[IluvMyPtsPeriod]

Hi! My name is Donna. I am an R.N. and currently I work as an agency nurse. Because of the shortages EVERYWHERE I have been lucky enough to pretty much choose my hours, floors, days and more...That is the good side of supplemental staffing. I love rehab. It is truly my favorite area of nursing. I also love working with people in the last chapters of their lives.
As an agency nurse of about 4 years, I have experienced so many different scenarios with regard to staffing. I have worked in hospitals, and been given the worst assignment on the floor. Worst = most acute, farthest from the nurses station, supplies, omni, and so forth. I have been shunned by staff nurses, verbally abused by staff nurses. I have had staff nurses assume that because I am an agency nurse I am an idiot. Funny story...one time I walked onto a unit, and the staff nurse I was to recieve report from was very rude, and condescending. When she asked me if I knew how to give insulin I couldn't contain my "Irish". I said....."ok....I am sorry if you were anticipating an idiot nurse. I am not. Let's start over...Good afternoon my name is Donna...I am a Registered Nurse!!" Recently I had the most unpleasant experience of having to write a written formal complaint about a night shift supervisor whom I had the displeasure of recieving report from for the last 5 months or so. She has treated me with contempt, rudeness, and simple immaturity. Let me tell you this.....I do not understand these staff nurses. It seems rather simple: if agency nurses were not showing up, they would have the work to do. I don't want anyone to kiss my ring...I just want to work in an environment where ALL nurses remember the most fundemental of all truth's in nursing.....IT IS NOT ABOUT US..IT IS ABOUT OUR PATIENTS!!. I don't care how much you make per hour. I care about whether or not you care enough about our patients to give me a thorough report, do you work, and work with me for the best possible outcomes for our patients no matter how little help we have!!
Thankfully I have had more positive experiences as an agency nurse than negative... I just wish that ALL nurses would realize this.....agency nurses work for agencies because it works for their personal lives. Yes the pay is better....hourly anyway. But when I want to take a vacation...I have to work 60-70 hours a week for the months preceeding to ensure I have a paycheck when I get home in addition to spending money etc... I only get partial healthcare benefits, and that is if I work 40 hours/week only. I do not get paid when I am sick...I have no 401k, and so on... It is simply a matter of me being able to stay home, and homeschool my little girl with learning dissabilities, see my son every now and then, and keep my home in shape.
As an agency nurse, I go into a facility/hospital with one focus...Optimal Patient Safety, and care. As an agency nurse, my antennae are always on alert, because I am in a new environment, and I don't know patients...As an agency nurse I find more med errors, transcription errors, documentation errors, and oversights by staff nurses because I have not settled in, or succumbed to the "routine". I have been told many times by my patients and their families "You have helped me more than any one else in this place...because you listened, and you followed through" That is the bottom line for me...I can go home and know that though I may never see that patient, I have cared for them as if they were my own familily member. Agency nursing is not for every nurse.... It works for me & my family. Nurses are in crisis everywhere, mainly due to staffing problems. I am tired of the words "have to rely on agency nurses who don't know the patients, policies, yaddy yaddy ya!!!" As I said with 4 years of agency nursing under my belt I can assure you that every LTC facility has relatively the same med books, treatment books, bowel books, INSULIN syringes, I & O records, staffing shortages, Medicare / medicaid charting guidelines, and so on... As far as not knowing the patients...in the hospital turn over is so high now that nurses on med/surg, post-op floors and such know the patients sometimes as little as I do. If you are a staff nurse...and you are truly concerned for your patients because you have an agency nurse coming in please do the following: Treat him/her with respect & hospitality (as you would a visitor to your home). Show the where to place their personal belongings, give a short tour of the floor or facility (clean/soiled utility, omni, treatment closets, supply closets, staff bathrooms, break room, patient rooms ex: your assigment starts here), Give a detailed report about illness, dx etc...but also specify orientation, crush vs. whole, any behav. issues., Point out who will be a finger stick on that shift in order to maintain compliance, and be sure the nurse knows where the glucometer is. Believe it or not....that is one thing that is different almost everywhere I go!! If your fingersticks are in the treatment book, mention this. Often times treatments are not done until mid-late shift...not knowing the fingersticks are in the treatment book can lead to non-compliance and risk for the patient. Be sure the agency nurse knows who the supervisor is... Believe it or not.....one night I was working in a hospital med/surg floor. It was 10:15pm. I was suppose to be off at 11:00pm Word came up that there was going to be an admission...strait from the street (not through the E.R.) For one reason or another the night shift supervisor was already on the floor...I heard her say to the 3-11 shift supervisor...."give the admission to the agency nurse you got on...she is making all the bucks!" So much for keeping it "all about the patient". I was assigned the admission...and you know what? That man went to sleep knowing that he was in a safe place, being cared for by professionals, and that his health was important to the staff at that hospital! He didn't know that I would have liked to poked the night shift supervisor in the nose...he didn't need to know that I was an agency nurse...He only needed to be taken care of... Please....Agency nurses are you friends!! Let's work together....Don't assume what you don't know!!
Donna
P.S. I noticed that there is not a forum for agency nurses on ALLNURSES.com HHHmmmmm!!!

[mustangsheba]

Donna: I am an agency nurse also. You spoke eloquently for us all. I have had a few bad experiences, but as you noted, most have been good. I do have the luxury of refusing to return to a facility if they are exceptionally abusive. I can - and have - refused to take additional patients when the numbers or acuity become unsafe. Surprisingly, the staff nurses back me up. I am in school and agency nursing is the only thing that works for me. I wish I had had this option when my daughter was little. Enjoy your babies - they are small for only a heartbeat.

[jamistlc]

Greetings All Nurses,


I am a Agency Nurse also not so much by choice as a need to work! I do like not having to put up with the politics a staff nurse has to endure and the clients who are resentful for being in a state of unwellness! I would in a heart beat give it up though to work where my heart and passion lyes! OB/GYN, L&D, P.P., Well Baby Nursery, or NICU. But I have two strikes against me for those positions, I am a male and a LPN. I can change one of those facts and am working on my ADN to that end. I do not like the areas LPN's are utilized mostly Geriatrics, I am not that patient. But when I work at these institutions as a agency nurse I can give it my all plus 10%, why becuase I may or may not be coming back and I am like a visitor in a way, I can afford to give my patients my best and not have it take it's toll on me. I have found that agency nursing has stopped me from burning out years ago! I look forward to working a shift or two here and there, rather than dreding the some old stuff, day end and day out!

I like seeing positive results of my efforts and that is lacking in Geriatrics, most clients are upset about the state thier health has taken and feel warehoused, rather than a human being with needs. I try to give to fill those unmet needs and do it as best I can. I then leave and do not have all the thoughts in my head about what I could do to make so and so feel better or how to improve the institution. I can leave work at work! I agree I find med errors and ect. all the time. Often because I want to use a PRN from the box have MAR that says it is legit and NO PHYSICIAN ORDERS! This appears to be the norm, no one follows through. As a agency nurse if I want paid I have to do my documenttation, charting, signatures, and Physician orders before I leave. As well as the client care I am suppose to adm.

[Katmease]

Hi. I'm not an agency nurse. I just wanted to thank you guys. It must be a difficult task to walk into a different environment on most every assignment you have.

[IluvMyPtsPeriod]

Glad to work by your side!!

[nurs4kids]

Donna,
Love your attitude. Your post shows you have much class. You made a good point. As irritated as staff nurses are because agency nurses make more $, there is downsides. I, personally, don't do it because I want the comforts of being in a familiar enviroment. You deserve more pay. Thank all of you for being available to help our in a crunch!
Tracy

[P_RN]

Wow you have had some awful experiences. Back in the late 80's our unit had some questionable agency nurses come to us from an out of state agency. I think it was a clique that worked for this particular agency. The same 3 or 4 would either not show up, leave during the shift, etc. In all my years there those are the only undependable Nurses (note NOT just Agency) that I can recall. BTW that agency IS no more!!

Wow "Agency Folks" I want to tell you I appreciate your work.
You were there when we had a call in. You were there when 16 nurses on our unit got called up for Desert Storm! You were there the night our place here in the sunny south had a snowstorm! You made it, some staff didn't. Thank you .

One of you saved a patient's life by recognising a 'funky arrythmia" she heard on a PulseOx ! The patient's nurse was a new graduate and had asked the Agency nurse for help. Thank you .

There is never any excuse for rudeness. We tried to treat our visitors just like the rest of the staff. We did fixed teams, so it was almost impossible to give you the worst patients. If you had Team 1 then you had rooms xxx-yyy.

So Thank You Agency Nurses.

[01Jetta]

Carole,

You're a trip!! You sound like me. I don't have much of a tolerance for idiotic people who make dumb assumptions either.

[debbyed]

Donna,

If you ever come to the Baltimore/Washington area I would love to have you work with me. I am a Clinical Coordinator of an Emergency room and Agency Nurses are usually a God send. They are always welcome and always thanked. We actually have a pretty routine group that come and work with us when we are short. They even look in the schedule book to see when there are holes they can fill.

I was very surprised to learn that these nurses would prefer to work with us even though our nurse/patient ratio seems to be a little higher than usual. The reason they gave was because they are treated like family. I was surprised to learn from them how some places and nurses treat them. I am thrilled to death when an agency nurse can fill a hole. Not only do the patients get the care they deserve, the staff profits as well.

We have a booklet we give to all new agency people which explains important policies and standards of care, It shows a map of the hospital and points out where supplies are. It also covers the important things like where the bathrooms are, the cafateria, and the smoking area. Agency nurses are also given a resource person that they can depend on to answer their question.

It is just unbelievable to me how others can treat you so poorly when you are helping them out of a tight spot.

Keep up the good work and try an pick the places that appriciate you. If some of these facilities suddenly couldn't get any agency nurses, I bet they'd change their tune real fast.

[nurse-lou]

Iluvmyptsperiod,

Please check out the new Agency Nurse forum! It was created for nurses such as yourself who work for an agency that don't travel!

Kelly