Registry Nurses don't feel part of a team

[kellbell1]

Are there any registry nurses who feel they stick out like a "sore thumb" in the hospital? You will feel better when you read this article:

Many staff nurses look at the registry nurse as some kind of second-class, poorly trained, third cousin to the staff nurse. This myth, in most cases, cannot be further from the truth. I have seen very competent registry nurses given lousy assignments by the charge nurse under the misguided belief that registry nurses aren't "real" nurses, or are less skilled than the hospital's own staff nurses. Are there bad or poorly trained registry nurses? Of course, just as there are bad or poorly trained staff nurses. Sure, the staffer will be more familiar with that particular hospital's protocols. But just because a nurse has chosen to practice nursing through a registry should not lead anyone, let alone another nursing professional, to believe that this nurse is any less committed to quality patient care than the nurse who has chosen to practice in the hospital setting. Our profession suffers from enough outside detractors--we do not need to join the fray as well.

Several years ago I was working, through the registry, at a local Los Angeles hospital. I got called down to the ED from the NICU to start a particularly difficult IV on an infant, when the baby's mother objected to my performing the procedure. She had realized that I was not one of the regular staff RN's, since I wore my registry I.D. rather then the standard hospital I.D. The head nurse apologized to me for calling me away from my patients and sent me back to the unit. Perhaps if the head nurse had explained that the reason the ED nurses had called me down was because they knew I could start an IV in the most difficult of cases and they wanted to avoid repeatedly sticking her child--perhaps then, the mother may have let me perform the procedure. Or maybe not. But at least she would have made her decision based on facts, rather then the mistaken belief that registry nurses are somehow less skilled than staff nurses.

What draws one nurse to the hospital setting and another to the registry are different challenges.

Some of the reasons that a nurse may choose to work for a registry or travel agency are:

* Not to have to deal with the hospital politics

So many nurses are driven out of bedside nursing because of the hospital/nursing politics of a particular institution. When a nurse works through the registry, she usually shields herself from the day-to-day politics since she is there on a temporary assignment. She doesn't need to invest emotionally in interoffice concerns. Consequently, registry nurses may be less likely to suffer from burnout than staff nurses.

* Have more direct control over their work schedule

Working the registry usually allows the nurse to have greater control over her work schedule. She can stipulate the days and shifts she is willing to work, and when she is not. Most registry managers recognize this as one of the satisfaction indicators for their nurses and they usually do their best to accommodate requests. However, when the need arises, they call their list of available nurses to see if one wants to pick up an additional shift. When this happens, the nurse has the right to refuse without suffering consequences. Furthermore, the nurse can often negotiate higher pay for the assignment or other bonuses.

* To make extra money

There is no question that registry and travelers generally make more money per hour then the permanent nursing staff. This is the case in most professions where a "substitute" for the employee is called in. Is it fair? Perhaps on the surface it appears unfair, but one must keep in perspective that a registry nurse only gets paid for the shifts that are worked. There can be, and often are, long dry spells when the registry nurse receives no assignments. Though many agencies offer perks similar to those offered by the hospital, such as health/dental insurance and 401K plans, these are only offered and maintained if the nurse works a set amount of hours per month or quarter. Though hospital-based nurses often face a similar challenge, it usually only effects part-timers. Generally, the full-time hospital-based nurse does not have to worry that their benefits will stop just because the hospital did not schedule them for some shifts.

* To travel to interesting cities or countries

One of the greatest attractions of working registry is being able to pretty much pick and choose the state or country where you want to work, and, in many cases, even select the hospital. Most registry and travel agency nurses have a great support system in place that can help a nurse secure a license for the state, as well as housing and transportation. Recently, an Australian registry held recruitment events in at least three major American cities to encourage US nurses to sign on to a one or two-year contract to work in Australian hospitals.

I know a Canadian nurse who works with a US traveler agency that puts her to work three months of the year. So far she has worked in Arizona, New Mexico, Southern California, and Florida. She loves "vacationing" this way with her husband, who is retired, and she explores the US, while making a little extra income.

* To work in certain hospitals

Another plus is that registry nurses can often stipulate the hospitals where they prefer to work, and avoid those that are not welcoming of registry nurses.

Hospitals sometimes put in place policies that are not registry friendly. These policies are meant to provide patient safety and to protect the hospital. However, they are often unwieldy and may result in placing the patient in harm's way. For example, one hospital in the San Gabriel Valley recently implemented a code system to access the high acuity areas of the hospital. A computer-generated access code and an individual code was issued to each hospital employee. However, the registry nurses were prohibited from receiving an access code, even a temporary code, with the reasoning that since the registry nurse was not a hospital employee, they could not be trusted with such sensitive information. Meanwhile, that same nurse who could not be trusted with a simple door access code in order to return to the unit after having used the restroom (which were located outside the unit) was entrusted with critically ill patients in NICU.

Another common misconception is that registry nurses are at heart troublemakers and could not "make it" in the hospital setting. As with any situation that involves people, this misconception could have some truth to it. On the other hand, many registry nurses know the very real threat of being made a DNS --Do Not Send. The DNS is the blacklist of the nursing world. Most hospitals have no criteria for placing a registry/travel nurse on their DNS list. Since there is often very little practice-based criteria used to place a registry nurse on the list, many registry nurses try to keep a low profile at some hospitals.

If you think the DNS list is just a myth, ask your staffing office. Most, if not all, will confirm that such a list exists. The original intent was to serve as a type of historical "gatekeeper" so that truly bad or incompetent nurses are not allowed to return, which is definitely a wise thing for a hospital to do. However, in some situations, little to no criteria is in place that decides when a registry nurse is placed on the DNS list.Often, it is not because of poor or dangerous nursing practice, but due to a more arbitrary reason.

However, some hospitals cultivate a work environment that is welcoming to the registry/traveler nurse. The staff nurses, in turn, are generally respectful of the registry nurse's skills and treat her as a member of the regular nursing team. Creating this environment ultimately benefits the hospital and the patient.

In a perfect world, nurses don't call in sick, go on leave or vacation, or miss any days of work. However, we all know how imperfect our world is, and the registry nurse serves a very real purpose. The other choice is to work even more short staffed, or require nurses to come in sick, or pull double shifts, which increases the burnout rate. The next time a registry/traveler nurse is assigned to your unit, be grateful she is there, sharing the workload.

Also keep in mind that this nurse is an RN in your state, who passed the same or equivalent tests as you, and has a diploma, associate, or BSN. Try not to pass judgement on the reasons why the registry nurse has chosen to practice through the registry. Be happy that there exists a pool of nurses who don't mind being the substitute nurse when we need them to be. And, remember, how can we expect those from outside of nursing to respect us, if we cannot ourselves show respect to our fellow nurses.

[fergus51]

I've generally had good experiences with agency nurses, and I am always welcoming of them. I certainly don't want to look after all the patients by myself, so I'm glad for any competent help. I have had experiences with completely incompetent agency nurses, but those nurses were dealt with by management so I don't worry about it.

[babynurselsa, RN]

I guess I have never encountered the attitude of which you speak. I feel that I am expected to be experienced and capable. The only times I have encountered a less than hospitable was by a floor that was legend for treating ALL that way.......wonder why they why they were chronically short staffed.

[BKRN]

I was a staff nurse on a MED/SURG floor when I decided to go Registry at that same hospital (more pay working the same hours). I felt that being registry and floating to different areas of the hospital took me out of my comfort zone. I felt very well rounded and prepared for anything. I never felt looked down upon by the other staff nurses.

[dreamlandeals]

Are there any registry nurses who feel they stick out like a "sore thumb" in the hospital? You will feel better when you read this article:

Many staff nurses look at the registry nurse as some kind of second-class, poorly trained, third cousin to the staff nurse. This myth, in most cases, cannot be further from the truth. I have seen very competent registry nurses given lousy assignments by the charge nurse under the misguided belief that registry nurses aren't "real" nurses, or are less skilled than the hospital's own staff nurses. Are there bad or poorly trained registry nurses? Of course, just as there are bad or poorly trained staff nurses. Sure, the staffer will be more familiar with that particular hospital's protocols. But just because a nurse has chosen to practice nursing through a registry should not lead anyone, let alone another nursing professional, to believe that this nurse is any less committed to quality patient care than the nurse who has chosen to practice in the hospital setting. Our profession suffers from enough outside detractors--we do not need to join the fray as well.

Several years ago I was working, through the registry, at a local Los Angeles hospital. I got called down to the ED from the NICU to start a particularly difficult IV on an infant, when the baby's mother objected to my performing the procedure. She had realized that I was not one of the regular staff RN's, since I wore my registry I.D. rather then the standard hospital I.D. The head nurse apologized to me for calling me away from my patients and sent me back to the unit. Perhaps if the head nurse had explained that the reason the ED nurses had called me down was because they knew I could start an IV in the most difficult of cases and they wanted to avoid repeatedly sticking her child--perhaps then, the mother may have let me perform the procedure. Or maybe not. But at least she would have made her decision based on facts, rather then the mistaken belief that registry nurses are somehow less skilled than staff nurses.

What draws one nurse to the hospital setting and another to the registry are different challenges.

Some of the reasons that a nurse may choose to work for a registry or travel agency are:

* Not to have to deal with the hospital politics

So many nurses are driven out of bedside nursing because of the hospital/nursing politics of a particular institution. When a nurse works through the registry, she usually shields herself from the day-to-day politics since she is there on a temporary assignment. She doesn't need to invest emotionally in interoffice concerns. Consequently, registry nurses may be less likely to suffer from burnout than staff nurses.

* Have more direct control over their work schedule

Working the registry usually allows the nurse to have greater control over her work schedule. She can stipulate the days and shifts she is willing to work, and when she is not. Most registry managers recognize this as one of the satisfaction indicators for their nurses and they usually do their best to accommodate requests. However, when the need arises, they call their list of available nurses to see if one wants to pick up an additional shift. When this happens, the nurse has the right to refuse without suffering consequences. Furthermore, the nurse can often negotiate higher pay for the assignment or other bonuses.

* To make extra money

There is no question that registry and travelers generally make more money per hour then the permanent nursing staff. This is the case in most professions where a "substitute" for the employee is called in. Is it fair? Perhaps on the surface it appears unfair, but one must keep in perspective that a registry nurse only gets paid for the shifts that are worked. There can be, and often are, long dry spells when the registry nurse receives no assignments. Though many agencies offer perks similar to those offered by the hospital, such as health/dental insurance and 401K plans, these are only offered and maintained if the nurse works a set amount of hours per month or quarter. Though hospital-based nurses often face a similar challenge, it usually only effects part-timers. Generally, the full-time hospital-based nurse does not have to worry that their benefits will stop just because the hospital did not schedule them for some shifts.

* To travel to interesting cities or countries

One of the greatest attractions of working registry is being able to pretty much pick and choose the state or country where you want to work, and, in many cases, even select the hospital. Most registry and travel agency nurses have a great support system in place that can help a nurse secure a license for the state, as well as housing and transportation. Recently, an Australian registry held recruitment events in at least three major American cities to encourage US nurses to sign on to a one or two-year contract to work in Australian hospitals.

I know a Canadian nurse who works with a US traveler agency that puts her to work three months of the year. So far she has worked in Arizona, New Mexico, Southern California, and Florida. She loves "vacationing" this way with her husband, who is retired, and she explores the US, while making a little extra income.

* To work in certain hospitals

Another plus is that registry nurses can often stipulate the hospitals where they prefer to work, and avoid those that are not welcoming of registry nurses.

Hospitals sometimes put in place policies that are not registry friendly. These policies are meant to provide patient safety and to protect the hospital. However, they are often unwieldy and may result in placing the patient in harm's way. For example, one hospital in the San Gabriel Valley recently implemented a code system to access the high acuity areas of the hospital. A computer-generated access code and an individual code was issued to each hospital employee. However, the registry nurses were prohibited from receiving an access code, even a temporary code, with the reasoning that since the registry nurse was not a hospital employee, they could not be trusted with such sensitive information. Meanwhile, that same nurse who could not be trusted with a simple door access code in order to return to the unit after having used the restroom (which were located outside the unit) was entrusted with critically ill patients in NICU.

Another common misconception is that registry nurses are at heart troublemakers and could not "make it" in the hospital setting. As with any situation that involves people, this misconception could have some truth to it. On the other hand, many registry nurses know the very real threat of being made a DNS --Do Not Send. The DNS is the blacklist of the nursing world. Most hospitals have no criteria for placing a registry/travel nurse on their DNS list. Since there is often very little practice-based criteria used to place a registry nurse on the list, many registry nurses try to keep a low profile at some hospitals.

If you think the DNS list is just a myth, ask your staffing office. Most, if not all, will confirm that such a list exists. The original intent was to serve as a type of historical "gatekeeper" so that truly bad or incompetent nurses are not allowed to return, which is definitely a wise thing for a hospital to do. However, in some situations, little to no criteria is in place that decides when a registry nurse is placed on the DNS list.Often, it is not because of poor or dangerous nursing practice, but due to a more arbitrary reason.

However, some hospitals cultivate a work environment that is welcoming to the registry/traveler nurse. The staff nurses, in turn, are generally respectful of the registry nurse's skills and treat her as a member of the regular nursing team. Creating this environment ultimately benefits the hospital and the patient.

In a perfect world, nurses don't call in sick, go on leave or vacation, or miss any days of work. However, we all know how imperfect our world is, and the registry nurse serves a very real purpose. The other choice is to work even more short staffed, or require nurses to come in sick, or pull double shifts, which increases the burnout rate. The next time a registry/traveler nurse is assigned to your unit, be grateful she is there, sharing the workload.

Also keep in mind that this nurse is an RN in your state, who passed the same or equivalent tests as you, and has a diploma, associate, or BSN. Try not to pass judgement on the reasons why the registry nurse has chosen to practice through the registry. Be happy that there exists a pool of nurses who don't mind being the substitute nurse when we need them to be. And, remember, how can we expect those from outside of nursing to respect us, if we cannot ourselves show respect to our fellow nurses.

great info

[dreamlandeals]

How to be part of team

[judonurse]

guess what,apart from the 12 hrs you work you are not part of the team... and all the staff nurses know it , embrace this ,its one of the blessings of registry and agency nursing. ive found that if i am pleasent and do the job im treated well . dont expect alot of pats and help ,you arent going to get it .

[NurseyTonyaLPN]

Hmmm, maybe it's just me but I feel wanted and appreciated when I go into a facility. They are happy to see me because they're shortstaffed and I've often been called at the last minute to fill in and they know I'm making their job easier. I always come on time when scheduled and I've had nurses make comments that it's nice having an agency person come in on time because so few do. I'm thinking WTH? Why would someone not be on time just b/c they're agency? But I've seen it when other agency people come behind me 30 + minutes late. I feel like I'm part of the group, the nurses are usually very nice to me and helpful. I love doing agency work. I feel like I'm getting paid well, get a variety of experiences, and my agency offers 60% instant pay after you do a job, gotta love that.

[gooch951]

Any feedback for agency called Just in Time staffing? i have an interview tomorrow here in corona. Any insight is well appreciated!

[buildingmyfaith57]

I was a staff nurse on a MED/SURG floor when I decided to go Registry at that same hospital (more pay working the same hours). I felt that being registry and floating to different areas of the hospital took me out of my comfort zone. I felt very well rounded and prepared for anything. I never felt looked down upon by the other staff nurses.

im not a nurse but i was a cna. when i worked for the agency i was look down by the regular staff. there were some positive staff with me and there was those who couldn't stand me, told lies about me and gotten away with it. plus they've gotten me fired. i really enjoy working for the agency.