NurseguyFL

As much as I love New York, I wouldn't move there to work as a nurse. Some of the hospitals are terrible there! And as for the poster who said that you make more money in NY, I don't know about that. Maybe its different now but travel pay in New York City used to be low compared to the outrageous cost of living there.

Depends on the deal you have with the agency. Some people take the housing stipend and find their own apartment. Last time I was there the agency put me up at the Oakwood apartments, and it included everything---linens, utilities, etc. http://www.oakwood.com/corporate-apartments/furnished/US/CA/Los-Angeles/prop22/showDetail.html But LA is a pretty large area. Depends on exactly where you will be going. If you've never been there then do some research into the particular area where they're planning to send you. Certain parts of LA are REALLY bad, and if you'll be living in or traveling to those parts then having a small apartment is the least of your worries. Wherever they plan to house you should also be reasonably close to the hospital because the traffic in LA is horrendous!

What do you mean by "a trend"? Exactly how many nurses in your hospital are doing these things---one, a few, all? Its difficult to believe that there is actually a 'trend' among nurses anywhere, to arbitrarily ignore doctors orders or protocols. Unless this is a hospital where the nursing care is generally sloppy, no one does quality control, no intervention from the risk management people, no clinical nurse specialists doing rounds with the staff, and the doctors themselves failing to follow up so as to demand to know why the tests they ordered weren't done, or why their post-surgical patients aren't wearing the SCDs, or what that CHFer's weight was done this morning. Sounds like there's plenty of blame to go around. You also have to consider that some of these incidents aren't necessarily intentional, or even errors at all. Maybe the patient isn't wearing SCDs because the hospital either ran out of the 'boots' or there's no one in central supplies to bring the machine. I've seen both happen. Maybe the doctor filed the chart back on the rack after writing the order, then the patient went off the floor for a procedure with the chart and nurse missed the order. I've seen that happen, too. Maybe the order was called in as a verbal to the charge nurse and she forgot to write it down. Maybe that CBC wasn't drawn because the patient was off the floor in a precedure when the lab staff came to get the blood. Maybe the nurses didn't intentionally NOT do certain things but were so busy during the shift that they ran out of time to do it all before the shift ended. Yes---a lot of maybes, but I have worked in places where all these things (and more) happened, and its not always the nurses' fault. But I've never seen it so bad that I would call it a trend. If this sort of stuff is commonplace where you are working then I'm surprised the manager hasn't done anything about it. Its difficult to believe that it could be as bad as you say and the manager is completely unaware of it. No staff meetings to discuss the problems? No write-ups for sloppy nursing care and serious mistakes??? One day something bad will happen, and when the lawyers come knocking everyone will held accountable.

Thank you so much for this perspective. I was recently talking to a recruiter who was REALLY trying to sell both these locations to me for my next travel assignment. Both are offering travel pay that is higher than they normally do, and now I know why? There's never smoke without fire.

Will they will accept your credits as long as they are coming from an accredited school? Yes. Will they accept ALL of your credits, as long as they are coming from an accredited school? Not necessarily. It depends on the school that you are transferring to. The private universities will be more willing to take all of your credits than the public ones. If you are transferring into a Florida state college from any private school in the state or from any out of state college, their requirements are a little different. They are notorious for refusing to accept certain credits in math and the natural sciences because according to them, the coursework is not necessarily the same. And, if the credits are more than a certain number of years old they will require you to take them again. So, go to the FACTS.org website and research the school that you are planning to apply to, then call and speak to an admissions counselor about whether or not specific credits will transfer. When I was in nursing school in Florida, I had a friend who had transferred into the program from a college in New York. And at the end of the program when we were getting ready to graduate, they audited her records and told her that she had to take microbiology and chemistry again. She fought them for months. But they prevented her from graduating with our class, and went into this whole thing about asking her old school to send information about the coursework, etc. It was all for nothing. She HAD to eventually take THEIR microbiology and chemistry classes to get her diploma.

Recall the stuff you learned during your cardio rotation in nursing school---the patho, the rhythm strips, the drugs---that's the basics of tele nursing. If the unit manager knows you don't have tele experience and she still offered you the job then it is reasonable to assume that she has plans to send you on a telemetry course as a part of an extended orientation. This will turn out to be a good thing for you because you will learn new skills, which means more opportunities will be available to you later on. I encourage you to go for it!

If you want to go to Miami try to get into one of the Baptist Hospitals there, or if you're into peds try for Miami Childrens. If you're looking for a huge level 1 teaching hospital, then try for the University of Miami/Jackson. I wouldn't recommend any of the other hospitals in Dade County---not Mt. Sinai on Miami Beach, certainly not any of the Tenet hospitals, and the only HCA hospitals that's halfway decent are the ones in Kendall and Coral Gables. If you decide on the Fort Lauderdale area, neither the North nor South Broward District Hospitals are using travelers now, but this could change when their busy season starts at the end of October. Except for the District hospitals and Holy Cross in Fort Lauderdale, I would not recommend ANY of the others. Pretty much all the others are owned either by Tenet or HCA and none of them are great places to work. The Cleveland Clinic hospital in Weston seperated from Tenet some time ago, and I've heard its not so bad now. However, they do require that you wear all-white all the time, and if you're a smoker you cannot work there (even if you only smoke while you're off work). These things may not be issues for you, but just letting you know. As far as the Boca/West Palm Beach area hospitals go. I would not recommend ANY of them---at all! Now thats for travel assignments. If you're planning on moving permanently to the southeast Florida area. Do more research first. I've lived here most of my life and I'm telling you that this place isn't all sunshine, rainbows, and lollipops the way some people make it seem. It is EXPENSIVE to live here, and even though home prices have come down a bit they are still high. On top of that the property insurance and taxes are also very high. Crime is also on the increase all over the Tri-county area--even in areas where you hardly used to hear about criminal activity at all. Robberies, assault, and murder are on the rise, and the criminals are becoming more brazen. During the past year there have been more than just a few incidents of them getting into shootouts with the police, and just a couple weeks ago another cop was gunned down on the job in Fort Lauderdale. But, what can I tell you, we have a mayor here who is more concerned about running gay people out of town than he is about the crime situation! As a staff nurse here you will be making mid to high 20s/hr. You can make more doing agency work, but there's not much of that available except during the busy winter season. The hospitals may offer big bonuses to go on staff, but the short of it is that whether you plan to buy or rent a home, it will be a challenge to keep up with the cost of living here unless you regularly do overtime. I feel that areas like Tampa and Jacksonville are generally better places to go to than south Florida, but that's just my opinion. The southwest coast is nice if you prefer a more laid back and less congested environment but that area is also very expensive.

The pay for the Boca area is similar to what Narcan posted above for Miami. You may be able to get a bit more with shift diffs, but not that much more. Also, the hospitals in that Palm Beach County area aren't such great places to work. Most are owned by Tenet and HCA, so be forewarned. In fact, I can't think of even one that I would recommend.

"Half-backers". I love it! LOL. I also own a home in Florida and wish I could unload it and get out of here permanently. Unfortunately, now is not a good time to try to sell a house in Florida because there just aren't any buyers out there. I have a lot of equity, and so far I'm doing ok, but I haven't seen any decreases in the insurance costs, despite declining property values, and the proposed property tax cuts are a joke. I've done the math and found that this tax cut scheme being pitched by the governer will actually INCREASE my taxes in the long run! I pray all the time that we don't get hit by another major hurricane any time soon. That would truly finish off a lot of Floridians, many of whom are now hanging on to the edge with a fingernail.

I don't doubt that its possible to make that kind of money in FL, provided you are working an average of 72 or more hours per week, and willing to put up with just about anything at all. All the power to you! I could never do it---especially not with the way nursing has become in many parts of Florida. I agree with the OP, and also with Tweety and Carol. Florida is very, very different now than it used to be. And, I'm not talking about the 'good ole days' because I'm not old enough to know about those. What I can say is that its now just as expensive to live in some parts of Florida as it is to live in some of the big cities in the Northeast and on the West Coast, and most of the hospitals don't pay nurses all that well. In many areas of FL, even the middle class are struggling to get by, and as Tweety already mentioned, a lot of them have either left the state or are planning to leave. Glad to hear you found a situation that works well for you.

Burnout is possible at any time. I've known people who quit altogether after only a few months. You are right that most people don't really understand what nurses do, and I can't think of too much that has ever been done to correct misperceptions about the nurses' role. For the most part, we accept it and say and do nothing. The hospital TV dramas may be fun to watch, but they all stereotype nurses as go-fers and make it seem as if doctors are the only ones who do all the important work. Now, if someone were to produce a true-to-life drama about what hospital work is really like, it wouldn't be very interesting to most people because there's nothing romantic about it and it might actually scare everyone who sees it away from the hospitals. What is really killing us now is the corporate shifting of nursing care from health care to 'customer service'. Now patients and visitors just can't seem to get beyond the 'hotel' mentality, and if they don't get the pillows fluffed and the pitcher iced, they are on the phone complaining to administration about you within minutes. I'm sure we all have our own collection of stories to tell about this, and its just ridiculous. Sometimes you can even spend more time catering to the whims and fancies of the visitors than you do taking care of the patient, which is silly. As for doctors, I don't take their crap either. When communicating with the ones who are rude, I just stick to the facts about the patient's care and then I'm done with them. If they decide to get snippy with me I politely let them know that I will be documenting, verbatim, whatever they tell me into the patient's record. That alone usually changes their attitude. Even the most arrogant of them know that nurses notes are fodder for a nasty lawsuit. Its too bad that some of us let them get away with abusing us. To Commuter, I didn't think your post was negative. It describes the situation exactly the way it is. I won't burn out because I don't put up with foolishness or unreasonable demands from anyone, and will not let any doctor, patient, or their family members stress me out. I love and respect myself too much to let other people destroy my body and mind that way.

Hey, NurseCyd, This is an old thread, but I strongly suspect that the agency you're asking about is the same one the OP was complaining about. I suspect this because the things she mentioned sound very similar to stuff that company did with me also. You are right to be very cautious. They quote very high pay rates but what they don't tell you upfront is that they don't pay for most of your utilities, and their furished apartments are not really furnished. As the saying goes, all is not gold...

You guys have got to be kidding! Whatever is going on with the patient ought to involve the nurse because if and when things change, how can the nurse maintain quality control of the patient's care if information about the patient is being hidden. What is the point anyway? The rationales for whatever a physician is doing for any patient can easily be gleaned from the progress notes, and, unless the physician is going to stay at the bedside and execute all the orders himself or herself, then such secrecy is just silly. The only exception I can think of when this would be appropriate is if the physician is a psychiatrist who is doing a highly specialized evaluation of the patient that involves very personal stuff that the nurse really doesn't need to hear. Otherwise, nursing needs to be involved. How else do you know when a development thats usually 'expected' for most patients is not what the physician wants for this particular patient? I wouldn't take it personally but it is still a 'dis' to nursing. And proof of this is seen in the fact that whenever physicians show up on a unit to evaluate a patient with a group of medical students, privacy is hardly ever an issue, and no one says anything. Maybe its the white coat that makes the diff.

I doubt that what your friends told you about making the same salary in FL as they did in NY is entirely true. Florida pay has never been high, but you can make more if you do agency instead of working staff. However, in most cases its like comparing six to a half dozen because staff positions come with benefits and most agency work doesn't (unless YOU pay for it). The way some nurses do it is that they take a full-time staff position and then either work in-house registry or pick up extra shifts at another hospital through an agency. The extra hours can definitely get you more than $60k but it won't be the same because you'll obviously have less time off available to do other stuff.

There is a school that specializes in continuing education for nurses in North Miami that does PICC line training and certification. Its called Nursing Unlimited. They have a good reputation in the area and I've taken some classes with them in the past. All their courses are taught by very experienced RNs, and I like their no-stress approach to teaching. Here is a link to their website http://www.nursingunlimited.com/CE/CLASSES.htm

As Suzanne said, local agency nursing is not 100% reliable in terms of the financial outcome you are seeking. If nursing in your local area is the way it is in many other areas during the summer, then the hospitals may not always as busy as they are during other times of the year, and whenever the census drops the local agency nurses are among the first to get called off or sent home. I remember that while I was doing agency work, there were some weeks when they called me every single day, and then there were times all of my shifts were canceled. I do not recommend relying only on local agency work if you need those hours. If your financial situation is such that you HAVE TO earn a lot of money real quick and you need guaranteed hours then you might want to consider doing a contract with a company that specializes in short term assignments with a guaranteed number of hours each week. I know some nurses here are not fans of some of these agencies, but if they are offering something that suits what you need for the short term then they may be worth looking into. I know that Fastaff and Nurse Choice usually have 4 and 8 week contracts. Sometimes On Assignment has them, too.

I would not recommend going to CT for $30. That money is just too low for the area. Kinda depends on whether its near the NY metro area or further out. Although I can't imagine there are many, if any, cheap places anywhere outside of Hartford. CT is a small state but mostly made up of charming little towns that can be outrageously expensive. Lots of well-heeled Wall Streeters and NYC yuppies commute between Manhattan and towns like Stamford, Norwalk, and West Port but the local traffic is not that bad and most parts of the state that I've been to are quite beautiful---especially in fall. I would recommend it as a great place to travel to, but, trust me, you want more than $30 to go there. There is a lot to see and do there, lots of great restaurants, etc., and you will be tempted to eat out a lot. If you are in the southermost parts of the state you will also be tempted to go into Manhattan a lot for the shopping and the Broadway shows (if you're into that sort of thing). Unless you are really tough with yourself its very easy to blow through a lot of your $$$ while you're living there :). Depending on where you are going, the housing costs might take a big bite out of the bill rate so you really have to decide if whatever offer you take is worth it for you. (Seriously, there are parts of CT where the COL is comparable to San Fran or NYC). You might run into problems finding a short term lease if you decide to do your own housing, and even if you do chances are its going to cost a bundle. Look around for more money, but be careful. Some agencies will promise you the moon and the stars but they won't tell you upfront that the "furnished" housing includes the very basics (a bed, a couch, a dining table, and maybe a TV) and NOTHING else. Also be sure to ask what "paid utilities" mean otherwise you might be surprised to find that it includes only a portion of the electric and NOTHING else! Watch out for 'deals' where you have to pay deposits and monthly fees for local telephone, cable, parking, and trash collection service, or a hefty security deposit for the apartment (even though it was rented for you through the agency). All of this stuff adds up to quite a bit. Oh, and forget about rental car. Drive your own, or at least rent one locally and drive it to the assignment. Its going to cost a lot more to rent a car in that area than it does in many other locations (well over $1000/month after you include the taxes); and if the company rents it for you that's going to drop your pay by about another $3 or so an hour. Trust me, get your list of questions ready, and ask, ask, and ask. And when you think you asked too many questions, ask a few more. I'm not a new traveler, but even now I still get burned by a few slick recruiters out there.

I had a similar experience with Meditech. You are correct. Scanning systems rely on the pharmacy to properly prepare and stock the right medications in the right dosages, and also on accurate setup of the medications, dosages, and times on the MAR but this is not the case 100% of the time so we still have to pay attention to every package of medication that we are giving to the patient.

I would also encourage the OP to reconsider his/her decision to quit after only 4 months. Hospital nursing is not an easy thing even for very experienced RNs, and its much more of a challenge for a new RN because there are so many things that you are still learning. If you want to continue in nursing you have to accept the fact that its nothing like the Florence Nightingale stuff taught in nursing schools. You have to be tough, you have to be quick, you have to have good time management skills, and you have to be good at juggling priorities all day long. The stress level can get very high in this profession because everyone is demanding your time, and its up to you to learn how to manage all of this in a way that works for you. How I do it is to divide everything into two categories: things that need to be done now, and things that can be done later. Most important thing at the beginning of your shift is to get a good report. That way you know exactly what's going on with each patient and which ones you need to do what for first. All my assessments get done within the first hour of my shift. That way, if the docs show up early asking for information I already have it. I do not ever allow patients or their visitors to waste my time with their list of demands. I tell them I will be back later to take care of their needs as soon as I finish making rounds. The only exception to my rule about this are patients who are in pain. I make it a part of my routine to give a report to my CNA. I delegate certain things to them, and tell them to get back to me with anything they feel is important. I find that a good working relationship with the CNA is important because they tell me every little thing that they observe with the patient and most of them that I have worked with respect and help me more if I respect them, too. This alone saves tons of time. Next thing I do is check my orders. So, I know who's having what tests done, and which docs I need to call. Once I have these basics down then I revisit each patient and I go over their list of needs after I do the first med pass. What I can do for them I do, and what the CNA can do for them I ask them to do. I always tell the patients that the floor is very busy (even if it isn't) and that it may take a while for me to get back to them. Most of the time, they don't put the call light on too often if I tell them this. If after you've given yourself a while to acclimate and you find that floor nursing is just not for you then there's nothing wrong with moving on to something else. However, you have to give yourself enough time to find a system that works for you. Four months isn't really a lot of time to figure this out. As a new nurse, you have to understand that no day on the job is ever going to be perfect. Again, knowing how to prioritize is key. There will be many days that you simply won't be able to do everything that needs to be done, and if you try to be supernurse you're only going to burn yourself out. So, you do the most important things first and whatever doesn't get done you endorse over to the oncoming shift.

I've had ALL my shifts canceled for almost two weeks straight while I worked agency and in many cases, it has nothing at all to do with the agency. Sometimes the docs walk through and d/c a lot of patients the day before, and once the census drops significantly there's no longer a need for agency help. Or, if they have staff who are willing to pick up extra shifts, it is financially advantageous for the hospital to cancel the agency nurse and use their own staff to work those hours because it costs them less to pay time and a half than to pay full bill rate to an agency. If you decide to work only agency you have to have enough $$$ set aside to cover yourself during those days when work isn't available, because cancelations happen---and sometimes they happens a lot.

I find that docs who ask "what do you think/want to give" are great people to work with. They are usually the more experienced clinicians who respect our professional judgment and assessment skills and will go along with whatever we suggest most of the time, as long as it makes sense for the situation and is safe for the patient. Once they are confident that you know what you are talking about they will go along with your suggestions most of the time. Daytonite is right. What they want is the facts. They're always going to want to know the latest vital signs, the patient's current condition, latest labs, etc, so have all your information in order before you call them. You could always say something like 'well the patient has a history of so and so, but the latest workup shows so and so, and she hasn't been responding to the previously ordered treatment, so maybe we could try so and so, and see how that works for her...' Of course, you always want to end the suggestion with 'how does this sound to you?' because you don't want them to think you are telling them how to do their job. About a year ago I invested in a critical care software program for my PDA, and it lists in detail, almost all medical problems, things to assess for, labs and tests to order, and all possible medical and nursing interventions. The program was written by a physician so it approaches the interventions mostly from a medical point of view. I use it all the time, especially when I suggest things to docs who ask for my opinion. Some of them think I'm exceptionally smart when I suggest these things, but the credit really belongs to Elsevier, Inc's wonderful software.

The South Florida area hospitals pay around the same for new grads---low 20s. However, I do not recommend Aventura for many reasons. Not a very safe place to practice if you value your license. They have had too many malpractice lawsuits (safety issues again), and had lost their accreditation in the past r/t to preventable patient deaths. It was less that 2 years ago that they got shut down (except for the ER), and during the legal fallout the nurses were blamed for not paying close enough attention to the patients. They claim to have made improvements but the place is still not very safe, and it has nothing to do with the abilities of the nurses there.

As I said before, you are entitled to your opinions. But you should be aware that they are just that---opinions. Clearly, you prefer to argue only about what you think you know instead of looking objectively at all the facts, and to take such a position makes any discussion redundant. Perhaps it makes you feel better about yourself to berate others with sarcastic and insulting remarks. However, I choose to neither endorse nor participate in such behavior because it would detract from my intelligence and professionalism, and it is also is of no value to people who are seeking legitimate information here. My reason for commenting in this thread was not to argue with you. It was to pass on information I had received from tax experts whom I have dealt with in the past and to encourage others who may not be very familiar with the tax rules to speak to a TAX EXPERT about their specific case so they may avoid problems with the IRS later on. Thanks, but I choose not to continue this discussion. If its important for you to have the last word in defense of your ideas and opinions---its yours.

You are still not getting the point, but that's ok. Your choice. I used to believe as you now do, until I worked with two different tax experts, both of whom demonstrated clearly to me that housing money falls into one of two categories. It is either a deductible business expense, if a company pays it for an employee who is traveling away from home for work, or it is a reimbursable expense if a traveling employee pays it out of pocket. In either case, whether or not it is taxed depends on specific IRS guidelines, and, in either case, it is still an expense, not income. Some people mistakenly view it as income because they sometimes end up with a little extra in their pockets if they find their own housing and it turns out that that housing costs less than what it would have cost if it had been provided by the travel company, and also because the IRS currently does not have a mandatory requirement that the difference be accounted for when you do your 1040 at the end of the year (IF the reimbursement was taken from the travel company). If one opts not to be reimbursed by the travel company, and instead decides to deduct all travel-related expenses on their own when doing his/her 1040 at the end of the year, then all the claimed expenses would either have to be rationalized and proven with receipts or fall within the standard allowances permitted by the IRS. Going this route clearly would not allow you to end up with many or even any 'extras' in your pocket, which is the reason, depending on your case, some tax experts don't recommend that travel nurses do it that way. If you choose to view housing and per diem costs as "income" and to believe that it makes no difference whether or not you are maintaining a permanent tax home elsewhere, just try recording that "income" on your 1040 next year without stating that you maintained a permanent tax home that is 'x' distance away from whereever you traveled to work. You're going to find that the IRS has a very different opinion about this than you do. It would also be myopic to presume that you make more money than a person who is paying to maintain a permanent tax home elsewhere based only one the amount of money you get in your paycheck each week. The IRS allows a traveling homeowner to avoid duplicating living expenses when traveling away from home for work so, such a homeowner would receive more concessions overall. So, even though a non-homeowner may earn more $$$ each week, he/she would also pay more taxes. So, what you are thinking of as 'more' isn't necessarily so at the end of the day.

This whole immigration thing appears to be extremely complicated. I hope that whatever new laws they come up with in Congress this time streamlines the process and makes it easier for nurses to get and keep their paperwork up to date. Just from reading these forums it seems like there are so many different types of forms and visas and processes that take way too long. Only my opinion, but as long as there are so many unfilled nursing positions it would make sense for them to open up a special visa category just for nurses. Thanks for the information.