All Content by imanedrn
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Boston?
Mass Gen depends on the unit. In the ER, travelers are put in 1 of 2 areas, and both are insane, to say the least. When I spoke to their rep, she echoed the same information a fellow traveler told me. I've learned very quickly, though, that ERs run and are staffed quite different from other units in a hospital.
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CATN is back!
I just saw this acronym somewhere recently and had no idea what it was. (What is it?)
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Tax Season!
If you don't go to a tax professional (like traveltax.com), use something like TurboTax. It helps walk you through the majority of the deductions for which we qualify.
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Any Las Vegas Travel MS Tele Advice ?
Ooh, I'm curious where you work there! You're still in ED? Vegas is my home. I started in ER at North Vista. I won't comment on it, as I still have many friends there. I will say, though, that I think I got a decent foundation from NVH, and that every ED in Vegas is bloody miserable. Some are far worse than others, but none of them seem to be in a good spot. Those never-ending holds make it almost unbearable at times.
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Any Las Vegas Travel MS Tele Advice ?
Vegas is my home, and I can't agree with you more. I started in m/s, and I don't remember it being horrible. I'm in ER now, and they're pretty awful. All of them are ridiculously overburdened. The pay is great, but I'd be happy if I never work there again.
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Providence Hospital in Everett, Washington
Oh, this makes me excited to read! I'm not sure what your specialty is, but I just spent 6 months in their ED. It was my first assignment, and I extended because I loved it so much. Their ratios are dependent upon acuity (3, 4, or 5:1), they'll work with you if you have a tanking patient, they have float nurses, you get breaks and lunches, and the staff are amazing. (I'm still friends with many of them and received a glowing recommendation from a shift supervisor.) I took the housing stipend because I actually wanted to go for Seattle and most definitely didn't want to be stuck outside of it on my days off. I spent my first contract living in Seattle proper (a 25 mile drive that was easy to do for day shift). For the second part, I moved in with a co-worker who lived in Mt Lake Terrace (about half way between Seattle and Everett). I saved a ton of money, but I didn't like being out of the city, so I wouldn't do that again. (I care more about the city experience than proximity to work.) Weather is important to consider. I went for the cold, gloomy rain. Of course, I didn't realize it'd be warm and sunny in the summer, which is part of why I'm happy I extended. That weather isn't ideal for a lot of people though. Seasonal Affective Disorder is very real, so keep that in mind. Overall, it was an amazing place, and I'm looking forward to going back! Feel free to PM me, if you have any other questions.
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Floating for 1st assignment?
This always makes me giggle when I read it. I'm an ER nurse, and I love floating to a different assignment (within the ER) every 4 hours. But, of course, we don't have to know our patients in exhausting details, so that makes it easier :)
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Miserable in my contract
This made me so teary-eyed! I started travel nursing last year because I want to explore the country through these "working vacations." I've been in love with Seattle for many years and ended up in Everett for my very first assignment, last year. I actually went for the rain (I moved to Las Vegas at age 10 from Hawaii and desperately missed it!), and I was so sad when I arrived in the summer, and it was so warm and sunny! I ended up extending and loved when it got gloomy and rainy (and even snowed one day!) before I left. I'm in Houston TX now. I came here instead of Austin for the pay. I like it fine, but damn do I miss the west coast! I miss the wildly progressive culture - and even the recycling bins and coffee shops on every corner! I hate the way the tap water smells here. People just feel different. I can't explain it, there's just a different feeling to them. Part of why I wanted to travel was to find a place at which I'd like to settle down. I want to live and work in every big city in the USA. But I think the PNW might be my home!
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What's your speciality?
I've worked in other units, but I stick with ER now. My first travel assignment was last summer. I have 5 years of ER and 7 years of nursing total. It took me 6 months to get my first assignment. I'd taken 2 years to finally commit to traveling, and the waiting was so discouraging. But then my first assignment was a gift! Super busy regional ER/trauma level II. (They see 300-350/day). When I interviewed, the interviewer asked how much travel experience I'd had. I told her none. She said the manager wanted people with at least 6 months. I emphasized that I'd worked on many different units and even in different hospitals/cities, and that must have sold me. My first location was Providence Regional Medical Center in Everett WA. It's fantastic! Their ratios are dependent upon acuity (3, 4, or 5:1), they'll work with you if you have a tanking patient, they have float nurses, you get breaks and lunches, and the staff are amazing. I fully intend to go back. I'm currently in Houston. Just started last week. Got FIVE days of orientation! Makes me feel like a staff nurse again! So far, decent place.
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Scared & Confused
So much of it will come with time :) If you end up with two critical patients, always ask for help. I've been doing ER/trauma for 5 years, and learning to ask for help has been one of the hardest things for me, but it's so vital! If none is available, notify your charge nurse, as it's ultimately his/her responsibility.
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How do I handle poor standards of care at a new job?
I concur with the others. I just started travel nursing in hopes of seeing that the grass can truly be greener -- and it is! It sounds as thought you went from lush gardens to the desert -- the opposite of my current situation. It's hard to know what standards of care are and have your facility completely disregard them. For the sake of your license and sanity, look elsewhere!
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How would you handle this?
I just started traveling, and this is one of the reasons I love it: I don't have to stay around for the BS. The above suggestions about tactfully talking to this tech are great (and I wish I could take them to heart, as I tend to be less tactful and rock the boat more often than I'd like). If that fails, always escalate (by email initially), if for no other reason than you have documentation to back your case.
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Orientation Length and Type
-What length of orientation did you have? 3 months -Were there specific ER classroom time or general nursing classes? How many hours would you estimate? I had a 2-hr critical care class once every other week or so. -What is your experience? (10 years med-surg or new grad) Prior to ER, I'd worked med/surg for 1.5 yrs. Now, I have 6.5 yrs experience total. During my last 5 yrs in the ER, I also did 6 months in PICU. - How long ago was your orientation period? (like was it 33 years ago or just last year?) 5 yrs ago -What is your current patient to nurse ratio? At present, it ranges from 5:1 (in fast track), 4:1 (for level 3's), or 3:1 (for level 1 or 2). At my last hospital, it was all 4:1, regardless of acuity. - What type of ancillary help do you have if any? At present, tons! Each pod (10-15 pts) has 1 ED tech. The entire ER has tons of resources too -- social workers, discharge planners, transportation coordinators, phlebotomy in the ER, IV team. I feel spoiled when compared to my last hospital which had almost nothing. We RNs (and a couple LPNs) did almost everything ourselves. - Can you send squads to triage? What is this? - Do you have protocols? Yes, and I love them! Again, my current hospital (I'm a traveler now) is fantastic. They expect you to put protocol orders in. I love that the doctors don't second-guess you for doing it. There is an expectation and then an appreciation for having done it.
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Sitters
Sadly, a lot of hospitals don't care about safety (patient or nurse) until a sentinel event occurs. This is the sort of thing worth calling administration about though.
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I never, ever went to ER when I was a kid
Like you, I remember a few bigger injuries. A few were pretty gnarly abrasions, one of which got infected for a bit, but my mom always tended to them at home. Another, I had a pretty bad radius fracture. My mom took me to a quick care for it. They ended up sending me to an ER because it was beyond their ability to cast. The other day, I had a mom get annoyed that it was taking me so long to bring Tylenol/Motrin to her febrile kiddo. Temp > 103. And she's annoyed at me. Go to the dollar store and then read up on how to parent your child properly! No way in hello my mom would have taken me to the ER for a fever!
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What's you're best drug seeker?
I love that you called the cops. I get so many people who I'm sure are FOS. But I play their game and kindly inform them that we have to be cautious about prescribing narcotics in the ER because, although you're in acute pain, a lot of people abuse the system.
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Tax question
That's a great question. I'd suggested you ask it here TravelTax ask us a question and then let us know. I'm curious also, as I'm planning on doing the same thing. Based on some of the information I've read, I'd assumed it was acceptable -- because I have a personal vehicle that I'll be leaving at my work location, but I'll also be working when I'm home. Seems to meet the "duplicative expenses" requirement.
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LOA while traveling
It took me two years to finally get up the courage to travel. I had a lot of the same concerns as you did, in addition to many others. I finally took the plunge at the beginning of June. I'm nearing the end of my contract and opted to extend. I couldn't be happier. It's exactly what I hoped it would be. I opted to sign on with a local staffing agency at home, so I can work episodically when I'm home, which will help fulfill my tax requirements. Also, if I'm ever in a position where I'm waiting on a new assignment, I can always go home for a bit and work while waiting. But no more staff work for me!
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Attention ER nurses and managers
Who said you're still a new grad? Granted, your experience is limited to a very narrow area, but you're technically not a NG anymore. Also, any ER that's part of a hospital without L&D would be thankful to have you! (The one I came from sure was!)
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Nurse Salary in Seattle
I thought the same and was quite surprised by it because I am from Las Vegas, which has some of the highest pay (especially compared to cost of living) in the country.
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no orientation as a traveler in Florida
What do you ultimately do in situations like this? I start my very first travel assignment tomorrow. I have read horror stories of stuff like this and, of course, have my quiet concerns.
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Ready to start traveling
Like you, I've been a nurse for 6 years and in the ER. Also, I'd felt overwhelmed for a long time! I read lots of information (on this site and various other places), but it all seemed to confuse me more. I'd been considering travelling for two years, and it really took all that time to solidify my decision. Although I am spontaneous and love to travel, depending on your personal situation, travelling can be complicated. I finally got serious about it in January. I had gotten a referral for a recruiter and reconnected with her (after the initial chat two years ago). I also decided to sell my major belongings (TV, bed set), move the remainder into my sister's home (and live with her), and travel with the rest. All of that wasn't an easy decision, and it really took those two years for me to decide how I wanted and was able to make it all work. I think the most confusing part is the taxes, and I'm still trying to figure it all out. (That part actually dissuaded me for some time.) There are some really good resources though. (One I really like is traveltax.com.) All of that said, I am writing this from Seattle, and I start my very first assignment tomorrow! Good luck!
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Registering with AMN and its Brand Agencies
I was talking to a recruiter with Medical Express for some months. I didn't like her method of communication (she didn't like email and insisted on talking to me on the phone every other day or so). After I asked that we sever ties, I was contacted by someone from American Mobile. It turns out Medical Express is a part of American Mobile. Apparently, after things didn't work out with the first recruiter, they passed my info onto a different recruiter. That recruiter explained to me that they're (technically) the same company, they just realize people work better with different recruiters, so they try to facilitate that. I'm not sure how the name differentiates any potential contract. So, to answer your first question, yes.
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RV's anyone???
I haven't started traveling yet, but this is something I've considered. Sounds ideal for me! For now, I'm in the process of selling the majority of my belongings and then leaving a few (keepsakes and a bed) at my sister's house for when I'm back home. Otherwise, seems like I'm ready!
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Nurses at Disney
This. Is. My. Dream. JOB! :hpygrp: