Travel Nursing in Texas in the ICU

NedRN · Mar 30, 2016

Can you compare Texas to other states?
I am am currently in the ICU in Houston as core staff.

I'm only going to address the last question. You will have to try hard to find a place as hostile to nurses as Texas. You may actually have a great job and not know how good you have it, but no point in pushing your luck. The grass is greener on the other side. Texas is a big state, but the rest of the country is even bigger. Travel!

I've expanded on this topic in past threads and linked some of them below. You can read more about my opinion and other folks who have worked in Texas in them. I know a good number of nurses from Texas who are travelers and refuse to work in Texas. I'm not anti-Texas the state at all, great place to visit, but I don't want to work there.

https://allnurses.com/travel-nursing/compensation-in-texas-944603.html

https://allnurses.com/travel-nursing/fellow-travel-nurses-905046.html

https://allnurses.com/travel-nursing/compact-license-question-1039017.html

https://allnurses.com/travel-nursing/looking-into-travel-935855.html

https://allnurses.com/travel-nursing/anyone-work-for-842545.html

https://allnurses.com/travel-nursing/travelers-do-you-998970.html

CardiacDork, MSN, RN · Mar 30, 2016

Thanks! I do plan to travel outside of Texas for sure! . I was just curious at conditions around my state.

I do work for a stellar facility in my opinion. Pro nurse. Teaching facility.

Wolf at the Door, BSN · Mar 30, 2016

As someone that was in Dallas, I found Texas physically exhausting. People are huge in Texas. I never seen so many 600-800lb people in my life. Three vented patients during the winter time. I won't do adult ICU anymore in that state. Freaking forget it.

NedRN · Mar 30, 2016

Well, that's a reason I haven't heard before! Perhaps bariatric specialty ICUs are in order.

CardiacDork, MSN, RN · Mar 30, 2016

Well, that's a reason I haven't heard before! Perhaps bariatric specialty ICUs are in order.

Interesting. Well my specialty before ICU was general surgery and bariatric surgery post op. I guess since this bariatric SURGERY, it's a bit different than what people usually think when they think bariatric.

When I worked in this department other nurses from different units would shudder and freak out stating - "how can you lift all those people", the truth is I used to tell them is that in bariatric surgery these people are expected to walk every single hour postoperative and the last thing we would ever do is their daily cares.

The surgeon would stop everything he's doing (except surgery of course Haha) and immediately come to the ward if ANY of the bariatric began acting up (refusing to walk etc.). He would give them an earful.

NedRN · Mar 30, 2016

I forgot about surgery. Duh. No wonder you see so many. I'm a bit surprised though about the size. 450 pounds is about the max I've seen in any kind of patient. Most of the surgeons I've worked with require significant weight loss prior to bariatric surgery to reduce mortality. And probably to check patient compliance and motivation as well.

Cannot even imagine ambulating a 600 pound patient much less a post surgical patient. It must require a huge assist device.

CardiacDork, MSN, RN · Mar 30, 2016

I forgot about surgery. Duh. No wonder you see so many. I'm a bit surprised though about the size. 450 pounds is about the max I've seen in any kind of patient. Most of the surgeons I've worked with require significant weight loss prior to bariatric surgery to reduce mortality. And probably to check patient compliance and motivation as well.
Cannot even imagine ambulating a 600 pound patient much less a post surgical patient. It must require a huge assist device.

Most of our bariatric patients don't exceed 400. In fact I've never had a patient above 350.

The preoperative council and check off is most rigorous. Intense psychological review, weight loss required to reduce mortality, and classes that explain the realities and what to expect status post bariatric surgery.

These patients come prepared and know what to expect, so when one of them tells me - "I wasn't told I had to walk every signals hour" I used to say "You went through an evaluation and several classes that told you what to expect immediately postop and beyond. So if you missed the part about walking q hour - sorry but not sorry time to walk!"

Wolf at the Door, BSN · Mar 30, 2016

Sad part is we had no lifts. Administration admitted to the employee health nurse we were not equipped to handle such patients. Did they send these people out, nope. Last guy we hand was 740lbs intubated and couldn't move, ridiculous. I ended up helping the unit out and they got us a turn system for him. No more Texas size adults for me EVER!

NedRN · Mar 30, 2016

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!

CardiacDork, MSN, RN · Mar 31, 2016

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!

Nope I never have to the first question.

I'm not sure, good question. Could be a diet/regional lifestyle thing.

Wolf at the Door, BSN · Mar 31, 2016

We were instructed to put a 600lb guy in the cardiac chair. He could not do anything. Never got him in the chair because we had no equipment. Can't hurt ourselves for one man.

Texas has a higher concentration of these extra large sized humans. My friend in San Antonio who was on a travel assignment encountered a 500+ man. I had an assignment with two patients over 350 each. I hurt myself and was out for a month by mid shift.