AngiereeRN

I’m referring to inpatient. I work in a hospital and we don’t require our patients to wear masks while they are in their rooms.

From what I’ve read there are risk levels. If two people come into contact with each other and neither is wearing a mask there is a high risk of exposure. If both are wearing masks then the risk is the lowest. If one is wearing a mask and the other person isn’t then the risk is moderate. Think about it, how many of our patients are wearing masks as we care for them? I think that’s why we’re getting it. We are wearing masks but our patients are not. That increases our risk.

Studies have shown that this Ebola outbreak has spread farther and infected more people because the virus itself has changed. . A study done by Harvard, Tulane, and the Broad Institute found 341 genetic changes that make this outbreak different. Five people involved in the study, died from Ebola themselves.To me, what that means is we don't know, scientifically, all there is to know about Ebola. Even the scientist who discovered it says it's following a different pattern than it has in the past.The MD and aide worker who contracted it said they had been following the same strict protocol as everyone else, yet they caught it. Why? How did a camera man, who shouldn't have come into contact with blood or body fluids, contract it? Obviously a disease, that has only ever affected a few countries, suddenly spreading worldwide means something is different this time. For that reason, self quarantine out of an abundance of caution, wouldn't be a bad idea. I'm talking strictly about nurses, like Kaci, who have been to West Africa and cared for Ebola patients there, where the disease is running rampant. I don't think they can legally hold her against her will, nor do I think they should, but I don't support what she's doing. It's not about fear, it's about being careful and cautious.

It's an LTACH so most of the units are similar. One unit is mostly ortho and one is for patients that are more critical and need more observation, so the unit issue isn't that bad. I just don't like the ambiguity. First time jitters, I suppose. On a positive note, I love my apartment, it's in a great neighborhood, and I already like my neighbors (3 of whom are cops so I feel a little safer so far from home)!

Hi Everyone I was looking for some advice from my fellow travel nurses. I finally found an assignment and I am in the first week orientation. I've just been in nursing orientation with all new hires and so I'm a little confused about the process. As of now, I don't have a schedule or even know what floor I'll be working on. I asked about shadowing and when I would get a chance to go on the floor and shadow with a nurse for a shift (preferably night shift since that's what I'll be working) just to get the feel of the floor and find out where everything is. The educator told me I'd be able to go on the floor tomorrow while everyone else takes a test and she said something about Friday but didn't give me a time or unit. I have a continuation of nursing orientation, just classroom, tomorrow and Thursday (computer class) and then I don't know what or where? I was even told by my agency that I was to show up for orientation on Monday morning only to get there and be told that travelers don't attend general orientation and I needed to come back Tuesday. Today, the same thing happened with two per diem nurses, they were told that they had to leave because the facility doesn't give orientation to per diem nurses. Basically, no contract no orientation. I only found out about Wed and Thursday because I asked. My recruiter has not been helpful, she just told me to ask whoever I could find tomorrow about shadowing. Is it normal to feel this in the dark in the beginning? I'm also concerned because this facility's lab is only open part time and so the nurses draw their own labs. I've been an RN for 2.5 years and the facility where I worked didn't allow nurses to do those. A coworker even got written up when she tried to practice right before becoming a travel nurse. How do I handle that? It's not something I could've practiced doing because it was against policy.

Thanks for the advice. Getting another med/surg or pcu staff job is something I might have to do but I really wanted to travel for a year or two before settling down. I'm going to keep trying for a little bit longer and see what happens.

I posted a while back about having trouble getting assignments because I'm an LTAC nurse (as in long term ACUTE care). LTACs are certified as acute care, it's not a nursing home. It's a form of extended acute care, average 25 days, for medically complex and, sometimes, critically ill patients too sick to go to skilled care or rehab. We see vents,trachs, wound vacs, chest tubes, feeding tubes,central lines etc sometimes all these things in one patient! We often admit patients straight from the ICU. NedRN suggested I re-brand myself as a PCU nurse since the care is similar (by the way, thanks NedRN ). I tried that, having my written references emphasize the types of patients instead of the name LTAC. Spoke to my recruiter and she said they still consider me a long term care nurse. I explained, again, how it's not LTC and she said "What's the difference?". I wanted to scream because I've been over it with her, I even sent her the definition of LTAC from the medicare website, where it says that LTAC is not LTC! After all that, hunting my references down and having them go through the trouble of filling out the proper forms explaining the type of patients, it did no good! LTACs admit med/surg, pcu, and sometimes critical care patients so why is it that they won't even submit me to med/surg positions? This has been a problem with multiple agencies. I've worked my butt off at an LTAC for almost 3 years, they are hard places to work with high levels of acuity, all to have someone basically tell me that I'm not qualified to take care of med/surg patients because THEY don't understand what LTACs are. I get the confusion, there are only 400 LTACs nationwide, even on this forum people continue to post about long term care in the LTAC forum, but if you are a recruiter and you've had it explained to you, what is the problem? NedRN, I can't send PMs yet, do you have anymore suggestions since you're an experienced traveler?

mparker3kids I don't know if you're a nurse, but if you are I'm worried. How in the world can you glean so much info about someone whom you don't really know? We are all human, we all make mistakes, do stupid things. People in this population are poor and many suffer from mental illness and/or addictions (which is a disease). The type of person who will not help themselves. Not a person who cannot help themselves, but will not. Those who come in hacking up lungs begging for the nurse to help them breathe when they were putting out cigarettes in the parking lot. Seriously? Who are you to know or judge this? Do you know them, have you lived with them? How can you adequately care for someone with all that judgement and assumption? Are you perfect? Judgement like this serves no one, not the patient, not the nurse. I go to work and care for my patients to the best of my ability, what they do or don't do in their lives is not my business. I've dealt with rude patients, patients who've treated me like a servant and been rude to me. We've all had patients who were difficult because that's not just in nursing, it's life. Everyone deserves care when they are sick regardless of what you might "think" you know about them. It's called empathy and it's an important part of giving care.

Thanks NedRN, I will definitely give that a try. I did many clinical rotation on a step down unit and a friend who is working in a cardiac step down right now. My shift manager and I talked about how what we do is more inline with step down nursing vs med surg. I just don't know how to explain that when recruiters look at the website of the facility where I work and see LTACH. It's annoying though because the site does say LTACH but it also says "extended acute care".

I have an issue and would like some advice. I'm an RN and have been one for over 3 years. My first nursing job was in an LTACH. It was very difficult and stressful but I learned more than I ever thought I would. When I graduated I had trouble finding a job because the economy was so bad that new graduates had a hard time finding a job. My sister knew a nurse that was the manager of an LTACH in our area. I had never heard of LTACH's and, like most, I assumed it was like a nursing home. I had always wanted to start in acute care but I was so desperate that I was willing to work anywhere. The nurse manager looked and my application and set up an interview. I began looking into info about the unit and, was pleasantly surprised to find out that it was actually and acute care facility and the patient's were medically complex. The manager offered me a job right after the interview. Orientation was rough, as I began to realize how sick the patients really were. I made it through and after 2.5 years I decided to pursue travel nursing. As I talked to recruiters I began to have difficulty getting them to understand that I didn't work in long term care. I struggled to explain how the "long term" part was more of an extended acute care. In addition, the managers I was submitted to didn't get it either. As a nurse working in an LTACH, I gained experience with ventilators, wound vacs, central lines, feeding tubes, chest tubes, pca's, telemetry, and diseases including aids, pneumonia, DIC, cancer, traumatic brain injuries, MI, sepsis, kidney failure, liver failure, etc. Med surg nurses are often not floated to our floor because they can't be assigned to many of our patients. I really want to travel but I don't know how to get past the assumptions about LTACH's. I've tried explaining it and even directing recruiters to my facility's website. Is there anything I can do or should I just move on to something else? It's so frustrating because no one seems to listen to what I'm saying. For example, after explaining again my experience, my recruiter still emailed me and asked if I wanted an assignment in a long term care facility.

I currently work in a LTACH (Long Term Acute Care Hospital), completely different from Long Term Care. As someone said before the patients are very sick, many are total care. Lots of vents, trachs, wound vacs, feeding tubes, central lines, telemetry, etc. I started there as a new grad and have been here for a over a year. I have learned sooo much! A float nurse once told me that if you can work in an LTACH you can work anywhere. There is a high turnover rate where I work. Many nurses start here as new grads and after a year or two move on to specialty areas. That's the main reason nurses here leave. CNA's often leave because the work is very difficult physically. Our team work is great, we nurse always pitch in and help, there is no task that is beneath us but it's still hard because they have anywhere from 10-15 patients a shift. Overall this has been a very valuable experience, it hasn't been easy but I'm grateful for all I have learned. One more thing, our patients and their families are with us for an extended period of time so we do get quite attached, it can be difficult when they pass away.

I currently work in an LTACH, I started in May as a new grad. The patients are usually very sick and require lots of care. We have lots of vents, wound vacs, chest tubes, tube feeders, central lines, complicated wounds, etc. It's hard work but I've learned so much already and I'm developing skills that will open up lots of opportunities for me in the future. The patients can be unpredictable and deteriorate quickly so you really learn to think critically. The team I work with is awesome, there is always someone there to help or answer questions. My shift manager is always saying "we're all in this together". An LTACH was not my first, second, or third choice but I've discovered that who you work with is just as important as where you work.

Sitting down and talking to patients is encouraged by the company I work for. As a matter of fact, when I did general orientation the CEO came and spoke with us. He told a story about a patient who had been diagnosed with breast cancer, during her first night in the hospital she broke down emotionally. She wrote a letter the CEO telling him how her nurse did the very thing you did, sat down and talked with her. He tells this story to all employees during general orientation. Caring for a patient's emotional needs as well as physical is our job.

Thanks, my old unit manager told me to contact adminstration so I will call them monday and see what they say.

Hi everyone I'm a new grad looking for a job applying everywhere I can. Like for many others it's been tough but I'm hanging in there. I worked way too hard to give up now! That being said, I've found myself in a bit of a pickle and am looking for a little insight. From 2003 to 2007 I worked on a labor and delivery unit as a tech, I was already a CNA but I was also trained to scrub in for C sections. It was a great job and I got a lot of experience but once school started I dropped down to prn status. I was going to work when I came home on breaks but my school schedule always conflicted with what my unit manager needed. She sent me letter in Nov 2007 saying she would have to terminate me if I couldn't work when she needed me. I called her and we talked and agreed it would be better for me to resign. I took my resignation letter to her and she accepted it. Well today I decided to check with my previous employers to make sure there was nothing in my employment history holding me back and they have me as terminated in July of 2007! After a slight meltdown, I called my old unit manager and discussed this with her, very politely asking for an explanation; at first she said she didn't remember but then called me back saying she has both letters (hers and mine). I did keep the letters but I have to find them. My question is what do I do now? How do I fix this? Also HR will not say whether eligible for rehire over the phone.