crew. We apply our food, locate it in the middle of the nursing station and we eat. Not all at once, mind you, but usually bite at a time. Eating French fry, go wipe ass in ER-1, a bite of the Big Mac, go clean up cherries cool-Aid flavored success of ER-4, a sip of Dr Pepper, then physically restrain a combative patient Scitzo-effective. By 2:15 we have polished off the last bite tighten hamburgers, ate the last old French fry us and sucked down the last sip of our watered down soda. A soda is now as hot as fresh urine and food which is as cold as Mrs. Mullins in ER13.

2:30 the AM

Ahhh, my favorite time of the entire shift is upon us. The “Last Call at the local bar group” (LCLBC) start pouring in the front entrance, but EMS brings those who got the shit kicked out of them through the back of the ambulance entrance. “Santa Rosa, this is unit 842 …. we are coming Code 2 trauma 19 years Male ….. closed head injury …. drown … combative …. dirty …. bloody. …. no guarantees ….. bla, bla, bla.

the Same Ole Song and dance spews from these patients grow bloodied as he is wheeled into trauma-2 ….. . “I was just minding my own business” …… “I only had two beers” … .. “I do not do drugs” ….. “Can I get something to eat?” “RAALLLLLLPHHH ! “” Housekeeping to trauma-2, cleaning …. “

2:31 the AM

” Dear Lord, if anyone can make time travel possible, it’s you, God. “” Pleeeese, send me on to 7 AM.

3:03 the AM

Patient waiting room intercom is screaming ……….. “Click” ……. “BANG, BANG, BANG “.

3:15 the AM

I started in the staff break room for “time out” and reminded the night supervisor that the cost of intercom will be deducted from my paycheck.

4:18 the AM

Portly our female animal woman finally began again in the room, but not before mumbling under her breath as she brushed past me, “pendejo”! Large “abdominal work up” is ordered. 40 lab tests, urine tests, stool culture, abdominal x-rays, Cat Scans, bla, bla, bla …… It is set in a gown that looks like curtains stolen from the Grand Ole Opry, and given a reprimand “opening on the back, please, “thrown in for good measure. ( “Lord, give me strength ……….. Oh forget it, never mind”)

She is given urine cup as she bounces his way to the bathroom. She fills it with a chair. “Offered in ER, STAT.”

Can not find the blood pressure cuff large enough so we have to take a chance on an erroneous reading by placing it around her calf or forearm. The fluid bed grunts and groans with some twitch and shift from this woman substances. She continues to bitch and moan and will eventually complaint with (a) human resources, I’m sure. Many attempts IV access provider finally vein that has not been choked off by a mass of arm fat and IV fluids are initiated. After a quick assessment is a doctor she’s off to radiology, with a slight 120 pounds technology pushing £ 600 of the patient bed and the third floor for a series of $ 3,000.00 radiologic examinations. X-rays was done just last week and it has no intention or means to pay for. It would have been easier (and cheaper) that she had driven to Sea World instead. Certainly more accommodating to a woman of her stature.

5:57 the AM

Many early morning stragglers are classified and sent to wait. The foul odor of urine, poop, BO, booze, vomit, etc, permeates the air. “One Hour Left”, I thought. We get all the test results voluptuous Ms. Hinojosa is back and surprise, surprise …. “diverticulitis.” Maybe this time it will be in accordance with the meds her, according to her diet, according to her guide, in accordance with life. “Fat chance,” I thought. (Pun intended).

IV it is removed and a half liters of fat globules ooze from harpoon hole. She pulled off the bed with the help of several departments within the hospital; half of which will call in sick the morning with severe back spasms. The battered stretcher which now resembles a low rider after disaster is withdrawn for repairs. Ms. Hinojosa is drained but not before asking for breakfast tray. Request denied.

Off she goes to the local “Taco Cabana” for a flurry of various breakfast tacos and a bowl of Menudo. “She you in a few days, Ms. Hinojosa.”

“pinche pendejo!”

6:47 the AM

miserable face morning crew are obvious as they make there way into reluctantly, some still in the middle of town, new nurses with the Walkman is, listening to the ocean waves or cricket noise saturated with Muzac. A quick report is given to the mentally exhausted night crew and made an apology for missing bed in the ER 3 and the body of IS-12.

7:07 the AM

Each member of the night crew, each with a phone in hand, waiting for the moment the clock strikes 7:08 in with lightning speed, the flurry of buttons will be punched in the clock out, end another horrendous but typical night in the ER.

7:47 the AM

I pull up to my apartment and sit quietly in my car. I recall the events of the night and wonder if I had made no major errors in care or court. I prepare mentally for answers to complaints the night before of this unique culture is ignorant, non-compliant, offensive, poor, helpless, drugged up, psychosis, dregs of society.

I say a prayer for Mrs. Mullins and her family and curse all those who have abused the system in the last 12 hours, spending thousands upon thousands of dollars of other people’s money while contributing nothing to society what- so-ever. When I think that I will have a job to come 6:45 in the evening, I relieve the tired body and mind shattered out of my vehicle, meander up my apartment and in bed, hungry, frustrated, angry. Since I will fight the evil spirits in an hour or so until I’m able to sleep. Not me. I awakened from a dream in which workers of all patients in the waiting room on a busy night. I called back as 500-lb female nurse is ripping my clothes off with one hand and swing 6 foot rectal scope in other like a pair of numchucks in a Bruce Lee movie. The alarm sounds and I immediately spring up and grab my ass, asking for a 6-foot proctoscope is not hanging precariously from it. It is not. I breathe a sigh of relief and make my way in the shower and another fateful night of chaos and mayhem.

6:43 PM-

I pull up to the ER, park my car and sit. I clip on my name badge, giggle as I read our “Mission statement” tattooed on his back. “To extend the healing ministry of Christ,” it reads, and I take a minute to reflect on that statement. I smile, admit it is a powerful and significant activity and turning my head to pray.
“Lord, today, give me divine authority to accept my responsibility in this service. I pray …”

Just then enter a Delta 88 rolls of two-wheeled, with a certain slope aside. I watch as they take up two parking spaces in the “staff” full and out pops Ms Hinojosa. I cringe. She leaves a trail of urped a Fajita and Menudo patient through the parking lot, parking in the brook, toward the ER entrance. Anger byltist inside me and I hang my head, looking down at my shield and the instructions on the back. I try desperately to find peace, and I felt proud just 2 minutes earlier and I continue my prayer …… “Sir, I just …. ……. if you could only find it in your heart ………… oh forget it !!!!! ……. never mind. “

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Source by Michael Wayne Brown