Do You Like Agency Nurses?

stevierae · Dec 14, 2004

LOL, I have been working registry since 1995. In the operating room, we always get the surgeons no one else likes to work with. That's OK. It comes with the territory. Sometimes I think staff are threatened by registry nurses--at least in the operating room--because we can literally walk in off the street and do whatever is needed; that is, scrubbing or circulating anything, with little or no orientation. The hardest thing is finding where supplies are stored, and that usually takes about 2 weeks. It's really hard not to get caught up in the politics, but, when you are registry, you have to remember that you are a guest, and try to stay detached from all that internal stuff. Almost everywhere I have worked as registry or as a traveler, I have ended up taking a per diem position--I am pretty laid back, easy to get along with, and not out to take anybody's job.

I did work at one little 4 room OR where the nurses did not like me. They had all been doing things the same way for 30 years; none of them had ever worked anywhere else, and they were deeply mistrustful of an outsider. Their complaint about me? "She seems a little too sure of herself." LOL, would they prefer that I lacked confidence and had to ask their advice about how to proceed on any little thing? Apparently so. Since that time, I have had a friend work registry for the same hospital, and have an identical experience. Let them sabotage themselves to the point that NO ONE will go there---and see how they feel when they can't get vacation days.

If it weren't for registry, it would often be hard for staff to get the days off (vacation etc.) that they want. We fill in those gaps.

begalli · Dec 14, 2004

We use travelers. In four years I can only think of only one who was less than stellar.

I LOVE these nurses who travel from far and wide to work with us staff nurses on our unit. We've had travelers from South Africa, Ireland, the UK, and Kansas (LOL!). Really, from just about every state in the nation. I really admire how they can acclimate so readily to our complicated and busy unit.

Sometimes they do get the lousy assignments....at first. I've never heard a complaint from any one of them though. Having them saves the staff RNs from having to float to the Trauma ICU, the only place we and they are required to float to.

I don't think I could do it. I really appreciate and admire these nurses!

LPN1974, LPN · Dec 14, 2004

I worked for a nurses registry many years ago when I lived in the Los Angeles area and I loved it. I was treated very nice by all the staff I encountered. I loved going different places and getting different experiences. Never had any bad experiences.

If they had registries here where I live I would work some of it now.

I've also worked in places where we used agency or registry.

I was grateful for the help.

If we hadn't agency nurses we would have been short and working alot of overtime.

Agency nurses deserve every dime they get. It's not the easiest thing in the world to go in and go to work with no orientation.

madi_88 · Dec 14, 2004

What is a registry nurse vs per diem vs traveler?

Haunted · Dec 14, 2004

It's true that an agency nurse has to smile a little wider, chart a lot more, go above and beyond because we really are scrutinized and so often the scapegoat for whatever went wrong on the unit. I have always worked registry since I passed the nclex and feel like it has afforded me a wealth of personal and professional experience.

I have learned a few really important rules:

1: smile, be friendly and polite during shift report, write down everyones' names as badges get turned around.

2: don't wait around for hand holding. Orient yourself as to layout, location of supplies, phone numbers etc.

3: Be VISABLE!!! Help a CNA with a linen change, answer a phone, offer to pick up food at the cafeteria if you are lucky to get a break and obtain substanence!

4. Hang back verbally for the first few hours of your shift so you can assess the vibe on the unit. Be approachable to staff but DO NOT BRAG ABOUT THE BIG BUCKS YOUR MAKING. That will alienate you faster than an STD at a Mediao convention.

5. Don't make personal calls on the unit phone.

6. Say please and above all, THANK the co workers at the end of the shift no matter what the treatment you received, " Thanks you Brenda for helping me locate the IV start kit earlier, it really was a lifesaver!"

7. When signing out at the end of your shift always compliment the schedular, often times it will be the DON or supervisor, on how kind everyone was, how helpfull, what a pleasure your shift was, etc. If you have a problem, take it up with someone at your registry, that's what they are there for. Use them to vent and complain.

8. Go that extra mile and document the feces out of everything. If something hinky happens, keep a copy for your records so it will be fresh. I had this happen a few years ago at a Newport Beach hospital where a patient died suddenly into my shift and the family looked at "who to blame". Fortunately I had, at that time kept copies of the charting I had done to document that the charge nurse went in afterword and attempted to change the charting to reflect that I had not done the assessment, etc. Fortunately I had printed out a copy and presented it to the registry attorney. This charge nurse was let go and suspended by the BRN for falsifying records!

VizslaMom · Dec 14, 2004

I work full-time in a hospital -and- do agency part-time 1 to 4 shifts per month in various hospitals in Kansas City. I behave the same on my agency job as I do at my full-time job (where I have ALWAYS had a great yearly review).

I've only experienced rudeness by ONE nurse during one of my agency shifts. All other RN's have been VERY nice and helpful in locating supplies and explaining hospital policies..... as I only get 4 hours of orientation at each hospital where I work agency. They are usually very happy that I'm there because they are so short-staffed. Of course, I wouldn't be there if they weren't. At each facility, the RN's have always told me to come back if I get the opportunity to do so.

GirlArcher · Dec 14, 2004

just in case anyone cares....here is my opinion. lol :chuckle i have worked agency, registry and staff. i don't think that an agency nurse, registry nurse or staff nurse has anything more or less to add to the profession than the other. i have worked with bad nurses from every aspect of nursing; just as i have worked with outstanding ones!
that's the funny thing about nursing....it is an "equal opportunity" profession. bad nursing is bad nursing, fantastic nursing is fantastic nursing, it does not matter one iota what heading you fall under!

you are so right about that!!! i've worked staff, agency (per diem) and travel. when i was staff, i loved to see the travelers as this allowed me my days off and my holidays with my family. i also learned so much from them as they had been around and knew a few more "tricks". as a traveler, i have encountered staff who resent me and are threatened by me, why? i haven't figured out. they warm up after a bit (when they figure i'm not out for their job) and i've had wonderful experiences traveling. but it is true: bad nursing is bad nursing and it can happen anywhere. no matter if you're staff or agency.

one big thing i've noticed is some nurses are threatened by knowledge and the person they perceive as having more than they do. instead of embracing the nurse with more knowledge and experience and saying, "show me, let me learn, i want to know more" these nurses will criticize and nit pic and make the other nurse feel unwelcomed. the day i quit learning, is the day i hang up my nursing hat. i will always seek out the one with more knowledge than i have, so that i can provide the best care for my patients.

Tweety, BSN, RN · Dec 14, 2004

What is a registry nurse vs per diem vs traveler?

We call them agency nurses here, and I haven't heard the term registry. But I gather it's a west coast term, same as an agency nurse. These nurses work for an agency and get assignments on a daily basis wherever there is a need. They work different hospitals and different areas depending on their experience.

Per diem nurses are employees of the hospital and work on an "as needed" basis. They usually get better pay, without benefits. There's all kinds of different plans for this.

Travel nurses travel to a hospital and take an assignment from 13 weeks to six months (there are even shorter assignments) and work for a travel agency. They usually get housing supplements, or like our hospital an apartment to stay in.

This is kind of simplified but if you have any further questions please ask.

nursemary9, BSN, RN · Dec 14, 2004

You know,a Nurse is a Nurse; What I mean is, if you haave a good nurse, she will be good no matter if she works for the Hospital or the Agency;if you have a Nurse who leaves a bit to be desired she will be the same no matter where she works. I do believe that's the bottom line!!

I have seen both.

MaryAnn

Agnus · Dec 14, 2004

I get a lot of mixed messages from staffers and have seen some nasty comments made to agency nurses by staff. I have also worked with some agency nurses who are quite a liability (gave heparin prior to a surgical procedure, another who literally nodded off while on the phone taking MD orders, another who would not offer help to anyone at all and was very rude to the CNA as well) so I am wondering from staff nurses your perception, horror stories etc. of registry, travellers, agency nurses. Thanks

That's like asking do you like white people. For every horror story you tell me about agency nurses I can tell you one about staff nurses. I had a staff nurse regularly nod off when she was giving report. It has little to do with agency it has to do with the individual nurse.

Agency nurses must be flexible and able to hit the floor running in hospitals where they have never before set foot inside, with little or next to no orientation. Not may staff nurses are willing to do that not to mention able to. (just look how bad staff crys when they are asked to float)

Agency generally requires a certain level of experience to start and they DO pay attention to evaluations from the facilities of each nurse. So if you have agency that are dangerous or poor performers and you are not commenting on the evaluation forms they provide then they problem becomes yours. As a staff nurse you can and should make input on these evaluations. If you are not the one signing the form then talk to the person who does (usually charge or supervisior) before they leave your facility.

Your hospital can refuse nurses by name if they did not work out well when there previously.

Tweety, BSN, RN · Dec 14, 2004

That's like asking do you like white people. For every horror story you tell me about agency nurses I can tell you one about staff nurses. I had a staff nurse regularly nod off when she was giving report. It has little to do with agency it has to do with the individual nurse.
Agency nurses must be flexible and able to hit the floor running in hospitals where they have never before set foot inside, with little or next to no orientation. Not may staff nurses are willing to do that not to mention able to. (just look how bad staff crys when they are asked to float)
Agency generally requires a certain level of experience to start and they DO pay attention to evaluations from the facilities of each nurse. So if you have agency that are dangerous or poor performers and you are not commenting on the evaluation forms they provide then they problem becomes yours. As a staff nurse you can and should make input on these evaluations. If you are not the one signing the form then talk to the person who does (usually charge or supervisior) before they leave your facility.
Your hospital can refuse nurses by name if they did not work out well when there previously.

Good post. And believe me as a charge nurse I evaluated honestly those agency nurses I was afraid of. I was responsible for alerting on a couple of occasions to management people they need not let back in the hospital. :)

Fiona59 · Dec 14, 2004

I worked "casual" as a new grad at two facilities. We were employed by the hospital, same union wage plus a percentage in lieu of vacation. No benefits unless you were hired as a permanent float nurse.

To sum it up, the staffing supervisor told me not to sweat it, if she'd had negative reports from the units I worked she wouldn't be booking me. I was willing to work at short notice or half a shift, without demanding double time or payment for the full shift. To me casual meant you worked a certain number of hours. I knew of casuals who wanted double time for less than three hours notice, or payment for the full shift when they arrived two hours into it. But then some union contracts state that the replacement will be paid for the shift that was filled. I guess its up to interpretation and the amount of nerve of the nurse involved.

It kind of made my day when I'd walk onto a unit and get "great, its you!". It kind of hurts after a while that nobody remembers your name, only your face and skills. Kind of bites when you need a reference for another position "tell them to ask about the chubby brunette that was willing to work half shifts?"

There were also staff nurses who when I saw them I knew it was going to be a long shift.

Like some have said, good/bad staff nurses, good/bad casuals.

Look at the individual nurse and not the title.