So I'm an ICU nurse who has experience in various ICU settings like Neuro, Cardiac, CV, Medical, Surgical. I've been traveling for about a year now and enjoy it overall and plan to continue to travel until CRNA school next Summer.
Something I've noticed here lately that doesn't settle well with me is the low acuity of the patients I'm being given. Why is it that I always get the patient going off all their drips, preparing to transfer to Med/Surg or Step Down, pulling the Swann, extubating, overall decelerating care? It's a little insulting actually not to mention creates a boring day and the risk of your critical skills becoming rusty.
Has anyone else noticed this? This is probably only relevant to ICU travel nurses. This hospital I'm at now won't even let the ICU travelers take a patient with CRRT or IABP! I'm not asking for you to give me your crashing ECMO or LVADs patients, Hell you can even not give me the fresh CABG's, but damn, do I always have to have Grandma from the nursing home crapping the bed on lactulose and hollering for ice chips?
Not to mention the connotation behind the action. As if you're not capable or intelligent enough to handle an actual ICU patient requiring critical skills.
It gets very old and I'm beginning to wonder how long can you not take critical patients and still consider yourself a current and proficient critical care nurse?
I'm ED. So far my facilities try to save the super sick for the orienting new grads and rightly so. They need that experience more than me. At my home facility I get the sickest. So it's nice to be the "fast track" nurse, be able to chat with my pts and do pt education cause they're not tubed :) I've worked trauma during travel as well and honestly I no longer have the patience to deal with tantruming surgeons or protocols that fly in the face of common sense.
Don't even get me started with my problems with hospitals forcing ICU nurses to float out to the floor against their will. You can even tell the facility you have no experience outside of the ICU and they still will pull you to the floor with no orientation over and over. I don't mind being flexible and taking 3-4 patients on your step down unit but putting me out on the floor, big problem. Only one hospital I've worked for has done this and I've been clearly vocal that I'm not staying for that one reason.
Staff gets first pick of the "interesting patients." Travelers get first crack at the chronic patients. That's the way it's been everywhere I've ever worked, as staff or as a traveler.
Just because it's the way it IS doesn't mean it's the way it SHOULD be. As a traveller, you ARE part of the staff for the duration of your contract, and should be treated with the same respect.
Exactly Ned! This red headed step child treatment that travelers get really needs to end. Do the staff members realize we are coming in to help and keep them from being overloaded with patients?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Just because it's the way it IS doesn't mean it's the way it SHOULD be. As a traveller, you ARE part of the staff for the duration of your contract, and should be treated with the same respect.
Exactly Ned! This red headed step child treatment that travelers get really needs to end. Do the staff members realize we are coming in to help and keep them from being overloaded with patients?
It has nothing to do with respect. It has to do with budget and safety.
Travelers have a 13 week contract, and in that short amount of time, it's very difficult for the charge nurses (who rotate through that position) to get to know any individual traveler and their strengths and weaknesses. The best we can do is assume that you're competent to take care of our basic patients. We don't have the time (or the budget) to train travelers to do devices such as VADs, IABPs, HD or ECMO. We don't have the time (or the budget) to train travelers on Dr. ImaFlamingDonkeyButt's "special" protocol for all of his transplant patients. So we assign the travelers to the patients without VADs, IABPs, HD, ECMO or Dr. I's special protocol.
There are many reasons to travel, but if you're traveling so you can take care of the most acute patients everywhere you go, that's not gonna work out. Staff gets those patients. And when you think about it, it's disrespectful to staff to give them the chronic patients while the traveler gets the sickie. You want to take care of those patients, you're going to have to go on staff somewhere.
It has nothing to do with respect. It has to do with budget and safety.
Travelers have a 13 week contract, and in that short amount of time, it's very difficult for the charge nurses (who rotate through that position) to get to know any individual traveler and their strengths and weaknesses. The best we can do is assume that you're competent to take care of our basic patients. We don't have the time (or the budget) to train travelers to do devices such as VADs, IABPs, HD or ECMO. We don't have the time (or the budget) to train travelers on Dr. ImaFlamingDonkeyButt's "special" protocol for all of his transplant patients. So we assign the travelers to the patients without VADs, IABPs, HD, ECMO or Dr. I's special protocol.
There are many reasons to travel, but if you're traveling so you can take care of the most acute patients everywhere you go, that's not gonna work out. Staff gets those patients. And when you think about it, it's disrespectful to staff to give them the chronic patients while the traveler gets the sickie. You want to take care of those patients, you're going to have to go on staff somewhere.
Great comment and on topic, but it doesn't address the common issue of interviewing ICU travelers who then find themselves on a float team and everywhere but the ICU.
Obviously you are at a very large hospital, but you are making nurses into generic commodities. With that hiring principle and expectations for travelers, one year of experience is more than sufficient. In fact, you might be able to save on your hourly cost by specifying no more than one year of experience. A good number of travelers will appreciate it and might be challenged by your hospital rather than bored.
Exactly Ned! This red headed step child treatment that travelers get really needs to end. Do the staff members realize we are coming in to help and keep them from being overloaded with patients?
HikingNinja, BSN, MSN, DNP, RN, APRN, NP
612 Posts
I'm ED. So far my facilities try to save the super sick for the orienting new grads and rightly so. They need that experience more than me. At my home facility I get the sickest. So it's nice to be the "fast track" nurse, be able to chat with my pts and do pt education cause they're not tubed :) I've worked trauma during travel as well and honestly I no longer have the patience to deal with tantruming surgeons or protocols that fly in the face of common sense.