DM74LA

Thanks for all the feedback, this information helps guide my decision process.

BigT, thanks for that info. So there quoted rate on the site IS the actual pay. im OK with that money being taxed as I've already calculated for it and I want to be able to hit some OT with base rates in the 40's. i don't think I will mind staying in an Extended Stay provided there are NO bed bugs or other pests.

Last question, so even a company like Fastaff, who advertises rates in the 40's and higher, incorporates housing into these quoted rates?

Yeah, that's why I'm asking. Cali has the highest state tax plus a multitude of other costs associated with living there. My eventual plan is to work for Fastaff, sell my home in LA (the state) and rent in TX to be able to claim TX as my tax home and to obtain the compact license.

Why is the issue of extended stay being expensive an issue if the agency is paying for it? Does this detract from your hourly pay? I'm not a traveler so don't shoot!

Hey everyone. I'm curious as to how much the state tax rate of 13% seems to impact your take home pay? It's possible that some nurses are pushed into the higher tax bracket of 28% some these two combined would be 41%. Adding Medicare and SS withholdings, we're getting very close to 50% of your earned income. does anyone with an out of state perspective have an opinion in this? thanks in advance.

Hey all, it's been a couple of years since someone has asked. Seems around 2013 someone had asked about the Dallas market and got a few replies that it was flooded due to all the nursing schools in the area. Has this changed any. Also, I am an ADN nurse and heard that this could also limit my options as well. I'm currently in Shreveport where at my facility we go through spells of having no positions after a graduating class comes out to being extremely short after a few months-usually due to nurses leaving after their commitment is up. Also what does the float/pool or agency/contract options look like in Dallas? Thanks

Hi all, I'm wondering how well a traveling acute dialysis nurse gets paid compared to med-surg or ICU. I've spoken with some non-dialysis travelers and they are convinced that dialysis assignments (I'm assuming they mean acute) pay very well. One nurse even told me like $100 an hour. I'm thinking 'yeah right maybe $100 per case'. But when I go online, I just see rates in the low 30's which is way below other areas. I've even spoken with a dialysis based travel agency and got a quote of around $32/hr plus housing. If this is what they're paying, it's definitely not even worth my time. Any opinions or first hand knowledge? thx

Hey, I'm not certain about any one particular course you could take, it really depends on what you want to do. General organizational and analytical skills are the best. Knowledge of Microsoft Office especially Excel (in my experience) is valuable. The majority of what we've been dealing with is refining our processes and policies. There's a lot of that to do. Technical work really cannot proceed until you get all that worked out. It's easy to hide bad process and workflows in paperwork. All that comes to light once you start to try applying technology a to it. We've just had a round of hiring and my manager hired people with no technical background, mainly nurses, who showed enthusiasm and courage in seeking the job. So I think that you're enthusiasm should speak for itself. If you do land a job, you can be as technical as you want. Our job duties range from education through writing reports and workflows. It's really up to you.

I happen to be a programmer and a nurse and I know people frequently get the terms 'configure' and 'programming' confused. But there is the possibilty of writing computer code in the informatics area if you have the desire to do so. Meaningful Use requires that the software system being implemented has a decision support system in place-we call this process 'rules and workflow'. This does require writing code and passing parameters between modules and not all nurses are interested in this level of technical detail. Thus some hospitals may let the vendor set this up for them. Some let their in-house programmers do it-but they usually need a clinician for the requirements. Most vendors hold classes to train those interested in learning and most hospitals would be happy to oblige since this is usually the cheaper option. Hope this helps.

74K in Louisiana. I'm content though, basically making the amount a float pool nurse would.

I have a similar background. I have a bachelors in computer science, but no job experience. I went directly back to get an associates in nursing. After nursing for five years I accepted a position that recently opened with our new clinical design team. After being there a few months people in the department started asking why I didn't apply to the department sooner? My response was, 'I had never thought about it'. If you hospital has an IT dept or even a data processing dept, it would hurt just to talk to someone in that dept. You may be surprised. I understand that it's hard to find someone with both skillsets.

Kathy, our informatics team is within the Data Processing Dept and we answer to the CIO.

Hi all, This is a bit overdue, but here it is. I was hired Aug 5th of this year to come in on a software build that is about a year in development. We are moving from our old system to an evidence-based system with CPOE, electronic MAR, decision support. I have been a nurse for 5 years now, but I hold a bachelors in computer science, so I was a rare blend between clinical and technical. There are nine of us nurse informaticists. I was originally hired to design and build workflows, since that area involves some programming with which I have experience. But our workflow deadline was not as pressing as other things and I was given the task of getting all our plan of care (POC) interventions configured and ready to upload to the software-I have oversimplified this because this in itself has been a challenge. Let me explain. We are driving at an interdisciplinary POC where all departments involved in patient care chart patient problems, goals, and interventions. The other departments however cannot seem to get their head wrapped around the need for a POC as they have their own treatment plans and our interventions are often too basic. So after much back and forth, we finally came up with a happy medium. We are also having assessment data trigger problems for POC and suggest appropriate ones based on the fields that have abnormal responses. So much combing of the assessment forms ensued. Of course, every patient will get a discharge POC and many will get a couple of others. So, having the POC stuff mainly complete, I'm starting to look at workflows again. This should be retitled rules and workflows. Rules allow the software to make decisions and send notifications, alerts, remimders, prompts and other whatnots. I had my first rules class today and there is some basic programming to evaluate data retrieved. There is a workflow called consult triggers that is rather involved. It sends consults to ancillary departments based on assessment data. So I have to meet with all departments involved to discuss what new triggers they want with the new system. The departments are also wanting more bells and whistles thrown in to make their life easier...understandable. So more negotiating with department heads. My job after the software is running live will be to maintain what we have and to add additional functionality to the rules and workflows area. We have 3 nurses working on assessment forms. 2 nurses working on predefined order sets. 2 nurses working on offline forms, 1 nurse and the systems analyst working on uploading all the current orders for every department (a huge endeavor). We also have a project manager who has been working with the order sets and POCs. All of us at some point, collectively or individually, interface with some of the finance people, some of the IT people, heads of departments, MDs, pharmacists, DONs, etc. We attend weekly and bi-monthly meetings. We have regular webinars, classes, conference calls, and other various meetings to attend to. I have to stay on top of email and make sure I respond in a timely manner. Although, the systems analyst and project manager probably get around 80 emails a day. The atmosphere is very laid back. If we need to come in late or leave early it's usually not a big deal. We have laptops we can take home and work from home some if we want. One nurse works ten hour days and leaves early Friday or does not come in on Friday. We get holidays and weekends off. So it's not a bad gig. But some days can be exasperating. I have been utterly confused to the point of mind-mush. Sometimes my mind is 4-5 steps behind a conversation and only catches up when the conversation stops or later that evening at home it'll hit me what they were talking about. I've wondered many times if I made the right decision entering this field. But today, when we started getting into programming, I knew everything was going to be OK. So that's it, not really a day in the life in chronological order, but more of a 'what I've been up to'.

Congrats, I just landed an informatics job myself, although my organization will have five informatics nurses. The first thing I would do is learn the management structure and secondly the structure of your network. Then start asking questions. Who made the initial decision to create this position? Surely there was some ephemeral idea of a need. Secondly, I'd ask if your current clinical software system is meeting the needs/goals it was purchased for. Is it possible to find out what the hospitals goals were in purchasing and what were the vendor's selling points? Is the software living up? Is management able to generate the metrics/reports they need to formulate valuable information? (Do they need to ask different or better questions to reflect current issues or core measures?) If not, there may be a problem with data capture or how the the database is set up. You may need to add fields to user input or take a look at how well the tables in your database are normalized. Are the users entering information correctly, or just selecting the easiest response due to time constraints? If the software does not seem to reflect the "meaningful use" concept, you may consider the need to upgrade with the same vendor or choose a new vendor entirely. There will be reimbursement coming from the federal government and that's why my hospital went with a new system. (My first day on the job, which was Thursday, we met with our vendor rep and hashed out Plans of Care, Problems vs Outcomes. The issue was deciding what Plans of Care/Problem areas we needed and then mapping them between the vendor and another agency that offers decision support tools that the vendor will incorporate into the software. I've decided Excel may be a good program to get acquainted with. All this is just a side note in case you were curious.) As far as your concerns of being a hireable as a nurse, the answer is yes-provided you maintain your license and any ACLS/CPR creds that you need. One of my first questions was if I would need extra CEUs now that I was not practicing bedside nursing. I had asked one of my coworkers who had personally called the state board of nursing and was informed that NI is still considered nursing and would not require additional CEUs. Your state may be different. I hope this helps, I'm still new and wet to informatics but this is the route I would take if I was not actively implementing new software. Dustin

We are moving from Meditech to another vendor. But currently, our ICU and stepdown do paper charting. Not sure how similar your facilty is, but under the critical care section we print all our assessment forms and notes out on a daily basis. You could possibly do this in advance under "Print Forms Without Patients" just to have some generic charting material. Of course, nurses who computer chart would need to have some orientation to the paper forms, just like our critical care nurses need to be oriented to computer charting. Hope this helps. DM74LA Dustin

Hi all, Just an update. I just recently sent a post about a job possibility that arose when my supervisor wanted to be a superuser at our hospital. I told her that I have a degree in computer science, so she mentions it to the implementation team and I had an interview this morning for a temporary position that could last a year. Well, the team leader called me back this afternoon offering me a full-time salaried position. She was impressed with my technical background and wants me to handle the more technical issues. I will be dealing with the 'rules and work flow" of the clinical environment. Of course I accepted. I had intended to go back to school for a certificate or master's, but now I think I will wait until the "Go Live" is complete and most of the problems are smoothed over so as not to have any conflict with my current demands. Thanks all, Dustin

Disclaimer: I am a regular nurse, not an informatics nurse yet. But if I were creating this training module, I would base around some instance that occurs on a regular basis. What technical problems do end-users have most frequently? What about management? I would ask different people in management if there was something that tended to give them a problem, could be with the clinical software or with Windows itself. I would then create a demo answering that and perhaps a couple of related problems. If you use something you've already done, it could come across as though you didn't want to take the time to create something for the interview, or that you couldn't come up with any new ideas. Another idea that just hit me is if there are any under-utilized areas of the clinical software that you think should be used more frequently by nurses or managers. Hope this helps, and good luck getting the job.

Oops, sorry Mission, thanks for your advise. Angela, Wow! That's a dumptruck's load worth of reading. But I will cut and paste this literature list to my own personal file. I've ordered the Scope of Practice along with another nursing informatics book. One more question, the CPHIMSS (sp?) requires you to have a bachelor's and 5 years of experience in clinical systems. I'm assuming they mean from a programmer's/sysadmin's position. Or do they include end-user experience? I noticed that only a small percentage of nurses hold that certification, the most are in IT.

rninformatics (sorry can't remember your name), Thanks for your advise. I looked up that book on Amazon, and while it does seem interesting, do you feel that it's relevant to informatics? It seems that it would be more relevant for therapy work, but who am I to say. I am currently reading Managing Health Care Information Systems and Beginning Database Design. The former should help solidify my understanding of the issues involved with implementing a new system, the latter might aid me in conceptualizing how good data yields good information and thus good knowledge. I like to read about theory and concepts in favor of actual vendor-specific technology-that's more for the IT people. Are there any types of software products that are valuable to know, say Microsoft Office or some other productivity software? BTW, the job that I mentioned on the build/implementation team will not be publicly posted. I feel that the person with the final decision has a couple of people who she wishes to hand-pick for the position. I emailed her yesterday to express my enthusiasm and qualifications for the job. If that doesn't pan out, I will still be a super-user for the system...it's better than naught. I will get into informatics one way or another. Thanks again, Dustin

Hi all, I have been an RN for 4.5 years now having graduated with an Associates in Nursing from an accredited college. I entered nursing having just graduated with a B.S. in computer science being as in 2002 there were many competing for jobs after the dotcom bust. So, I had originally planned to eventually go into informatics. Well, as fate has it, my hospital is going to change from Meditech to Soarian in a few weeks. The build stage is mostly done I suppose and will soon go live. My supervisor, not knowing about my computer science degree, had asked me to be a superuser. I told her that I would be excited to do so due to my previous degree. She then said, well if I'd know about your degree, I would have put you in on the build team. A few days later, I received an email from her stating that there may be an opening for a nurse to join the IT team while all the kinks in the system were being worked out. The position is temporary but could last up to a year. There is a lady who is supposed to call me, having received my contact info from my supervisor, but I've yet to hear from her after about 5 to 6 days. I guess, I'm excited and sitting on the edge of my seat hoping I get the position. I've purchased an informatics textbook (pub 2005) and a general database theory book both on Kindle for iPhone to brush up on information concepts. My questions are as follows: Is this a good entry point into the field of informatics? Will I need any additional formal training? Any other recommendations for reading? Should I call her if I do not hear from her in a given amount of time? Would a year of experience in this position help me get informatics jobs afterward? I've seen some jobs requiring a bachelor's in nursing. I have an associate's degree and hope that my bachelor's in computer science will account for something. I love information technology. In college, I would rather write code (C++, Java) than eat or sleep. I don't anticipate being in a position to write code, but working with databases and reports may be fun as well. I would also look forward to training nurses to use the system. Anyway, any input would be appreciated. Sorry for the length, I'm just really excited, even if I'm only a superuser. thanks

Wow, that seems like a lot to know, esp for a nurse new to the OR who is unfamiliar with the equipment. Of course, I guess some procedures have more to chart than others. Is most of this narrative charting? Or are there standardized forms other than what you already mentioned? I'm guessing that meds that the Dr. gives are written on a MAR? Does he sign for them? Thanks for the detailed explanation.

What exactly gets charted though? I know that the counts are charted, but what else? Anything about the pt? ID verified? Condition during surgery? Tasks performed during surgery? What color clogs the scrub is wearing?

Thanks Marie, Yes, I am interested in informatics. That's one of the main reasons that I got into nursing directly out of my computer science degree. I'm not sure if shadowing is an option-I guess I could do it on my own time which I wouldn't mind doing if they'll let me. I figured that I needed some background experience in nursing prior to landing an informatics job. I have lurked around on that forum however.

What does the circulating nurse chart throughout a surgery? Does the scrub chart anything? Thanks Wade Apologize if this has been asked before.