tazzyjo

So very, very true. I left bedside because it was getting so unreasonable, unfortunately I may have to return to the bedside since I moved and need to start over. But if you don't treat people well (both staff and patients) you will never maintain a favourable place to work and use for healthcare. If the management person(s) do get admitted they are provided VIP care so they do not feel the pinch that most patients feel from the inadequate provision of staff/care. Let them really feel the true care and see how they like it. I'm sure they won't or they will tell themselves some lie to gloss over the underserved care.

We are now having this rammed down our throats in my hospital. We are to do a FULL report at the bedside or we get yelled at and written up... I've casually mentioned to just hand me a dozen violations and I'll sign them, then they can just date them each day I work. We have attempted to give partial reports at the nursing station and get chastized for these as well...ALL AT THE BEDSIDE. As the oncoming/off-going nurse we now ask our patients if they want to be disturbed with report, some do not want us in the room, many at the time don't care. Medicare is basically looking for any and all ways to not pay for medical care of patients, they are setting the system up for failure and as always it is the nurse who is to blame. These idiots making these decreas should understand that not everything is black and white and as nursings and facilites we should be able to establish the shades of grey that work for everyone.

Our facility is making it mandatory and I still find it is a pain in the ass and a HIPPA violation. We have very sick patients but we also allow visitors 24/7 and that makes it even more difficult. I have received the worst reports from nurses now since we started doing this they are short on useful content because no one will say much and it seems to be more for show than anything else. I prefer the information at the desk do a meet and greet to go over dressings, tubes, IV's and plan for the day, but not the whole report. I find it takes way to long at the bedside when the patients and family start asking questions that have nothing to do with the report and they don't take no for an answer when you tell them you will be back to discuss this when you are finished report. It's even worse if you have a different nurse for each of your patients. I have refused to do it and my manager understand that but says I need to be careful for the higher ups are now rounding to make sure we are doing it. I've just continued to be defiant and don't care if they don't like it. There has to be a better alternative. I like to look up my labs when we talk and at the chart so I can make sure nothing has been missed, now I can't and it takes me even longer to get back to the room.

I travel with 2 cocker spaniels and it all depends on where you are planning on going how dog friendly places are. I've primarily done CA and AZ in my travels and with the exception of Santa Barbara had no problem with the agency finding me a place that takes dogs. Just remember some places have size as well as breed restrictions, you may have to pay a pet deposit and a monthly pet rent. My stint in Santa Barbara had me commuting from Ventura (up to 1 hour one way, depending on traffic) as I could not locate my own housing in Santa Barbara that would allow for pets. Good Luck, you'll love having the companionship of the dog!

Although I haven't had time to read all the in's and out's of the proposed "universal healthcare" I have worked in both the US and Canadian systems and have seen both sides of the coin so to speak. In Canada it's great that EVERYONE has access to healthcare for little or no cost depending on which province they live in. But this system also leads to abuse of the healthcare system by some patients. It is hard to find a PCP in Canada as the government regulates where new docs can start up a practice and if a doc does start up a practice you can be sure he will have a full contingent of patients within a month. So then the ER becomes the fall place for many people without PCP's. There are walk in clinics that operate on a first come first serve basis, but people have become demanding and think that they deserve immediate service (as in the US) even if their problem is minor (i.e. a patient showed up at a "new" hospital thinking it needed to be seen by a physician for a zit (can we system abuse)). Universal healthcare should ensure fair and equal access for all, but does need monitoring and limits set to some degree. Limiting where doctors can work only leads to further healthcare industry problems, incentives to work in rural areas would be a more sound alternative than forcing new docs out to the rural area and still paying them the same. Medications, although expensive can vary from place to place. I've bought a particular medicationin someplaces for as little as $40 and as much as $300+ (just to note the most expensive place was in Canada and not the US). All were "generic" so there is no explaining the differences. Costing would be something that would have to be between government and drug companies (and we all know who will be forced to give in). I am sure insurance companies will fight this change tooth and nail as they will be forced to give up plenty of money and autonomy, same as the drug companies who may be forced to take longer to recoup their expenses in R&D. For profit hospitals may also oppose I would think as it may become a lost leader for them??? There has to be a happy medium between what now exists and what has been done in many other countries for years at the expense of tax payers.

My view is that some of their ideas are good in theory, but will little or no regards to implementation from a nursing point of view or standardization for hospitals point of view, we end up with a quagmire of inconsistency and unattainable goals. I find I rely on my CNA's way to much to know exactly what is going on with my patients moment to moment because I'm so busy TRYing to get all the paperwork done correctly, instead of attending to my patients (at least in some hospitals). Even with lower nurse to patient ratios, it is hard to stay on top of the patients condition because of the never ending requirements of JCAHO and hospitals inept attempts to satisfy the beast call JCAHO. As a travel nurse I've noticed that even with JCAHO many hospitals put their own interpretation on the rules which makes it very hard to find any of this a serious endevour.

Jeff, I've been travel nursing for 2 years and it depends a lot on your recruiter, not just the company. Interview the companies / recruiters, talk to other travellers and see who they recommend, if they have a good recruiter go to that recruiter within that agency don't let them tell you that it isn't possible. If you like the company but not your recruiter ask for a new recruiter. For info on travel companies check out Delphi forum they have good info. I also found this website http://www.highwayhypodermics.com/travel_nursing_hospitals.htm which gives some info on the various companies out there. I will tell you the benefits are minimal they can really suck if you get sick or have major dental work. The benefits are your housing is paid for and if you don't like a hospital you are only there for usually 13 weeks. You can change hospitals and yet stay in the same apartment if you like the area... it is a great way to see places and experience various parts of the country. :welcome:

I have had friend get out of tickets when wearing their hospital ID/scrubs. But here in Tucson they actually sit in a 25 zone in back of the hospital (apparently residential streets here are almost always 25) just waiting for the doctors and nurses to come along so they can ticket us. When I got my ticket I was new here and from out of country, never even saw the speed limit signs...they also like to space them extremely far apart and usually hidden off to a side. I've dated police and still have some ex-police friends and they all are the same it is professional respect that they will give us warnings. This guy however didn't care and then had the nerve to try and chat me up while I'm getting very close to being late for work. I was not impressed... I got the last laugh, because being from out of country as were my plates, it does not affect my insurance, I don't have to go to traffic school, and I didn't pay the ticket... they have no real way to get me. I just have to be careful not to get pulled over again.

Customer service is providing a service to a person or persons, we provide the service of health care not in room hotel services. I have seen a patient press the call bell, and immediately after we hang up the family member is in the hallway wanting to know what is taking so long. In the meantime the CNA or nurse is on the way to the room. Last time I checked we didn't have instant teleportation to "service" as stupid request that they could easily have done themself or a family member could have done...like get ice. In this day and age of computer charting, computer medication dispensing, high acuity (which hospitals NEVER take into account when creating assignments) we spend more and more time away from the patient and families spend more and more time at the bedside... if they want instant one on one service then they should start hiring their own private nurse and maybe hospitals should offer that... instead of expecting us to balance 5-8 very sick patients with little support.

I'm hoping to get some feedback from those out there that have done some travel nursing. I moved down to the US from Canada, but I find that I am very uncertain about the agency I am with and the little things that seem to pop up that were never explained properly or possibly ignored by the agency to benefit them. I am currently thinking of finding another agency but I am still a little leary about what to look for from the agency... benefits, housing, pay rate and if this is guaranteed if cancelled by the hospital... etc. I have yet to have a complete set of shifts in a payperiod and now on a renewed contract they have doubled my housing cost I have to pay if I am sick... I just had 3 shifts cancelled by the hospital and now I'm out those shifts with little or no chance to make it up... any thoughts... thanks.

I am in a diploma program, with the option to stay in for a degree. I have opted to take the diploma and do my degree afterwards. Staying in is not an option as I've run out of money and I don't want to be paying big bucks to write papers for another year. I have found that I learn more from the nurses on the job than I learn from my program. The program concentrates so much on what I call "fluff" classes and less on the practical stuff. I will be graduating next spring and feel like I will be unprepared for the work force. I have been reviewing already for the RN exams and find that so much of what I've been exposed to barely scraps the surface of what is really needed to survive. My program has, in my opinion, gone way to far in the other direction for effective training. We don't get taught or understand the basics such as the value of lab results (nurses on the job have taught me that) or enough experience on things such basics as catheters and dressings. You can only learn so much working in a lab on a dummy. As for instructors some good, some not so good, but with the limited supply the school takes what they can get and we suffer for it. I personally don't think it's fair to the nurses on the job, to be training us after we graduate on the realities of nursing. Schools need to take a hard look at their curriculum and find a happy medium between the old ways and the new ways.

Well it's pretty obvious we all have experienced one instructor or another that should not be teaching...schools seem to forget that just because the person has a masters degree doesn't mean they are capable of teaching, they are capable of being a student and who knows if they were even very good students... "those that can do, those that can't teach!"