Agency Nurses Have No Rights?

[AGaston]

While working at a hospital in North Texas, I complained about the continuously turn around on getting admissions before I could thoroughly assess and do rounds on my other patients I was assigned to that day. Patient load continue to increase with no PCA or minimal at best, frustration continued to build as I had requested a CT of the abdomen of on a fresh post-op patient whom was complaining of severe abdominal pain unrelieved by analgesics; I was told by the radiology tech, that he didn't have time to do the CT, although I had explained to him that this was urgent to determine if the patient was bleeding. 3 hours later and after speaking with his supervisor the CT scan was done, he in turn reported me as being rude. Days later I started my shift at 0645 a.m. and was not given access to the pyxis until 0945 that day. I had a full assignment including a patient that routinely requested pain medication every four hours on the hour(her pain meds were due at 0700). I requested access to the pyxis 3 times before I was given access. I voiced my concerns of having to wait 3 hours into the shift to administer medications and that no nurse was willing to assist me, days later I was made a do not return. In the complaint I was referred to as rude, (labeled rude because I voiced valid concerns), the complaint also alleged that I was not doing hourly rounds or answering call lights. I would answer call lights while the other staff nurses were sitting at the nurses station discussing their personal affairs. What are we supposed to do when we have concerns and no one cares to listen and if you speak you will be labeled as rude and made a do not return. Agency nurses have no rights! What do we do?

[Been there,done that, ASN, RN]

The agency nurse experience will be individual with each hospital/ unit. Some will welcome your experience, some will dump on you. You have all of the rights that you demand.

I had the exact same experience .. I knew my patient needed a repeat CT scan stat. Medical imaging tech was out of the building and gave me flack. I called the nursing supervisor to GET IT DONE. ( my diagnosis was correct, CT revealed active bleeding). In this case, I was then labeled as a hero .. and the facility LOVED me.

It's all in the approach.. remain cool , calm, and collected. I suspect you were not.

In the future, do NOT accept your assignment , until you have Pyxis access.

[AGaston]

Initially I was calm, but it's not easy to remain calm if you have a patient with a possible hemorrhage and one needed to be medicated for pain and there is little that you could do. I had to push to get anything done.

[Been there,done that, ASN, RN]

Initially I was calm, but it's not easy to remain calm if you have a patient with a possible hemorrhage and one needed to be medicated for pain and there is little that you could do. I had to push to get anything done.

Been there, done that...as agency and long time staff/ charge nurse. I was called into the office .. because an ultrasound tech was calmly performing a bedside scan on a patient that was diaphoretic with respirations of 40. I told her to GET OUT OF MY WAY, so I could do my thing.Tech did not like that and reported me. Bottom line is .. we call the shots and technicians do not get the whole picture . Their butt hurts should NOT be considered in an emergent situation.

You were taking control of the situation, the facility did not get that. It's their loss, not yours.

[KatieMI, BSN, MSN, RN]

Been there, done that...as agency and long time staff/ charge nurse. I was called into the office .. because an ultrasound tech was calmly performing a bedside scan on a patient that was diaphoretic with respirations of 40. I told her to GET OUT OF MY WAY, so I could do my thing.Tech did not like that and reported me. Bottom line is .. we call the shots and technicians do not get the whole picture . Their butt hurts should NOT be considered in an emergent situation.

You were taking control of the situation, the facility did not get that. It's their loss, not yours.

What I eventually figured out, the key is to complain before the other side gets a chance to do it. First make sure patient is stable, then immediately call division supervisor, and write a note while waiting on the phone. Literally, whoever comes first gets things his way.

Good thing is that after being spoken with a few times and for less than life-threatening reasons most of the techs get it, and then the whole department can do the same. In my place, Xray was not to touch anything deemed as "medicine"; therefore, for PEG tubes controls, for example, they had brought bottles of Gastrographin in room and calmly went for coffee with an idea that staff RN will find it, dilute, fill syringes and call when she is ready. Sometimes they had audacity to leave cassettes there as well, expecting them to be positioned. I was first to start calling, and then other nurses followed. We agreed (between each other) to be polite but whiny to no end. After few dozens of such calls wheels started to move about. It is now complete responsibility of the tech to do the procedure, and they politely ask, not demand, another pair of hands (which is, ok, needed and even necessary).

That's a squeaky wheel that gets the grease, but it must be just squeaky, not falling apart.

[Been there,done that, ASN, RN]

What I eventually figured out, the key is to complain before the other side gets a chance to do it. First make sure patient is stable, then immediately call division supervisor, and write a note while waiting on the phone. Literally, whoever comes first gets things his way.

Good thing is that after being spoken with a few times and for less than life-threatening reasons most of the techs get it, and then the whole department can do the same. In my place, Xray was not to touch anything deemed as "medicine"; therefore, for PEG tubes controls, for example, they had brought bottles of Gastrographin in room and calmly went for coffee with an idea that staff RN will find it, dilute, fill syringes and call when she is ready. Sometimes they had audacity to leave cassettes there as well, expecting them to be positioned. I was first to start calling, and then other nurses followed. We agreed (between each other) to be polite but whiny to no end. After few dozens of such calls wheels started to move about. It is now complete responsibility of the tech to do the procedure, and they politely ask, not demand, another pair of hands (which is, ok, needed and even necessary).

That's a squeaky wheel that gets the grease, but it must be just squeaky, not falling apart.

I realize that the first one that runs to mother usually wins. I would never care enough to call supervision "first". My actions and reputation are all that is needed when the whiny one goes to mama.

[RN/WI, ADN, BSN, MSN, RN, APRN]

Of course you have rights as a professional with a license. Unfortunately you are the one that has to speak up and change the environment. More than likely the unit has issues. Any licensed professional should be able to walk on the unit and have equal access to equipment and patient care. I would take it to your agency and refuse placement at the facility for safety issues to patient care. What the permanent manager and staff don't understand is it hurts the facility credentials and reputation in the long run to treat the agency staff poorly or not equip them equally as perm staff.

[TheCommuter, BSN, RN]

As an agency or temp nurse, you are being utilized as a band-aid solution to patch up deeper problems that pervade the facility where you are being sent to work at. Facilities generally do not need agency or temp nurses when staffing and working conditions are optimal.

The agency nurse is a stop-gap measure for a much larger problem of a systemic nature. Management often knows the facility's exact problems, but do you think they want a temp worker calling them out? Nope, no, nada...

As long as the temp/agency nurse remembers (s)he is not there to solve the facility's systemic woes (or even point them out), management will have no problems with him/her. Remember, there are reasons for the facility's continual utilization of agency, temp and travel nurses.