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GardenRN
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On the verge of a big decision

So I am almost done with prereq's for the nursing program, and last week at work something that has been brewing for a while really slapped me in the face. I don't like nursing! Well, actually I take that back. I like "nursing", however I don't like how hospitals work, I don't like the patients, and I don't like how the whole system basically sets you up for failure by putting you in situations where it is impossible to succeed. I don't like that as a nure you spend more time in charts and doing paperwork than having any actual contact with the patients.

And now that I feel bad about saying I don't like my patients, let me explain. I work in a mental health facility, as many of you already know. I completely understand that SOME of the patients are not capable of controlling their actions, they don't understand that they are behaving inappropriately. SOME of them come from horrific backgrounds that no person should ever have to go through. HOWEVER, many of them are completely capable and knowing of how they control their behaviors. Probably about 90% of my patients are ones that I know by name because of how frequently they visit. Which tells me that we aren't really helping anyone. It's just a big carousel. They treat you like garbage and there are no real repercussions when they behave in a completely inexcusable manner. Doctors are as bad as insurance companies when it comes to flat out fraud. And the hospital talks up a big game but really couldn't care less about it's employees. It is a giant money machine. And I know it's not just my section of the hospital, or even just the hospital I work in. I hear the same complaints from people that work all over the place.

I had a teacher in high school that said the key to finding the right career is to find something you love to do and get someone to pay you to do it. That's damned right. So I am on the verge of completely abandoning the nursing track and switching to horticulture, and probably specializing in plant production.

I know that jobs with a horticulture degree are somewhat limited. Mostly landscaping, county extension work, teachers and nursery owners or managerial jobs at a nursery. I think the pay is relatively low....which kind of stinks. There is something to be said for being able to do what you love for a living for sure. But you have to be able to pay the bills too.

I guess I'm hoping someone may have a little advice or insight. Most of what I am seeing as far as income with a hrt. degree is between 26k and 60k. Of course, 60k being on the very upper end, that means that most people aren't making very much. It seems like pretty low pay for a bachelor's degree. IDK. Any thoughts?

On the up side, a handful of my nursing prerequisites would apply toward the hort. deg. So it's not like the classes I have completed would be a total wash.

gumbo2176
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You say you are almost done with the pre-reqs for nursing, so are you now getting your practicals in by working at the mental health facility??

I don't know much about nursing even though there are 2 in our extended family along with an MD., but I'm assuming since you are close to having all the pre-reqs, you aren't an LPN or RN just yet. If so, what are your chances of getting away from the mental health end of it and working at a local hospital as a floor nurse tending to patients with more conventional needs?


Maybe all you need is a change of scenery to find your niche in that career. Most of the nurses I've gotten to know over the years really love their job, but I don't believe any of them work with the mentally ill.

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GardenRN
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Well I have worked as an EMT for some years now...although that's volunteer. And it's getting to be the same thing there. We do have a share of real emergency calls, but most are people that just need a ride to the hospital.
Let me give you a sample of some of the calls this last month: Sore heel, possibly infected earlobe, "I don't want to use my c-pap and I'm having a hard time breathing", can't have an orgasm....do these sound like emergencies to anyone? Ok.....maybe the last one :lol: but seriously...

I'm not sure it's the scenery. I get so mad when people come in detoxing from another drug binge and want to feel so entitled and tell YOU how it's gonna be. They refuse all care except what they want, which is pain pills and sleep aids that get you high.

I am not doing clinicals yet, the classes I have taken aren't even nursing classes. Just all the math, bio, and that stuff. And you can't work in the other areas of the hospital anyway until you are program placed at a minimum.

Many nurses do enjoy their job, and God less them. I can't blow off getting treated like crap every day. I'm not asking for a pat on the back or even a thank you. But when you have someone yelling and cursing at you while you are trying to clean up the feces that they got on TWO beds and the floor in their room, while trying to convince them it's a good idea to take a shower and wash up. It's a bit much. Even my 3 year old knows better than that.

cynthia_h
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It sounds like this is the equivalent of "hazing." Once you get the degree, others will be doing these duties. When I was in the hospital after my two knee-replacement surgeries, CNAs did this work (Certified Nursing Assistants)--people without degrees but with a two-year certificate.

The RNs had other responsibilities. My brother is an RN, and although we (my entire sibling group of four sisters and my brother) have problems among ourselves and no one has heard from Brother in at least four years, it is known that he's a charge nurse on a psychiatric unit at a large hospital in San Francisco.

He was originally a corpsman in the Navy, working with Marines, but when he took discharge from the service, all he could get were the (literally) cr*ppy jobs. Even though he had been in charge of prescribing and dispensing medications, performing minor procedures, and the like in the service, civilian rules made him almost less than nobody in the medical field--he couldn't even do CNA jobs. :( He *finally* found someone to listen to him and get equivalencies of his service experience to pre-nursing courses, which left him with only a few courses to take and then sit for exams. We're pretty sure he sailed through (but he never told us). He's...ah...not very communicative, at least with family.

But he has kept this position for several YEARS. Major urban psychiatric unit. RN. Charge nurse. Scheduling. Man. (You definitely know, or maybe you don't yet, what that additionally entails.)

I'd say ask around among your classmates; if none of them are performing similar duties, then go to an instructor and ask what's up with the bathroom chores. But if others have the same sort of yucky tasks, it's probably "hazing": "I had to do it, so everyone else will have to do it." Disgusting, but often the case.

It's a lot (I think?) like student teaching. When I was going through the teaching credential program, I was assigned the most difficult class by one of my master teachers. He couldn't deal with this class of messed-up kids, and I had never been in charge of a classroom, at that time. What "fun" I had. The kids, too (sophomores in high school). :roll:

If you're close to finishing--within 1 year--hang on. Nurses in California, at least, top out around $120,000. You would be giving up half of your lifetime earnings to stop now.

Cynthia H.
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gumbo2176
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I worked for over 20 years on our local fire department so I know a bit about being appreciated and unappreciated, sometimes all by the same people.

I can't tell you how many times my company had to go out at 2-3 a.m. for a call for an alarm going off only to be someone's smoke detector with a weak battery that was chirping to tell you that it's time for a new one. Then they say something like "Oh, it's been doing that for a couple days now" and I'd want to hand them their "STUPID" sign.


I have a family member that was one of the 60's flower children that is now in her mid 60's, has Parkinson's, some mild dementia and loves her pills that make her feel good. To hell with the medication for her overall health, just give her the ones that knock her out. I know I could not deal with that on a daily basis. Heck, I don't even like to go visit her because when she's awake, her mouth is moving a mile a minute with no train of thought, just verbal diarrhea.

I've got an 84 yr. old mother-in-law that stayed with my wife and I for 2 months last year when recovering from cancer treatments. She was such a handful and pretty much refused to do anything for herself even though she could. She had a feeding tube and she refused to use it to feed herself so my wife and I did it. She also didn't want to take her medication so we crushed it up in a mortar and pestle and placed in water to administer it via the tube. She tried our patience more times than I care to think about and I know I couldn't deal with that on a daily basis for total strangers. If anything happens to my wife, that's a totally different story, but I know even then it would be taxing mentally and physically.

My hats off to the nurses that have tended to me when I had to be in a hospital. The Dr. gets all the glory, the nurses do all the dirty work.

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pinksand
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I have a couple of friends who have worked in the mental wards of hospitals after getting their degrees in Psyc and not really having anywhere else to go without furthering their education. I can tell you that I have had very similar conversations with them. Particularly the feeling of hopelessness when there isn't any apparent progress and patients aren't willing to take the necessary steps to help themselves. My friend had teeth marks on her leg from where a patient bit her through her jeans and still drew blood. She was also punched, scratched, kicked... eventually she had enough. She transferred to the eating disorder ward and although she is no longer abused, she's still very discouraged by the lack of progress she sees in her patients. After a while, it's frustrating and just down right depressing. My other friend was in a similar situation and has decided to go back to school.

I also have a friend who is a firefighter who has very similar stories... "emergency" calls from addicts needing to go to the hospital to get their fix. It's very sad :( Basically, you aren't alone. I think these feelings are quite common in the field.

On the other side of things though, I know several ER nurses that really love what they do. My guess is that it probably depends on finding a good hospital that is well run by the right people. Should be easy enough right ;)? Also, get out of the mental health facility!

If you want to change paths, I don't know anything about hort. or positions available and salaries. I guess you'll have to do the research and decide if it will be doable for you and your family. That's definitely a difficult position to be in. I wish you the best of luck!

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I almost thought about horticulture but there were too many cons in my eyes. First of all there is not many jobs out there so there is a lot of competition. Next, the pay is pretty low, but still not the end of the world. But another thing that bothered me was they are not very stable or recession proof jobs/careers. My biggest concerns are ease of finding a career/job and whether it is stable. You can find a career that is not necessarily your dream job but is something that you like. Right now I am thinking about being a clinical laboratory scientist. The work is fun and interesting, plus the job is in demand, and pretty recession proof. I figure I can do the things I really love in my spare time. But I am still not 100% decided on this but whatever I do will be a part of biology.

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GardenRN
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IDK. Basically I have until feb to decide because that's when the next semester will start. Whatever I'm going to do I need to make up my stinkin mind. I'm 32...time to $hIt or get off the pot...as they say.

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He was originally a corpsman in the Navy, working with Marines, but when he took discharge from the service, all he could get were the (literally) cr*ppy jobs. Even though he had been in charge of prescribing and dispensing medications, performing minor procedures, and the like in the service, civilian rules made him almost less than nobody in the medical field--he couldn't even do CNA jobs. He *finally* found someone to listen to him and get equivalencies of his service experience to pre-nursing courses, which left him with only a few courses to take and then sit for exams. We're pretty sure he sailed through (but he never told us). He's...ah...not very communicative, at least with family.
Did you watch the debate this evening? President Obama told a similar story. He would like to fix this issue. :)

Eric

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GardenRN
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Eric you know the story of pandora's box right? You're dancing on the edge of a similar fate when you open the can of worms known as "The Political Debate" :) Careful buddy!

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rainbowgardener
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Much as I love working with plants, I agree with all the comments about thinking it through. In my experience horticulture jobs are hard to find and low paid, while nurses are constantly in demand and high paid, with a lot of flexibility about whether to work full time, part time, scheduling etc.

AND there are so many different kinds of nursing. If you don't like the kind of nursing you have been doing, train for something else... ER nurse or surgical nurse (those patients are knocked out, they aren't going to give you any grief :) ), ICU, pediatric or neonate or obstetrics, etc etc.

And remember, if you are just now finishing your pre-reqs, what you have been doing so far is NOT what nurses do, it is what aides and orderlies and other underlings do. You aren't qualified yet to do what nurses do.

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GardenRN wrote:Eric you know the story of pandora's box right? You're dancing on the edge of a similar fate when you open the can of worms known as "The Political Debate" :) Careful buddy!
Thanks Jeff,

When it comes to dancing, I'm two "left" feet. :wink:

I just found it interesting that a topic I read here was echoed there.

Eric

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DoubleDogFarm wrote:
He was originally a corpsman in the Navy, working with Marines, but when he took discharge from the service, all he could get were the (literally) cr*ppy jobs. Even though he had been in charge of prescribing and dispensing medications, performing minor procedures, and the like in the service, civilian rules made him almost less than nobody in the medical field--he couldn't even do CNA jobs. He *finally* found someone to listen to him and get equivalencies of his service experience to pre-nursing courses, which left him with only a few courses to take and then sit for exams. We're pretty sure he sailed through (but he never told us). He's...ah...not very communicative, at least with family.
Did you watch the debate this evening? President Obama told a similar story. He would like to fix this issue. :)

Eric
No, unfortunately, I didn't watch or even listen to the debates last night. I feel un-informed listening to the comments and "analyses" today on the radio....

There was "someone else" in the house who, for some strange reason, decided to turn the TV on about 5:30 when a local baseball team, counted completely OUT of the playoffs, had a 5-run third inning, giving said team a 7-0 or thereabouts edge over the "was supposed to win" team. With the TV on, sick doggie upstairs with "someone else" and helping to watch the TV, older girl dog also upstairs, and the TV making so much noise, I said the he!! with it and thinned out my email for quite a while. But I finally went upstairs at the 7th-inning stretch.

You (or others) may have heard that the San Francisco Giants will meet the Detroit Tigers in this year's edition of the "World" Series, beginning tomorrow in San Francisco. Much to the surprise of many, many people.

Is there somewhere online I can read a complete transcript of the debate? I'd like to see what was said.

Thank you!

Cynthia

DoubleDogFarm
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Cynthia,

Youtube video.
https://www.youtube.com/watch?v=tecohezcA78
Start at 1:06:45 Joining Forces

Not much detail.

Eric

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GardenRN
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rainbowgardener wrote:And remember, if you are just now finishing your pre-reqs, what you have been doing so far is NOT what nurses do, it is what aides and orderlies and other underlings do. You aren't qualified yet to do what nurses do.
No, I'm not doing what nurses do. Which is about 65% chart work, 10% pharmacy orders, 10% passing meds, and 15% patient care. It's not that I mind wiping behinds and helping people walk and doing the "dirty work". That's what I like.....helping people. It's just that today's breed of patient is a person who is over entitled, judgmental, over demanding and under educated about their condition and the treatment they should and shouldn't have. People don't go to the doctor to find out what's wrong and what to do about it anymore. They go to the doctor to tell them what they have and what medicine they need so that the doctor can write them a prescription.....mostly. That's what happens when you inundate people with pharmaceutical ads at every commercial break.

Whether or not I go for the horticulture degree I have until Feb to decide. But I've been thinking about it heavily the last few months and quite intensely the last week or so... and reaching out to friends in the medical field for insight. Nursing, is not where I'm headed. The money IS good, and they ARE always in demand, you're right. But it's not all it's cracked up to be. The flexibility of the schedule isn't quite what you'd think either.

If I want to do patient care and ACTUALLY DO patient care, I'm gonna have to stick with EMS. But I already turned down paid EMS positions to volunteer because I don't agree with how the paid EMS companies do things. (leaving you with only one provider and one driver on a truck when there should be at least 2 providers) The medical field is all about the almighty dollar, less and less about the patient.

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Jeff, let me encourage you to talk to someone that is just a little outside your field of work. You are in school so there are people there for you to talk to.

What I found is that discontented fellow workers tend to add to each others discontent. Some folks aren't even intending to make any changes but may just get some relief by talking about problems. That doesn't mean that they are bothering to listen to your problems, tho'. And certainly, doesn't mean that they have any positive feedback to give.

You need that relief, that venting, too. There should be knowledgeable people who are available to you right there in your academic setting. Don't be poisoning any wells or burning any bridges . . . if I can mix my metaphors. You can express yourself well and let others close to the nursing field provide some insights. I mean, just talking about these frustrations helps you I'd think but some positive route to take may be just as close as a door you walk by every day.

Steve

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rainbowgardener
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I agree. And I am quite suspicious of any generalization that starts with "patients today." Patients today are as they have always been, a very mixed bag that includes some of the whiny, entitled folks you describe and some people who are bearing pain and suffering and deteriorating function with remarkable patience, courage, and fortitude and good spirits -- and of course everyone in between.

I heard part of an interview on NPR at lunchtime yesterday with a man who was in an accident where he was burned over a lot of his body AND had his left arm severed just below the elbow. As he was being loaded on to the ambulance, he wanted to say something to let people know he was ok. He was afraid if he said "tell Cindy I love her" it would sound like he thought he was dying. So he made a joke instead. I know that's an extreme case and way more presence of mind than I would have in even slightly similar circumstances, but just an illustration.

I also think that people tend to react as they are expected to and your perceptions are shaped by your own expectations. If you always expect that your patients are lazy and worthless and ignorant, then you are going to see a lot of that. If you go in thinking your patients are worthwhile human beings who are doing the best they can in bad circumstances (which circumstances may include a lack of education and ideas about medicine shaped by the drug culture), then I think you will find a lot of that. I am a psychotherapist working in community mental health with the poorest of the poor, mostly uneducated and unsophisticated, and unhealthy in mental and physical ways, many with chronic mental and physical pain. And yet when I work to connect with them on deep levels and to find what is unique and lovable about the person sitting in front of me, I almost always can find that and sometimes find the most remarkable examples of courage and resilience through incredible sufferings.

Incidentally I have two good women friends who recently retired after long careers in nursing that they loved.

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I've been following this thread with interest, and agree there are no easy answers. Were I a few yrs younger, could be having the same discussion, though nursing not the variable.
In brief, have worked garden centers, mostly part-time/seasonal. It's great when in season, weather pretty etc. Crappy when weather bad, bad managers, etc. One thing with anything farm-horticulure based is it is everyday, not just the pretty days! One thing I did notice was the turn-over in managers, and people moving around to different garden centers. Good ones usually can find a niche. Even the box stores (Home Depot/Lowes) have managers for the garden center. A major factor to work in small garden center or box store is you need business and management skills. If you just have people and plant skills are on the floor making $10/hr. I was in that category and at the time making less.

As my life evolves, and now growing herbs in the back yard, in ground and lots of containers, and selling fresh cut at the farmers market. I am working with a most interesting group of fellow vendors. Some are retired, still healthy, and with their retirement income can indulge in farming. There are the younger ones hanging in with day jobs and trying this avenue. And there are the dreamers and idealists who are going for it!

Is there a way you can work in plants while doing your nursing career. A couple of things come to mind. One is growing more and trying the farmers market, even if not every week. That in itself not a career choice, but it does put you in the middle of it. Do you like to start plants? There is always a niche market for specialty plants. This could be all kinds of garlic to okra to native plants. Be a go-to person for a specialty, and that can be run on the net. Starts can also be peddled at the area garden centers. You will need whatever ag license in your county/state.

Keep thinking, never quit dreaming, and don't be hesitant to think out loud.

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A note on the Farmer's Market.

I've noticed that most vendors have their loyal customers. If you are not selling every week, especially in the Summer, you will lose such customers. Consistency is a must. A niche is another.

Eric

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GardenRN
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If I was going to go into farming, it would almost definitely be a mix of livestock and a few choice plants. Maybe the Yakon that I've grown so fond of. With a mixture of pastured, free-range chickens and ruminants (probably meat or dairy cows). I like the idea of a multi-faceted plan. Much like polyface or many others that you can find with a quick google search. But IDK if the farm dream could ever materialize. I don't have land, I am probably close to upside down on my mortgage right now because of the economy etc.

Maybe one thing that is nipping at me is that until a year or two ago I thought, "a farm would be an amazing thing to do for a living, but there is no money in farming anymore. That's something people did years ago and now you have to grow 100k acres of corn to barely survive." But I am coming to realize that that's not so true, and that mostly just applies to conventional, industrial farming. The ones depending on the same hand that beats them. (In case you're not following, that hand being the government.)
The want to be some sort of farmer has nagged at me for as long as I can remember. The horticulture degree is just something that might serve as a second income should it be necessary, which I all but fully expect. IDK. I have a lot of thinking to do still.
I understand everyone's suggestions to talking with someone, and I will probably seek out more insight. But at the same time, nothing anyone says could kill the desire I have to drift toward SOME SORT of farming. And I would consider a nursery a sort of farming, in a way. At least in the same industry sort of.

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GardenRN
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I just had to add this last note since it was the epitome of one of the things I can't stand about the hospital. :evil:

We VERY recently have moved a lot of the paperwork involved with tracking individual patient's progress onto computers. This is in reference to our "observation notes" sheets. We, one a shift, would write a short paragraph just talking about the patient's mood that day, whether they were med, meal, and group compliant, if they had any issues blah blah blah. This moved to the computer and one thing we have to note is the patient's affect during the therapeutic group session. Well leading group is one of the better parts of my shift, the patients are usually happy to sit down and talk about what bothers them and how to handle it. Plus I always throw a fun question on the end such as "If you could travel anywhere in the world and money was no issue, where would you go and why". It gives me a little insight as to how clearly they are thinking also.

ANYWAYS, so on the computer now we have to punch in the patient's mood during group. I was pulled aside by the floor supervisor (she's in charge of 3 of the 5 units at the facility I work in) and told that even though there is an option for "Happy" , that I should never put that. Because if the patient was "happy" all the time it was very hard for them to justify not discharging them. Excuse me?? Hey I thought it was funny that the amount of time a patient needed in the hospital and the amount of time their insurance ould allow them to stay ALWAYS coincided exactly! And I also thought it was amazing that everyone was discharged on mondays and fridays. Mondays and fridays should be studied more extensively in the medical field! Evidently they have some kind of magic healing power. :roll:

Sorry about the rant, this is just a taste of some of the things I hate about how a hospital runs.

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It's sad, but it's not a reflection on the health care, but more on the corruption that insurance has wrought on hospital policies. Any further than that, and my analysis will drift into the troubled waters of the dreaded "politics," a land from which few return unscathed.

But I'll bet that if you asked nurses, doctors, case managers, and social workers privately, what they thought was best for the patients and money were no object (kind of the same question you asked of the patients), you'd get good insight into the dissonance between the health care they want to provide and the health care they're required to provide.

Cynthia, fortunate enough to have had enough insurance to cover my two knee-replacement surgeries *and* the rehab for each

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GardenRN
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cynthia_h wrote:It's sad, but it's not a reflection on the health care, but more on the corruption that insurance has wrought on hospital policies. Any further than that, and my analysis will drift into the troubled waters of the dreaded "politics," a land from which few return unscathed.

But I'll bet that if you asked nurses, doctors, case managers, and social workers privately, what they thought was best for the patients and money were no object (kind of the same question you asked of the patients), you'd get good insight into the dissonance between the health care they want to provide and the health care they're required to provide.

Cynthia, fortunate enough to have had enough insurance to cover my two knee-replacement surgeries *and* the rehab for each
As much as I hate insurance companies, they're no worse than the doctors scamming them. It's kind of a which came first chicken or the egg thing. Both are trying to get one up on the other so neither can let up.

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rainbowgardener
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I'm sure there are some doctors scamming the insurance companies. I think in the majority of cases they aren't really scamming, just playing the game to be sure the patients get the care that they [actually do] need.

Even in the cases you mention, people that stay in the hospital exactly as long as the insurance covers, in the past they would have stayed a lot longer (before insurance, people often stayed in psych wards months at a time). So maybe that is just an indication that they are getting as much needed treatment as they can. When the coverage runs out, they have to leave, whether or not they are ready.

Similarly re the happy notations. Just because the patient can laugh in the group, present as happy for a few minutes in that setting, does not necessarily mean that they are well or ready to go home. But if you mark them as happy, the insurance co may take it that way. So avoiding noting the happy is playing the game, but not necessarily scamming the insurance co. To me scamming would be getting insurance coverage for treatments that are not needed for patients that are not sick. And yes in a mental health setting all that gets a lot fuzzier, since there are fewer clear objective indications (temperature of 103, etc).



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