Looking to be an RN in Cali next year...but I need FACTS!!!

[tanyaRN09]

Hi guys!

I may need to move to California sometime next year and I would like to do bedside nursing. I was talking to someone the other day who said aboslutely NOT!! I said one of the main reasons besides Cali having better pay than Illinois was the 4:1 nursing ratio. He then proceeded to tell me that although the ratio is there, there are no CNAs so the RN are resposinble for bathing, feeding, toileting and that there are no transporters for pts (to take them to MRIs, CTs, X-rays, etc.) he said RNs do the transporting. Along with that, he said there are no IV RNs, I'd do them all myself. Is this all true!!!??

I work a a hospital where the ratio is just about 4-5:1, and there is one CNA for every RN. Transporters take pts to all exams needed, and we have an IV therapy team so we never start IVs. I feel so spoiled compared everything that was told to me. I really would like to know if any of this is true at all. I came back from Cali (actually, yesterday) and I absolutely loved it. Hope you guys can help.

Thanks so much!!!

[itsthegreeneyes]

I think whomever was giving you advice grossly misrepresented California. This maybe the case at some hospitals, but definitely not at all of them and probably not at larger, more urban facilities. I work in the Bay Area on an oncology/pulmonary unit and the nurses usually have 3-4 patients, only 5 when we are short and that does no happen very often. On a 26-bed unit there always at least 2 aides, 4 for days, 3 for pm shift, and 2 for noc shift. So the primary care is mainly up to the CNA, but of course the teamplayer RN's help when they can. I do know that with the recent budget issues at most healthcare facilities, that some are practicing primary care or a mixture of you doing primary for a couple patients with an CNA for a couple of your patients. However, in the Bay Area this is not the norm, I know that the Sacramento area this is more common. We also have a Lift Team that you can easily call and come help with the heavier patients for repositioning and transferring (this super helpful). Sometimes the RN does need to go with the paitient depending on their acuity, but we have transporters around 24/7 and I think a transport RN is available at least during the day. However, most patients just go with a transporter. Lastly, the IV team is there for us to use with the hard sticks, PICC placements, etc... You must at least try to start the IV, and then call them. However, on my floor if you cannot get it chances are you can find someone who can and really wants to rather than calling the lines team. I love working at my facility and California is a great place to work, not to mention the higher wages, especially in the Bay Area. However, this comes at a price because the cost of living is higher and the competition for jobs is way tougher than most parts of the country even for experienced nurses. With that being said, and as most people on this board will tell you, make sure you have a job before you make the move unless you are financially blessed, because it make take you a while to find a job. Good Luck.

[RNKPCE]

I agree with itsthegreeneyes. Where I work we already were pretty much staffed at ratio levels on days an pm's before ratios were implemented. We also have a break nurse to help the charge give breaks. We have CNA's not one per team of 5 patients but you sort of share a CNA with another RN. Of course there are always days were we might be short staffed and not have a break nurse etc but this is not the norm. Night shift does not have an CNA. We have transporters to take patients to ancillary dept and a resource nurse who if not tied up in a rapid response will transport unstable patients to test. We do not have an IV team, never have, we start our own IV's and if unable to get ask a co-worker and/or resource nurse. We have an IV nurse for PICCs.We have respiratory care techs for breathing treatment and housekeepers to clean the unit. I believe there probably are hospitals in Cal that did what your friend said when ratios went into effect but not all did. Just chose your hospital wisely and don't let the high wages fool you the cost of living is quite high.