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nursetaminator, RN 5,078 Views

Joined: Jul 10, '07; Posts: 145 (28% Liked) ; Likes: 86
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  • May 25 '16

    Pretty sure that nurses are ethically required to be fit for duty,
    when they present to provide cares, & must be cognizant of this.

    If your functional capacity is compromised, even by fatigue,
    it is best to call in, rather than risk a real bad outcome.

  • Feb 27 '15

    Pts don't remeber the name or doses or frequency of their BP meds, cardiac meds, necessary supplements, or anti coags. But when it comes to their sleeping pills, pain pills, or sedatives, they know the name, dose, and how often they take it. When they are close to discharge, and the route is changed from IV to PO in prep for going home, at least half my pts become upset by the change and request one more dose IV. At this point, I don't give a flying fig, so I ask for a one-time dose to make my job easier, and that's exactly what I say to the prescribing resident.

    in my short career, I have learned that I can't care more about a pts well-being than they can care for themselves. It's not a "good fight" I'm gonna win, so I refuse to fight it.

  • Feb 23 '15

    No standard there but a day is good business for all the involved parties. Really, you shouldn't interview unless you are already 90% sure you will take it.

  • Oct 9 '14

    The agency cannot go to bat for you and you need to understand their perspective. The hospital is their client not you. The agency has no control over your work or your workplace. Your recruiter is in sales and has no clinical training. You are the professional here and only you can impact your practice. If the charge nurse is unresponsive and you cannot practice safely, then you need to move up the chain of command to the manager. I do know you are clinically capable of doing this job as were other travelers before you. The main obstacle is yourself. Yes, this clearly wasn't the best first assignment for you and the staff may well be jerks. The recruiter is also at fault here for placing you in a bad first assignment even if you pushed for this particular assignment. It is up to you to restore your professionalism and make the best of it. It is only three months and it will get better if it can be completed. There is a good chance it won't if the agency upsets the hospital.

  • Oct 9 '14

    Quote from Mary C
    Yes but if I am missing facility specific things, I hear the other nurses talking about me, but no one ever mentions it to my face.  I ask for help or where something is on my third shift and get told that I should already know.  I had a migraine the last two shifts the entire time, and this morning threw up just thinking about going to work so I called off.

    I know that breaking a contract is a huge black mark on myself & my travel company, but I can't do this for 11 more weeks.
    This will sound harsh, but you are headed for failure here. You are not 15 living in a goldfish bowl, you need a thicker skin. You need to disregard what people are actually saying about you or what you think they are saying about you. You are a professional focused on patient care. If someone is not a team player and won't answer a question, ask someone else. It is not uncommon to throw up before a stressful event, a number of successful actors and politicians have been doing it their entire career. The show must go on.

    If if you feel like the situation is so severe that intervention is required there is no point in talking to your agency, that can only make things worse in this case. You are effectively staff, the agency only handles the money. So you handle it as a staff member would do, go to your manager. It is possible that a mutual decision (or a unilateral one) will be made that you are too weak to continue (more likely emotionally than clinically) and you assignment will be over. Or some effective mediation will happen to get you back on the right track.

    Either way, that is the right way to approach this matter if you cannot handle it on your own. If the assignment fails, then you can work things out with the agency. I would again encourage you to buck up and pretend to be an island at work and focus on patient care. Throw up daily if you have to but don't quit. Perhaps this is the most stress you've had that you can remember, but with little effort I think you will be able to imagine a worse position you could be in. Every day at work and on the street, I see people in horrible health and life circumstances and think about how relatively fortunate I am.

  • Oct 9 '14

    You will be OK! It was hard for me to let go of what apparently is a little streak of perfectionism (my co-workers at my last permanent job are shaking with laughter right now). I hate making mistakes and I hate leaving anything undone. When I could remind myself to let go, being a traveler was a lot less stressful. This isn't like a permanent job where you have to learn this stuff because you're going to be using it for two years, teaching others, etc. All they expect is for you to take good care of the patients, ask when you need help, and otherwise, do the best you can. The expectations are different--repeat that to yourself as needed. You are never going to know all the little ins and outs of this unit or this hospital. Let that go. On my last shift I am still asking people where a piece of equipment is or whether I need to call a doctor (per protocol--obviously from a clinical standpoint I know when I need to call a doctor). And if the staff isn't very nice about answering questions or about the little things in the charting you didn't even know you were supposed to do and think you're the dumbest nurse they've ever come across? They won't, because you haven't killed anyone, but even if they do--big deal! You're never going to see any of them again. You probably don't even need a reference from them.

    The role of a travel nurse isn't just to be a staff nurse for thirteen weeks at a time. It's actually a different role. Perhaps it would help to think of a substitute teacher. No one expects a substitute teacher to come up with lesson plans or write tests or make up classroom rules--she's just there to keep things going while there's a need.

    Good luck! It's only going to get better from here.

  • Mar 25 '14

    I don' think it is NETY....Some people just don't know how to behave. If you forgot something the professional thing to do would be to tell you the next time you worked.

    My approach...Hey...the other day when you gave me report on the patient that was a pain in room 2. There were some things I noticed that you need to do ....I know how overwhelming being a new nurse can be. I finished them up but I want you to know so that we can work on you becoming more and more independent. Here is how I handle these situations.

    Some people love to complain and have no people skills. ((HUGS))

  • Mar 25 '14

    Quote from DEE S.
    I am sure it may be a panel or atleast 2 people, director and clinical coordinator. What is a career portfolio. My goodness it sounds interesting and a great idea. What goes in it, how long should it be?
    A career portfolio is where you put in a bunch of things showing what you have done - i.e. certificates, awards, a nice write up of all your volunteer activities, detailed write ups about any externships you have done etc. You can also include extra copies of your resume and cover letter. I used a nice report portfolio that you can find at Office Depot for about $4. It has a black cover with about 7 sheet protecters sewn in (so 14 pages) that you fill with your content. It also had a spine insert so you could put your name on it.

  • Mar 23 '14

    Quote from chare
    Could you clarify exactly what it is you’re trying to say?
    Hood Rats, Gangbangers, Multi-Generational Wellfare Recipients, IVDA ER Abusers, Non-Compliant Homless Addicts, etc..

    I think we all know what the OP means. Lets be real, many of us had worked in that kind of facility.

    Hey look, I have been there. Putting on a smile while these pts and family are being absolutely rude to me. This is one of the few careers where we literally have to swallow our pride and take it. I hate that feeling. I solved that problem by transferring. Now I absolutely love my job!

    I feel for the OP. That is what my MS floor was like, and I hope you find a niche that is more suitable for your health and sanity. You do not have to explain to us your reasons for wanting to leave. Just know that I feel for you. Stay strong and get out of their ASAP, Save Yourself!!! Transfer Transfer Transer!

  • Mar 15 '14

    Anticholinergics inhibit nerve impulse activity of the parasympathetic nervous system. If you remember your A&P, the PNS acts on digestion, urination, salivation and lacrimation. PNS 'rest and digest' which is opposite of sympathetic 'fight or flight.'
    An ex. of their use may be bladder spasms. Major common side effects are that they dry you up because they inhibit the PNS. So the way that I learned to remember it was:
    Can't see
    Can't pee
    Can't sit
    Can't s***

    Maybe not the most professional rhyme, but it helped me numerous times on my nursing school exams. Hope this helps.

  • Mar 14 '14

    It is really difficult to compare staff pay with travel pay and it often depends on where you are staff for whether you can really make a financial case for it. In terms of total compensation per hour, most contract pay between $40 and $50 an hour which is 80 to 100K per year for minimum weekly hours. But this doesn't tell the whole story as it doesn't include tax benefits which can increase your bankable pay substantially beyond staff pay of a similar gross amount. However, the benefits of being staff with good insurance, vacations, holiday pay, education and sick pay does add 20 to 30 percent to staff pay (at least from HR's perspective). If you are in fact making between $40 and $50 an hour as staff, then you may have a difficult time doing the math on paper. For nurses from the south (where most travelers come from), it is easy.

    Some travelers working rapid response jobs working 48 hours plus can actually make over $200,000 a year, but this is far from the norm and usually requires a lot of hard work at crappy hospitals. I think of most travelers working normal contracts and not taking time between assignments as making on average 80 to 100K gross, but more take home with tax benefits. Some new travelers do much worse as they spend as if they are on vacation. To do better in savings, you have to be disciplined, especially with housing. Lots of no cost or low cost ways to enjoy new locations. I do a lot of exploring by bicycle myself.

    Things are really different going from staff to travel. For myself, I went from 3 years as staff in Baltimore to travel and there was no comparison. In 3 years, I just saved enough to buy a good used car ($2,000 in 1995) and started traveling broke. And I am super thrifty but housing ate up too much. My first several assignments paid within a couple dollars an hour of my staff job, but with housing and per diem I started saving 80 percent of what I made. Some 18 years later, I've paid for a house cash and have enough banked to retire modestly.

    There are tons of individual variables, specialty, ability to adapt, people skills, family, health, and desire. The last is the most important. Basically if you do anything just for the money, you are not going to be happy. If you have wanderlust, or truly want to improve or maintain professionally and not get in a rut, these are the best reasons to travel. Don't do it for the money, if you have a good staff job with a decent pay to housing cost, you may well do better financially to stay put.

    Too much thought about number crunching and you will never do it. You will have to try it to see if it works for you personally, professionally, and financially.

  • Mar 12 '14

    There are days when I walk out the door so proud of what I do, and days like today I come out completely exhausted ...I've been running like a chicken with its head cut off from the moment I got report to the very moment I gave report. I also had to stay 1.5 hrs behind to catch up with charting. Sometimes I wish the pace wasnt so fast. Moments where my heart isn't racing either. :-)

  • Mar 6 '14

    Start with paid housing, travel, and meals. Would you believe the agency also pays for every hour you work?

    Best deal since high school with paid everything, an allowance, and keys to the family car! And no parents to cramp your style.

  • Mar 2 '14

    It is do-able..yes. It is right, no but you will get better, faster and more efficient. You will get better at time management, delegation and dealing with families more effective. The first 6 months will be the worst time, it will be a huge learning curve for you. You will make mistakes, you will miss things BUT every mistake is a lesson learned and next time, you won't forget When in trouble, ask for help, not sure what to do, ask. I promise, you will get better and if after a few months, you feel this is not safe; find a new job with a lesser ratio.

    My first 3 months were hell, by 6 months I was getting pretty good at keeping it together and by a year I had a real understanding of what I was doing and how to manage it all. This takes time, don't be too hard on yourself.

    Also nothing wrong with asking for more orientation time if you feel you are not ready to deal on your own, but just keep in mind, your NM may not feel the same way.

  • Feb 25 '14

    My facility has recently instituted a new policy that ambien may only be prescribed/given in doses =<5mg; even with a doctors order for 10mg; even if the patient's home dose is 10mg. I'm wondering if anyone else's facility is doing this, and what are your thoughts on it?
    In my opinion, this sucks.

    There are plenty of people - me included - who use Ambien on a routine basis - either in split 5 mg doses or a single 10 mg dose, - without any difficulty.

    I say, let the clinicians and patients work out what's best on a case-by-case basis and not saddle them with blanket policies that can inhibit optimal patient care.