Bottomed out, BSN, RN 4,602 Views
Joined Jan 29, '12.
Posts: 239 (24% Liked)
I'm working in the LA area and have fellow nurses who are licensed CRNP's still working at bedside nurses in the ICU because they don't like the idea of the huge pay cut they'll take when they take their practitioner job. The medical groups you'll join up with don't care how well your nurses union got you paid as a bedside nurse, it's a whole different ballgame as a salaried CRNP.
Also I know there are a lot of California nurses talking about how they have got great pay in California but I should shed some perspective on that for you. I've lived in The San Fran and the LA area in the past year, you need to earn $130,000 to $150,000 to live somewhat comfortably there with the outrageous cost of living. In the SF area you need $1 million dollars (literally) to buy a crappy 1000 sq foot 3 bedroom home that needs updating. In SoCal you'll need around $500,000 to $600,000 in a cheaper/higher crime neighborhood but your pay is significantly less in SoCal as well.
I've lived and worked from New York/Connecticut down to Atlanta to Tennessee to Texas then all down the coast of California. I love California but don't let these high pay numbers fool you. A nurse making $90,000 a year in 85% of America is probably actually having a better and more luxurious lifestyle than a nurse making $130,000 in many places in California.
I think we may have worked at the same place! Call the company that sent you there. Review the contract and if you have no penalty for leaving, give a notice and get out the door. I've gotten a call 5 times about an interim position for an ADON position. They told me up front they expect the ADON to work the floor and do the rest of her duties. It's no wonder they can't keep staff.
Yup, I don't think I would take another assignment at that hospital or Agency A.
I'd keep moving forward with the second company. If a hospital and agency cancelled me on the fly like this I would not look back.
Screw that. LBMMC recently had a EMR conversion right? The hospital should had been upfront about things and they were not. It is not as if the contract issue between the Union nurses and Hospital happened within the last two months. These things take many many months of negotiations. Hospital knew things had soured and used the EMR conversion as a coverup to the real back story.
Since you have strong feelings about the messiness that is occurring I would say follow your gut and bow out.
I got my last paycheck because I called in sick till payday then I sent my recruiter an email and like you said kristinetdb...I changed my numbers and have been very happy since. I have me a FT job in Dallas and I am making twice the money I was making with the travel agency...it was a rip off...I was making like 20 bucks/hr because they were paying for my housing...it just wan't worth it to me...Plus I did have a true emergency at home, so once I came to take care of it..I decided not to go back to misery...I haven't heard not one word from them since I sent them the email explaining that I would not be returning...
I just quit my contract with 7 weeks left on it...I was miserable and my son was at home not with me on assignment and he was starting to rebel agaist his uncle...who he was at home with...I was getting floated everyday and sometimes twice a day...I just hated it and I couldn't take it anymore...so we'll see what the say but it doesn't matter...I'm not going back!!
HealthSource Global always has a bunch of strikes. I've worked with them before with no complaints although they were recently acquired by AMN so for that reason alone, a lot of nurses will bash them.
I felt like the Nurse/MD relationship was about 25 years in the past when I worked in Texas.
I actually had a critical care pulmonologist blow up on me because I didn't obtain consent forms filled out and signed by a vented patients family for a procedure. He showed up randomly expecting me to have explained the procedure, got the consents and set up the bronchoscopy cart and be prepared to assist him for the procedure. All of this with out even an order placed in the chart to do a Bronch!
There was another MD who would walk up to the station, bark which nurse had X patient then he would summon you with two fingers to signal you were to follow him to the patients room. When you'd get there he wouldn't address you or ask you anything, he just wanted you there in case he needed something while he was in the room.
Other MD's did the typical thing where they expected you to give up your chair or workstation. The nurses would make a point of making coffee for the MD's and doting on them like it was 1972.
I was expected to write orders for the MDs or act as their scribe very often. They knew I was from out of state because I refused to do this and would constantly be saying "Joint commission standard is ...." and "In non third world countries usually hospitals don't....."
I really enjoyed Texas as a state but not to practice as a nurse.
I thought maybe it would be different as advanced practice but I was wrong. A cardiologist was doing a TEE on my patient one day and he requested his personal team of nurses from his special procedure dept to come up and just be there for him. Not to mention this is the ICU where the ICU nurse is the assistant for procedures, so I had to be there as well. Not to mention the ultrasound technician who operated the machine because he didn't want to do it. To top it off he wanted a CRNA to come up and push the 50mcg of Fentanyl and 2mg Versed even though ICU nurse are totally capable to do conscious sedation and we push much more than that all day. The CRNA was insulted and pissed and the cardiologist demanded his presence and then ignored him pretty much.
I hoped it was just my hospital but many other travel nurses have made this same observation in Texas.
Have you ever been required to ambulate (perhaps with a PT or PTA) that weighed more than 400?
Also, why so many patients of this weight? I do understand that they must have some serious comorbitities so my question is not so much why hospitalization as why this population is concentrated in your catchment area? Without Googling demographics, I'd bet there cannot be more than a dozen Americans that weigh 600 pounds or more. Mind boggling possibilities though!
I would try plan C or plan D. In other words, I would not choose either of the options you suggest. I would not do the online program because of the reasons you gave. I would find a better way to fund the education. Perhaps just take a few classes on a part time basis while you work to earn the money to support yourself and your child. Look for a job with tuition reimbursement to pay for most of the part time classes. If part time is not allowed at Georgetown, then go somewhere else ... or just work a little extra and save up some money for a few years -- money that you can use for school when you are in a better position to go.
But I would not go that deeply into debt for an FNP.
You do not need to work back home in order to maintain your home state as your Tax Home. If need be, you just need to prove that you do live there (like paying rent), and you probably get your main mail sent there.
Whether you paid a friend $250/mth rent, or a total stranger, the IRS will not ask you who you rented from and what you paid. I know travelers who will stay with family for free on assignment while pocketing the housing stipend, and there is nothing illegal about it. The housing stipend is a part of your pay and you are entitled to it, no matter what you do with it.
I am not a NICU nurse, but I have worked at Duke in Durham, NC. They also have a Duke Hospital in Raleigh. While I didn't like the snobby attitude of the HR dept during my orientation, the staff and the hospital are wonderful. It is a great place to work. I would recommend it. It is also an affordable city. Not too crowded. You can have city living, and if you like the mountains or the beach, they are barely 2 hours away. I haven't worked in SF, but they of course have a lot of wonderful hospital to work for. I have been to SF and it is jammed packed with plenty to do, but very expensive to live. If you have friends you could stay with, all the better.
While you don't want to cheat the government, I think you do not have to worry about being audited unless something looks odd on your tax forms. I fill out my forms like I always did. You do not have to divide your pay on the form (like hourly pay, housing stipend, etc..), just report it as it comes on your W-2 form. And nowhere on the tax form does it ask for a tax home location.
Best of luck. Travel nursing can be a lot of fun.
Not me personally, but I work with several PAs who were once nurses. They wanted to first assist in procedure and work with surgeons. (Our facility does not use nurse first assistants, even if they're NPs) They do not regret any loss of autonomy and manage the day to day care of our most complex cardiac patients.
I'm still on the fence. There may come a time that I will want to be independent. Overall, I can see the draw on both sides. The PAs I know state that they also preferred the emphasis on the medical model versus the nursing model. This seems to be an important factor in their level of satisfaction.
Come clean, is this a student assignment?
My vote is for Clinic 2. It just sounds like a much better deal all around. Plus FQHC means you can apply for loan repayment.
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