knowurjoe

I feel your pain, I have been waiting 1 1/2 months for my license. It was not even a new one. I let it lapse because I moved to another state. I went back to Ga. planning on staying a few months and working while there. So far.... The BON is taking its sweet time on getting their job done. Guess Georgia does not really need experienced RNs..

Anyone doing any traveling to Georgia? What hospitals? What companies?

The Doctor's have had the power of the prescription pad all along....

when assisting an individual with current competence in advanced airway management, including emergency intubation procedures While the physician or other health care provider performing the procedure may possess the necessary knowledge, skills and abilities to rescue a patient from deep sedation and general anesthesia, it is not prudent to presume this physician will be able to leave the surgical site or abandon the procedure to assist in rescuing the patient. The Board again stresses that the nurse's duty to assure patient safety [Rule 217.11(1)(B)] is an independent obligation under his/her professional licensure that supercedes any physician order or facility policy.2, 3 It is important to note that the nurse's duty to the patient obligates him/her to decline orders for medications or doses of medications that have the potential to cause the patient to reach a deeper level of sedation or anesthesia. The nurse's duty is outlined in detail in Board Position Statement 15.14 Duty of a Nurse In Any Practice Setting.

From the Texas Board of Nursing Website: Of concern to the Board is the growing number of inquiries related to RNs and non-CRNA advanced practice registered nurses administering Propofol, Ketamine, or other drugs commonly used for anesthesia purposes to non-intubated patients for the purpose of moderate sedation in a variety of patient care settings. It is critical for any RN who chooses to engage in moderate sedation to appreciate the differences between moderate sedation and deep sedation/anesthesia. Moderate Sedation Versus Deep Sedation/Anesthesia According to the professional literature "moderate sedation" is defined as a medication-induced, medically controlled state of depressed consciousness. Included in the literature from various professional organizations is the caveat that, while under moderate sedation, the patient at all times retains the ability to independently and continuously maintain a patent airway and cardiovascular function, and is able to respond meaningfully and purposefully to verbal commands, with or without light physical stimulation. Reflex withdrawal to physical stimulation is not considered a purposeful response. Loss of consciousness for patients undergoing moderate sedation should not be the goal and thus pharmacologic agents used should render this result unlikely. If the patient requires painful or repeated stimulation for arousal and/or airway maintenance, this is considered deep sedation. In a state of deep sedation, the patient's level of consciousness is depressed, and the patient is likely to require assistance to maintain a patent airway. Deep sedation occurring in a patient who is not appropriately monitored and/or who does not have appropriate airway support may result in a life-threatening emergency for the patient. This is not consistent with the concept of moderate sedation as defined in this position statement or the professional literature and is generally considered to be beyond the scope of practice of the RN. Although Propofol is classified as a sedative/hypnotic, according to the manufacturer's product information, it is intended for use as an anesthetic agent or for the purpose of maintaining sedation of an intubated, mechanically ventilated patient. The product information brochure for Propofol further includes a warning that "only persons trained to administer general anesthesia should administer propofol for purposes of general anesthesia or for monitored anesthesia care/sedation." The clinical effects for patients receiving anesthetic agents such as Propofol may vary widely within a negligible dose range. Though reportedly "short-acting", it is also noteworthy that there are no reversal agents for Propofol. The patient receiving anesthetic agents is at increased risk for loss of consciousness and/or normal protective reflexes, regardless of who is administering this medication. Again, this is not consistent with the concept of moderate sedation outlined in the professional literature. Though the RN or non-CRNA advanced practice registered nurse may have completed continuing education in advanced cardiac life support (ACLS) and practiced techniques during the training program, this process does not ensure ongoing expertise in airway management and emergency intubation. The American Heart Association (AHA) cautions ACLS providers about attempting tracheal intubation in an emergency situation since "Repeated safe and effective placement of the tracheal tube, over the wide range of patient and environmental conditions encountered in resuscitation, requires considerable skill and experience. Unless initial training is sufficient and ongoing practice and experience are adequate, fatal complications may result."1 It is also important to note that no continuing education program, including ACLS programs, will ensure that the RN or non-CRNA advanced practice registered nurse has the knowledge, skills and abilities to rescue a patient from deep sedation or general anesthesia. Furthermore, it is the joint position of the AANA and ASA that, "because sedation is a continuum, it is not always possible to predict how an individual patient will respond." These organizations state that anesthetic agents, including induction agents, should be administered only by qualified anesthesia providers who are trained in the administration of general anesthesia. Therefore, it is the position of the Board that the administration of anesthetic agents (e.g. propofol, methohexital, ketamine, and etomidate) is outside the scope of practice for RNs and non-CRNA advanced practice registered nurses except in the following situations: when assisting in the physical presence of a CRNA or anesthesiologist when administering these medications as part of a clinical experience within an advanced educational program of study that prepares the individual for licensure as a nurse anesthetist (i.e. when functioning as a student nurse anesthetist) when administering these medications to patients who are intubated and mechanically ventilated in critical care settings when assisting an individual with current competence in advanced airway management, including emergency intubation procedures

Be sure to check your state board of nursing websites. In Texas RN's can not push Propofol , Ketamine , Etomidate or Brevital unless pt is getting intubated, already intubated or when a CRNA or anesth. is present. Found in position statements on the boards website.

I am not an expert on this tax advantage pay offered by so many travel nurse companies now, but I am very leary of it. One company actually told me "only $11 of your hourly pay will be taxed". What about my social security and workmans comp, it would come out at that $11 rate. I have had them tell me it is FREE MONEY. I would never have to claim it. I did have to jump on that band wagon:no:. No money is free. You need receipts for everything unless IRS says otherwise. It benefits the company so they don't have the payroll taxes and its more $ for their pockets. Once I tell them I am in no way interested in that package, they go on and on about how wonderful it is. I want to be a travel nurse , not an accountant. I just can not bring myself to go the tax advantage way. Be careful. Be very careful.

Try a local sporting goods store, one that makes trophies for local sports teams. They may be able to help you.

Department of Labor Wage and Hour Division... call them