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CrazyGoonRN 10,661 Views

Joined Aug 14, '09. Posts: 430 (30% Liked) Likes: 342

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  • Feb 18

    Sounds like you are considering a career move to the wild and wacky world of travel nursing.

    I retired from State service a while back and went into traveling with my big, dumb smile and my eyes shut. You would think I would know better after being an RN over 35 years at the time. Anyway, here's to your queries and see my update at the end.

    -How close is housing to the job site usually?
    My first assignment was right over the line from Washington, D.C. in Virginia. I let the company get my housing when they promised an extended stay hotel. That's what I got: an extended stay hotel, at Dulles Airport. Where all the construction workers stay. If you don't know about D.C., Dulles International is 1 1/2 hours away, on toll roads. It took me almost 2 hours to get home because of Washington gridlock. And I still had to pay tolls !

    -Does furnished really mean furnished? Or is it just partially furnished?
    My extended stay was about 300 square feet, nice sized bed and little kitchenette. Not bad, really. Maid service weekly.

    -Is housing usually decent, clean, and in an ok area?
    It was decent and the area was OK. BUT, the dozens of construction workers came in on Fridays with, literally, truckloads of beer. They partied hardy until Sunday. At least three times I had a guy pound on my door at 5:00 AM to get someone up that was NEXT to my room.

    -Do you usually have the opportunity to extend the length of the job, or is that rare?
    I wasn't even consulted on my first assignment. My 13 weeks were up and the office wouldn't return my calls. I just kept going to work every day. I figured if they quit paying me, it was time to go home.
    Quick Aside about pay: I didn't get paid for the first 6 weeks of my first assignment. I just thought that was how it worked (IT ISN'T).

    -Do you bring your car? If not, do you lease or how do you get around?
    I drove to D.C. from Tennessee and then put over 1000 miles per week on it just getting to and from work.

    All righty, then. Let's go back and see how our wayfaring nurse is doing.

    HOUSING - I found out the agency was paying $1500 / month for my little hidey hole in the woods. I have always been able to find furnished places, most with really nice stuff (better that I have at home!). I went on Craig's List (a gold mine for travelling nurses) and found a 700 sq. ft. basement apartment, one bedroom, bath, kitchen huge living area. Full cable, internet and all utilities included. Best part: it was 5 minutes from work ! I didn't even have to get on any major highways. The all inclusive rent was $1200 / month with the other $300 going in my pocket. This is how I have done it ever since. As soon as I get confirmation on an assignment, I hit the nearest C.L. and start home hunting. In Texas I had a great one bedroom, first floor apartment, huge front yard, with a garage for $600 / month, all inclusive, 10 minutes to work. Once I had to stay in a hotel in Podunk, Kentucky and thought I was going to die ! I work nights and they don't clean rooms at that time. I had maid service about every 3 weeks and had to do my own garbage. The food was left over Korean war surplus, I think. I did use one of their fried eggs to patch a tire one Saturday, though.
    I am currently working Psychiatric Crisis E.R. in Milwaukee. I rented a basement in the home of a retired hair dresser: one bedroom, bath, kitchen, living room, $600 / month, all inclusive, 10 minutes to work, very well furnished with antiques and art pieces. Bathroom was just completely redone.
    My method is usually to let my agency get a hotel for the first few days so I can find my way around and get a better idea of the neighborhoods. Then I get "The List" and find me a place. Only 2 of my temporary homes didn't have security systems.

    EXTENDING - If you and your Employer/Manager, etc. feel it's a good fit, there are almost always opportunities to extend. The only place I didn't get a offer was a big psych unit in Nebraska that down-sized and hired new nurses while I was there. And, who got to train the new nurses ? ME !!!!

    The car thing is personal. The furthest I have traveled was North Platte, Nebraska, just South of the South Dakota border. It took two full days of driving to get there. I really love to travel by car and explore along the way so I like it a lot. Depends on your own viewpoint. My travel vehicle is a 2003 Toyota Camry that has never failed me. I ride a motorcycle also and trailer it with me. All that being said, when I was on a job in Kentucky, a nurse from another agency was there from Mississippi and her agency rented her a new car. She could drive it the whole time and even drove it home twice. I have also worked with nurses who negotiated into their contract that they could fly home one weekend per month at company expense.

    -Anything else I should know? -
    Yes. Lots and lots and lots. This forum is excellent. There is a website called Gypsy you want to check out, too. Keep reading, asking questions and give it your best shot. Even if you only do one assignment, it will definitely be in your story book when you retire.

    Remember, as Steven Wright said,
    It's a small world. But I wouldn't want to paint it.

  • Feb 18

    Travel nurses please share your stories.

  • Jan 31

    I know I've asked some really, really stupid questions in my day. Right now, though, none of them come to mind. The stupidest question I can think of right now was asked by a married father of three who was an intern years and years ago. I was working Med/Surg as an RN, and had 30 patients with an LPN and an NA. The intern came by the room where the NA and I were struggling to clean up poop on an obese, elderly gentleman who had been rolling in and fingerpainting with the stuff. The intern told me that I needed to put a catheter in Mrs. P "STAT" so he could look at the urine under a microscope. This being before the age of customer service, I (probably not so politely) told him that I was busy, and if he needed it stat he could do it himself. He nodded and disappeared for long enough for us to finish cleaning up that gentleman and move on. The NA and I again had our hands full with an incontinent patient when the intern popped his head into the room saying he had a question. I anticipated something like "what do I hook the catheter to" or "where are the specimen labels?" but it was nothing like that.

    "There are THREE holes down there," he told me. "Which one does it go in?"

    The NA told me later that my jaw dropped and my mouth was hanging open. The only response I could come up with is "HOW long have you been married?"

    The NA was the one who drew him the picture, labeling the three holes "poop" "pee" and "baby."

  • Jan 22

    Answered the phone in Peds ICU late one night and man wanted to know if he could come visit the patients dressed as a well-know local mascot of an amusement park about 100 miles from the hospital.

    Told him no- he would need to arrange through PR, go through a background check etc- that we don't just let anyone onto our unit.

    Two hours later (about midnight) HE SHOWS UP dressed as this mascot. We turn him away and make sure security accompanies him out of the building. We are collectively shaking our heads at the desk when a patient's mom walks past and hears us discussing the strangeness of this situation.

    Turns out- he was stalking her, she had a protective order against him!

  • Jan 22

    Quote from AcuteHD
    Had a lady call me asking if we do fresenius dialysis, when I told her we are not afiliated with fresenius she asked, "well, what kind of dialysis do you do there?" I guess I could've explained that fresenius is a company and the different modalities of dialysis, but I didn't...I refered her to an outpatient clinic (not fresenius either). I guess I'm bad.
    Forgive me for picking this bone, but I'm bummed that you didn't take the time to at least go into the basics. This wasn't a strange call at all. Many people that are newer to dialysis don't realize they have choices in companies and types of dialysis. I've had patients devastated by the news they had to get dialysis because they've mistakenly assumed they'd have to give their lives up because of the 3x weekly 4 hour commitment they now would need to make.

    I'm not saying this to call you out or be cross. I'm saying it more so that the next time you get a confused individual, you might take the opportunity to guide them just a little, even if to say, that is a company, not a type, and by the way, outpatient dialysis offers a couple of choices/types. No sense in going into way too much detail since you're inpatient (I'm guessing by your SN), but at least help her get her head on straight so she wouldn't be so confused when she calls the next place.

  • Nov 21 '16

    Quote from Buyer beware
    So the crew was unhappy about the election and that Trump was elected. So I take it from the majority of posters so far that that was a bad thing?
    that's the wrong take on it. the staff could be as happy or unhappy as they like about the political situation but all that should be discussed in front of a patient being readied for surgery was the patient, or the surgery. It was pre-op not a cocktail party.

  • Nov 21 '16

    The day after the election I had minor surgery. During the preparatory phase, the crew began to negatively discuss the presidential election, specifically their unhappiness with the president elect.

    I said "Are you really going to talk about Trump?", in disbelief.

    Thankfully, they shut the ---- up.

    I think I'll mention this on the feedback survey. I thought it inappropriate. The patient shouldn't have to correct professionals in this way.

  • Oct 5 '16

    What a nurse has available to sedate/wean with is entirely up to the physicians. Each hospital/physician has their own protocols and "comfort levels" if you will for what they do with patients needing sedation. Can a nurse ask for certain medications to assist with weaning or increased sedation? Of course! Does that mean it will just be handed to them if the physician is not accustomed to ordering those things? Consider for a moment that one might not fully understand the situation as explained and therefore doesn't have all the answers or the moral high ground.

    Take the title of the thread for what (I assume) is it's intent: a little dark humor after a crappy, busy day.

    We all know how ugly it can get when a patient has an undesirable outcome and lawyers get involved. No need to hash it out.

  • Oct 5 '16

    Do I agree that fentanyl is an analgesic and not a sedative? Yes. Do I stick to my physician orders of ramsey of 2-3 and make sure my pts are not in any distress and titrate when needed? Yes. Do I wean my pts off of sedation when it is time for weaning parameters and always continue to assess? Yes. I think BOTH the nurse and patient had a bad day and I dont think that you have to be so harsh when another fellow nurse is venting about a bad day. If you feel there could have been more done then say so, just do it tactfully.

  • Oct 5 '16

    Well we are trying to wean her off the vent so she doesn't end up with a trach. I can't keep going up on the fent or she won't initiate her own breaths. And that was the first time she bit her tube. I don't routinely tell my patient they are going to die. I was doing everything I could to keep my patient alive.

  • Oct 5 '16

    Quote from elizabeth321
    oh my god....if I am ever tubed I pray to whoever is listening to sedate me is a skill! When someone is delerious they can't be "reasoned" with and bringing up the "your gonna die" card is really cruel.
    I don't think this nurse purposefully tried to be cruel or not fully sedate her pt. It sounded like a very busy busy day, and it was unfortunate that this pt had to code bc of biting her ETT. And I do agree that pts do not always know what they are doing when they are on diprivan,fentanyl, or versed. Should sedation have been titrated up, yes, but I dont think this nurse knew about it until it happend, like I said a code and an emergency intubation can cause you to be busy. Hindsight is always 20/20.

  • Oct 5 '16

    One way or the other.....they WILL stop chomping on that ETT.

  • Oct 5 '16

    Quote from CCRNdude
    Out of curiosity, why do you guys/gals think so many hospitals pay ICU and ER nurses a critical care differential?
    One hospital that I work for pays us a whopping $2.00/hr critical care differential, which comes out to an extra 4k/year. My per diem gig pays staff pays critical care nurses (ICU, ER, and PACU) an extra 7k/year. Progressive care is paid a slightly lower differential, and med/surg and tele do not receive differentials at all. I'm not saying it's right, but that's just the way it is.

    I like Harveyslake's analogy in a prior post that compares the worth of a smart phone vs a simple cell phone and a short order cook vs a gourmet chef. I think it's spot on. I've had nights in ICU where I've been busier than I ever was working on the floor. The stress that comes along with helping other units with rapid response, being the hospital's IV start team, and cleaning up the rest of the hospital's mess makes working the floor not so bad. From my experience, taking care of 5 patients in no way compares to the stress of having multiple family members breathing down your neck while taking care of their family member who is maxed out on 5 pressors and is barely hanging on by a thread. There's just no comparison.

    Then again, where I live we have patient ratios where med/surg tops out at 5, tele 4, PCU 3, and ICU 2. If you live in a state that gives you 8 patients then I suggest you move or change specialties because that sounds like horrid working conditions.

  • Oct 5 '16

    I just enjoy debate for the sake of debating. I honestly don't care either way. I don't mean to offend anyone. I'll be the first to say that med/surg is hard work. However, we're all entitled to an opinion. To the individual who asked if ICU housekeepers deserve more pay, I would have to respond by saying...touche. Additional training and certifications are not required by ICU housekeepers though, so I would say no. ICU housekeepers do not deserve more pay.

    One thing I would like to poing out is that intensivists earn a higher salary than internists. Sadly, I think that your post reticently illustrates exactly how administration views both nursing and housekeeping: as an expense that can be cut.

    Here is my rebuttal to all of your comments:

    1) Who would come to the critical care section of a forum (an area of the site that critical care nurses obviously frequent) and expect critical care nurses to not state that they should get more pay? I'm sure if we went to the corrections/prison section of this website and asked them if they deserved to get paid more, they would more than likely say yes. I'm sure plenty of med/surg nurses feel that they're entitled to more pay, which I think is reasonable. If we asked ED nurses if they deserved to be paid more than ICU and med/surg nurses, the ED nurses that I know would respond with a resounding "YES!!"

    2) I never implied that med/surg nurses weren't with their patients 24/7. Pointing out that med/surg nurses are with their patients 24/7 is pretty much stating the obvious.

    3) There are obviously a lot of different variables that affect profit and loss. At my hospital, ICU does bring in quite a bit of revenue. Likely because our boss rides us about not being wasteful with resources. Also, our physicians do a good job of justifying ICU level of care to medicare, transferring patients to subacute rehabs ASAP, downgrading asap and/or convincing the family that palliative care is the best option. No family? Ethics consult is put in QUICK to evaluate quality of life. Our intensivist pay is affected by our unit's revenue. No revenue? No bonus.

    4) If a patient's crashing, who does the med/surg nurse call for a higher level of care? Me. The ICU/RRT nurse to evaluate and see if the patient meets ICU criteria. Patient needs an IV and nobody else can get it? Call ICU. Patient's about to code? Call ICU. Patient codes? We need ICU. Patient is VIP and the family is too high maintenance? Put them in the ICU.

    5) I've worked med/surg. It's hard work that requires good time management and a lot of patience. I'm glad there are nurses that enjoy it. I got burned out by it, so I went from med/surg--> tele--> intermediate care --> ICU. It's not like I've only worked ICU and I'm claiming that ICU nurses should get paid more. The floors are very stressful. While I'm not as physically exhausted working in ICU, the stress is at a different level since there are different stressors, in my opinion.

    Out of curiosity, why do you guys/gals think so many hospitals pay ICU and ER nurses a critical care differential?

  • Oct 5 '16

    I think they should. We respond to codes, Rapid Response Team's, Stroke Alerts, Trauma Alerts, etc in my hospital. Also there is no busier unit in the hospital than our ICU. We are required to do more education than everybody and we are required to hold more certifications than everybody and can take any type of patient. For these reasons I think we should.