Sunnibee

The best way to locate a good travel company is to talk to travelers! Delphi's forum, or the ones here, or in your home hospital. A company is only as good as its recruiter; use Healthcare Traveler magazine to help you narrow down which benefits and perks are most important. Don't take less than $14 hr more than you currently make or you will lose money; don't go with a company that jerks you around on benefits if you don't have health insurance another way; don't take less than private furnished housing with local telephone and basic cable, or a stipend equal to that, from anybody. (That rules out American Mobile!) Beware of contracts that focus on bonuses; they are rarely paid due to fine print or the habit of hospitals to cancel your contract two days before you are eligible for them. And bonuses are taxed at the highest rate, so you actually keep about 50% of them even if you get them. Per diem money and stipends are not taxed and should get more interest from you. But ask flat rate first; they will lowball you bad if you ask about per diem or housing stipend first. Flat rate being, hourly rate at guaranteed hours per week for specified number of weeks, with private furnished housing utilities paid including local phone and basic cable. If you don't get that they are suckering you. When you are travel in a hospital you are low man on totem pole, first to float and first to be cancelled. Period. Your weekly hour guarantee is for wherever they can find for you to work; if you never did L&D or operating room, those are about the only places they won't try to float you. And that's not for patient safety; that's because the family in L&D will be able to see your inexperience and sue them, or the surgeon in the OR will throw a tray at you and call the administrator! Never accept a contract that involves showing up without first interviewing with someone on the hospital staff. Ask them nurse to patient ratios and let them hear you write down the answer. The reason hospitals pay agencies $80-100/hr for you to take a 13 wk contract with them is: either they are HORRIBLE places to work and can't get help, or they have lots of business in a highly populated or highly uneducated area, and no nurses to take care of folks. It costs a hospital $80K to train you; they expect a travel nurse to show up trained and at least able to fake a JCHAO inspection, etc, so that they can save money on HR and training that they spend on the often seasonal need for your services.

There is so much meth in the Central Valley, ER work there is pure drudgery; constant drug-seeking and scary patients and families when triaged. They will try to meet you in the parking lot! You can do better in farther North California, like Sacramento, and the pay scale gets higher as you go North. Oh, and Fresno is hot, dry, and smelly.

I worked an assignment for them several years ago...my first travel assignment. I would not recommend them; they tried many sneaky to illegal stunts, were unavailable for help until they wanted me to renew my contract, and treated the other nurses on contract with them poorly as well. Low pay, poor housing when they can get away with it (can you say, bathtub with mouse-holes?) Attempted violations of CA wage laws, i.e., threatening to hold last check until apartment "clears" damages, etc. No, no, no. Get a reputable agency, talk to the director of the unit before you take the contract, and get EVERYTHING from hourly $ to stipend to furnishings of your housing to utility bills to float policy written in the contract.

Three patients is the standard for step-down in CA, and you generally have a teletech/unit clerk and CNA to help. I sometimes take three patients if we have some huge (generally holiday-related) crunch....but I think any critical care nurse who finds her/himself expected to do so needs to grab a new job. When you are interviewing, ask good questions, and look at the assignment board in the unit on your tour. I got one shift on agency at a local hospital that goes to three patients apiece at 3 pm and I won't ever go back. If they don't care about your patient's quality of life they sure won't care about yours. Vote with your feet, and tell the MD's why you found a safe job...if enough do so then the bad situation will have to change.

KSQ has a good strategy! I have seen some folks make a template of that report sheet and put 4 to 6 on a page, then run it off in bulk at Kinkos. That way they dont have to write it constantly, and if they have the same pts next day they can just add new things. In critical care it is actually easier, just write down your body systems and add lines and drips at the bottom; most of ours have foleys and are just lying there!

We got a HIPPA notice that 37 employees lost their jobs from illegal disclosures stemming from Pres. Clinton's heart surgery...Some folks let a little celebrity go to their head. As for being a nurse delegated to SERVE the little trash basket in question, if I worked at that Scottsdale Hospital, I'd call in if scheduling my vacation didn't coincide with the icky delivery! Who would want that slimy dad leering at their butt while they bend over the whiny princess mom? Can you imagine the drama from starting the IV or positioning for the epidural? Please.

c/o: havent eaten all day....and there was the woman who complained of nausea p swallowing her husband's semen.....and the innumerable elderly patients who come in after 11pm for constipation....and of course in CA you have drug addicts who call 911 to get an ambulance ride to the ER to try to get a dose of Demerol...which is one reason their taxes are so high. there was the convict who stuffed small pebbles and milk carton scraps up his urethra until he couldn't pee so he could get a ride to the ER for a change of scenery...and did it seven times in a few months....

Fresno is hot and smelly in summer; there are lots of gangs and your L and D job will be many pts who don't speak English. Take a job in Sacramento instead. When you are traveling, don't take any job you don't interview for...something is wrong when they don't care who they get!

I saw a lot of young inexperienced travel RNs get totally ripped off by American Mobile companies when I was in CA for a year. Some of the nurses were getting 66% of my hourly for the same job, and were given lousy shared housing with inconsiderate or thieving strangers. Extensions were always a ripoff and they would leave them stranded in a heartbeat. Worst travel company I heard of besides Nurses in Partnership.