JoeMacERRN

email [email protected]

[color=#1111cc]hypodermic highway

Check out Talemed.com. I'm traveling with them and things are pretty cool so for first month of my travel career.

I did sign with TaleMed. They are flying me out and paying for rental car for my 13 week assignment. I am excited about my first travel job. As soon as all the details were worked out, and signed the contract, I got my Alaska RN license, shoot! The dream job will have to wait. I jump off in 5 days!! Ready to get to work again!!

I actually passionately hate nurse killers. I never would spend a dime reading a book about one. I've devoted most of my life to helping others, EMT-P to RN, and because of these freaks, we now need FBI backround checks, fingerprints cards, adult and child abuse screenigs, all that and more, as a basline to qualify, to get a nursing job. Nope, forget these guys.

if the physician truly believes that he/she is right and the policy is wrong, we need to try to change the policy rather than just ignore it. i'm having that problem where i work right n do some research on joint commission standards on what policy your having problems with. if a medication order is contraindicated, you have the right, under jaco to refuse to give it. hospital medication errors is at the tops of jaco"s to fix list.

BTW, your question about honor...you should say accountability!! Accountability is a trait that seperates good nurse's from great nurse's. Anyone can be trained to watch a monitor, start and IV. But when a mistake is made, it takes alot of character to pony up. If you haven't made a mistake, you haven't been a nurse very long. What you do when you make that mistake will define YOU!

Over my 23 yrs of ER nursing have been to court once, but I've been deposed in discovery hearing by shifty lawyers many times. Alot of stuff never makes it to court. If you are asked to go to a discovery hearing, that doesn't mean you'll end up in court. It's just each side showing their cards by questions asked. A hospital attorney told me once he thinks nurse's talk too much. We want to explain things that really don't need to be explained, or rationalized. Keep to the facts. Short answers. And wait at least 10 seconds to think about your respose before saying anything. This is a freaking game, need to learn the rules. In the mean time, I'd become an expert on chemical restrant, JACO standards regarding chemical restraints, your hospitals policy on use of chemical restraint. And hope to hell the proper procedure's were done. Usually includes a specific doctors order for the restrants used. I assume you had some limb restrants also. Need to check the policy and be able to recite it without notes if you want to be act like you know what's up. Which I'm sure you do. You should have a briefing with the hospital's lawyer before you talk to the dude you sedated lawyer's. My response, once you've talked with the lawyer, " I was following doctor's orders, and there was no indication that there was any contraindication of the orders. Dude was at risk to harm himself."Don't saw anything without consulting counsel. If you have malpractive insurance...call them. Don't let the hospital hang you out there. They'll be going for the hospital's insurance carrier, and you may end up being a witness for the guy you sedated.

Well, all the hoop jumping, ( and I'm still jumping), I interviewed with 3 hospitals and got 1 offer. Heading to Maine in 10 days for 13 weeks. It's $44/hr but that includes the housing stipend, travel expense, rental car. I put an ad on Craig's list for the town I will be working at and got several responses. Found an fully furnished apt at a Lakeside home, above a garage with kicka$$ deck, view, on a Lake known for Lake trout. I'm an avid outdoorsman so I would work for free to be in a setup this way. Well, almost free!! i also just received my Alaska License. Folks it was so much hoop jumping to get that license by endorsement. I had a arrest for public intox 30 yrs ago. They wanted court records, not just an explanation for which I've given after background checks showed the hit. Well the county where I got busted has no records dating back that far. Alaska still wanted a letter from the clerk of courts saying that there was no records. This all takes phone calls, letters, etc. Then, after I sent in the letter from the clerk of courts saying there was no record, I get the FBI fingerprint results back. They, FBI, sent Alaska and me a copy of the report. It had that arrest, just as I had described. Goes to show that you can't fib on the applications...period. So I'm ready to rock, but it hasn't been an fun experience yet. Hope the fish are biting!!

Yes I'm really tired of hearing the same pitch, and then spending 2 days filling out applications, sending reference requests, faxing ACLS, TNCC certifications.I went thru 2 agencies with no solid offers in 2 weeks. Then signed up with 2 more, I haven't even had a solid offer from anyone, 4 weeks and i'm tired of it already. I've come to the conclusion that Hospitals can be very picky, and the agencies are trying to get as many signed up as possible, hoping that 1 out of ??5, 7, 10 ?? applicants will get picked. This is just my opinion, and I'm in for now, but I may be a short time traveler if things don't start happening.

Folks, I just received a list of ER openings and the hourly wage was between $29/hr to 32/hr. Also only offered $500 relocation money. This is pretty close to the top of a Staff RN wage scale at a decent hospital anywhere. Is this the sign of the times, or is this company trying to keep the pay low, hoping a desparate traveler will take them up?. I just can't see traveling at that low of pay. Might as well try for permanent job and take the 4-6 week standard orientation. Any thoughts?

Fellow nurse's, M or F, old or young, pretty or not, please lets work together. Don't give up on this profession. Not only is it a decent wage earning job, but it's the most righteous job you could be involved with. We are on this earth to help one another. By being a nurse, it implies that you/we care obout other humans. We will always struggle to pay bills, struggle with interactions with other humans who are going thru stressful situations. Whether it's that rude trauma resident who hasn't slept in 36hrs, or a new mother who presents at 03:00 with a sick kid...we are health care professionals that CAN make a difference in someone's life. What other profession has multiple oppurtunites, as we do, to do good? Don't let those oppurtunitues to impact a pt., family memeber, co-workers, go by. I feel so blessed that I'm an RN. I couldn't be happier with my choice of professions!!

The same thing happens with overflow if your doing triage, or not. You put people in hallways, you do EKG's ASAP, and use your critical thinking skills to match wits with obstacles. Once all the rooms are full you go back to your basic triage. So the "new" system defaults to the "old." Happens eveyday, somedays sooner than others. It's crazy, healthcare is crazy, ER nursing is crazy, but that's why i dig it so!! BTW at a local hospital the head nurse of the ER came in with her H who was having C.P. and the ER was full, waiting for triage he coded in waiting room. So that happens regardless of what type of triage your doing.

yes, I know of 2 hospitals in Iowa that "meet and greet," and pt's go straight back to a room if available. The bases for it is all about pt satifaction. Pt's don't want to be triaged .They want to see a doctor. So to keep them happy, you try to get the pt back to a room, doctor and nurse come in at the same time, so there is only one question period, and the treatment regimine started. It works as long as you have enough room, and staff that are multi-task oriented. There has been research done regarding this type of "through put" and the pt's like it. What they haven't studied is the impact it has on the staff. It can be tough to process 4 pts in 20 min. Some folks just can't drop what they're doing to go see the new pt that was just put back into a room. And the system is as strong as the weakest link. More of the future of healthcare.

I'm just getting ready for a travel assignment also. I have 23 yrs ER experience. Done the busy Level 1, and currently in a small community level 4. Our census is dead. I don't know how they can afford to keep the doors open. One pt on the floor and 6-8 a 12 hr shift thru the ER. I"m bored to death. I'm afraid my skills are dulling. I need some juice. So I'm looking to travel. Wading thru all the compaines is kind of a trip. Everyone has the highest pay, best benefits in the industry, treat their nurse the best...blah, blah. Show me the money!!!

Yeah I'm just starting the hunt on travel jobs. Have talked with telemad, but not impressed with the package they offered. Also have read acouple of negative posts on other forums about them. You never know, it's a jungle out there. Tax incentives, stipends, free housing that really isn't ,blah, blah,..

ChicagoNIT...I'm with you. This beat down on our fellow nurses' all needs to change, just like healthcare in general is changing. Those bad attitudes neeed to be checked at the door. Or those folks will be looking for new jobs. Believe it...Press-Ganny scores are going to be influencing medicare/insurance reimburshments to hospitals. When revenue is affected, you know heads are going to roll. I'm old school, have experienced all the bad that's out there, and change is coming!! If you can't change...it's best to get out now! Put on that happy face when you come to work. Answer the phone like your a professional. Leave your ipods in your locker! And be nice!

Travel company tells me they have a ER job in Anchorage. They are offering $48/hr. Only problem is my housing, travel, insurance, rental car, all are coming out of that $48/hr so it puts me at new grad pay..$30/hr. I'm new to traveling. This will be a 13 week assignment. Does this sound right? I was thinking they should pay for housing at least, and I'd handle a rental car, family insurance. Put me closer to $40/hr. Anyone with travel experience, or Alaska Nurse's have any thoughts. Shoot me a PM or post, I'd appreciate any advice.

I also can't figure out the question. Addiction is a mental illness. What is unethical about it?? Stealing narcs is a crimminal offense, a feloney. Swiping meds for saline is unethical yes, deplorable yes, illegal yes. If people ignore the signs around them, narc counts that are off, strange behaviors, then you are part of the problem. Your liscense could be in jeopardy for not notifying a supervisor. Hopefully it isn't your supervisor who is stealing the narcs. Is it unethical not to notify a supervisor if you suspect someone is stealing narcs, no...it's more objective than that. It's a policy violation and you could be punished. As inurse points out, addiction in our workplace is complex. You can debate the subjective nature of it once an intervention is done, before that keep it objective and follow the policy. BTW, addiction in nursing occurs at the same rate in our overall population...about 5%.

This has been a topic recently in our nurses station. What happened to the work ethic?? The fact is there is a generation gap going on in nursing these days. I'm "old school," which means professionalism has been drilled into me. As has accountability, work ethic, organizational skills, etc. The younger generations comes to work with the idea of, lets have fun at work, texting, checking their facebook on their cell phones, just more focused on setting up and reviewing their party life, then the task at hand. Pt care should be the priority, but I don't see that happening. When I see a co-worker walk into the nurses station and plugin their cell phones to charge, I just chringe!! It's worse enough when patients come into the ER and plug their phones in, but co-workers...it's just plain wrong. And i don't get it, that they don't get it...hince the generation gap! Now most hospitals have had to block the Facebooks, and other social web pages. Soon the cell phones will be not allowed. It needs to be done ASAP!

YES! You will experience more in 1 yr on med surg than any othe floor. No brainer!!

You should have plenty of documentation to cover yourself. however, it may come back to bite you also. If your trying to get relief, and what you have isn't working, 8/10 pain 1hr after pain meds would get me thinking. After another pain med administration, and no relief 30-60 min later, you need to be calling for new orders. Or at least notifying the doctor that the treatment regimine is not working. They may say, "well what else can we do, blah, blah", and you may end up with no changes. But at least you can document that you called a status report regarding the pain control and no orders received. That would show that you were doing your job ,AND THAT YOUR TRIED TO ADDRESS THE 8/10 PAIN. All you can do is wait, maybe ask to come in 1 hr before the meeting and request to review the chart. Good Luck.

Low morale just comes with the territory. Not all can be fixed with food bribes though. What helps is recoignition from the docs and managemet regarding wow well the staff is doing with high acuity or high census, the usual reason for bumbed out workers. Also team work adds to cohesivness of the unit. Leading by example....that is getting the charge nurse out from behind a desk and helping with a bad trauma or even cleaning some rooms.....goes a long way for low morale.

Yes Vit K is a dangerous drug to give IV, but it is an acceptable route per the PDR. And that is what the lawyers go by. Consider this, if you had someone in hypovolemic shock, cool, clammy, pallor skin, from a GI bleed, and they are on coumadin. How well do you think the absorbtion would be on a subq injection for that person? THe body is shunting the blood volume to the core vital areas.

Good luck guys, be sure and buy some nursing liability insurance. When your working off your license, you'll see how much difference there is between being a tech in a busy ED and being an new grad RN.