beachbum3

I am a full time agency nurse. I started a little over a year ago, did it to pick up some extra shifts as I needed to supplement my staff position. A year later, I quit my staff job and have been full time for about 2 months. It took quite awhile (close to that year) to get established with enough hospitals to be able to work regularly- most require some sort of orientation, and as they've gotten to know me they call and request me. I work as much as I want, minimum of 3 shifts a week (my own choice, I can work as little or as much as I want). I work per diem only, I don't want a contract... then you have to commit to a schedule. I work for one agency. I make nearly twice as much as what I made in my staff position. Will clear about 80k this year. I purchase health insurance on my own, though my agency does offer it- they don't pay much towards it and my plan is less expensive than theirs. I love it, I don't plan on quitting. As long as I can get my shifts and the work is steady I'll ride this as far as it takes me, until I leave the bedside. I love the variety, the not having to put up with BS politics, the better pay, the freedom, never having to work weekends or holidays unless I choose to. I can't say enough good things!

Offer help, praise, credit where credit is due. And mostly lots and lots of humor.

I wouldn't count it as a liquid at all... its not something that would be included even in a full liquid diet... you'd see it as a component of a pureed diet or possibly mechanical soft.

I have been an agency nurse for about 6 months and I LOVE it. When I first started I was scared too, only 1 year experience as a RN, so I'd never worked anywhere else besides the hospital I started in, on the floor I started on. I decided I'd just do it, even though I was scared, and that if I hated it there was no obligation to continue. To my surprise I loved it. The first time in any facility is a little rough, just figuring out where things are etc, but after that its been great. You'll find that nursing is nursing, regardless of facility. You go in, get report, do your assessments, pass your meds etc.... I revert back to the same time management/flow I've always used, and tweak it as I get to know the facility. I go to the same 2 hospitals almost all the time now. People are generally friendly and helpful. You meet the ones that are jerks, but the great thing is, you don't have to put up with them every day! You do your 12 hours, and go home, and may or may not see them ever again! I started out keeping my full time staff position I've always had, did agency 1-2 days per week. In December I went down to part time (2 shifts/week) at my staff position, and do 2 agency days per week. I've been thinking of quitting the staff position to just do agency alone lately, but I'm going to save some money first so the times I get canceled won't hurt so much. Like another poster said, it can be feast or famine, you just have to plan accordingly and be flexible. Agency is great, great money, great flexibility, I love that I don't have to put up with the politics, that I get to just go in do my job and go home. I ask questions and never have gotten snapped at.... but you do have to have confidence in yourself, the other nurses will be able to tell if you don't, and then they will start to question your competency themselves.

Also wanted to add.. shes basically like the workplace bully. I may be a new nurse, but I'm not new to working and in all of my years of working, I've NEVER encountered anything anywhere close to what she is like. Its absolutely unacceptable. She has no business being in any kind of leadership role.

So last night was the very last straw for me. I am a new RN, been working for 5 months now. I get along great with everyone, except for this one particular charge nurse. Everyone I've talked to holds the same opinion of her as me. She is known for being rude, condescending, treating people like they are dumb, lazy etc, making a huge issue and freaking out over EVERYTHING, being high strung. I've been told she tends to target people.. and I guess I'm her new pick.. which I absolutely hate to go there, but several other nurses have told me they think she has it out for me, and I've had so many say they were completely willing to stand up for me if it comes down to it. I love my job. I love the unit I work on, as long as she isn't there. Its like a completely different place to work when she is... the environment is tense, and stressful, whereas when she isn't and someone else is charge (or the other charge nurse is there) it can actually be fun.. we all get along, everyone has a great sense of humor, we laugh together and joke around all night (while getting our work done) help each other out and support each other. I've tried to just stay away from this particular nurse. I don't talk to her, if I have questions I find someone else, I take a ship and chart back in a corner to avoid her, and basically just spend the shift trying to avoid her in every way possible. Last night at shift change I was supposed to be getting a transfer as part of my assignment. Sometimes they take awhile to come so I went about my business, doing my assessments and passing meds for my other patients (I had 3 others plus the transfer, and the other nurses had 4 each with a couple who went home early in the night... so a couple of nurses were sitting at 3 also.) As far as I knew we only had one admit come, because I honestly don't pay attention unless they tell me I'm getting one, or if it seems really busy. We may have had two. Either way, on the board, it didn't look like I was getting skipped over for an admit, it just didn't look like it was my turn yet. So about 8 pm rolls around, no transfer yet. I asked a couple of the other nurses if I was supposed to call about it, or if they call when they are ready to bring the pt out. The other nurses said that the unit would call when they were ready to bring out the patient, and not to worry about it. I figured the charge knew the transfer hadn't come yet because there was no telemetry on the monitor where we'd put the pt's name in and all of that. So I went about my business again, passing my 8pm meds, charting etc. At about 1045pm I noticed on the tele monitor that they'd discharged the pt out. I figured charge did it, since the pt never came. So I go out for my break, and come back to find the charge nurse all kinds of mad and chewing me out at the nurse's station about sitting with 3 patients since shift change. I told her I thought she knew, and she went on and on, and then told me then I could be the one to go home. Ok, fine with me, I guess, even though I know it wasn't my turn as I just went home early because of low census last week. So I finish my stuff up as she is sitting there giving me dirty looks, and shaking her head. Like I purposely sat there all night with my 3 so I could avoid admits. You know what? If she was any one else, I probably would have said something about the transfer not coming, but she is so totally unapproachable that I just flat out don't talk to her unless absolutely necessary. And if I had gone to her and said "oh hey, btw, my tsf. hasn't come out yet" I guarantee you she would have totally freaked out and somehow I would have been made out to be doing something wrong, and it would be something that she'd act like it needed immediate attention and take up a ton of my time when I needed to be taking care of my other patients. And you know what, if everyone was busy and we were getting admits left and right, or if it looked like I had been skipped over for an admit I would have brought it to her attention. But we weren't busy. Everyone was caught up and just kind of hanging around on some downtime. Another nurse pulled me aside before I left and told me that she went around to every single person there and went on and on about how I had only had 3 patients since shift change, and how she was going to write me up etc. Or like the other day, when she made me out to be an idiot and slacking off because I was off for 6 days and when I came back we had some new skin protocol thing going on that I had no idea about. She was so condescending, telling me "oh yeah, you had something in your box telling you about it and that there was an online learning thing to do. Don't you check your box? You should have known about this already." I said I didn't have anything in my box, and that I didn't know anything about it." To which she rolled her eyes and acted like I was completely full of crap. Guess what happens through the rest of the night? EVERY other nurse came to it on the charting and every one of them said "what the heck is this?? When did we start new skin protocol and charting??" I am to the point of refusing to work with her. I'm going to talk to the dept manager on Monday. I will not deal with this woman any more. Either they can schedule me so I work nights she doesn't, or I can transfer to another floor, or just quit and go to a different hospital. This is totally ridiculous. I go to work and work my butt off all night. I dont slack, I don't take shortcuts, I ask questions when I'm unsure, I'm learning still, but I haven't made any huge errors, and I'm catching on at an appropriate rate. I don't leave stuff for the oncoming shift, I get along with ALL of the staff (except for this one), I help out the other nurses even when I don't have the time, I don't complain about getting admits, or scheduling or whatever, and my patients have for the most part been complimentary etc. Thoughts?

I frequently fantasize about going back to my nice quiet office job in the city, and I'll tell you what, if I was as miserable as you sound I wouldn't waste a minute feeling bad about going back to it, 4 year degree down the toilet or not. While I really like being a nurse, at the end of the day, its a job, not my life. Yes, its my career, but still.. just a job. No harm/shame in changing jobs/careers if its not for you. I already know I won't be a bedside nurse forever. I like it now, but I can totally see getting worn out and really being tired of it after awhile. So I'll take this time while I still like it and further my education so that when the time comes that I just don't want to do it anymore I will have some other options. And if I hated it right now, I sure as heck wouldn't be doing it. Find another job... any job, even non-nursing/healthcare related. You have to take care of you first....and that means doing what makes you happy.

I don't know. I think you ought to try to talk to your preceptor and let her/him know you need more direction. I personally was taking patients on my own with my preceptor checking charting etc after a couple of weeks. I tend to ask alot of questions anyway and I preferred being more hands on and kind of left alone, because if there was something new I hadn't seen before, I'd always ask what the best way to handle it was. Also, my preceptor would kind of meet with me once we got our patients and fill me in on any "extras" beyond the usual routine that needed to be done. I think that it just depends on the person whether or not the type of orientation you've had would be effective. I'd prefer it the way you are getting it, but then you would prefer it to be different... everyone has a different learning style.

You know, I don't even know if there are any real guidelines as far as uniform where I work. I'm sure there are the typical no visible facial piercings, no nail polish/acrylic nails, etc. but as far as the actual uniform goes I've seen alot of different things- most staff nurses wear scrubs, any print/color with a variety of different kinds of shoes, from crocs, to white nursing shoes, to sneakers. I've seen our team leader wear scrub pants with a long sleeve knit/thermal top (solid). I've seen a tech wearing white sweatpants with a scrub top. I wear scrubs, usually solids, though every once in awhile I put on a print top, and now that its winter I wear a long sleeve teeshirt underneath in a complimenting color and sneakers, and I have a white zip up hoodie that I bring and put on at 3am when everyone is usually freezing!

Reminds me of a pt I had last week...just a mean and nasty guy... nothing was good enough, everything was a bother, but yet he wouldn't allow us to do anything to try to alleviate what ever his issue was .. ie.. complained his bed was wet, but refused to allow us to change it. He would be moaning and groaning in his room, and tell his room mate how much pain he was in, but when I'd go in and ask him if he was having pain he would just get annoyed and tell me to take my pain pills and stuff it. (even though I hadn't even gotten the pain meds out of the pixis. I was just going to offer) He wouldn't let me take his blood pressure, pulse ox, do an assessment... nothing. He barely took his meds. I'd go in to give him meds, and he'd get all annoyed and huffy. At one point at about 2 am, after he'd been throwing me out of the room all night, he called his daughter in law to tell her how they needed to come and see how he was being treated, and that he was laying in a wet bed, SOB and having pain. (He hadn't even attempted to tell anyone, just threw us all out of the room, and calls his family) The DIL calls the nurses station, but knows how he is and was very apologetic. So I reported this to the dayshift nurse. When I came back that night she reported that she went in there and he tried the same crap with her and she said "Then why are you even here?!" he replied "I don't even know, I don't want to be here in the first place!!" so she said "Then get your shoes on and sign out and go!" I had him 3 more nights after that and he was like a different person!

We'd just stop the heparin, flush and draw the labs. Never heard anything about labs being skewed as long as you waste the first 10mLs

I'm hoping day shift was able to get him something more to keep him comfortable. Next time I see the nurse who had him I'm going to find out.

So I last worked the other night. Had a pt who was having severe chest pain. 93 yr old DNR. At the beginning of the shift, his vitals were ok, EKG was ok, lungs clear etc. Pt was totally freaking out, full of anxiety. Nothing we did relieved his pain. He had a hx of angina (and about a million other health problems) and so while I thought he probably really was having chest pain, I also thought the anxiety was exacerbating the whole issue. This guy was on the light literally every 3 minutes. You could barely walk out of the room and he'd hit the light again. My preceptor and I (I'm a new grad, going to be off orientation in 2 weeks) were literally running like crazy trying to take care of this guy (never mind the other patients I had) and every time he got on the light, you'd walk in the room and he'd say "You gotta do something". So both of us were getting fairly annoyed with it- him being on the light every 3 minutes and the whole "you gotta do something statement" like we weren't doing anything when in reality we had spent between the 2 of us 4 hours straight trying to help him. Preceptor was on the phone with drs while I'm running back and forth to room with meds. Finally the cardio dr orders fentanyl and follows that with versed. So the guy calms down but still says his chest pain is no better when asked. About 3 hours into the shift I'm in the room and his breathing was audibly wet. So listen to lung sounds, they were wet too. He went from clear to wet in about a half hour. ABGs were ordered, they were crap, he goes on bipap. Family finally gets there, and the guy is still feeling the effects of the fentanyl and versed. Still complaining of pain, but his primary wasn't ordering more morphine for him. He was on scheduled vicodin, and morphine q 3 prn. (At that point neither dr expected him to make it thru the night, and neither did we. I thought they should have put him on a morphine PCA) As day shift came on thursday morning his family had left and I think the sedatives started wearing off because he was back on the light every 3 minutes. I had been thoroughly annoyed by the guy, but still gave him the best care I could, but there were a couple times earlier on in the shift where I might have been a little short with him. I did one time explain to him that we had given him everything we had orders for and had to call the dr for new orders and that I couldn't be in the room with him and on the phone with the dr at the same time and to give me a few minutes and I'd be back. (he hit the light again as soon as I left anyway, and when I walked back in he once again said "you gotta do something") So I saw in the obits that he died that day. (after I left) Now I'm feeling bad because I was annoyed with him. I do know though, that as annoyed as I was there were several times I took his hands and tried to comfort him and help him calm down. I've had patients die before, but I just feel bad because I was annoyed with this guy even though I knew he was dying. Everything was just really frustrating.

There are plenty of positives to being a nurse! But, as with any job, there are negative things to go along with it... positives: Work 3 days a week Decent pay right out of school for having a min. 2 yr degree Making a difference every day in one way or another every day So many different career paths to choose from as a nurse For me, while its been tight, I feel a good amount of pride that while my SO has been out of work, I've been able to provide for my family of five.. bills are paid, food is on the table. We have few extra things we are able to do, but the necessities are provided for. There is nothing like the feeling you get when you see someone come around... whether they've been uncooperative with other staff and for some reason you are able to connect with them and get their cooperation, or when they've been looking pretty bad, and they start to get better. I remember a guy in particular who came in with dehydration, acute renal failure, respiratory failure, tachycardic with underlying Afib... he was not making any urine at all, even though he'd been on IV fluids etc for a couple of days. He was starting to have third spacing. I'd taken care of him for a couple of nights, and he would respond to his name, but he had bipap on, and would only really respond when you took it off (Which I was doing fairly often, probably hourly, to do mouth care). This particular shift the renal doc had just finished rounding and was trying a couple of new things. At about midnight I went in and looked at his foley- there was 800 of clear pale yellow urine in there!! I practically did a dance in his room. Truth be told I was a bit overly emotional to begin with from PMS at the time, and I actually got a little teary eyed!! He was by no means cured, there were still many problems to deal with, but this was a small little victory for this guy. He was on our unit for over a week, and there were many issues that happened, and for the first time as a nurse I advocated like crazy for the guy. Days would say he was unresponsive, but every night I'd go in his room immediately after report and he'd respond to me, but you had to take the bipap off. (which every day I'd report) His poor mouth was just peeling and cracked from the bipap, and I practically begged the oncoming nurses to do his mouth care hourly. IMO he could have come off the bipap about 4 days before he did. Every time I took it off of him, his O2 sats stayed in the 90s on room air, and they drew ABGs which came back fine, but because it was difficult to get an accurate O2 sat on the guy, they were reporting that he desatted all the time. Anyway, we eventually got him off the bipap, and he looked like a different person a week after he came in... he eventually transferred out to a medical floor, but I will never, ever forget him. He was the first patient who really touched my heart. Anyway, I got off on a tangent there, so to answer your question, yes, there are many positives to being a nurse.

We call them ships.