ninja-nurse

As I said, never worked at the main campus, but I heard it was better. Not to be insulting, but as I'm sure you know, anywhere down south is going to be low pay and high ratios. (I say this as an Alabama native, who still lives there between contracts) it's going to be hot, but there are plenty of lakes to go swimming or boating in. Anniston doesn't really have much going for it, but there is a lot of state parks and forest around. Alabama has a lot of civil rights events if you're into history. Whatever you decide, good luck! ?

Which unit? And is it actually RMC, or the sister hospital Stringfellow? Never worked in RMC, but did a contract in Stringfellow about 2-3 years ago. ICU was great, though I wasn't there often. M/S/Tele was... eh. 6/1 average, though that's pretty much typical anywhere. Largely staffed by travelers for the night nurses. They were nice, but the pca's on staff were ah, not great, to put it mildly. Got reported to management for making one 'feel stupid' by asking her to please help me keep an eye on a patient whose drain was having a lot of output. Literally said 'hey, it's on me for not catching it earlier, but this was really full, can you please help me watch it closely'. Had one night where all 3 nurses on shift were travelers who had been there less than 3 weeks. So watch your back if it's there. From what little I heard, RMC main is supposed to be better. It's bigger, at least. Anniston itself is also kind of a dying city. Didn't have any real problems, but it is definitely going downhill. The area is fairly pretty if you like the outdoors, but not a lot of things to do otherwise. I'd advise looking at Gadsden if you want a smaller city. I personally hate Birmingham, but a lot of people like it there, and there are a bunch of hospitals.

Hello all! I have about 10 years in ICU, 5 of them traveling, and while I won't go into why, I'm about ready to get out (of ICU, still love travel). I know that I will have to stop traveling for at least 2 years to switch specialties. That said, there are 2 hospitals within 30 minutes of home base. Both have openings in cath lab, one has openings in interventional radiology. I find the idea of either one fascinating. I'm aware that cath lab generally has lots of call, and that seems to be the biggest thing people dislike about it. But I would eventually want to return to traveling after I get enough experience, and I have always seen postings. Cath lab folks, is call really that bad? It also seems from what I've heard, that IR doesn't have as much call and has more varied cases. But I don't recall having seen a lot of travel needs in that field. For the IR folks here, do you tend to have lots of call, and have you had problems finding assignments? Or are assignments only in the bigger metropolitan areas? Thank you all for any answers or advice.

I was working med/surg on nights. Had the same patient for 2 nights in a row - young male with crohn's, post resection. He was doing GREAT! Was off the PCA, up walking, one of 2 JP drains out. They were going to pull the other JP in the morning and were talking about sending him home a day or two after. The last 2 hours of the shift, I got THAT feeling. No idea why, he seemed fine. VS stable, labs okay, incision fine, A&O, denied pain, everything. One last quick check before morning report and the patient was laughing b/c I just kept checking on him. I passed on to the day nurse: "keep watch on him, something just isn't right." Went home worried about the guy. When I came back that night, the day nurse rushed up to me as soon as I got off the elevator. "You were right" she said. Turns out not an hour after I left, the patient's remaining JP drain went from empty to full of stool. His anastomosis had come completely apart and he had to be rushed to emergency surgery! I still don't know what I picked up on, but I just KNEW something was wrong. And I was right.

Pulse ox machines are notoriously unreliable. SO many things can interfere with the reading - nail polish, callused fingers, cool fingers, diaphoresis, gripping something tightly, the list goes on and on. As everyone else has said, watch your patient. If he's breathing 6 times a minute no matter how deeply, he's not getting enough air. If he's breathing in the 30's, he won't BE getting enough for long. Is he drowsier than you would expect for whatever meds he's had? Or unusually agitated/confused? How's his color? Cap refill? There's a few big clues and a dozen little ones that will tell you if you need to worry about oxygen. If some of them are there, then an ABG is appropriate, if not, continue to monitor. Lastly, I haven't done it myself, but a class I recently attended suggested that an adhesive finger probe can be placed inside the cheek. Not sure how you'd get it to stay, but... might be worth a try if you really need a number.

OP, good luck! I hope you find a place where they'll treat you right, you seem like a wonderful person.

Thank you, everyone! I had thought that I was about ready, but then I started reading those skills checksheets. Halo's, IABP's, open heart recovery, PA caths, trauma.. I read all of that on the list and freaked. This is the only ICU I've worked at, so I wasn't sure how it would compare to anywhere else. It was my nightmare to think that I'd take an assignment only to arrive and find out that EVERY patient on the unit was one of these high-skill/rare machine. You've all made me feel SO much better! Hugs!

OP, I may not have the right to respond to this, as I am not African American (or any other minority). But coming from a Caucasian point of view: some of your coworkers might not be trying to be offensive. I personally TRY to be sensitive and understand where my minority coworkers are coming from, but there have been a few times I've said something jokingly that I was told was a bit offensive. I was honestly shocked and fell all over myself to apologize, then make sure that I didn't say anything like it again, but it had to be pointed out to me because I truly didn't think it was anything beyond a casual comment or joke. And in regards to the "Angry Black Female" stereotype... I have noticed that a fair percent of black females seem to have naturally louder voices than their other ethnic counterparts. Not that they are trying to be loud, just that it seems to be the natural timbre of their voice. It's not something that they can help, much less intentionally do, but it can make otherwise innocuous comments come across as irritated or even angry. Anyone who actually bothers to get to know you even a little should quickly learn the difference, but unfortunately... lots of people won't bother, and even more will listen to their comrades first and come into meeting you with prejudiced expectations. If you are that uncomfortable, by all means leave. No one should have to stay in a hostile workplace, no matter the reason. Hugs to you, and I hope something changes for the better. Good luck!

Ok, all, please forgive the long post, but I want to lay the situation out properly. I managed to get into a Neuro/Cardiac ICU. Yay, me! Loved the area, so I got a little house. Figured I'd get a few years experience, then I'd have my tax home and a place to come back to in the winter (Florida ALWAYS needs nurses in winter). Fast forward 2 years, and... I may have a problem. What I had thought was great and exciting now seems fairly low acuity for an ICU. I almost never see much cardiac equipment. We get an Arctic Sun or balloon pump MAYBE once every 6-8 months. I've seen a rotation therapy bed ONCE, and CRRT maybe twice in 2 years. We don't get external pacers or cardioversions all that much. And I've never even seen a PA catheter. We mostly seem to get STEMI/NSTEMI, HTN crisis, CHF, COPD, strokes, tumors and the occasional sepsis. I can do drips and vents. I can pull lines post-cath. I'm comfortable with monitoring EVD's (not setting one up - our docs take the pt down to OR for that), I'm NIHSS certified, and I think I could do neuro checks in my sleep. I really want to travel, but looking at some of the skills checksheets on different sites, I'm a little concerned that my ICU experience may not be as "Intensive" as I'd originally thought. I am planning to sign on with a local temp. agency to do some per diem at other places, but the only hospitals within a halfway reasonable driving distance from home are just as small and have about the same acuity as mine. Some of my co-workers who came from traveling have said I'd be fine in smaller towns/hospitals, and I was thinking maybe stepdown/IMC units on larger ones. Does this sound feasible? ARE there a decent amount of stepdown units or small hospitals needing travelers? I just don't want to get out there and hurt my patients or my license by jumping in if I'm not reasonably ready. Thank you to anyone who takes the time to read this, and virtual hugs for any advice. ~N. Nurse

Ok, thank you everyone! That's very good to know.

Loved this!

Depending on the night, either vent alarms or call bells. I could SWEAR some days that there are alarms in my car.

Drug wise, hydralizine (on a neuro/cardiac ICU - that was fun) and protonix. Linens during the night. And frequently - in a crummy little rural place I will never, EVER return to - formula for the babies management kept putting on our ADULT med-surg unit.

Well written. In my facility, respiratory does the intubation, and nurses give the meds (no pharmacy for us - at least on nights. Don't know about days) but otherwise this is spot on.

Good day, all. I am considering starting to travel come spring and therefore doing some research. My question today is this: I have read that in order to move/vacation with pets, one is supposed to have a vet do an exam and issue a health certification. But in most places that cert. is only good for about 30 days. So do you have to get a new vet and new certificate with every assignment, or is this one of those things that "should" be done but never actually is? How do experienced travelers handle this? Thank you in advance for your time.