Expectations of agency nurses

BeenThereDoneThat74, MSN, RN · Feb 6, 2005

My personal favorite.
I worked Christmas Eve....and I was floated.
One the floor where I was floated, virtually EVERY STAFF MEMBER WAS AN AGENCY/ CONTRACT/TRAVELOR FLOAT. On a 55 bed unit, the only regular staff was the charge nurse. And the floor was full.

Isn't that nice, that their entire staff got the holiday??? Happened to me once, as a staff. Got floated on Thanksgiving. I guess someone was 'too sick' to come in, or she just got the holiday to begin with :angryfire Working a holiday is bad enough, but working it with total strangers and completely different pts is even worse :crying2:

BETSRN · Feb 10, 2005

What is the deal out there today? Is it me or do staff nurses place increasingly unreasonable expectations on us?
Seems like every shift is the same...they sit and watch me run with the worst assignments AND admissions. And what is this deal about expecting an agency nurse who comes in once in a blue moon to manage a critical unstable patient? What kind of charge nurse would make an assignment like this? I don't know their docs, their unwritten protocols, their 'ways' of doing things....
Had to vent guys...its getting to me....can anyone relate? How do the rest of you manage getting 'dumped' on...sadly, I can no longer find anywhere to go where this does NOT happen to some degree and its more than wearing on me...
maybe its time to retire....

It's so unfortunate when units do that to their travellers. In L&D, we have been so lucky to have the best travellers. Each one becomes one of us and they usually do not want to leave at the end! What recourse do you travellers have for lodging a complaint about safe practice? I'd sure use that. We would never in a million years dump on our travellers. They save our butts sometimes. Sadly, with finances the way they are, we are no lnger using travellers, at least for now!

Crumbwannabe · Mar 10, 2005

Well I guess the staff's attitude is the agency nurse should do whatever they don't want to do that shift. I don't mind taking my share of admissions in ICU after I've gotten comfortable with the place and their computer, etc.......but my first shift there?? and every shift? Sometimes 2? I'm good but not that good....it feels like dumping to me. We all know how time consuming the admissions processes are today and someone who doesn't know the place has it even tougher. Add an unstable new patient and...well those of you who are ICU nurses can relate I'm sure.
I have tried to say 'I'm uncomfortable with that' (unstable new admit my first time at this facility) and then I am DNR'd. As I shared before I find this same type thing every ICU I go to these days. Guess its time to do something else for a living as I'm no longer adaptable to this type work environment. I hate the politics of onstaff so that's out too.
I always asked an agency nurse (just like I asked my own staff when I did charge) their comfort level. I never expect a nurse to be comfortable with EVERY situation and tried to make assignments based on skills, experience, and comfort. I never enjoyed my coworkers's discomfort and seems like staff plays games with agency today...I've watched them do this to other agency nurses as well so I don't feel singled out.
I tried to be a nice person to everyone I worked with but I'm not the norm out there anymore. More and more I work with hateful, vicious, bitter people. I'm hating going to work and am fearful the entire time I am there. The hostility is overwhelming.
I cannot do this anymore. Quit the agency today, gonna read a novel, watch some warm fuzzy Christmas specials, bake some cookies for the kids and be good to myself awhile. Then I will look for other options. It will not be in a hospital and maybe not even in nursing.
Whatever has happened to the majority of the nurses out there in my local ICU's I don't know. I can understand their frustration but not when it is directed at coworkers so blatantly.
God Bless all of you who are still hanging in there...I cannot do it anymore. Thanks for letting me vent and come to a decision. It is not worth doing something that makes you feel this bad.
Hope everyone's holiday season is joyful and relaxing. Hugs to all here. :)

I've worked one on one type specialties such as cath lab, G.I., E/P, surgery, et.c so long that I've really forgotten a lot about organization in med-surg, tele, other floor work (I'm nice to have around when someone goes sour). I agree with you. I dread working, and I dread being cancelled. I need to regain my experience, but it's a difficult learning curve if you're not at the same place for a few days, or getting cast into different places day in/out.

Really losing my confidence. It's like you have committed some moral wrong because you need to get used to the place. Hate the politics of steady jobs so badly that it's just not an option. And temps on the one on one specialties are pretty rare around here. Ah well, thanx for the chance to blow....

Jay Levan · Mar 11, 2005

I work in LTC and it seems they sometimes give the "agency" nurses the hard
assignments. I think some of the regular staff are jealous of the "agency" nurses making more money than regular staff. I'm not jealous of "agency" nurses and I try to help them when I can. :)

If our own compatriots,are jealous of us, then where are we as a whole??!!

:uhoh21:

Jay Levan · Mar 11, 2005

I have worked Agency Nursing for the majority of my career, primarily because I hate cat fights, and I'm not good at it. I thought that I had found the solution, to that problem, only to have this type bias to rear it's UUUGLY head. In case there are people out there, that do not understand UUUGLY, the definition of UUUGLY= 12 different kinds of ugly.! I have found by asking questions, that most if not all these type people are biased against everything they consider a threat. If you do not believe this, think about it, here comes a nurse that in all probability, is better at taking care of sick people than they are or choose to be. Agency Nurses, they know full well have not had anywhere near the Orientation they've had. Their attitude about this ranges from "Oh, they think they are better than we are", to "They make the big bucks, let them have the toughest assignments!" :angryfire :angryfire Of course, one can only generalize others opinions without eliciting data from the individuals in question (Regular Staff Nurses), however if there are enough responses here, we may be able to see the true pattern that does exist. These nurses will do anything they can to a. take some of the "HEAT" off themselves, and b. trip up the Agency Nurse to make the point that they are better than any Agency Nurse! They sit down with policy manuals, while we are to busy to notice and look for things in them to call us on, or even worse yet they report us without giving us any chance to correct our "by the book" mistakes. Even in the rare instances where we are mistake free, (I don't know anyone mortal, that does not make mistakes) they will eventually blame us for something like "Team Cohesiveness, or the lack thereof while we are on duty. Once again they (Staff Nurses) know if "Push comes to Shove" they can scuttle us out by continuing to complain about us whether they are honest or not, simply because they are "ON STAFF" and we are not! :angryfire

mattsmom81 · Mar 11, 2005

Yes you are right Jay. We are the 'outsiders' and they have the power to hurt us if we don't dance to their tune. That is why they can get away with it. Nurses have so little power and authority.

Nurses turn on each other so quickly...its the only power they wield, and the only power that is supported by administrators ie 'weeding out those bad nurses'.

dysfunctional but I've seen it time and time again. Those nurses who report other nurses are rewarded by administration and thus the 'nurse eating' behavior is supported.

Agency nursing 'used to be' my favorite role..I could stay OUT of politics. This worked well for me for about 10 yrs until I noticed the trend of increasing hostility and demands made on us, without any support...ie 'dumping' getting worse in my metro area of Dallas- Fort Worth Texas.

I have since moved to another area (Tacoma Washington area) and am VERY tentative about trying agency work again, due to my last experience.

I am worried I will walk into similar hostile situations and I honestly don't know if I ever want to take that chance again. Luckily I do not have to work right now so I can take some time and consider my options. :)

I appreciate this forum and the chance to bounce things off my colleagues here, get their 'take' on things, and their input. :)

kjt2004 · Mar 15, 2005

So true, they don't realize the benefits they have that we don't! The few extra dollars we make is because we forfeit those benefits.

ITA with the above statement. I am a CNA, but I have seen it in my own facility, and doing agency work. Regular staff are often upset because agency nurses are making more for the same work, so they give them the hardest of everything on the floor. What I think that regular staff doesn't understand is that they have things that agency nurses don't have such as job stability, agancy work isn't alwasy constant. They also often have benefits that agency nurses don't get.

kjt2004 · Mar 15, 2005

I don't care what the staff nurses think or do!

I do my job to the best of my ability. If you don't like me, tough luck!

Yes, the things they do and say are hurtful and annoying sometimes. But, on pay day they are not signing my check.

They can be as bitter and nasty as they want. They have to live with themselves. After my travel assigment and many $$$ later I will be saying goodbye with a big smile on my face.

Whatever they ask me to do, I do it with a smile. I try to never give them satisfaction by being angry or nasty like them. I don' t let them walk all over me. I yes them to death and work at my own pace. Don't think I am going to start with 2 pts and have 2 different ones at the end of the day while you sit on your fat a#*.

I say goodbye at the end of my shift and tell them what a wonderful experience i have had with them :chuckle ...laughing joyfully in my head at the anger in their eyes when they realize their unfair and just down right "mean treatment" did not affect me.

They are not going to get me to quit. No way! I will only hurt myself and satisfy them at the end of the road. Why should i be broke because they are jealous?

Well I guess the staff's attitude is the agency nurse should do whatever they don't want to do that shift. I don't mind taking my share of admissions in ICU after I've gotten comfortable with the place and their computer, etc.......but my first shift there?? and every shift? Sometimes 2? I'm good but not that good....it feels like dumping to me. We all know how time consuming the admissions processes are today and someone who doesn't know the place has it even tougher. Add an unstable new patient and...well those of you who are ICU nurses can relate I'm sure.
I have tried to say 'I'm uncomfortable with that' (unstable new admit my first time at this facility) and then I am DNR'd. As I shared before I find this same type thing every ICU I go to these days. Guess its time to do something else for a living as I'm no longer adaptable to this type work environment. I hate the politics of onstaff so that's out too.
I always asked an agency nurse (just like I asked my own staff when I did charge) their comfort level. I never expect a nurse to be comfortable with EVERY situation and tried to make assignments based on skills, experience, and comfort. I never enjoyed my coworkers's discomfort and seems like staff plays games with agency today...I've watched them do this to other agency nurses as well so I don't feel singled out.
I tried to be a nice person to everyone I worked with but I'm not the norm out there anymore. More and more I work with hateful, vicious, bitter people. I'm hating going to work and am fearful the entire time I am there. The hostility is overwhelming.
I cannot do this anymore. Quit the agency today, gonna read a novel, watch some warm fuzzy Christmas specials, bake some cookies for the kids and be good to myself awhile. Then I will look for other options. It will not be in a hospital and maybe not even in nursing.
Whatever has happened to the majority of the nurses out there in my local ICU's I don't know. I can understand their frustration but not when it is directed at coworkers so blatantly.
God Bless all of you who are still hanging in there...I cannot do it anymore. Thanks for letting me vent and come to a decision. It is not worth doing something that makes you feel this bad.
Hope everyone's holiday season is joyful and relaxing. Hugs to all here. :)

kjt2004 · Mar 15, 2005

:) I hope things get better for you. We all have those moments in our lives.

I have had several injuries in the past few years that cause me chronic pain. ICU has been my niche and so I've tried to stay in it. To me it has less physical stress than the general floors. Lately, all the stresses of my job have become too difficult. Some of it is due to me not tolerating the crap out there as well anymore (due to my own stresses) Some of it is the changing environment of hospitals today...very unsupportive, unfriendly, 'dumping' mentality. I left a staff position and went agency hoping I could handle it but it was not to be.
Thanks for everyone's well wishes. I am trying not to feel like a failure but it is hard. I am fortunate I was able to return to nursing at all following my injuries... and I try to tell myself that. :)
Now its time to stop the craziness. I need some time to decompress...maybe see my doctor about better pain control. The fact I was working in nursing kept me from getting stronger painkillers...but I need to reasess...also the depression and anxiety that I am feeling. Perhaps a visit to a counselor is in order too.
Thanks for listening all and hugs to everyone. :)

kjt2004 · Mar 15, 2005

I am sorry to hear that! :rolleyes:

If I were a full time employee, I would expect to get the easier assignements, and for the temporary staff to be given the harder ones. Obviously, a facility wants to keep their full timers, so why wouldn't they give them preferred treatment?
Also, I firmly believe that an agency staff should be able to walk in and do the work. None of this "orientation".
I have worked agency since 1987, and have watched the changes, both good and bad. Choosing agency work includes all that goes with it...the tougher assignments, sicker patients, pain in the ### jobs, etc.
.

DallasRN · Mar 20, 2005

I just returned to hospital and agency nursing after a long absence. I had worked agency for years off and on - dating back to 1986. As others have said, I've given up guaranteed income and benefits for the "benefits" of agency work.

It seems that one of the major things overlooked in some of these posts re: agency nurses being dumped on is simple patient care and patient safety. I'm not lazy, and in my years I've met few lazy agency nurses. However, the fact remains that an agency nurse, regardless of his/her credentials and abilities, is unable to provide the same quality care as a regular staff member and especially during the first few shifts at a facility. Personally, I would rather be assigned 10 "easy" patients than 5 sicker or more complicated patients. I can handle sick patients once I know a unit - where supplies are located, who to call for what and even where the phone numbers are listed. However, working with your hands tied behind your back compromises patient safety.

I worked a facility last week...first shift...and I was assigned 5 of the sickest patients on the floor. During the shift, I had a discharge and an admission. In this particular facility, the regulars would bite a cyanide capsule before they would offer any assistance. To make matters worse, about two hours before the end of my shift, a patient started going bad with a possible PE. B/P soared to over 200 systolic. Doc ordered stat scans, etc., and the charge nurse was kept well informed. Amazingly, when my relief showed up, she was an agency LVN and another person that had never worked in this particular hospital. I was astounded at the assignment!! To me, this reeked of total lack of regard for quality patient care and patient safety.

Is this fair to the patients? I think not. Quality and safe patient care is supposed to be our primary concern as nurses - agency or staff.

Unfortunately, I don't have a solution, but like someone else said, I do my best to just smile, smile, smile. As they say, never let them see you sweat. The most frustrating thing to me is that after all these years in nursing, nothing has changed. We will never progress as a profession as long as we attempt to destroy our own. That is so sad.

Mister Chris, MSN, NP · Mar 20, 2005

I just returned to hospital and agency nursing after a long absence. I had worked agency for years off and on - dating back to 1986. As others have said, I've given up guaranteed income and benefits for the "benefits" of agency work.
It seems that one of the major things overlooked in some of these posts re: agency nurses being dumped on is simple patient care and patient safety. I'm not lazy, and in my years I've met few lazy agency nurses. However, the fact remains that an agency nurse, regardless of his/her credentials and abilities, is unable to provide the same quality care as a regular staff member and especially during the first few shifts at a facility. Personally, I would rather be assigned 10 "easy" patients than 5 sicker or more complicated patients. I can handle sick patients once I know a unit - where supplies are located, who to call for what and even where the phone numbers are listed. However, working with your hands tied behind your back compromises patient safety.
I worked a facility last week...first shift...and I was assigned 5 of the sickest patients on the floor. During the shift, I had a discharge and an admission. In this particular facility, the regulars would bite a cyanide capsule before they would offer any assistance. To make matters worse, about two hours before the end of my shift, a patient started going bad with a possible PE. B/P soared to over 200 systolic. Doc ordered stat scans, etc., and the charge nurse was kept well informed. Amazingly, when my relief showed up, she was an agency LVN and another person that had never worked in this particular hospital. I was astounded at the assignment!! To me, this reeked of total lack of regard for quality patient care and patient safety.
Is this fair to the patients? I think not. Quality and safe patient care is supposed to be our primary concern as nurses - agency or staff.
Unfortunately, I don't have a solution, but like someone else said, I do my best to just smile, smile, smile. As they say, never let them see you sweat. The most frustrating thing to me is that after all these years in nursing, nothing has changed. We will never progress as a profession as long as we attempt to destroy our own. That is so sad.

You are so right :angryfire I have worked agency on and off for many years up to 1999 then went totally self employed - and am still working as an independent registered nurse. The freedom is great as you say, so is the money, and there is plenty of work about at the moment with the nursing shortage we have down-under, but I have moved away from the general hospital now and mainly do night shift at aged care facilities! Many years ago I did fight back when I was "put upon" with unfair work loads, and refused to go back to any of those places that treated me like a skivvy.

Love your answer - smile and dont let them see you sweat or suffer. Stay cool! I did find that very difficult but it was reward in itself.

Keep waving the flag for the agency or independent nurses.

Love loy all.

Mister Chris :specs: