Kaiser LA, San Jose, San Fran- who's been?

Cali · Apr 18, 2012

I worked at Kaiser in Downey. Before going into Kaiser, I had heard many negative things from other travel nurses. I wanted to go and see for myself and gain my own experience. I was at Kaiser for 5 months and then ended up canceling my contract. I don't usually extend contracts but I extended this one because I feared unemployment. To start out Kaiser has a really low pay rate when it comes to travel nursing so initially, I felt like I couldn't really take the job seriously. So I'll give you the pros and cons....

Pros:

-Organized

-There's someone called T.O. that's able to bring supplies, blood etc., they also transport your patient to procedures so you never really have to leave the unit.

-There's a Hospitalist in house every night so if you have a problem with a patient or need a PRN there's always someone available. They will also come to the unit to assess the patient if they're going bad.

-The cafeteria has good food.

-The Downey hospital is really nice.

Cons:

-There's no Rapid Response Team.

-Lower pay rate, for more work. (I did more work at Kaiser than any assignment I've ever had. It's so overwhelming because they expect perfection but time will just not allow you to do all the things they require. Kaiser is the lowest paying travel job I've had in a really long time. I still can't believe I took a job with such a horrible pay rate.)

-Kaiser rarely has a CNA to help on the floor because there are so many sitter cases, so your CNA usually ends up sitting in a room all night. (In a 'normal' hospital this wouldn't be a problem but Kaiser expects so much more out of you, it's impossible to get everything done. I floated to DOU/Step-Down frequently and that's a tough unit to work on without a CNA because majority of the patients are total care and there's alot more charting. You can't get your charting done because the call lights are constantly going off.)

-Micro-management. EVERYONE is an auditer. (I had a patient in restraints once, and I know documentation is important. I forgot to document the 0600 restraint check and I didn't remember until I got home that morning. When I went back to work that night, I went back in and documented it. I saw the house supervisor at around 9pm that night and she said "thank you for going back in and charting your 0600 restraint check." I didn't know anyone was watching that closely! On 2 occasions I had a new admission and the assistant clinical director came by the unit and told me the patient had an IV that was never charted as being discontinued on their last admit and I need to chart that it's no longer in. Foley catheter and central line documentation must be done at 2000 and 0400, which is fine but if you forget, the Charge Nurse will kindly remind you. How did you know I didn't finish my documentation yet?

-The nurses are FREAKS and expect everything to be perfect during morning report. (On 2 occasions I had patients who had a Potassium of 3.3, both times the morning nurses looked at me and asked if I called the Dr.? If morning labs are critical, I will definitely call the Dr., but when I'm overwhelmed with trying to close out my shift and do my work plus the CNA's work, I can't call on every lab that's a few points from normal.

-Excessive charting. (You must chart your hourly rounds EVERY hour, chart pain every 4 hours, chart your assessment every 4 hours. There's so much charting. It's hard to chart at all when you have total patient care just about every night.)

-They like to float travelers midshift ALOT. (I don't mind floating, I know it comes with the territory for travel nurses. My problem is that I start my shift at 7pm and then get floated at 11pm. The first 4 hours are the busiest time of the shift. When you get floated at 11pm, you have to rush and finish your work from the first unit and then go to the next unit and start the entire process over. The nurse who's taking over your patients from the first unit expects everything to be completed as though you've had 12 hours to get your work done. No one cares that you've only been there 4 hours. The day shift nurses have it the worst though because I've spoken with at least 2 travelers who worked on 3 different units during their 12 hour shift. The problem is that some of the permanent staff do 12 hour shifts and others do 8.)

-If you change a central line dressing you MUST do it with 2 people. (That's just a Kaiser specific rule)

-Morning report takes a LONG time. (They recently started beside report and you have a little sheet to follow. You give report at the pt's beside and then you open the computer in the room and you go through the morning labs, any overdue meds, vitals, I&O's, etc.)

-You must call on EVERY critical lab. (If the troponin was 8.5, 5.4 and now it's 2.5, you still must call the Dr.)

-Every week, there's something new added to your task list. (They expect us to do one hand washing audit every shift. I'm sorry, but I don't really have time to sit and watch you wash your hands and then log into the computer and document how good or bad you did it. I'm really too busy being the RN and CNA.

Bottom line, Kaiser has so many extra rules/regulations. The nurses are like little robots. (Ever seen the movie "The Stepford Wives"? Kaiser was really an experience.

wanderlust99 · Apr 19, 2012

wow that sounds horrible....and I love the Stepford Wives comparision, I've really witnessed that at some of these hospitals (non Kaiser) in Ca. It's insane.

NYCRN82 · Apr 20, 2012

wow guys, thanks for the input. i am glad i have people to help me not go into this blind. i have been working 6 yrs as a nurse, the last 5 in a 970 bed major medical center in nyc, in the icu. i have a lot of skills that took a really long time to learn, and i swear if i were on the receiving end of a reminder to chart someone elses handwashing, i would just lay down and die. a 2-person central line dressing change? i dont even know what to say. im working with talemed and they have all these assignments but they are kaiser and i am doing my best to stay away. i like a hospital that strives for safety, competence and compassion, not "perfection" and policing each other. thats big talk for an organization that floats people 3 times a shift....i guess continuity of care isnt a priority.

is this the nursing culture in ca in general?

Cali · May 12, 2012

No, I don't think it's the nursing culture in L.A. I've worked in a few L.A. hospitals and none compare to Kaiser. Kaiser is just SO extreme.

Liketravln · Sep 19, 2012

Thank you Cali! Your post helped me decide not to submit to Kaiser! Would be nice to just take care of the patients without all the fluff