Qwitcherbitchin', Crybabies

Burning Platform has some whiny rant (and coming from me, that's really saying something) about a guy billed $426 for an $8 can of OTC pain spray.

Well, gee, no shit, Sherlock, and if you'd seen the report from MIT on the topic, or drove by Homeless Depot any time since 1986, you might have noticed those 200 Julios standing outside their branch in Greater Aztlan Assland, which heritage Mexican homeland apparently stretches all the way to Anchorage AKand Bangor ME. (Who knew?) And unlike whom, you have actual insurance.

Oh, and back awhile, your congressweasel voted in EMTALA, mainly in response to anesthesiologists passing gas for docs doing C-sections on pregnant migras who were crowning, and getting sued by them afterwards, but never actually getting, y'know, paid for their twelve years of higher-education services or their $1M expertise. Those bastards!! Doctors should work for free, amIright??
Occupy!

Short story long, if you show up at the ER, yours, mine, anybody's, you get to play, but you don't have to pay. At least, not up front. Unlike, say, your doctor's office, Urgent Care, or - waitaminute - every other commercial establishment in the flipping country, including the DMV and the Post Office.
Well-played, Fucktard Minions of Stupidity.

So, by the by, exactly how long d'ya suppose Mickey D's or Burger King would be open as a business anywhere, if tomorrow Congress passed the WAAH! My Tummy's Rumbling Active Hunger And Deadbeat Wimpy Act of 2018, dictating that anyone who wanted a hamburger now could get it now, solely on the promise to pay for it next Tuesday?

And if you worked at a business similarly burdened, how long would you have a job when that enterprise subsequently went tits-up, in about a New York minute??

And if the pharmacy at Wal-Mart had to hand that spray out for free, how much d'ya figure they'd start charging for kettle corn bags and underpants to subsidize that largesse? Say, somewhere around $426 dollars, just mebbe?

Anyways, they go on to knee-jerk call the price of the pain spray to government regulation and socialism(!), rather than all y'all getting the system you pissed and moaned for, and now finding out you're getting it good and hard.

Then, a couple of comments down, this nugget:

"Husbands bill was over $2000 to tell him his arm wasn’t broken.
Xrays were separate, about $50.
$256.00 for a tetanus shot.
For comparison, i can get a tetanus shot for a horse at tractor supply for $4.00
Tetanus boosters have been around for decades. Not like they’re rare or anything.
This is after sitting there for 4 hours among a couple dozen non English speaking persons."

Some people cannot put two and two together, and come up with the answer.
Let me help:

And that's why you're paying $256 for the shot.
You're paying for all the Julios and Marias and Wangs and Achmeds and Crazy Homeless Alcoholic Eddie guys with no insurance.

And of course they get a bill too (despite another idiot commenter suggesting we don't bill them).
Which we can't make them pay.
If they gave the right address.
If they gave the right name.

And also, because if your husband got an infection from poor injection technique, or they hit a nerve or blood vessel, or the sun was in your eyes, it was $256 to offset insurance premiums, because you'd then sue the hospital for a gazillion $$$. So you have a doctor ordering it, a pharmacist stocking it, and an RN giving it, rather than you grabbing a dose at Tractor Supply, and doing it yourself.

And of course, if he'd just gone to your doctor and gotten the booster himself, on time, months ago, it could have been had for maybe $20 co-pay, or even less than that, right?

Make your congressweasel pass tort reform, stop suing everybody for everything, build the frickin' Wall at the border, start throwing people back over it, get your annual checkups, and quit using the ER for drive-thru Urgent Care.  Now, how much of that is within the hospital or ER's control, and how much is within yours?

Otherwise, pony up. Walking in the door at any ER worth the name starts at about $1500.
If it was open, depending on day of the week/time of day, you could've gotten the same X-ray and treatment at any competent Urgent Care for a few hundred bucks.

People will price-shop for a ten dollar difference on a cell phone, but they won't use common sense about an ER bill of $2K vs. one at Urgent Care of $500.
Genius, right there.

(And if Urgent Care wasn't available for you, for any reason, then let's be reasonable. You had no choice about the ER, that injury hurt - a lot, and you wanted to know now. Fair enough. You want care now, you pay now.
We take cash, check, almost any insurance, and VISA/MC. Tell me they do things different at Burger King and Target when you want a Whopper or a pair of jeans.)

But don't bitch when you got the gold-plated care you demand, at prices your insurance company mostly pays, while you rarely see 10-20% of that cost.

This is the system you wanted, and now it's not so bitchin. I get that.
Now go fix it, as outlined.

I'd chat further, but I'm on duty at the ER tonight.
Where, if someone comes in with a heart attack, and we save their lives via the Cath Lab and first-world medicine that should be the envy of every Swinging Richard in human history since Adam, the only thing they'll remember afterwards, and go online to bitch about afterwards, is that the baby aspirins we gave them were billed at $20@.

So don't take this the wrong way, but as someone who couldn't have made two car payments in their life if they received $100 for every "thank you" heard from patients or families in 20 years of saving actual lives, if you complain about anything but gross negligence or egregious harmful malpractice, like having the wrong leg amputated, please, I beseech you most humbly and sincerely, go and fuck yourselves up the ass with a lit flamethrower, m'kay?

Because If I gave you that enema, I'd bill you for it at the price you deserve, and laugh while I did it.

Maybe when the shift is over, if I feel like it, I'll tell what you ought to be doing, and bitching about.
Knowing full well the odds of you taking such concentrated experiential wisdom is about as good as the odds of you listening to the discharge instructions you get.

Keeper

Subject: New (to me) nursing blog

Title: Florence Is Dead

Instructions:
Go.
Read.
Repeat.

Florence kicks @$$.
Made my day. Added to the Bloglist--->.
MOAR please!

(h/t to Shrtstormtrooper, and her bloglist )

There Are No Stupid Questions, Only Stupid People

From time to time, just to do an internet pulse check, I tab through my own stats to see what's bringing people here.

Sometimes it's surprising, or a I find a new blog, or I see someone has thoughtfully given me a shout out and there's a spike in page views.

And then there's today's little moment of mirth for moi.

Because one of the categories I find the most interesting is to see what keywords and searches dumped people on my little island in the Matrix.

One of this week's snort-worthy queries to the gods of Google and Bing was:
"how can you fight your ncclex score".

So if you end up here in general, or at this post because I put NCLEX in it, allow me to give you a leg up on this difficult and pressing question, especially for would-be nurses.

Here is the seldom-revealed-in-such-clarity, Top Secret:Codeword Access Sooper-Dooper Guaranteed Method to crack this deal wide open, and solve your NCLEX problem.

DON'T BE A DUMBASS. Study. Learn. Succeed.

I'm pretty sure I covered both study and test-taking strategies for your boards in the middle of 3 essays towards the new grads, a few weeks back.

So, sportsfans, in case you figure your state nursing board is going to jump back once you sic your lawyer, J. Noble Daggett on them, and cough up a passing board score because the sun was in your eyes that day, allow me to offer you a great deal on a barely used bridge right next to some beachfront property in New Mexico. Just send me your credit card number, bank account information, social security number and your ATM PIN, and I'll get right back to you.

(If that sarcasm went over your head, go back to beautician school, or perhaps consider a career in either food service or janitorial endeavors.)

You aren't going to "fight" your NCLEX score, as a rule. And in case no one ever let you in on this tip, let me let the cat out of the bag:

Your patients don't come with four handy multiple choice options tattooed on their chests.
That means you have to use Mr. Brain to come up with actual thoughts, and then behave appropriately and arrive at a rational course of action, based on what you see.

Y'know, pretty much how 99.9998% of the rest of life works.

So if you've somehow arrived at your nursing boards, and bungled them, either regroup and do better, or go home. But abandon any thought of arguing your way to a passing score if you didn't earn one. If you flunked your boards, let me be the first one to encourage you to try again. And if that amount of integrity and honesty with yourself eludes you, let me be the first one to say I'm really glad you're not a nurse, and I hope you never get to be one without undergoing a successful brain and character double transplant, if a donor match becomes available.

Because if test-taking kicks your ass, in a situation where you have oodles of time to successfully pick one of four letters on a keyboard, in an ideal test environment, the last place I want you to be placed is at a patient's bedside when some serious crap is going down. Try to remember that your kindergarten teacher lied to you, you aren't the most special snowflake, and if you can't hack the easy stuff to get this gig, you sure as shooting aren't going to be able to handle the life-and-death stuff day in and day out for twenty to forty years.

So please, either perform a Valsalva Maneuver (look it up!) until you hear a loud popping sound, and your head breaks suction from where you had it stuck, or pursue another career endeavor.

But thank you, whoever you are, for providing me the chance to mock your anonymous and unintended flash of honesty, once I found your jam-smeared fingerprints all over the NCLEX cookie jar. But please, pull your pants up from around your ankles, and decide if you're serious about this profession, or just comedy relief.

Endangered species?

One thing that's boggled my mind since kicking off this blog, is the absolute dearth of actual ER nursing blogs.

Or at least, blogs that survive.

Even the ones I linked to are generally anything but regularly contributed to.
Maybe nurses don't make good electronic diarists, or maybe most of the people who actually work in the ER are just too ripped up most days to put a few words together. I don't know. I can certainly confess to feeling too tired to do much besides eat, shower, feed the cat, and sleep after a string of tough shifts.

Everybody's blog list I've run across has any number of blogs with dead links, from people who quit, logged off, ran out of things to say, or just never had time to start.

As I said, I don't have the answer to this, and it's like trying to study the sound of the bell that doesn't ring.

On the other hand, self-expression has never been one of my weak points. My friends laugh when someone describes me as "quiet" because it generally proves they either don't know me, or haven't known me very long, because I've been told that I talk too much since the second week of kindergarten. Maybe they were on to something.

My reason for holding it in so long now was a simple lack of internet access. Obviously, that's been remedied. It's just that I expected to find scores of people scribbling away, given how many of us there are, and instead what I find, internet-wide, probably wouldn't fill up a city bus.

It's just peculiar. Not X-Files peculiar, but definitely a little bit unnerving.
I haven't seen this much trouble finding an ER nurse since the last Saturday night shift of a three-day weekend.

At any rate, while now and then I may go a couple of days without anything bubbling up, I'm not going anywhere anytime soon, as long as I'm breathing.