Travel Nursing: I'm in Maine Now! Part 2

[Have Nurse, ADN, RN]

It took 36 hours to arrive at my destination. It was pitch black and chilly when I rolled into northern Maine. The night air fragrant with flowers and dampness, moist in my face as I rolled down the car window to breathe it all in. Suddenly concerned that a bat might decide to zing through, I closed my window. One thing to keep in mind, there are no street lights in Maine where I was destined to be. The roads wind and twist up in the hills. The whole state is a series of mountains, pines and twisted roads. The pavement is usually in terrible shape, "repaired annually" I was told.

"Oh well, " I thought to myself, at least it's job security for the natives. I'm from Minnesota. We never have to repair major highways, not the same ones anyway. There are wild animals and water everywhere as there are many lakes and Maine of course, borders the Atlantic. I cannot count the number of dead deer I saw on the road or the number of "Moose Crash Area" signs that met me on a hill. I phoned my would-be Landlady who attempted to guide me to her driveway as my GPS got fouled up. It was a very steep grade and not a safe one: a brook on one side, a steep grade that scattered to the road below it on the other.[ I was exhausted! So tired that when I unpacked briefly I went straight to bed. It wasn't until the next morning I realized I had made a serious mistake. The "studio" add-on, was actually a cellar, with a concrete floor, damp, dank and bug infested. The appliances hadn't been cleaned. The toilette, though new and clean, was too big for the space so one literally has to climb around it to reach the sink. The shower stall was too small, the showerhead limited in movement so one could not get truly clean while using it. The threshold to the shower was not high enough so water would spill over it all over if one wasn't careful. The information the landlady gave to my company included free cable and free internet. There was no TV in this "furnished apartment," nor was there any internet access. I phoned my company the next day. While I did that, I went to a local Walmart to purchase nearly 200.00 worth of cleaning supplies, bug spray, towels, etc.

After attempting to negotiate less rent versus me moving out, my landlady wouldn't budge. There was no lease and I was "free to move." "Oh, sure," I thought, "Like I can find a vacancy I can afford at the height of the tourist season!" I told her I would move as soon as I could find another place. In the meantime, I insisted she get a decent de-humidifier, as I was quickly becoming ill, 3 days after my arrival due to the dampness. My coughing wouldn't stop and I didn't sleep well. She argued that the present de-humidifier worked fine, which it clearly did not. The receptacle in the dehumidifier that was to catch the water, was bone dry after 4 days. It wouldn't stay on either. When she got the new one, I emptied it 7 times the first day and it kept running. The ironing board collapsed on me twice. It was an old wooden one. The iron, from the 1940's, fell apart in my hands when I turned it on. She replaced it with yet another one from a similar vintage with a cloth cord. It worked but would spit out rusty water on occasion. The landlady replaced the ironing board with yet another antique but it stayed up at least. (She prides herself on never buying anything new.)

The bathroom rug was moldy and had to be thrown out. She replaced the showerhead with a handheld at my request so I could at least get clean! For the privilege of living here, it cost me 1000.00 a month. It wasn't until later I found out I could get more for less. I began my search. In the meantime, I decided to go explore after one day of rest from cleaning for 5.5 hours. As I drove disgruntled up the windy mountainous highway, I asked myself, "Did I make a mistake coming here?" Then I saw it. It was a cute little front porch restaurant that offered wonderful food and reasonable prices. The outside porch wall was covered with messages written by tourists, and country sayings. Feeling a bit lost, but hungry, I smiled at the folks who were conversing at a large dining table, noting the country feel of the place.

"Would you like to join us?" An older couple from Vermont headed home offered me a place at their table.

"I'd love to!" I replied. After brief introductions were made, it turned out that we had quite a bit in common. Not only did we serve our country long ago, but share a deep faith in The Lord. That automatically made us family in my book. The conversation and tasty pancakes along with the cooking smells of coffee, bacon and maple syrup, and the homelike atmosphere of this charming cafe was balm to my troubled spirit. I made some friends. My spirit was soothed, my tummy fed. When the couple left, we exchanged addresses.

"We feel as though we have known you for years," said the wife. "If you are ever in Vermont or just need to get away for a few days, please come and stay with us. It's just a big farmhouse, but we call it home." We hugged and said goodbye.

"Maybe it was going to be o.k.," I told myself. My first week of Orientation was pleasant, though, by lunchtime, my brain was on overload! The following week I shadowed my preceptor, Dawn. As I sat in the front passenger seat of her Toyota, zooming along twisting country roads, I wondered how I'd fare here. Maine is a wonderland by itself, with its winding roads, misty mountains, low silvery clouds, ghostly wilderness, moose and bear dropping in unannounced. Frankly, some of the "mountain folks" are a pretty no-nonsense bunch, flying their American flags on the front of their pick-ups, speaking their minds. Actually, if these boys had been in charge of the war in the mid-east, I think it would have been all over in 2 weeks. My preceptor shared an incident that happened to one of my colleagues while up in the hills. She came upon a dead bear in her patients' bathtub! Naturally, when one comes upon something unusual in a client's home, one does not wish to appear disrespectful. But a dead bear....really????[ She then went on laughing under her breath to say that that same nurse was in traffic in town a week later, and a moose came up to her car and refuse to stop licking her windshield. It was only my first week and already I was getting nervous. "This would be a good time to possess a permit to carry," I told myself.

Since that first week, I have progressed slowly into my new temporary assignment. It's gotten a bit easier finding my way around, although honestly: there are times when my patients' residence simply doesn't show up on any GPS. (I use two of them.) Over the weekends I try to take road trips, although at times it feels like I am never out of my car. Working full time, 5 days a week over the road, driving many miles, and then taking off over the road yet again....well...Worse still, if one doesn't know where the gas stations are on the back roads, that too can be a bit nerve-wracking. Not knowing any better, I took a country highway across several towns on a Sunday, before realizing my tank was getting too low and no gas station in sight. I began to pray, "Lord, I need a gas station. Would you help me please?" Over the hill I saw what looked like one but when I got there, it was falling apart and abandoned.

"This is not funny," I said upward. Then, at the top of the hill, there it was. Not only a gas station but food, bathrooms, good stuff! Whoohoo! As I left the station and wound my way through the town of Augusta the bells rang in the towers of the local churches. The old Victorian homes and offices of old design seemed to come alive as I drove by. It was like stepping back in time. I wasn't sure I would like driving on the weekend. I mean, when one drives many many miles doing the kind of work I do, one sort of enjoys the off-road time when one can. Still, the beauty of the glistening coast, the smell of the salt sea air, and seeing the sails of the wonderful yachts and clipper ships are truly breath-taking. The colors and geography of places such as Camden and surrounding towns make any excursion worth-while. Each day brought different experiences with my patients. It wasn't unusual to visit a patient living in very primitive or poor conditions up in the mountains, or in town. Still, scattered among the old rusty dilapidated mobile homes, one would also find an old tired Victorian house or two, struggling to retain its' charm. There are many many unusually structured and old homes of that era, with wraparound porches, gables, filigree, turrets and the like, each one different than the next.

One thing that stood out for me while viewing these wonderful old confections, was how the paint had peeled, possibly due to the high humidity in Maine, being so near the sea.Early morning, regardless of the month I was in, started with mists over the mountains, and sometimes even the lakes too, making one feel as though they were living above the clouds. By late morning, the sun shone and began to burn off the mysterious fog. By evening, the temperature began to drop and some lovely sunsets could be seen, moving one into twilight, the sweet grass and moisture of the pines, perfuming the mountain air. Even though it may have been 80 degrees during the afternoon, one might need to light a fire by evening. The experience I had with working with the company in Maine for Home Health was a learning experience. Most of the frustration I experienced was due to lack of communication between the office staff and field staff, but not their fault really. You see, when one is doing casework in the field as a nurse, one is dealing with things such as:

• Multiple wounds and sometimes multiple wounds on one client
• Wound Vacs
• Medications setups (sometimes 30-40 different bottles at a time)
• Physical assessments
• Blood draws combined with lab runs to deliver the specimens to the lab.
• Admissions, discharges re-certifications, transfers to Hospice, all under the Medicare requirements of OASIS which really takes time.The problem the office staff had had, was that they are not allowed to see the cases so they don't know when they are over-loading a nurse.

I have never understood that, as they are HIPPA protected so technically, they should be allowed and thus make our job easier. I tried to set up a meeting with the Director to present my concerns, but she was unavailable. So was my Preceptor. She was on vacation. The nurses who were assigned as resources to me did not return my phone calls or emails. So, needless to say, I have learned sink or swim. I chose to swim. I emailed a message to the Director. She wrote back to say she expected to link up by this week. It didn't happen. Resources that were promised to me while nurses were on vacation for me to turn to if needed, didn't respond to my questions so I felt pretty much on my own for the most part. Because of confidentiality issues, I cannot mention the names of my clients or any demographic of where they live. But I will say this. There are a few who have made an impression on me that has not only helped me in nursing to be more compassionate but also better skilled in my wound care technique. A few of them I would see on a regular basis, thus enabling me to get to know them more and make friends with their pets. It got to the point where the cat(s) would greet me at the door when I arrived. This was progress you see because initially, they would plant themselves smack in front of my patients' feet so I would have to climb over them to do my work. That can be a challenge because cats love to climb up and in bags, thus risking contamination to my supplies. I managed to keep them out of the bags, but not my lap. A flashback of a conversation that took place back in Wisconsin with one of my colleagues: My preceptor then was relaying a story to me of an experience she had with a patients' cat while she was attempting to do IV line site care which requires a sterile field. "The cat jumped up and landed right in the middle of my sterile field!I glared at him and said: "Really?!" "Oh," said one lady, "he knows you now, so he trusts you."

Over time, my exhaust system on my car began to scream at me. As I mentioned earlier in my story, I was missing a tailpipe. It wasn't long before my patients started asking me if I was perhaps driving a motorcycle? My landlady's friend recommended a local garage that he trusted. Thankfully they were able to squeeze me in.

When I called to set up the appointment, I specifically said that I would need the car assessed and fixed the same day as I cannot take time off during the week to do it.

"Well," replied the mechanic, "I'll just order the part today and we'll have it handy tomorrow or we'll think of something else." This left me a bit uncertain, but, ok. I took it to the garage a few minutes early and parked out back. This was an old auto store chain left over from the 1950's that still was in business. As I walked in, 3 men were sitting around the counter, one behind it. One fellow munched appreciatively on a submarine sandwich, the other two talked. "Which one of you is Ben?" I asked. Ben nodded.

"I'm Cynthia," I introduced myself. "We spoke yesterday."

"A yep", he responded in his New England brogue.

"I've parked out back," I said, handing him the keys. "Do you have the part? You mentioned you would order it yesterday."

"Nope. They didn't send me a tailpipe, just a rubber ring but we can put something together for ya." He informed me.

"Yikes!" I[ thought to myself, but then thought again. This is Maine, a different mindset, a different culture. While some of my conversations with the folks here implied a lack of being informed, they certainly were not stupid, just innovative and willing to roll up their sleeves to find an "alternate" and less expensive solution. It occurred to me when I left the garage on my way to the local cafe, that I hadn't received an estimate so I phoned him back. "Ben, how much is this going to cost?" I asked.

"Oh, do you want us to look at it first?" Was he kidding?

"Yes," I said. "I believe that is customary."

"Ok," I'll call you with an estimate." He did. It was reasonable so I gave the go ahead. They planned to custom weld a pipe to the muffler and felt it should do fine. The car had to be repaired twice the same day as the new tailpipe wasn't quite secure. Still, during that second repair, the time I spent in the shop waiting and conversing with the clerk and the friendly folks who sauntered in, was well spent. I felt as though I had made some friends along the way.

To read Part 1 of this story, go to: Travel Nursing: The good, the bad, and why I probably will never do again-Part 1

[middleagednurse]

Very interesting!

[middleagednurse]

Is it really necessary to bash the OP? Can you do better? If you can't say something nice don't say anything at all.

[middleagednurse]

I tried to post above comment on the first part of the article. I also tried to delete this comment but computer wont let me.

[Have Nurse, ADN, RN]

Is it really necessary to bash the OP? Can you do better? If you can't say something nice don't say anything at all.

I'm sorry, am lost here. What is the "OP?"

[ChrisMMS]

It stands for Original Poster

[susumarie, MSN, NP]

Awesome post! I look forward to reading the next! =)

[Have Nurse, ADN, RN]

Due to the holiday weekend and upcoming nursing schedule, I have posted part 3 early. It is in for approval first. Enjoy, and Happy Easter!

[Have Nurse, ADN, RN]

Awesome post! I look forward to reading the next! =)

Thank you. Will be posting part 3 earlier than anticipated due to my schedule and upcoming holiday weekend. Enjoy! And thank you!

[brandy1017, ASN, RN]

You're a good storyteller, makes me want to take a vacation and check out Maine. Looking forward to more installments! I've only worked as a floor nurse, but am curious to learn about others experiences. I've worked with several travelers some young and old and they all have their own unique history to share. Some do it only for a short stint and others make it a lifelong career. Thank you for sharing your experiences and letting us live vicariously through them.

[momofm1998]

I myself took an assignment in Maine and being from the deep South fully believed I was heading to "Yankee" town. I was sure i wouldn't like it and be treated poorly, but the money was good so I took a chance. I had the most marvelous experience, the people are amazingly sweet and friendly. If you have to get old and don't have family, get old in Maine. Those CNAs took such wonderful care of the patients. They would actually meet at shift change and note who needed what that evening. I have never before seen the impressive care the staff took with those elderly clients. so caring, so gentle and thorough. Never saw a bedsore there. When I left, I left some of the dearest people and will always carry good memories of them. But I too also had an "apartment" through the agency. It was straight up a mountain, then straight up steep stairs to a tiny bedroom with low ceiling. I bet the agency paid her mortgage for the whole winter. Maine is a delightful memory...Good people!!!

[TriciaJ, RN]

You're a good storyteller, makes me want to take a vacation and check out Maine. Looking forward to more installments! I've only worked as a floor nurse, but am curious to learn about others experiences. I've worked with several travelers some young and old and they all have their own unique history to share. Some do it only for a short stint and others make it a lifelong career. Thank you for sharing your experiences and letting us live vicariously through them.

Yes, I'd like to travel to Maine, now too. It sounds very intriguing. Can you give me your landlady's address so I can make sure not to stay there? I really hope in your next installment you find better digs.