Today is my first day with an agency!

  1. I'm really nervous but excited. Start 3-11 on a hospital rehab floor. Have a notebook, colored sticky notes, phone, stethescope,license and cpr card. Am I forgetting anything? Any tips or suggestions appreciated!
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  2. 21 Comments

  3. by   nightingale
    Suggestions:

    Go Early
    Bring your med pocket stuff (sissors (sp?), flashlight, tape, hemastat (sp?), I try to also carry purell, and highlighter)

    Jot down: (I carry a separate 4X6 Binder in my pocket)

    Find out when I/O's are done
    " how report is done and the time you are expected to do this
    Pyxis code (if they use Pyxis)
    Med. Pass times of regulars like Coumadin.
    Find the Important Number List to Call Pharmacy, etc...

    Be a sponge

    Be an Asset

    Have fun and wear your smile!

    B.
  4. by   nightingale
    Did you have a good time.... details please....
  5. by   Nebby Nurse
    Thanks for asking. To tell you the truth it was "OK". I worked 3 days at the same facility on the same Rehab unit. The first day was stressful and the last two I had a routine. Felt like I gave my patients good care. However I am feeling a tad down and don't know if I'm going to go back there. All the regular nurses I worked with with the exception of one were rather unpleasant. The minimum amount of seniority was ten years and the others had been there greater than twenty years. Each of the regulars had their own med cart and I had to float between the two. Even though this is the usual situation I felt like a pain in the butt as I stood ready to pounce as soon as a cart was freed up. Throughout the evening I was heavily scrutinized, my MARs were reviewed frequently, my patients checked and rechecked and my documentation was thoroughly analyzed. The only form of approval I received was from the two NA's who like the nurses have been there since the place was built and encouraged me to return. Now I understand that I am not going to these places to make friends but somehow I expected the nurses to treat me the way my coworkers and I treated the agency nurses who came into my facility: with a little kindness and gratitude for the help. It also meant one less nurse mandated. The last night was great.I worked with two other agency nurses and it went smoothly.

    Now I am plagued with self-doubt. Too insecure and people-pleasing for agency assignments? Or did I just happen upon a place with bitter and resentful nurses that was the exception rather than the norm? Too soon to tell since this has been my first assignment. Again, thanks for your kind encouragement and for giving me this opportunity to talk about it.
  6. by   nightingale
    Nebby:

    First and formost... only you can deside whether it is worth it or not. To be honest... I have run the gambit of reactions. Today I might reflect upon the way I was treated last etc.... I have had moments where I never wanted to step into a new door and other days where I just LOVE having a new experience.

    I do not have a strong opinion to blurt out. For me, agency works well because I LOVE the flexibility; Next big attraction is the money is what we should all be making. I can (and often do) call my agency on Sunday to book for the week (and I work days 7A-7P)... to me that is glorious (been there done that with working days and hours that were not for me).

    In addition, I have worked different areas I never would have otherwise been in; For a while I worked in Corrections and really enjoyed the exposure to that clinic setting. I also became ACLS certified (payed for by my agency). I, for the first time, worked in a cardiac setting because of agency and loved it (never thought I would have)!

    I share all this to show the diversity of agency. I have been fortunate too in never having to deal with "old koots" looking over my shoulder! That stinks! It sounds like it makes them feel "special". Geez... if they have that much free time... why did they hire an agency nurse? lol....

    Do you usually do Rehab. or LTC? I find those two so glum (sorry comrades....)... You may want to tell your agency you are open to new assignments and ask them not to send you there. I always say something really positive like.... "I want new experiences" to keep it on a positive note (not.. those old hags won't leave me alone... lol)....

    The first few hours at a new place are the hardest. Once I get my report and routine under way, I find I can keep up with most of the other nurses if it is an easy layout and the charting is simple to follow.

    I hope you decide to stay with it for a while and give it some time.... Whatever you decide... we are here for ya!

    In peace,
    B.
  7. by   canoehead
    Having dealt with a few travellers who "forget" to do vital signs, or were "too busy" to put the chest pain patient on a cardiac moniter, or to report said pain I keep a close eye on them until they've dealt with a crisis competently, and have taken the initiative to ask some questions. Sounds like you are passing the test as some staff have asked you to come back. Give them another week and I will bet they will ease up. People need to get to know each other a little, and then I bet their carefulness will make them one of your preferred assignments.
  8. by   FHE3
    I have heard horror stories from agency/travel nurses related to their first day on a unit. As a senior manager for a travel company, our nurses at times comment on poor treatment for the first few days. However, generally speaking, it does get better.

    Sadly, the staff nurses tend to feel resentment towards agency and travel nurses. They have a misconception that all agency nurses are bad clinicians and do not care about anything but themselves.

    I recall a particular incident earlier this year in which an outstanding L&D nurse, with a BSN and 3 years L&D exp., was treated horribly by the staff nurses. She was scrutinized every step of her first 7p - 7a shift. In fact, the charge nurse told her that she could tell that our nurse was going to be a "liability to the unit." She was on a 13-week temp to perm test drive of the hospital as she was permanently relocating with her husband to the area.

    They dumped all of the "train wrecks" on her and proceeded to sit at the nurses station reading magazines and chatting while she was busting her rear end taking care of 4 patients (they had none).

    One patient was having a particularly problematic pregnancy.
    The fetal heartrate dropped suddenly and without warning. Our nurse immediately called for help. Begrudgingly, the charge nurse and staff nurse casually strolled in and basically later laid blame at the doorstep of this well-intentioned traveller. The baby was delivered (healthy) shortly thereafter and our nurse was hailed by the attending physician for her excellent patient care under fire. When a doc says, "thank you" it is a story for the newspaper. But, I digress!

    I received a call from the Unit Manager several days later asking to cancel the contract due to our nurse's "inadequate skill sets for the department." Needless to say, our nurse was distraught and a little angry.

    I immediately scheduled a meeting with the L&D Director, the DON and the CNO. I was not going to allow our nurse's reputation be dragged through the mud.

    During the meeting, our nurse spilled the beans on the unit operations during the 7p-7a shift. Her revelations included the charge nurse and staff nurse SLEEPING in vacant patient rooms while our "substandard" nurse treated the patients on the unit (they must have had some confidence in her skills!), the charge nurse making frequent and long lasting personal calls, the staff nurse telling our nurse that she hated working there and wished she had not signed a 1-year contract, etc.

    You should have seen the shock and horror on the CNO's face. It was priceless. The DON was casting glaring looks at the L&D Manager. And the L&D Manager looked like she wanted to crawl under the table and hide. They had lost a great nurse and they all knew it.

    The meeting ended with the CNO and DON apologizing in concert and offered our nurse a new contract - on the same unit! Thankfully, our nurse, in a most professional way, told her what they could do with the contract.

    She is now a charge nurse at another hospital and has been recognized no less than 5 times by patients, doctors and even the hospital Administrator for her outstanding contribution to the facility.

    Staff nurses should take a moment each day to thank God for agency and travel nurses. Without them, they would be overwhelmed and patient care would undoubtedly suffer. If an agency nurse is a poor clinician, so be it. However, the vast majority of agency nurses were once staff nurses that just got tired of all of the politics, personality conflicts and general hospital management BS.

    They are now getting paid what they are worth and at the end of the day, they can just walk away - with a smile - and know that they have made a positive impact on the lives of the patients and families that they have touched.

    God bless agency/travel nurses!!!

    Peace,

    FHE3
  9. by   nightingale
    and Thank YOU for backing up the agency nurse..... BRAVO! Great Story! B.
  10. by   jmspeach
    does anyone have information on an Agency in Minnesota? If so what is the name of it?
  11. by   Nebby Nurse
    Thanks to all for the kind advice and positive support. It's been a few weeks now and thing are going much much better. I have five or six facilities that I choose to work at now and have met many excellent nurses who I enjoy working with and who have bent over backwards to answer questions and point me in the right direction. Sometimes the workload is tremendous but when your working with good staff it makes it a challange rather than a nerve-wracking eight hour torture session. I can't speak for all of you agency nurses but after weeks of self-doubt I am beginning to find a new sense of self-worth and confidence in agency work, something I never experienced as a staff nurse. Until I went agency I got very little positive reinforcement from my employer and felt taken for granted. Now people are glad to see me come! I am actually starting to like nursing again! And being able to schedule my own days is heaven. And by the way, I haven't returned to the first place and its lazy staff. Thanks and good luck to all!
  12. by   nightingale
    Nebby..

    Glad to hear you are enjoying it!
  13. by   FHE3
    Nebby,

    That is awesome! I am happy to hear that you are doing well. I wish you the very best.

    FHE3
    Good things may come to those that wait; but only those things left by those who hustle. - Abraham Lincoln
  14. by   Grace Oz
    DEAR NEBBY,
    G'DAY FROM DOWN UNDER...I WAS SO SORRY TO READ YOUR POST RE YOUR EXPERIENCE WITH YOUR FIRST AGENCY SHIFT. BUT... SO GLAD TO READ THAT ALL IS NOW GOING OK FOR YOU. US AGENCY NURSES ARE EXPOSED TO A WIDE RANGE OF EXPERIENCES, INCLUDING THE BEST & WORST OF HUMAN NATURE!!... WE HAVE THE EXACT SAME PROBLEMS HERE IN AUSTRALIA WITH PEOPLES ATTITUDE TOWARDS AGENCY NURSES. I'VE TAKEN TO REMINDING THE PERMANENT STAFF IN ANY FACILITY / HOSPITAL THAT THEIR WORKLOAD WOULD BE A HELL OF A LOT HEAVIER WITHOUT ME, SO THAY CAN MAKE AN INFORMED CHOICE; EITHER YOU WELCOME ME & TREAT ME AS AN EQUAL, INCLUDE, SUPPORT & ENCOURAGE ME, OR.... I WALK, NOW!!...YOUR CHOICE!... THEY SOON CHANGE THEIR ATTITUDE WHEN THEY REALIZE I'M DEADLY SERIOUS & THEY'VE YET TO GET THROUGH AN 8 HOUR SHIFT!!...FORTUNATELY, THIS DOESN'T HAVE TO HAPPEN TOO OFTEN. MOST PEOPLE ARE REASONABLE & SO GLAD TO HAVE YOU THERE. MAKE SURE YOU KEEP ABREAST OF CURRENT PRACTISES, POLICIES ETC. ALWAYS BE WILLING & CHEERFUL, ARRIVE ON TIME & BRING YOUR SENSE OF SELF & HUMOUR!!... REMEMBER; "DON'T SWEAT THE SMALL STUFF & IT'S ALL SMALL STUFF"!...
    I'VE BEEN DOING AGENCY NURSING FOR 2 YEARS NOW, THIS IS MY SECOND TIME WITH THE AGENCY & I LOVE IT. THE FLEXIBILITY, CHALLENGES, CHANGES OF FACILITY, NEVER GETTING EMBROILLED IN THE POLITICS OF ANY ONE PLACE & THE MONEY'S PRETTY GOOD TOO! YOU LEARN SO MUCH AS AN AGENCY NURSE, EVERY DIFFERENT FACILITY TEACHES YOU SOMETHING NEW & DIVERSE. KEEPS YOU UPDATED & REFRESHED. KEEPS YOU HUMBLE TOO AT TIMES! YOU DON'T GET COMPLACENT OR 'STALE'.
    ENJOY YOUR NURSING & WALK TALL & PROUD AS AN AGENCY NURSE!!... CHEERS FROM OZ.
    GRACE.

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