seabiscuitRN

I work in a small (8 bed) specialty unit. We use mandated overtime. During our busy time, about November-March, it is common to be mandated for 16-hour shifts more than once a week. We work 3-day weekends, and we can pretty much count on at least one of them turning into 18 hours. One of our nurses was mandated to work 16 hours on Friday, Saturday, and Sunday over the course of one weekend. Over one 5-day strectch, we had mandated a nurse more than 20 times. We also do mandated EARLY overtime, such as if you are scheduled to work at 1900, they can "mandate" you to come in at 1500. I put that in quotes because since I'm not on call, I don't "have to" be available. Anyway, I'm posting here partly just to vent, because I'm considering leaving a job that I otherwise love. And partly, I'm wondering if anybody reading this also works in a small unit like this and can offer suggestions. We do have a float pool at our hospital. I have been told that scheduled call "won't work" on our unit but nobody can really tell me why; I assume it's that we are such a small unit that we would all probably have to do 8-12 hours of call a week just to get one extra nurse available around the clock. Many times, there is more than one of us mandated at the same time. AAAARGH!!! HELP!

Looking for some clarification on dose ranges for prns. Example... If an order says 1-2 Vicodin q4 hrs prn for pain: Can we give 1 tab at 8am and 1 tab at 10am? Or If we give one tab at 8am, do we have to wait until 12pm to give any more? I've had a few different jobs as an RN and have noticed that there is a split between what nurses think. I'm looking for what's legal, what the order actually MEANS. I was originally taught that if the MD order says you can give something q4h, you can't give it at any frequency other than 4 hours. (In the above example, the order does NOT say that I can give 1 tab q2h, but that I could give one or two tabs q4h.) As this was how I learned it, it's what makes the most sense in my mind. But my current DON just made a statement that you can give it at any time within the time frame as long as you don't exceed the maximum dose. If anybody can actually give me a link to some research/evidence/proof, it would be much appreciated. I'd also like to hear some humble opinions :)

I'm just curious about anybody's feedback or suggestions...trying to decide what I want to do... My apartment is $485/month plus electric (about a hundred a month in the winter, half that in the summer). Would I be better off financially: a) keeping it and getting the tax-free allowances and deductions -or- 2) not keeping it and traveling without a tax home and getting none of the tax-freebies?

Hey, MSUnurse: I have 7 mos med/tele experience and will have a year in psych in Jan '09. I plan to start traveling at that point... in psych, because I feel totally confortable and competent. So, good luck finding an assignment and I hope to hear that you love it!

PS I thought you had to be a CO resident to get the Colorado pass but there's no residency requirement for the epic pass?? And- Does anybody know if/where there are psych RN jobs in the mountains?

Thanks for the mid-October warning. I'll be in Vail in September, so I guess I have till then to decide... Vail and Beaver Creek were $90/day last season (somewhat less for buddy passes or ski with a friend). That's why I'm thinking I might as well get a season pass... even if I don't get a travel assignment, I'll "have to" take enough vacations to make up the cost of the pass. :) Any other (random or specific) Colorado advice/suggestions welcome. --Salt Lake would be my 2nd choice, but I have friends & fam in CO--

Cross Country Trav Corps has a list on their website... a list of walk-through states, as well as a list of estimated wait times to get temp and permanent licensure in each state. I wish I could remember exactly where on the website. And now that I'm thinking about it, I'm only about 90% sure it's Cross Country. I hope I'm helping. (Too many google searches... I'm a little disoriented today!)

I'm being proactive and working with recruiters now. Hoping to be an early bird! I learned to snowboard at Vail last winter (with an inadvertent adventure with a black diamond on day #4) and I'm super excited to get back, hopefully as a traveler instead of a visitor this time. (This 90 degree Wisconsin summer is torture!)

I'm interested in travel nursing in Denver. If my dream comes true, I'd move out there in January or Feb. I know it can be hard to get an assignment out there at that time but I'm gonna try! Does anybody know anything about the ski passes -the Colorado Pass, and the Epic Pass- as far as buying them late season? Can you? If so, what are the prices? Do you have to be a CO resident? (As a traveler, I'll have an out-of-state driver license.) Any other info or suggestions? Thanks!

Got it. Thanks!

Sorry if this question has been answered on a previous thread, but I searched and didn't find it... I've always thought I knew that you could maintain licenses in multiple states. But I found this, an excerpt from https://www.ncsbn.org/358.htm "A nurse changing primary state of residence, from one party state to another party state, may continue to practice under the former home state license and multi-state licensure privilege during the processing of the nurse's licensure application in the new home state for a period not to exceed thirty (30) days. (Statutory basis: Articles 4B, 4C, and 4D[1])" -and- "The former home state license shall no longer be valid upon the issuance of a new home state license. (Statutory basis: Article 4D[1])" If you have a compact license and travel to a compact state but do not maintain a tax home, what do you have to do? Can you maintain licenses in multiple states? (For example, if I get what I want, Wisconsin and Colorado?) Thanks, and happy 4th!

I'm almost decided on not maintaining a tax home (seems like too much work!) but I'm curious about a few things...If you're an itinerant worker, how does that work? Does the tax on the supplemental income get withheld or do you end up owing at tax time? What about mileage reimbursement. How/when do they tax that? And your licenses? If I have a compact license now (WI) and travel to Colorado without maintaining a tax home in WI, is my compact license valid? I'm not traveling for a few months yet, but I want to know what to expect and what's appropriate before I start. Is there anything else anybody can think of that I should know? Thanks in advance.

One of the RNs I work with told me that after a few years of working psych, I'll be "worthless as a nurse." Um, no. I don't totally understand why psych nurses are so often worried about losing their medical skills. Shouldn't we be more focused on honing our psych skills?

I worked as an LPN in psych for a year before graduating as an RN. Then I worked med/tele. I learned a lot, got really good at IV starts, piggybacks, blood tx, hep drips, etc. But I missed psych, so I came back. I'm glad I had that expereince in tele; I feel like it gave me a background -sort of a little boost- to be a better psych nurse. It's nice to know that if one of my pts crashes, I know what to assess and how to manage a medically-unstable pt. But that's what worked for me, not what should work for somebody else. I work with some awesome psych nurses who (by their own admission) don't have any medical skills. Some of them are happy, some of them gripe about it. We had a pt with a PICC and nobody heparinized it after IVPB abx because in their 20 years of nursing, they'd never worked with a PICC. We had a pt who needed blood and the nurses didn't know they were supposed to be doing anything different than a normal IV fluid and so the pt ID/blood band didn't get checked at the bedside and nobody did frequent vs. We had a pt get IV mag and nobody did any kind of cardiac assessment, muchless tele or an EKG. But things like that don't happen because of a lack of medical experience, it happened because the nurses pracitced outside of their knowledge/skill base. If you work psych for a few (or many) years and then go medical, you can re-learn your skills. You can re-learn the medical knowledge like labs and heart caths or hip bolsters. You can figure out how to manage a load of medical pts. But keep in mind that some facilites require medical experience prior to working psych. Most importantly, do what you feel is best for you and your career, and try not to base your choice on what worked well for somebody else.

Check with a travel tax professional. I think I read on traveltax.com that you can rent out part of your home. Like if the lease said you were renting out one bedroom or whatever, but you're maintaining the rest of the home for YOUR living space, then it counts as a tax home. I could be wrong, but it'd be worth finding out for sure.