cvryder

I've been a nurse for 21+ years, was a "late entry" who went back to school when my kids started school. Been doing travel nursing for the last almost 2 1/2 years and enjoyed it as I was divorced within that time and it was an opportunity to try my wings and see what I'd missed. Now I am considering relocating and settling down. I have a place in mind and have been looking for a job in the area. I've submitted resumes to both career sites and individual facilities, been called by recruiters, and had several interviews, but nothing has come of them. In one case, I was invited back at company expense for a second interview and was told I was their "leading candidate," then after that interview did not hear from them for a week. I finally e-mailed the first person who interviewed me, who would have been my direct supervisor, and 2 days(!) later received an e-mail back stating that they had decided I wasn't a "good fit" after all. (This after they had told me I was!) I got an official notice from their HR department the following week, which they didn't have enough class to have a human being sign. Last week I had an interview for a job I'd been recruited for and I haven't heard a thing from them either. In all cases I've sent the requisite thank-you notes, etc. BUT...I am approaching what some might consider retirement age. I don't look it, I'm in excellent health, and I have a good attendance record. If it's come up at all (it only did once), I've assured prospective employers that I have no intention of retiring any time soon. You'd think with that, and my experience, and the nursing shortage, I could get somewhere. I am seriously thinking that there is ageism at work, and it looks like I'm doomed to finish out my career as a traveler. Discrimination on the basis of age is illegal, but you can't ever prove it.

I had a similar experience some years ago. I applied to COU after speaking with the manager and being told that yes, she *needed* more RNs, please apply for a transfer. A couple of weeks later I got a note saying there were no needs in that unit; however, there were still (multiple) positions listed for the shift I applied for. It wasn't rocket science, the unit I was on had an awful time keeping nurses and I later found out I wasn't the only one whose transfer the manager blocked. I went to another hospital and had no trouble getting hired for the same kind of unit.

I took PBDS at Pitt in Greenville, NC, summer of 2006 and passed, but I think a couple of nurses in my group failed it. My biggest complaint was how it was handled...we were told we'd know first thing next morning and it was well along in the afternoon before anyone found out. It's a very poor assessment, IMO.

Heparin protocols are CRAZY! Every where I go it's something different....Cruikshank, weight-based, some personal kind, just anything. What drives me craziest is the differing concentrations of heparin. I was always used to a 1:1 which makes the titration easy, but lots of places use some other concentration and it gives this traveler a headache. I think standardization of this sort of thing, maybe not just heparin but a lot of drugs, is something JCAHO could look at rather than some of the craziness they do.

NO, and I'd have done exactly what you did. Sounds like she is about ready to buy herself a pacemaker!

It varies according to what they call PCU. Some are nothing but glorified tele floors and you get anywhere from 4-6 patients. Others are self-contained and just this side of ICU with a lot of really sick patients. Best ratio I ever got in PCU was in Cincinnati, 1:3; worst was 1:5 and occasionally 1:6 in MD. General rule seems to be 1:4 on days and 1:5 nights. You can get anything from fresh post-ops to open heart stepdown (>24 hours out) to detox to vasoactive drips. Lots of total care patients. The post-open hearts are actually easier because they have to get up for meals and walk in the hall!

I went to a MSICU about a year out of school, and it wasn't till then that I *really* got my assessment skills down. On med/surg you're too darn busy to do more than superficial assessments, and that was even more true that many years ago. I disagree tht you need med/surg first because it's a different type of nursing--I'd describe it as "horizontal" nursing because you have to have an overview of a bunch of patients, whereas ICU nursing is "vertical" in that you have to have a *deep* knowledge of 2 patients. I think the instructor is just jealous because she had to do med/surg first

That sounds like the Syvek patch we used at one hospital I worked at. I liked them a lot. We then switched to the Clo-sur patch which you wet with a small bit of arterial blood, then hold over the wound firmly while holding pressure on the artery above it. Generally one nurse did it by themselves because we never had enough staff for 2 to be in the room. If your hands are big enough it's possible to do a Clo-sur one-handed...mine are NOT!

Go visit the Travel Nurse forum here, or the ones on Delphi...you'll hear plenty about all kinds of agencies. Travel nursing depends a lot on your recruiter, not just your company. Some pretty good companies have the occasional awful recruiter. That said, I've worked mostly for On Assignment and a couple of times for TNS. On Assignment had generally better positions and their housing is almost always really good. My recruiter calls me every week and listens to me when I call her. TNS might pay a little better, but I am not as happy with their positions, though I am fond of my recruiter. I won't go with Fastaff partly because they do strike nursing which I don't do as a matter of principle, and partly because I've always heard they work you to death in some pretty rough places.

Oh my goodness...the first two were peds and it took me about 4 months in each place to figure out I didn't like it. Went to M/S and was hating it, but in that small hospital the ICU manager picked me out as "good ICU material." Since then I've changed jobs about every 3 years, except for the 6 1/2 I spent in home health while my kids were in high school. Now I travel. I think my ultimate love is really cardiology, but I won't turn down a good ICU spot ;-) Peds, M/S, nursery, home health, ICU, cardiology, travel-travel-travel!

We had to do that once with a morbidly obese patient whose brand-new trach came out before it had been in 24 hrs! He ended up keeping that ETT in until they could get a specially-ordered extra-long trach for him. Normally there should be an extra taped at the head of the bed.

I'm contemplating moving to another state--long story, but involves a divorce. I know there are a lot of travel jobs within 3-4 hours of the city I want to move to. I'm not quite ready to give up the joys of travel nursing, but I'm wondering about doing something that I've heard about, which is getting your schedule "blocked" (3 in a row, which I'm doing most of the time already), staying in a hotel while you are working at the assignment, and commuting back home for the other 4 days. My understanding is that you take the housing stipend, use what you need for the hotel room and food, and get to keep the rest. I'm told it works pretty well for a lot of people. Has anyone done this, and how did it work out for you? Do some companies give you a better housing stipend than others? And do they pay differently for urban areas as opposed to more rural ones where cost of living might be lower?

I recently posted a resume on a couple of job boards. It states quite clearly in the "Objective" section that I am seeking a PERMANENT position in a particular area. I am planning to relocate to that area, though the specific location is yet to be determined and will depend on the job offers. HOWEVER....I have been inundated by phone calls and e-mails from recruiters for assorted travel companies, offering travel assignments everywhere including about halfway around the world from where I plan to relocate. It's gotten so bad that I don't even answer my phone unless I see someone's name on my caller ID who's on my list, and I have to keep my phone off if I want to sleep. I swear I wonder if these "recruiters" are bots, or if they just can't read! I am SO over this!!!!!! Friends have had good results from these job boards, but I'm not so sure.

It really varies with the unit, not so much the hospital, and I believe the attitudes come from above (usually the manager, who is either part of the clique, or is isolated/uninvolved/incompetent or all three). My last assignment was in a hospital that has an excellent reputation, on a floor that was pretty harmonious and on a shift where everyone really worked together. Once, however, I got pulled to another unit, where people wouldn't help you if you were on fire. I was surprised and appalled that this unit could exist side by side with mine, but I was told by staff on my unit that it was always that way and that it was basically because of the manager, and that "they can't keep staff up there." Gee, wonder why? Hang in there, it's only 13 weeks!

TNS has short term contracts also. I'm talking to them again for just that reason. Also you could consider strike nursing (Fastaff does that, and I just learned that On Assignment does too) but I don't do that, feeling that when nurses strike it's usually for good reason, like staffing issues which affect patient care.

Best hospital? Hands down, Mary Washington in Fredericksburg, VA. The whole nursing atmosphere is different there. I worked M/S tele. Favorite place? Richmond, VA, for a variety of reasons...small enough so you don't get swallowed up, big enough to have LOTS of amenities.

Not impressed with either one, after listening to other nurses for the last 2 years.

Yep...ended up changing agencies, and until right now haven't had more than 2 weeks unplanned time off. My only hangup now is trying to get my ACLS before I go again, since tele positions pay better. I just submitted my resume for a job which would take me off the road, but I'm not counting on getting it. I'm just going ahead with plans as if I were leaving next week.

Well, now I've been informed that my ACLS has been expired for too long (60 days) and now I have to do the 2-day class. AHA is the most UN-helpful outfit I've ever dealt with as far as finding a class. I'm basically having to individually call every hospital in a 200 mile radius.

Good grief! What's your company? Remind me to stay away from them....

I've been to all that, and the problem I'm having is in finding a person to do my megacode through the AHA business. This is a small area and hospitals are pretty clannish. I can sign up for a class in a nearby city next month but that is going to mess up my travel schedule.

I'm told that AHA does not approve corses, only sells them through their franchise. AMRG states that their course is within AHA guidelines. Problem is in finding someone to run the megacode for me. I've tried some of the hospitals hereabouts and they're not very friendly to non-staff.

Does ayone have any experience with online ACLS renewal? There are several outfits offering it, and because of time constraints I'm contemplating the one offered by AMRG http://www.aclsonline.us/recert/pages/home.jsp My recruiter (I'm a traveler) is trying to tell me that hospitals only accept the AHA version. I don't see how this can be true, but I suppose it could. She's not a nurse, so I don't know if she has the full info. I asked the info desk at AMRG but the answer wasn't quite helpful. Any feedback?

I'm a traveler just dipping into this forum for the first time. I've used a blue million computerized charting systems and every time I think I've run up on all of them, I get to a hospital that uses a different one! For my money, the best is McKesson Care Manager. I've used it in 2 different places with their own "tweaks" to it, and it's quite user-friendly and flows nicely. I liked what I saw af VSICU but I think it's only for ICU. Meditech is positively the WORST system I've ever worked with....it's DOS-based, so any updates are merely add-ons, it's clumsy, and it's definitely not user-friendly. It's also used in a lot of HCA hospitals, so you know it's cheap.

Top drawer with On Assignment, and they furnish everything right down to the forks and bedsheets so you don't have to drag all your stuff around. TNS put me up in some nice extended stays, the bonus with them being that you get housekeeping service weekly. They use Kenwood and Candlewood Suites, among others. You can just take the stipend and choose your own, but that's chancy sometimes. I like the agency to do the worrying for me.