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NedRN's Latest Activity

  1. NedRN

    Compact license question

    Nope, nor should your MO license say compact on it, it is a single state license. You need to reside in a compact state to have a compact license.
  2. NedRN

    Travel Nursing in the OR

    I did 3 years as a staff nurse before traveling at a teaching hospital. Before I started travel, I tested my skills by doing "local" per diem at other hospitals first. That completely reassured me that I would be able to adapt anywhere, and I have. Mind you, there was no EMR back then (paper is easy) and some of them are insane. Last place I worked did Epic for the first time, not really so hard I suppose, but other travelers told me this particular facility did double the "pages" as other Epic ORs. If I hadn't been doing CVOR with relatively long cases, I'd never be able to finish by the end of the case. And in 25 years of traveling, that would have been a first for me. It was compounded by the week of hospital (no OR) orientation where the IT people did not have a working OR training software. So not really here to tell you about one hellacious start to an assignment but every hospital is very different (also surprising how many ways surgeons do the same surgery) so it really helps to have your clinical skills down pat. So if you are at all insecure, yes, do another year of staff. Not that many OR assignments right now anyway for the first time in 25 years of my own memory, too many elective surgeries cancelled to have much need for travelers and those assignments are really competitive! In my 25 years of travel, I've never been thrown in without sufficient orientation - at least for me (shortest ever was 4 hours, but that was back when open heart was easy and everything was a few feet from the room). I personally learn a lot faster if my orientation is shorter - when a surgeon is yelling at you for something, you really remember where that supply is! And that is the major reason why OR nurses typically have longer orientation than other specialties, you have to learn where thousands of items are and retrieve them on a surgeon's clock (which as you know is at least 4 times faster than real time). One thing some hospitals do is have you pull cases during orientation. I volunteer to do them if a hospital isn't organized, a great way to learn the place. As far as EMRs go, don't worry about it. Most hospital orientations train you for at least three days on it, much of it completely wasted in the OR. I've done a lot of EMRs, including Meditech before IBM compatibles before they had mice - all keystroke navigation. Documentation is far less in the OR than most specialties and I try to skip most of the hospital orientation and just learn by watching in the room. Most travelers (not just OR) feel like hospital orientation is largely a waste of time. You will also get at least three days, usually a week, to orient in the OR.
  3. NedRN

    Home Health Traveler

    There are home health travelers. I believe compensation varies when it comes to miles and visits. Possibly an hourly rate instead with guaranteed hours and travel expenses.
  4. NedRN

    Referral Bonus, Y'all

    Just to point out, this is a zero sum game. If the agency pays a referral bonus, that is a dollar less an hour that they are going to pay you. And in return, the agency gets a referral without any personal knowledge of that nurse from the referrer, deleting most of the value.
  5. NedRN

    Semi-retirement plan & questions

    The following is excerpted from a PanTravelers article on health insurance. It does predate the ACA, however the COBRA law was not amended by the ACA. Make sure your agency is covered by COBRA though, there is a minimum employee threshold. I suspect you will be better off seeking the best compensation package rather than looking for good or even adequate insurance coverage.
  6. NedRN

    Semi-retirement plan & questions

    Doing two contracts a year will raise no questions for potential employers. Insurance is a complex problem. First you have to realize that the cost to COBRA is as much as an exchange plan. At least your permanent employment plan. Second is that few agencies have insurance plans for travelers comparable to either of those options. So if you COBRA an agency plan, you again get what you pay for, lower cost for poor insurance. Becoming a traveler makes it obvious who is paying for insurance: it is you! If your employer wasn't paying for it, they could pay you much more in cash compensation. In fact, that is why in-house per diem and travel pay (usually) more in cash than regular staff: loss of benefits. So there is no free lunch, but you are going to have to consider the true cost of insurance, especially year round insurance and working half a year. Yes, COBRA has a lot of employer unfriendly workarounds such that you can be covered for a period of time without having to pay. But it won't cover you for 6 months and if you need it, you would of course have to pay premiums for the lapsed period. In the pandemic with a large number of elective surgeries being cancelled, there has been a significant drop in OR assignments. However, CVOR still has assignments, and many are paying well. I'm tempted myself, but I'd hate for my next assignment to do permanent injury. Now OR nurses are perhaps equipped with more knowledge than most about how to protect ourselves and others from infection, but do consider that at our age we are at high risk from complications should we become infected.
  7. NedRN

    Cynet..good or bad?

    Good plan. However, while PanTravelers is a good site for basic and advanced traveler info, they do not have information on individual agencies. The exception to that is a list of agency brands owned by the two largest agencies, which can be rather opaque when sifting through agency brands and not realizing that they are not independent brands.
  8. NedRN

    Contracts, Safety Ratios, and Stipends - Oh My!

    Yes, it is common to have stacked shifts written into the contract. Typically recruiters should have a good idea if this is possible at a given facility. Worst case? I've heard some horror stories. But remember, you have choices. You don't have to take any particular assignment. Any hospital that isn't a traveler mill (extremely heavy user) is going to have the manager interview you by phone. If they call you, they already want you and unless they need a specific skill clarified, it is really for you to interview them - they are trying to sell you on coming. Grill them about staffing ratios, turnover, patient population or anything else, like why they need you! (best answer, pregnancy leave). Any bad vibes, just tell the manager you will talk to your recruiter and say not a good fit to your recruiter. Everything is negotiable. However, there is only one pot to draw from. The industry works on all inclusive bill rates for every hour you work. That is split multiple ways into your compensation, and the agency margin. If the agency margin is fixed (they have a goal of keeping the lights on and recruiters and other staff paid), all you are doing is changing how your compensation is split up. Yes, assuming you keep your home (valid IRS tax home), housing, per diem, and travel reimbursement can all be paid tax free. This is often already maximized, at least to the extent that their accountant or tax lawyer feels comfortable with - so you may not need to negotiate a low hourly wage and higher tax free, that is the way most agencies already deal with compensation packages. So per the article you read, call lots of agencies and talk to lots of recruiters. You will learn a lot about stuff you haven't even thought about yet. A useful side effect of all that work finding good recruiters.
  9. NedRN

    Cynet..good or bad?

    All "best" agency sites have a bias. Not one can possibly know which one - or more specifically - which recruiter is best for you and in what way. Not even a travel nurse with 25 years of experience can tell you. Start with there are no good agencies and you will begin to approach the business of travel nursing from the right perspective. As you have recently read my article on how to find an agency, I won't go on at length here.
  10. NedRN

    Cath Lab Travel Nurse Questions

    Assignments with no call do exist but are rare. I've had them as an OR nurse but have never sought them out specifically. Lots of solutions when you are on call. Some hospitals will allow you to use a call room. Sometimes staff will let you crash at their home on call nights. When I worked in Monterey, there was a staff member who lived in Big Sur with no phone reception (and a bit far for 30 minute response). So he drove halfway to the hospital where there was cell coverage and camped in his car overnight. One does what has to be done. Certifications do not pay more directly. But they make you more competitive and you may land assignments that you would not otherwise get. So indirectly, you will get paid more.
  11. NedRN

    First time travel nurse to California

    The best way to find out what you are worth is to shop around. Maybe you will be lucky and someone with two years of NICU experience who just landed an assignment in Huntington Beach will give you those details. But even with such luck, who knows if the offer is representative. You are going to have to call a lot of agencies to get an answer specific to your abilities and search area. While it is a lot of work, it is also the only way to find a recruiter who is not full of it and will work in your best interests and with whom you communicate well with.
  12. NedRN

    pending Compact legislation in PA

    Culture is a difficult thing to change. Look at policing. People do not necessarily work in their own best interests.
  13. NedRN

    pending Compact legislation in PA

    Yes, the more workers that side with employers gives cover to legislators to appear labor friendly. History of our country.
  14. NedRN

    pending Compact legislation in PA

    So it was a super-specialty, CVOR. Not really applicable for bread and butter assignments. But rapid response crisis pay assignments do come up in every state, right down to tiny ones like Wyoming. Perhaps most agencies don't have access to them, as they occur when regular agencies have failed or cannot react fast enough. For regular assignments, again, non-compact states tend to pay more. Reduce supply, and cost goes up. Compact does just the opposite: increase supply and pay goes down. Basic economics which is strongly apparent in travel jobs. Staff jobs skew basic economic laws because of anti-labor employer practices and reduced mobility of staff (don't want to leave their home area). In Ohio, Cleveland Clinic effectively has a monopoly on Northern Ohio, and influences all heathcare compensation. Too much strength in the hands of employers or unions makes compensation less balanced and less subject to rules of supply and demand. My first job was at University of Maryland, and my pay started at $13 an hour in 1992, and finished at $15 an hour in 1995 when I became a traveler (still the same pay as a new nursing graduate). No unions, and Johns Hopkins actually paid less - for the status of working there. In general, the South has a huge oversupply of nurses, and an almost total lack of nursing unions, a recipe for low staff pay in the decades since I started working there. I didn't care so much about the pay, I knew I was just putting my time in to becoming competent until I became a traveler. The training was priceless, but I do have compassion for the nurses stuck in the low paid South, and indeed most occupations.
  15. NedRN

    pending Compact legislation in PA

    If you live in Ohio, you don’t have a legal compact license. Thus the compact status of PA doesn’t affect you. Good paying contracts can happen in any state. I had a contract 12 years ago in Ohio paying $75 an hour. Your point?
  16. NedRN

    pending Compact legislation in PA

    The hospital credentialing process for physicians usually takes a good bit of time too.

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