dixRN

Go to Delphi forums then to their travel nurse section. One of the headings there is taxes & a very helpful tax guy specializing in travellers will give you an expert answer.

Bortaz I left Houston 2 weeks ago. Memorial Hermann had NICU level 3 positions posted. I believe Women's did also. The Medical Center just had a major shift of NICU nurses. Texas Children's hired a bunch of Memorial's level 3 RNs, then Memorrial hired a bunch of Women & Children's, but some of them changed their minds & went back. There may even be a position or 2 at Texas Childrens still as they are opening a new hospital with L&D,etc which they have never had before. This might be a good time to make that major location change.

It usually is about a 2 week window from accepting the contract to reporting for the 1st day of work. Just tell your travel company that you need 2 weeks before starting a contract because you have to give notice to your current job. The thing I want to stress to you is please do not start travelling without 3 months expenses saved up. Things happen, like contract cancellations & cars breaking down. I have read many a post about running out of money & being far from home. Just be prepared. Check out delphi forums in travel nurses. There is excellent info there. You are going to have a great time seeing this wonderful country of ours. Good Luck.

Finnmackenzie, If you can switch to L&D do so. You will be helping with the delivery of infants & that is much closer to NICU than adult ICU. See any newborns there? You will take NRP & probably have access to NICU classes such as STABLE, which you should take if you can. You will also get to know the NICU nurses that attend hi risk deliveries. You should make a point to get to know them. Make yourself known to the NICU nurse manager & when a NICU position comes available you will know about it right away & have positioned yourself for it. I don't think you could do that from adult ICU.

Michelle, I am a travel nurse & worked in many NICUs but none with such nice systems of communication as mentioned below. Usually care conferences were only set up at parental request or for babies with severe developmental problems or very complicated cases involving many specialties. Usually the bedside RN was the main line of contact with the parent & in my case I usually get the chart & tell the parent the new orders for the day. Then clarify the orders for the parent & answer any questions. Then I do a general review of the babies current condition. I always reassure the parents that if there are any major changes in condition I will call them. If it's been awhile since they spoke to their child's NNP/Neo I will ask them would they like to speak with them. I have been working NICU forever & I can tell you that in the last few years the Neos have become much more accesible to speak to parents. It used to be like pulling teeth to get them to come to the bedside to talk to parents but that has changed for the better. In the majority of places I have worked the bedside RN is the main communicator & the facilitator of communication with physicians & NNPs. Wow, that was a mouthful. Hope this helps.

Bortaz You should consider Houston. The Texas Medical Center meets all your requirements. There are 2 level I trauma ERs there. Memorrial Hermann has the busiest trauma ER & busiest life flight in the country. There are too many level III NICUs to name & a couple of level IVs! But the icing on the cake is that cost of living is low compared to the rest of the country & Houston pay is good for RNs in the city. I am a traveller & have worked a couple of times there. Most of the nurses had beautiful homes in the suburbs but they did have to commute. The downside were the freeways but if you lived on the southside of Houston then it was an easy drive. I would love to take a permanent position there but it is too far from my family.

Don't feel bad. Lots of travellers get burned the 1st time out. But the 2nd time they are much wiser. If you guys have a tax home, have you thought of taking the housing stipend for each of you & finding your own place. With 2 housing stipends you could spend one & bank the other. You already obviously know how to do the online research needed to find your own place. I find my own housing & particularly like furnished basement & garage apts. Before you sign the contract have any company send you their insurance plans & how much your premiums are going to be. Yes you will have to push them. it typically takes several requests. You need to have your info at about 3 different companies so you can compare. You also have to be very clear with your recruiter about the submitting you without your permission. I have found this to be a common practice. I like my recruiter & company, but would not recommend them at this time for that very reason. Nothing like a surprise call out of the blue from some hospital you didn't even know you were submitted to. It makes the travel nurse look stupid because you haven't had a chance to research the hospital. You don't even know what the pay rate is & if you want to work there. I recently had that lovely experience & was so surprised I didn't ask my usual questions or even get the name of the nurse manager I talked to. Keep all your info current at several companies & then you have much better choices.

If you go to delphi forums under travel nurses there is a heading for tax questions. There is a respiratory therapist turned travel tax specialist who will answer your question. He gives excellent advice. All I know is you do NOT want to be on the wrong side of the IRS. Don't forget they charge interest on any money owed them.

You are being paid as traveller with a tax home but you do not qualify for this even if you have a tax home due to the fact you are only 10 miles from home. You are going to be slammed on taxes. Your company has no business paying you this way & not taking out appropriate taxes. Start putting aside 25% of your income because you are going to need it to pay Uncle Sam.

I have worked nine NICUs all over the country & all of them checked for NG/OG placement by aspirating for stomach contents & by listening for air "bubbling" with stethoscope when air injected via NG/OG. ND & NJ tubes required xray verification after placement.

Elliern: I just wanted to add that if you update your report sheet with any new orders it also is a terrific tool to give report with. For example: on your report sheet you have written current feeding order of FBM 24cal 26ml q3h, then you receive a new feeding order to increase to 28ml. You cross off 26 & write the 28. I keep my report sheet updated & totally current & can give report off of it. I write anything I need to pass on to the next shift on my report sheet (hourly flowsheet) so it is there to remind me to give that info in report. I looked at the flowsheet offered above & it looked like a great tool. Please get back to us in a couple of weeks & let us know how it is going for you & if any of our suggestions worked for you.

Scissors, hemostats (hang on to them tightly--people will walk off with them) a extra pen, if you want a beverage in the designated area then a travel mug with lid that is marked with your name (I always slap a piece of tape on it to write my name). Most NICU's have their own stethoscopes at every bedside but NOT all. Many nurses set their cell phone to quietly alarm hourly to remind them to get their hourly infused total off the IV pumps. I know you have already had your first day but am responding in case it could help someone else. Why don't you write us back & let us know what you found that you needed in your 1st day.

You are having major organizational problems. You need to use a hourly flowsheet & as you take report write the med due that hour in that hours space. Usually during report you will reveiw the MAR on each patient. Ditto for treatments, feedings etc. Then you can see at a glance what you need to do & cross off your meds as you give them. Most NICU nurses I work with organize themselves in this manner. If I lose my "brain" sheet I am in trouble! I do not rely on memory. I have seen many different variations of this report sheet but the principle is always the same. I am constantly checking my sheet on each baby. I also leave my PIV sites where I can see them when I walk by. If you have a higher rate you can get an infiltrate in much less than an hour. So if I have a crib baby with a foot IV then the baby is all wrapped up with that little foot sticking out. I might then throw a loose blanket over the baby where I can just lift a corner & immeadiately view the IV site without disturbing the baby. Hope this helps.

Go to www.indeed.com & enter your specialty & location in their search box. You will get job postings for whatever city you enter. A lot are different companies posting for the same job. Do NOT let different agencies submit you for the same job. That can be the kiss of death. I have worked in Houston for several contracts with Supplemental Health Care & Travel Nurse Solutions (now Jackson). The HCA hospitals use their own agency which I believe is now Parallon. You can call one of the big companies like Cross Country & ask if they have any exclusive contracts in these cities. If you want specific info on Houston I can give it to you. I am not medsurg & know nothing about hospitals in respect to that specialty, but love the Texas Medical Center in Houston.

Try local agencies to see if they have per diem work for you. You need about 3 months living expenses saved up when you are traveling for just this sort of situation. So sorry this happened to you.