My travel nursing nightmare

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · May 8, 2010

Shanna, IMHO, talk to your recruiter. If going back to the stone ages makes you that uncomfortable, you shouldn't stay. If a mistake happens, you'll spend the rest of your life wishing you'd got out of a bad situation early. Now you know why they need travelers for staffing.

Traveling requires some adaptation, but if you walk into hostility, nothing you do is going to be right, and nobody is going to warn you in advance. I had some great traveling experiences and some terrible. I'd been charge nurse in a Level 1 ER for 5 years. When a job is bad, just bail. Your agency should appreciate your assesment.

George Millar · May 9, 2010

Couldn't agree more with dthfytr. I've done a fair bit of travelling and have seen some dodgy stuff. But nothing compared to your letter above. You're short term, a band aide of sorts for the hospital. Your are not going to make a change in their system. Talk to your agency, nurses are needed everywhere and you'll find a place that works for you. Best of luck.

highlandlass1592, BSN, RN · May 9, 2010

I have been and L&D nurse for a year and a half at a level one trauma center that delivers over 500 babies a month. Needless to say I have seen A LOT in a short period of time and have become very comfortable with any situation. Due to life changes I moved back home and unable to find a permanent L&D position I decided to try travel nursing for a little while. I'm in the first week of orientation which has been mostly computer stuff, not on the unit and I feel like I've made the hugest mistake. I have been going up to the floor after the main hospital orientation to try to get my bearings on the floor and I am appalled at the conditions. The nurses are so rude and either don't know or won't answer my questions. I have no idea of patient flow, where they come from, how they get to a room, who makes the chart, who becomes the doctor, who becomes the nurse. Not to mention, all of the equipment is different, I don't know how anything works, they use drugs I've never heard of and some that are not backed by evidence-based practice and the computer charting is a nightmare.
I should tell you that my old hospital used a WONDERFUL computer charting system specifically for labor and delivery and I am used to charting EVERYTHING at the bedside down to "patient turned to side" and "chux pad changed". These nurses don't chart anything at the bedside and instead keep notes and stay up to 2 hours after their shift to chart...of course by that point all you can remember is "patient delivered baby" and "no lacerations". I'm used to charting every last detail and being easily able to do so. Their system is so complicated that the nurses just chart everything like a little story in a "notes" option instead of in the places where they are supposed to be.
This hospital also does not have gloves in many of the rooms, you have to go out to get them and the triage rooms don't even have overhead lights, how am I supposed to do my job in the dark? I'm a very clean nurse and I like to keep things tidy and they just have little trash cans in the rooms like an afterthought, they don't even have biohazard trash in many of the rooms. They also treat their patients like crap and do not focus at all on patient CARE, but how could they with all this peripheral crap slowing them down? I'm not used to doing my own AC sticks for labs and I'm not used to requisition forms, these things were previously taken care of by our secretary and phlebotomists unless in a real emergency situation. None of the patients have prenatal care and I'm not used to that and they don't used proper precautions with infectious disease patients.
Let me just say I'm terrified of a bad outcome and getting sued later on, I feel terribly sorry for the patients who are not even given a chance to bond with their babies before they are taken to the nursery, I feel like an idiot who doesn't know how to do anything and the scary part is, I'm wondering if this is normal and what I'm used to was just heavenly? And of course, I'm single all alone in a far away city which doesn't help at all. Oh, and this hospital has a wonderful reputation for being on the cutting edge, its a university hospital. I am shocked and appalled and 13 weeks seems like an eternity right now. Can anybody relate? How do I make them answer my questions and learn how things are done? Any advise is much appreciated!

Gonna warn you about a couple of issues: you can definitely speak with your recruiter but the agency may try to force your hand to get you to stay. They are spending a great deal of money to have you there and would lose money they couldn't recoup if you up and bail. If you have taken company housing, you run the risk of having to repay that money to them and may end up not getting paid at all for the time you've put in. You could always fight it if they hold your last paycheck but it takes time and money.

The crux of the matter is going to be your contract and under what terms you can cancel it. You need to go over this with a fine tooth comb for any penalities they may be able to assess. That is your ticket to getting out of this situation. I'm gonna be honest with you, the contract is NEVER made to support you as the nurse, it's made to support the agency. Hopefully, you've made some changes and got language put in to help you.

I think you bring up an important point about traveling: you have to be flexible in what you're going to deal with. Every hospital has it's own ways of doing things, you're not gonna find it like what you left. In reading your post, that may be hard for you. I know you feel like you left your nursing paradise, but is there nothing positive you can find about the facility? Sometimes you have to look pretty hard. If you feel your nursing license is in jeopardy, that's a different thing. But sometimes, being open to new experiences can really open your eyes to differing care models out there.

I guess what I'm trying to say is it's normal to feel a bit stressed on your first assignment. You are a newer nurse, still getting your bearings. You've learned how to do things one way only....and that brings it own level of stress. It's pretty eye-opening at this stage of your career to have to experience such a drastic change. You're also gonna have to realize house staff may not always be welcoming, you may think you're there to help out staffing issues, they may see you as taking away their overtime. There's also the frequent misconception travel nurses make WAY more than staff...so they may resent you for that. (When you look at bennies and sick time, you actually usually end up making LESS than staff.) Until they get to know you, they may be very reserved. But I guarantee if you stry to stick it out and go in with the attitude that you know more than everyone there and they are doing everything wrong, you're not gonna make any friends. But if you go in with the attitude that you are there to help and are open to learning how they do things, people will usually give you a break. In almost 5 years of traveling, I only had one facility where staff remained openly hostile..and it had more to do with their manager than me.

Travel assignments in some parts of the country are harder to come by than others. If you do decide to leave, please make sure you've got something else lined up. You don't want to be stuck with no money, far from home. If I can help, feel free to email me.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · May 9, 2010

Couldn't agree more with all of the above. The traveling I did had a contract for anyone to break the contract anytime. I guess it comes down to priorities. If I thought I might be risking my license, I'd pay any penalty to protect it.

You have a lot to offer in an atmosphere where people are interested in learning. People who already know everything can't learn anything. People willing to learn would welcome you with open arms and I'd suspect they'd want to extend your contract. Now you've learned some questions to ask your agency before accepting your next assignment.

It occurs to me that if the co-workers on your unit are really that negative, the hospital may cancel your contract anyway. It's a gamble anyway. Try to find a comfort zone.

CaLLaCoDe, BSN, RN · May 9, 2010

I am so sorry for your situation. Sounds grim. The part about late charting and "patient delivered baby" is classic me all around. Timely charting is favorable in all instances!

This sounds like a hospital run to the ground for the big guys on top to peel away the profits.

tablefor9, RN · May 9, 2010

I, too, have had an assignment at what I consider(ed) the armpit of the obstetrical universe. So, man, I know how it can be and how tempting it is to give those cretons the finger and keep trucking...

However...you signed a contract, and there will be consequences in most instances, for breaking it.

And, not to be ugly, so take this in the spirit in which it's intended, but...

hospitals that are doing great don't hire travelers. I *always* *always* *always* ask 1. why is it you are hiring travelers 2. is your facility still able to maintain AWHONN/ACOG standards of staffing and care and 3. about other highlights for me personally. You have to expect that things aren't going to be a bed of roses, and probably aren't what you're used to. And that *you* (and not just they) will need to learn new things and adjust. Even if the place you came from was Magnet City, Awhonn poster perfect, and did 500 deliveries a month, YOU didn't personally take care of all 500, right? So, I'm sorry, hon, but a year and a half makes you competent. Not necessarily expert. And I'm really not slamming you. It's just that if you are going in there having already decided that you rock and they suck...you aren't going to win friends and influence people. No one likes to get the "well where I come from...", even if it's only on your face.

Anyway...it's fairly common for staff to feel very territorial. I had a charge RN pull me into the nourishment room one night to tell me that I was "only there for 13 weeks, so it wasn't like I needed to come in trying to change them". All I was doing was getting PKUs at the 25 hour post initial feed, instead of immediately prior to dc. It wasn't like I was trying to be Betty Flipping Ford, but hey...you can do ANYTHING for 13 weeks. And you may even learn a few new things.

ShannaBananaRN · May 9, 2010

Thank you all so much for your replies, it helps a lot just to know I'm not alone! I've decided to stick it out. My biggest problem is that if I don't know something, usually clerical stuff and I ask another nurse "how do you print off the req form?" for instance they just look the other way. Hopefully some days and some nurses will be better than others. I think you are right in that I'm not there to change things...this is a slow realization for me but I'm getting there, haha. Thirteen weeks, thirteen weeks, thirteen weeks....

bonesrn · May 9, 2010

Good Luck! No matter what, you will walk away a stronger, smarter, more confident nurse. Kill them will kindness and be open to change. Agree with Tablefor9..travelers are not in hospitals for a reason, but you can do anything for 13 weeks! Don't stress. On your off days, take time to explore the city your in and enjoy it! Keep us posted!

AlaskanRN · May 16, 2010

I can fully relate to your situation. My home hospital was great. First rate equipment, great doctors, helpful nurses, traveler friendly...really everything you could want in a hospital. Then I decided I wanted to go traveling.

My first assignment (I do ER) was a level ll hospital where the ER saw over 300 pts a day. It was absolutely insane. We didn't get any fast track type pts, it was strictly high acuity. Like you, I was far from home with no friends and I was completely overwhelmed. The nurses weren't so much hostile as they were too busy to take time to answer my questions and believe me, I had many. The equipment, while old, was new to me. My experience with computer charting was minimal, theirs was total immersion, and not only were the docs too busy to know your name, they might not have even recognized your face. Like most ER's we had to hold ICU pts but unlike most ER's there were no ICU nurses to take care of the pts, they were part of our assignment. I had NEVER worked ICU a day in my career. I had no idea how to care for a pt on an ICU level. I barely knew an ART line from a chalk line. I would have been envious of your weeks orientation. I got 6 hours

I was initially appalled at the care being given. What I was used to was much different. Care was fast and furious, even the most critical pts were dealt with in what I thought was a less than thorough manner, not to mention my having to learn a whole new array of meds. I left every day telling myself "it's only ten more weeks...it's only eight more weeks...Please God, let me keep my license...it's only three more weeks...".

Needless to say, I got through it with my license intact, and I must add I learned a thing or two from those nurses and that experience. The least of which, when I stood back and looked much later, they had a very high success rate. Their save rate was phenomenal for the acuity of the pt population they received. Very impressive when I wasn't in the middle of it! LOL

First and foremost I walked away thinking "If I survived that Hell Hole I am now qualified to work Anywhere" and I have to say, no job I've had since has been quite so bad (although there was one other that was a close runner up!) So unless you are seriously in jeopardy of losing your license (and try to look at it clearly, not just in panic mode from new situation) put your head down, barrel through and you will be a better nurse and a better traveler for the experience.

Good Luck and let us know the outcome.