Agency experience...

  1. Hey Everyone,

    I just started Agency nursing. Previously I only ever worked at one facility as a nurse and it was third shift. I went agency so I could cut back my hours to spend more time with my son who has health problems. My first agency job was at a place where I had been an aid and it was third shift. I truly enjoyed that.

    Last night however, I worked my first FULL second shift at a place where I had no experience. (I had done second shift second med pass once in a while where I last worked.) WOW! With people being out of their rooms, some meds missing and a resident Halloween party going on it took me the entire shift to do both med passes and my treatments. By the 'entire shift' I mean no breaks or lunch and I went from 4pm - 11pm. Talk about embarassed! I felt like I did not have any training at ALL!

    Can anyone offer some suggestions to maybe cut that time down? I had 6 sets of vitals to get and 4BP is it OK to ask the aids to assist with this? I really liked the facility and the RN I was working with was very nice and most helpful.

    Is there a thread anywhere with some other agency war stories? I want to be asked to come back and NOT have people think I am a . Anyone else ever take that long for first agency med pass? I had only 25 patients, 4 feed tubes and no real pill crusher just a small mortar and pestal. OMG! Never used that before. Guess how many tubes I clogged I had crushed everything fine but the syring and tube were so narrow everything clogged even the bolus nutritions did not drain down with out pushing each and every tube full with the plunger. I was used to 24 french these were....TINY!


    Does it get better? I know what I am doing, I can do the job. I guess I forgot how hard it was when you didn't know the patients by sight. Thankfully this facility had all residents banded, no exception. Once I found someone I was able to verify it was them.(I never solely trust staff ID).


    Thanks,
    wearyLPN
    •  
  2. 7 Comments

  3. by   oneLoneNurse
    You will get faster and more efficient. Just be yourself, don't panic, try and not make any mistakes. Thats the one that will take the time.

    You should be able to ask the techs to get the vital signs. Any one out of whack you might want to check yourself.

    On the small mortar and pestal you are using a paper cup so that you don't have to wash these each time, right ? One of my first med passes they never told me to use a paper cup, instead I washed the mortar and pestal for each patient's meds.

    Doesn't sound as if you co-nurse had unrealistic expectations which was great.


    Quote from wearyLPN
    Hey Everyone,

    I just started Agency nursing. Previously I only ever worked at one facility as a nurse and it was third shift. I went agency so I could cut back my hours to spend more time with my son who has health problems. My first agency job was at a place where I had been an aid and it was third shift. I truly enjoyed that.

    Last night however, I worked my first FULL second shift at a place where I had no experience. (I had done second shift second med pass once in a while where I last worked.) WOW! With people being out of their rooms, some meds missing and a resident Halloween party going on it took me the entire shift to do both med passes and my treatments. By the 'entire shift' I mean no breaks or lunch and I went from 4pm - 11pm. Talk about embarassed! I felt like I did not have any training at ALL!

    Can anyone offer some suggestions to maybe cut that time down? I had 6 sets of vitals to get and 4BP is it OK to ask the aids to assist with this? I really liked the facility and the RN I was working with was very nice and most helpful.

    Is there a thread anywhere with some other agency war stories? I want to be asked to come back and NOT have people think I am a . Anyone else ever take that long for first agency med pass? I had only 25 patients, 4 feed tubes and no real pill crusher just a small mortar and pestal. OMG! Never used that before. Guess how many tubes I clogged I had crushed everything fine but the syring and tube were so narrow everything clogged even the bolus nutritions did not drain down with out pushing each and every tube full with the plunger. I was used to 24 french these were....TINY!


    Does it get better? I know what I am doing, I can do the job. I guess I forgot how hard it was when you didn't know the patients by sight. Thankfully this facility had all residents banded, no exception. Once I found someone I was able to verify it was them.(I never solely trust staff ID).


    Thanks,
    wearyLPN
  4. by   wearyLPN
    I had read about the paper cup issue on here so I did know that.

    Thank you so much for your reply. It helps to know it will get better. I got a call from my agency and the LTC facility I worked for my first night as agency called and asked for me for 4 more shifts in the next two weeks. I guess things will work out ok.

    Thanks again!
  5. by   feisty_lpn
    There are many shifts where I do NOTHING but meds and txs. The only part about being agency that I hate is that I do not know the patients by name and face until I've been there several times. I have to find an aide and ask "Where can I find so-and-so?" then have an aide or PT verify that information. I'm so terrified of giving the wrong patient the wrong meds that I double-check their identities with staff members. And if they're AOx3, I ask the patient themselves to tell me their name.

    OH and I don't know how many times I've politely suggested to facility DONs about updating patient pictures in the MARs. I refuse to return to one facility because the pictures are several years old &/or missing altogether. If they can't even provide that basic information to help with patient safety, they don't get my services.
  6. by   wearyLPN
    Thank you!
  7. by   RNKay31
    That is so truely said
  8. by   yankeesrule
    Myself i am fairly new to agency work almost a yr. It is difficult. I do take the whole shift to pass meds. Anything other than nightshift I dont get a lunch except when I sit to chart. But i have learned people are people and the geriatric a majority are on the same meds so i am familiar with them when I dont i ask. As far as the pass of the meds to the tubes here is what I do. ONce the meds are crushed put them in some warm tap water and they disolve going down 1,2,3.. however if the tube has been in a while and has a buildup on its walls a little ginger ale will help break some of that down. This is if the person can have it. Was a trick of the trade I was taught at my first night from the agency job. good luck.
  9. by   pjs91n
    I have been agency for ten years, your experience is common to most of us. It will get better, when taking report ask if the pt takes whole, crushed, with or without applesauce and about their fluid, (thicken or regular) Try using strong coffee,if allowed,for a clogged tube. Hang in there

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