MCH123

Those are actually two of the hospitals that I've been thinking of working at. I have spoken with Agostini (have you heard of this agency?) and they have available contracts w/ these hospitals. They are very close to where I will be living. What unit do you work on? Do you know anyone who has worked these hospitals' ICU's. I am getting excited about moving out here. Will be coming from Louisiana with my new husband in two months. He'll be doing his CRNA clinicals at LomaLinda Univ Med Ctr and Arrowhead. Thanks for the info!

To RNOTODAY and everyone in the "same boat", It amazes me how many people have responded to this post. While refreshing to know that I am not the only one, it is also very sad to me. I, too, have been a nurse for 4 years (what is it with the 4 year mark?), working on a med-surg floor straight out of school and then for the last 2.5 years, adult ICU. Started off as staff in a large teaching hospital, now I am working agency. For about the last year or so, there's not many days that go by that I don't dream about having another job. I guess to say I'm miserable is an overstatement, but boy oh boy, I do not see myself spending my remaining years before retirement doing this! (Ha, I'm only 27!) I empathize with so many of you. While I did not have naive visions of what nursing would be, I would never have "signed up" for this if I had had a glimpse of what an average bedside nsg job is like. I am proud of my BSN and I love the career of nursing, but bedside, sadly enough, is not for me. Before reading your responses, I just figured that after only 4 years, I just better toughen up and get happy. But now I'm beginning to realize that maybe we should trust our instincts and our hearts more, and listen to ourselves. My dilemma: in about 3 months, after my wedding, I will be moving to San Bernardino California with my new husband to support us while he completes CRNA clinicals. How scary is that. I have to move to a state I've never stepped foot in, to live in a new place where I'll know 1 person, (who will be absent alot to say the least), to support us in a field that I'm pretty much fed up with. If it wouldn't be so scary, I'd actually laugh! For me right now, unfortunately, money is the priority. I feel like I don't, and will not for some time, have the luxury of taking a pay cut for something better suited for me. But you know what, and this goes for all of us, HOW WILL I KNOW IF I DON'T TRY???????? I have not lost faith; I still believe that nursing in some form, is what I'm meant to do. We can't let ourselves believe that we are in some sort of deep rut, with no other options. I thought that after 4 years of pretty grueling college and hefty debts, I would just fall in love with my sweet new nurse job and it would fit perfectly. I was sadly mistaken. However, I will continue to "pay my dues", work extra shifts, and trod through, but I am/will continue to seek out new prospects. I would encourage everyone who feels like they'd rather have a root canal than go back to the unit tomorrow for another shift to do the same! Thank God, I have someone who is very supportive (he is a nurse, too; hence the reason he's in CRNA school!). Ultimately, if we are not happy in our careers, it will spill over into other facets of our lives. There are many valid reasons for counseling and antianxiety/antidepressants, but our jobs??????? God willing, not for me!!

NU570, I don't know if you are still searching for your leveling device, but if you are, here goes: Nancy Townsend, owner of Nursing Knowledge (critical care courses, etc.) formerly located in Metairie, LA has a product called Levalign. This is the portable, can put it in your pocket level you are referring to. $25 plus shipping on her website. Hope this helps!

Jen2, In my experience, like with most things, there is good and there is bad. I've been doing agency nursing now for 7 months. I am not supplementing; this is it. I relocated and am living temporarily with my parents. Because I really couldn't sign on as staff somewhere b/c I will be moving, agency seemed like a great fit for me. I must say, some of the horror stories I had heard have not come to pass. For the most part, it's been a great experience for me. However, you must be FLEXIBLE. Coming from a top-knotch Magnet facility where I worked in the ICU and received high acuity patients and was trusted, I have been knocked from my pedestal a little! I remember how I used to feel as a staff nurse working next to the agency/contract nurse who made considerably more money than me........if you are familiar with that feeling, than that is how you will be looked upon (for the most part). Depends on the facility and how much they need you. In one hospital, in a tiny ICU, they actually called and pleaded with me to come in to take care of a IABP pt b/c no one there knew how..........in another larger hospital, staff are nice and accomodating, saying I'm doing a good job, but shift after shift after shift I get the gomers (you know what a gomer pt is, right?). If you are independent, have a strong skill base, and can put your pride aside to be floated every now and then and/or take less than thrilling pt assignments, then go for it, and smile when you make twice as much as staff b/c you know what....... I always tell the "critical ones", just about any nurse can make the effort and sign up with a local agency and join in, right? I look forward to supplementing with agency, not totally relying on it; I think that's probably the best fit. If you are able to take advantage of your husband's insurance benefits, or look into BlueCross Blue/Shield for insurance. I am still coming out way ahead and I have a pretty thorough inexpensive insurance policy. Don't forget to get nurse liability insurance, too. Should have that even if you are staff. If you have any other questions, be sure to let me know. I've learned alot in a short amount of time doing the "agency gig."

thanks so much for the info!

Hey all, If anyone could give me a couple of suggestions/opinions on local agencies in the San Bernardino, CA area. I'm looking for per diem or contract work in ICU. Looking for top pay, agency with good reputation. I've googled and found so many. Rns (think that's the way you spell it) stands out b/c someone personally recommended them. I firmly believe word of mouth is the best reference. Any suggestions would be helpful. Thanks:wink2:

Sorry just writing back, Thanks alot for the info. I actually did find the "studyguide only" option on the website. I called and spoke with Tom Tennant, a marketing coordinator for McKesson. I asked his advice on which (cpur/cpum) would be a better option for an RN w/ no case mgmt experience trying to get her foot in the door. He suggested the cpur, stating that many jobs are beginning to require this certification before employment, or that once employed, you are required to get certified. Also, he said that it would be more appropriate to take the cpur 1st b/c the cpum builds on the cpur. Apparently, one has a calender year to complete the study guide and take the exam, and then you are cert. for 2 years, providing you keep up your ceu's. The total is $385; the studyguide alone is $150. You have the option of purchasing the studyguide alone first, then when you are ready to take the exam, paying the remainder. Anyway, I ordered the studyguide today and I'm very excited to begin! I figure at the very least, after studying/learning much more about the terms and concepts, I will have a much better idea if this is indeed something I want to pursue. Hopefully, one day, it'll lead to something good......:)

Thanks for the info. Any suggestions on who with/how to take the exam. McKesson is the only company that I know of. Also, after successful completion, what is the next step. I'm assuming it will be somewhat difficult to get my foot in the door b/c my only experience is clinical; by then it will be 5 years worth (med-surg and adult ICU). It seems as though many people worked in UR in the past or worked for an insurance company. Will this, even with a cert., hinder my chances?? Thanks!

I guess the only way to determine who the seminars are geared for would be to call and ask. I did not see an option on the McKesson website to purchase the studyguide and take the test elsewhere. This would be a great option for me. The seminars are nowhere near where I live and they are very expensive. I'd like to "get the ball rolling" and I am pretty good at self-study, anyway. Since I would prefer working in a clinical setting, I guess I would choose the CPUM cert. In the meantime, working and gaining clinical experience can only help us. I, too, long for a more "normal" schedule. Please let me know about the studyguide option and any other advice, ideas....Thanks alot!

I'm interested in the prospect of pursuing case mgmnt. I have 2 years of med-surg telemetry experience and 3 years of adult ICU experience. Today, I met with the director of utilization management at the hospital where I'm currently doing agency work. She gave me a great overview and valuable information on this avenue of nursing. Since so many case management positions prefer or require both clinical background and utilization review/utilization management/case management experience, she suggested that a certification in UR would be a good place to start. I researched and there is a company called McKesson that certifies in 3 day conferences; pretty pricey with hotel accomadations and all, but afterwards you are certified for 2 years. My question is, should I certifiy in utilization review/CPUR or utilization management/CPUM? Has anyone been in this situation or used McKesson for certification/recertification. Thanks for any information you can provide.

Can anyone recommend a reliable organization to acquire malpractice insurance through? What about NSO (nurses service organization)? Read about them in nsg journals.....I will be beginning an agency contract soon and I want to have sound insurance. Thanks in advance.

Hello all, I am planning to take my first travel assignment later in the fall. The agency I've chosen is Cross Country. I will be working in Manhattan. As New York is currently not "starving" for nurses, the pay isn't fabulous, but money is not my sole priority. The hospital my recruiter and I are considering is New York Presbyterian; there are positions available in the CT ICU. This is right up my alley as I currently work in an adult ICU where I care for many very sick cardiovascular patients like CABG's, valves, and AAA's. My current hospital is a Magnet hospital, and while no facility or work environment is without problems, I am very proud to work here. However, even if just temporarily, I want to broaden my horizons, and I'd like to have another impressive hospital or two to put on my resume. If anyone has taken an assignment here (I think there may be more than one campus) or has any knowledge about the working conditions, quality, pt care, treatment of travelers (ha!), etc of this facility, I would appreciate your input. As I am still in the beginning phase, I have not spoken with anyone from NY Pres. and expect an interview. I know this will tell me alot as well. Unbiased opinions are always helpful. Thanks and good luck with all your endeavors. This site, as well as all on all.nurses.com is very informative.

Thank you very much for the advice llg. I agree that more concentrated experience is probably in my, and perhaps my future students', best interest. I guess I am just so motivated about teaching, I want to start as soon as I can. I actually do have some experience w/ charge and precepting. Pretty early on in my first position on the med-surg/tele floor, I was given the opportunity first to act as "team leader", or what is sometimes termed "float nurse" on the unit. Then I acted as PCC (patient care coordinator), and then eventually charge nurse on occassional weekends. While I loved the experience and challenge, I did feel a bit overwhelmed because I felt like I was thrown into it, and my collegues....well, let's just say I was already the youngest on the unit, so to have been asked to act as charge nurse, it seemed as if many nurses, PCT's/CNA's, and even the unit secretaries all had a chip on their shoulders and turned against me. I did the absolute best I could, and I enjoyed the manager-like role, but at the time, it was not the fit for me. My experience precepting new grads and/or transfers from another unit/hospital was much more enjoyable. I also worked w/ many students while on their clinical rotations. Still being fresh out of school, they appreciated that I "still cared" and could relate to their pain. Ha! However, once again, I was seemingly chased out of this position, b/c when making assignments for the days w/ a student(s) or new grad, they figured, "well, there's two nurses, so sure, give her that assignment, the one w/ one guy who'll be receiving his 26 meds this am, through his NGT/PEG if he hasn't pulled it out, the woman in four point restraints yelling "bloody murder", the other two patients who'll be discharged so we can give her another 2 admits right away"............you get the picture. I felt that many, many times I was not able to take the time I needed to meet the new grad where he/she was, experience/knowledge wise, b/c the patients would not get taken care of. Yes, yes, I discussed this w/ charge and UD, but I guess what is boils down to is that this unit was insanely busy and very low on the totem pole of staffing, supplies, or any support for that matter. This, ultimately, is what caused me to transfer to ICU. Wow, going from 7 patients to 2 was wonderful. Granted, these are not exactly what I call "walkers and talkers", but the entire way this unit is run is completely different - in a good way. It's a shame, though, b/c I truly did like med-surg. Was the only one iin my graduating class who actually wanted to start in this specialty. I think med-surg nursing holds endless clinical experiences for the nursing student willing to dive in. It does seem that the floors "get the shaft" when it comes to support for the unit. It makes sense to me, though. I can only imagine the revenue that is generated from all the transplants which make my hospital/ICU nationally reknown. I was recently asked by my current UD to mentor/precept students, but b/c of the bad memories I just spoke of, I turned it down. Now thinking that may have been a mistake. After all, this is a different unit. However, I am such a meticulous nurse that even though I absolutely love teaching, I don't know if I will be able to portray a calm demeanor when things get really hectic, etc. Perhaps this comes w/ time. The desire is there.

hello all, first off, i think this is an amazing site and i have gained so much information from everyone's posts. thank you! i have been a nurse for 2 1/2 years. my first 1 1/2 years was spent on a med-surg/telemetry floor, wanted to get the med-surg experience and i had no clue what i wanted to specialize in (even though i now feel that med-surg is a specialty). that was tremendous experience, but as anyone who has spent time on the floor will probably relate to, for most nurses, you can only take so much of this specialty! my unit was a 42 bed w/ tremendous turnover!! for the change and challenge (a different challenge, not the ....how long can a person physically go w/out urinating, eating......is my patient in room__ actually alive.......i know this is a bit exaggerated, but really, the floor is just crazy) i moved to a 32 bed adult ICU. this is where i've been since. cabg's, heart, liver, lung, kidney transplants, gi, renal, neuro, everything. it's a wonderful unit. however, i am still searching.....haven't found my niche yet. teaching, even before nursing school, has always been an interest for me. i certainly want to go to grad school. my short term plans are to take a travel assignment in ICU this summer and when i return.. i don't know. maybe i'll try NICU. so, having 1-2 years experience in med-surg tele, ICU, and by then NICU, is this sufficient to take the nurse educator path, or would this appear to be too "patchy" for lack of better words. i realize that the more concentrated experience in one area, the better, but i don't think i like ICU enough to do this. and, i am 25, would like to finish school at any early enough age to have kids, all that stuff before i'm 35. any honest advice would be greatly appreciated! :wink2:

hello all, i am new to this so bear with me. i have been an rn for 2 1/2 years; the first half was spent on a med-surg telemetry floor; since then, i've been on a med-surg ICU. both experiences have been absolutely invaluable. i never thought so much learning and experience could occur in such a relatively short amount of time. it is my ultimate goal, as is everyone's i hope, to truly find my niche. while i love nursing as a career and wouldn't trade any of my time in it, i feel as though i'm seeking something that i definitely have not found. fortunately, this career offers countless options for the asking/seeking. in nursing school, and in my current practice, i strive to excel and become knowledgeable about everything pathophysiology, every technical piece of equipment or treatment modality, and while i have acquired an adequate knowledge base for a novice, i just "can't get into it" the way i want to. it's not my passion, which is what i so desire to find. it seems as though i am still drawn to the mind (as i was in school), the personality, the emotion. i am fascinated by mood and personality disorders, suicide, depression, everything mental. much of it scares me, but more than anything, i am drawn to the wonder of the human mind. however, even as soon as i realized this in nursing school, i pushed it aside, thinking, "i want to be a real nurse; psych nursing is not real nursing." and the "A's" and praise on tests and assignments, while other classmates were struggling to pass, kept coming. so now i'm thinking, i'm not really happy where i'm at (my boss, the whole unit/job is great), but i don't feel driven, so why not at least try to give something else a shot, even though i never thought it would be mental health nursing. how do i get into this? i want to get my masters, definitely. i know i need to do some exploring w/ this type of nursing before grad school, but i DO NOT want to work on some locked-down unit where all i do is push meds, chart, and look through a plate glass window at my patients. i want to learn about what fascinates me. if anyone could give me some advice/insight/options, i would greatly appreciate it. thanks!