A penny for your thoughts

[Sundowner]

I have a few questions I would like to pose to fellow agency nurses. I have been an agency nurse since oh,, I think March. I find it enjoyable and yet very difficult. I have come to the conclusion that it takes one hell of a nurse to be able to walk into a facility and pick up the ball and not miss a beat. I take great pride in my ability to do that, though I will state that I only take assignments to ltc facilities, for that is what I know. You wont see me jump from ltc to a hospital setting.

I guess I don't have questions, more like thoughts I would like to hear responses too. Be aware that I intend to bash agency nursing, which I am enjoying so much for many reasons, money, scheduling my own hours,,ect. In another post I stated that I felt that Agency nursing was a brilliant idea that served a good pupose, that seems to have turned into a money making monster. By this I meant that over the last five years, agency's have come outta nowhere, to take advantage of the shortage. (Somebody out there is making alot of dough).

I have also stated that I fear that there are too many agency nurses out there that have the horrible attitude. The attitude of I am just agency, dont ask much of me, I will pass my pills and be on my way, I will not lift a finger unless I absolutly have to, I will insist on having the regular staff hold my hand all shift.....you know what I mean. I also stated that Agency nurses with this attitude have been the down fall of many facilities. Too many agency nurses floating in and out, not caring about the facility itself and barley caring about the patients they are to care for, just covering their own butts and nothing more and sometimes not even that.

Now mind you one of the reasons I turned to agency is to escape the pressures of management, but I didn't throw out the idea of caring for the facility. By this I mean showing concern for the things that keep the state from shutting them down. The little things that I have seen agency nurses say "let the regular staff take care of that", like reordering med's, charting properly, stocking supplies, knowing the protocols they have inplace reguarding skin care, toiliting charging for supplies, dating insulin bottles etc. These are things that we all know need done, why don't we do them? Why do so many of us go in, do the least we can do and leave.

Now tell me that the reasons are due to lack of info provided by regular staff, no orientation. Then I will ask you how many times do you need to be oriented and can you not ask questions.

Why is it do you think that so often you enter a building for the first time and get "the eye" from the regular staff as well as the patients and their families. Why is it that so often you feel the staff is rude and cold, unthankful for your prescense, unwilling to orient you. Why are we often viewed as a hinderance instead of help. Why have so many of us gone from a regular staff position to agency?

I often wonder if we have become too much of a self sevrving society. By this I mean, do we all tend to merely look out for number one. Take the easiest road for the most amount of money.

Why do I so often find myself bashing other agency nurses?

[Dave123]

Well I moonlight for an agency and the reason I do it is to make some money.

I think any agency nurse that says she does it for the patients is just flat out lying. If that was their main concern they would not be working agency. They could be doing PRN work somewhere. Hospitals and even some nurses want you to buy into more that what it is about. Its about getting paid close to what I am worth for the same good quality and caring job I already do.

Now that said, when I take an assignment I hit the floor (usually ER) I ask a few questions and go to work. I can not stand someone holding my hand. I must do a good job because of the call backs and job offers.

I know I am getting ready to go to a "WAE" position at my real job because I want to do more agency and I just signed a 13 week contract working (36hrs)3 days making twice what I do now with ZERO BS. That means I am not doing inventory, ordering supplies, signing for equipment, not going to any meetings, or stupid classes. I am there to provide quality care and thats it.

For me its about "Show me the money" because I am already showing you quality care. If the hospital and other nurses want loyalty from me, well that's going to cost.

If I go somewhere and they are good to me then I do a whole lot more than I have to. But if they keep giving me all of the "trainwrecks" and dumping on me then they get nothing extra from.

Just my opinion

Dave

[Sundowner]

Okay Dave,

You managed to define every reason why I turned to agency. Money being of the most importance,my sainity a close second.

My question is now this....What do we do when the rest of the world joins up with agency, and facilities are left with permanent staff consisting of new nurses that dont have enough experience to land an agency job.

Where does this put healthcare. Will this eventually force the hands of facilities to "show us the money"? (love that phrase).

And pehaps most importantly,,,this place that you signed the 13week contract with.....will they have appreciation for your underwear selections.

[canoehead, BSN, RN]

that's why they offered him the job in the first place.

is it an er dave?

[Sundowner]

ROFL!

[Dave123]

That was a good one guys

I see it truly as simple economics at its basic form. The Greater the demand for skilled, caring, competent help the higher hospitals are going to pay.

It will be agency nurses that force hospitals to pay those on staff more. As they have to hire more and more agency they will have to offer more to their staffers.

In my dream of a true and just medical world maybe someday we will be able to Bill for services rendered (just like other medical professionals). Thats what I want.

The hospitals are not our friends or the patient's friend. I think they will try to get to the state boards to force us somehow to work for less or some other "For the good of the Profession" crap.

The contract I took is not in an ER but a Recovery Room. I haggled with them a lot and stood my ground on what I wanted. They wanted me there 5 days (8hr shifts) and I said no, I want 3 12's and no weekends or nights. Plus I wanted a higher bonus and higher tax free living allowance. Even though the contract is right down the road.

I call this type of work "Mercenary Nursing".

As for the "fun" at work. I am sure there will be some "fun" people there too. I hope...... :)

Just my opinion

Dave

[Sundowner]

OH WOW!,,, never thought of charging for services rendered! HEE HEE.....one enema....that will be $27.50....lol.

I am having a hard time picturing how that would work, you have to tell me just how you see this...I am very intrigued by the thought.

[nur20]

Hey, you guys,especially "mercenary nurse"Call me nuts but i'm just not money oriented. Maybe i should say that money is not my ruler Would you believe that i didn't even know what nursing paid unti i graduated. I did no research in that area, (honest) !!!!!!!!!! I went into agency nursng so i could have a more of the type of life that i believe in such as being well rounded mentally and emotionally, caring for my husband ( home cooked meals,etc) Nursing can chew you up and spit you out if you let it. When i worked in facilities the politics drove me up the wall. I was good for nothing after a shift because i gave it all i had, and still felt that i didn't have the time to properly care for my patients, putting them and my license at risk given the staff/patient ratio, understaffing etc.To be granted a day off or vacation was like pulling teeth. I won't go on, because i would still recommend nursing as a career, it's just a matter of finding your NICHE. Dave, the only thing i can think of that comes close to your dream is becoming an INDEPENDENT MEDICARE PROVIDER. They will assign you a number, you can go in, provide your services and BILL THE STATE, but of course you have to deal with your own taxes. I now have time to pursue other interest and work at what i love

[Brita01]

As far as there being bad agency nurses out there, yes there are, but there are bad staff nurses also. And I have cleaned up behind my fair share. Even knowing that I would possibly not be coming back to the facility, but cleaning up and making things right again anyway, just as should be done by all.

But I have to disagree with you when you say that agency nurses have been the down fall of many facilities. Bad attidudes or not, those facilities had major problems before they had to bring in agency nurses en masse. If you've been doing agency work since March, I'm sure you've been in at least one facility where there's only one or two staff nurses and the rest are agency nurses. Hell, you might have even worked in a facility where there were NO staff nurses on your shift. That's because that facility ran their own staff away with either bad staffing ratios, bad pay, bad benefits, not enough supplies for patients, empty promises, etc. etc..... That facility is responsible for it's own spiralling downfall. And of course when you have to get a bunch of different and new nurses to come in every day, you're going to have a few bad apples. Unfortunately, there's no way around it and they're in every profession. But those bad apples being the facilities downfall? Nah. It was already happening beforehand.

[Sundowner]

Good point there Brita,

I do agree that there are many bad staff nurses out there also, no doubt about that. I say what I have said due to what I have seen and experienced.

The facility I worked at for many years prior to going agency, was a decent place. Administration and management were fairly decent to us, decent enough. With in one year we had two staff nurses die of CA, one retire and one cut back to two days a week and we never recouped of course there were other problems like the drug addict we had for a DON for a year. Administratiion threw raises at us left and right for a year and still couldnt keep us. Before I left, I was making my own schedule even. The problem was lack of continuity. A different charge nurse every night, having to orient someone new every other day. I am an Lpn and I was orienting charge nurses to their responsibilities, doing the admissions, except for calling the doc's (not smart enough):) .

Now I was told by the administrator, help these girls out, and damnit I did the best I could to orient three of them at a time in one night, but two outta the three didn't give a crap. Orders werent being taken off, things not passed on in report, meds not being reorderd, med errors out the butt, for no other reason than lazyness. Once in a while I would find a good one, or one that didn't need me to hold their hand. Hell, I had one come in and handle three admisions like it was cake.....I told her, if I went "that way" I would like her to marry me! lol.

After a time, and it doesnt take long, the place goes to hell. This place inpaticular, from what I have heard can no longer keep agency even in there because it is now a threat to your license to even look at the place let a lone walk in the door. People have died needlessly over there on several occasions out of shear neglect.

What I hate is the fact that so many agency nurses feel the need to be oriented. That is crap. I can walk into any facility and do my job well without my hand being held. I have eyes and can find things, I can ask questions if I have to, which you always do, but I have never asked a dumb one, I take initiative. Someone once said there is no such thing as a dumb question....I think that is a lie. I am not a lost puppy all big eyed and confused and scared. Too many are.

Too many have the attitude, well if I am not told who to chart on,,well then I wont....if nobody mentions treatments,,,I must not be responsible,,,someone els must be going to take off those orders cause no one has asked me to.

I can't honestly blame that particular facility for its downfall, yes it played a part, but they were as good to us as could be for as long as they could be. They tried to apease us as best they could. Agency walked in the door and within a years time, the regulars all walked out. We saw the money and lack of stress and went running.

I no longer feel the heat from management, but darn it I do try to keep up the standards they want and need me too.

I signed a six or eight week contract with the facility I am at now,, and my heavens it is an all too familiar scene. They are currently banned from admissions. The regular staff is dropping like flies. I am having dejavou!

[Brita01]

That's sounding pretty scary Sundowner. Drug addict DON's? Facilities banned from admissions? Wow! I used to wonder why people didn't just do the job they KNEW they were supposed to do. I mean if every nurse would take care of all the things their patients needed, things would flow so much easier. But no! Something is always left undone and they figure it's ok to pass it on. Especially day shift nurses to night shift nurses. Being that night nurses don't work anyway because all of our patients sleep, why shouldn't we have the jobs of both shifts?! I'm sorry. I'm going off on a tangent, had a particularly lousy night shift last night. :)

Anyway, I wonder if some of these nurses just don't know any better, think they need to be told everything, and that's even scarier. Some of these agencies are taking new nurses and I don't understand that. Of course they need floor orientation, they're not even really sure how to be a good nurse yet. What they really need to do is take at least a year at being a staff nurse where they can learn all of the "everydays".

Veteran nurses working for agencies who feel they need to be oriented to the floor? No, I don't get that one either. I usually just walk down the hallways until I find what I'm looking for. If I can't find it or if there's a code on a locked door that I need to get into, that's when I'll ask someone. I hate to bug people and I try to be as self sufficient as I can.

[nightingale, RN]

Hi Sundowner:

We have talked on this subject before... I agree with the person who said there are lazy staff nurses AND lazy agency nurses.... It has been my experience on a hospital floor that with the inconsistency of staff coverage we work in a catch up fashion to get the job done.. Things get passed from days to nights and nights to days.... I only pass on what is reasonable to do so.. i.e. new admit 15 minutes before shift end... I do as much paperword as possible and let the next shift do the IV start etc...

I think agency nursing is a need that willl not go away for a very long time... Our advantage.... We the fillers of this need make more money.. the reason I do this is to keep a sane schedule.. I work MY schedule and I am not SUBJECT TO CHANGE at mangers will.....

I love nursing and almost always enjoy my patients.... I am now trying to figure out how to get into an ICU / CCU training and staffing situation while agency.... I am somwhat bored with tele. med/surg options I am being staffed for. Growth is what has attracted me to nursing and sustains me in keeping the focus on positive issues....

B

:) :)