May I ask a few questions?

nightingale, RN · Nov 7, 2003

Sure

Originally posted by angelbear
Over the last yr we have had several agency nurses at our facility. For the most part they have all been awsome. My biggest problem as a staff nurse at my facility is the politics and personality conflicts.

One of the big reasons I stick to Agency Nursing

Originally posted by angelbear
The agency nurses tell me these are their main reasons for not working as reg staff. What I want to know is how do you adjust from place to place?

With a solid Backround, it is predictably easier. It takes a while to transition. The first two hours at any new facility is usually the hardest. This would envolve (for me) the pill administration, checking orders, Dr. rounds, assessments, etc...

Originally posted by angelbear
I know alot of the snobs where I work feel that agency should just be able to jump in and do the job with no orientation. I dont think I could safely do that. At most of the places you work do you get any sort of orientation or are you just expected to jump right in?

Most facilities give at least a days orientation, some none. Honestly, most places need that day or two of orientation; some truly do not. Keep In mind, I also do Nursing Home Facilites that are usually pretty generic.

Originally posted by angelbear
If so how do you do that and how is it safe for the res/pts?

You get used to the constantly changing environment. I find I am able to focus more on the patients and am very good at the diversity. It took several months to be able to flip around and rotate to different hospitals.

I do not go back to facilites who are unreasonable with the patient load, dump on me cause I am the Agency Nurse, or are a dangerous environment in general. Not only is it "not right or good patient care" but it is a potential danger for my license and reputation.

Originally posted by angelbear
Are you generally treated well or do you face alot of attitude and resentment?

More then 75% of the time I am treated well; I DO NOT go back to facilities that are not safe, unreasonable, and very unpleasant. I think by and large, nursing is tough; I do my best to grit my teeth (even at the worst of facilites and get through the shift). If I am treated poorly, I lick my wounds and have a quiet pity party while I cash my check (okay so I am being a little dramatic).

Still, as in any nursing environment, you have the right to refuse a patient load or assignment. This is standard nursing practice to protect you and the patient. I once refused to take care of a Neutropenic patient with another who had MRSA; the charge nurse did some switching and everyone understood it was good patient care with a little flexibility of the other staff. I also speak up when I have not done a particular type of, say diagnosis, to se if I can have a readily available resource person (who truly will and has the time to help me). You can pull a lot off with a kind smile and diligent attitude.

Agency Nursing is here to stay in many cities across the country. Most facilites, are smart enough to know it is an necessary component in safe and appropriate patient care. I am committed to being a strong advocate for my patient, while providing the best patient care. I am, at least, equal to the top nurses on the floor I am working in that particular day. I do not ask for what is not reasonable and work to only add positive support and care for the patient... Oh and I do make top dollar, I have worked hard on my skills, credentials, and me... I deserve the best because I give the best.

Originally posted by angelbear
I would definately like to get away from the day in and day out drama and politics plus it would be awsome to set my own scheduel but I dont know if I have what it takes to jump right in all over the place like that.

You can do just that and more, depending on the availablity of needs in your area. I wish you only the best. Please let us know how we can support you in your endeavor.

Originally posted by angelbear
I appreciate any comments.

There has not been one facility, job, or credential / degree that has empowered me more then Agency Nursing. The confidence I have gained in Agency Nursing with an emphasis on my Entrepreneural Nursing endeavors has been more then I could have ever hoped for.

Please try searching on this BB; this forum and the Entrepreneural Nursing forum disuss many issues that involve this same type of queries.

Whatever you choose... enjoy...

graysonret · Nov 15, 2003

Nightngale pretty much summed it up. It's important to get organized quickly and setting your priorities for the shift. Most of the time, other nurses are helpful, that first shift. I get orientated "on the fly", sortofspeak. :). Biggest problem is getting familiar with the patients, and them to you. I've been doing agency work, exclusively, for years. Love it and don't think I want to do anything else. Over time, 13 years, I've only run into 2 places that I've "DNR'd myself. Both times were hostile staff. I look at it this way. I'm there because they needed help. I'm paid well for my skills, my ability to think on my feet in new situations, and to get the job done in reasonable time. If they want to be hostile to me, then they can find someone else. I don't need them. However, I've built up a good reputation over the years, and places who do use agency nurses know me. I'm in business for myself, so I need to have that reputation to get the shifts, and money. Only 1 shift, in recent years, has been "overwhelming" to me. It took me 10 hours to get everything done, instead of 8, and that was "running". 2 days later the place split the unit for 2 nurses. LOL. One last thing. I make it a goal to get every patient to, at least ,smile once, on my unit. A laugh or a smile goes a long way in the healing process. And, it does me a lot of good too, when a patient will remark later..."Can I have that nurse again? I like him." Get enough of those, and you go right to the top of the list, when they need a good agency nurse. :cool:

BarbPick · Nov 16, 2003

These posts are hard acts to follow. There is a way you can try agency like nursing and that is to join a different hospital's pool. Believe it or not the secrets of the universe are everything you learned in Nursing 101. They all apply no matter where you work. Something people do not reinforce enough is you have to be a duck. (huh?)

You must be able to let things roll off your back.

If you leave your ego home, and bring humility and honor with you, you can't fail. Now why would I say that, easy, think of every person you have oriented and think of the things about them that drove you nuts. My best example is when I would go over the area policy, and Someone who wasn't really paying attention to me, wanted to argue and say "When I was at Mount Sinai, we did it this way...(I wanted to scream you are not at Mount Sinai anymore, we do it this way)

The best way to do agency nursing is to remember you are not there to do anything other than give patient care, and your silence plus assisting your Pateint Care Techs will get you asked back again.

mattsmom81 · Nov 23, 2003

I do ICU agency work rarely anymore in my area. More and more I find units with unresponsive leadership... charge nurses who are not available to the agency nurse and/or will not be a resource to me. It did not used to be this way...only in the past 5 yrs have I noticed this. If a critical care area has a good resource charge nurse an experienced agency ICU nurse will do well there. I suspect this is true of other units as well. Today's nursing unit is more likely to have hidden agendas and rules, unwritten policies, etc. The agency staff can become scapegoats in these types of units. So I choose NOT to be.

I'm perdiem in my home base ICU, and when I do agency I generally pick and choose. I have found a few rehab facilities I like here: LTC acute centers as there is less liability for me. I am comfortable with my ability to manage things without a lot of orientation.

I guess one must try agency to know if you will like it. Then weigh the pros and cons: looking at YOU, and the local atmosphere. One can always say no to going back to a bad unit: this is one big pro to agency...

Agency can be very rewarding but it does have it's pitfalls. And rarely do I get an adequate orientation anywhere: it's 'can you come in a half our early for orientation?' We hit the floor running usually. Not everyone is comfortable with this.

cannoli · Nov 24, 2003

Originally posted by mattsmom81
I do ICU agency work rarely anymore in my area. More and more I find units with unresponsive leadership... charge nurses who are not available to the agency nurse and/or will not be a resource to me. It did not used to be this way...only in the past 5 yrs have I noticed this. If a critical care area has a good resource charge nurse an experienced agency ICU nurse will do well there. I suspect this is true of other units as well. Today's nursing unit is more likely to have hidden agendas and rules, unwritten policies, etc. The agency staff can become scapegoats in these types of units. So I choose NOT to be.

I'm perdiem in my home base ICU, and when I do agency I generally pick and choose. I have found a few rehab facilities I like here: LTC acute centers as there is less liability for me. I am comfortable with my ability to manage things without a lot of orientation.

I guess one must try agency to know if you will like it. Then weigh the pros and cons: looking at YOU, and the local atmosphere. One can always say no to going back to a bad unit: this is one big pro to agency...

Agency can be very rewarding but it does have it's pitfalls. And rarely do I get an adequate orientation anywhere: it's 'can you come in a half our early for orientation?' We hit the floor running usually. Not everyone is comfortable with this.

I've noticed that also, what you describe in the first paragraph, and because of it have refused to go back to a floor. As far as I'm concerned, they are just shooting themselves in the foot, though I'm sure they don't see it that way.

dragonfly954 · Nov 26, 2003

I've been an agency nurse x 2.5 years.I find that the only time the staff tries to draw me into the politics and problems at their facility is after I've been there for awhile.Sometimes it can get really ugly listening to them backstab one another.It's usually only one or two that do this on a regular basis,thank goodness.I quickly learn who they are and do my best to steer clear of them.It's funny how a select 1 or 2 can really disrupt a unit.The best thing to do is to keep in mind that you are only there a few hours and there's usually enough to do to keep you busy. If it gets really out of hand,remember you don't have to go back.They do!