KatieBell

Once you have signed, you are really committed. It's unfortunate that another offer you like better has come up, but you are really committed to the first. Since the hospital accepted you with your experience level etc, then it really doesn't matter. It's only 13 weeks, you'll be surprised at how fast it flies by.

I'd defintiely call your recruiter and let her know, but of course gaurenteed hours are gaurenteed....This week they were trying to sned home nurses left and right (Never good at the beginning of an Emergency Dept shift, go figure) but all the travelers stayed, and of course within a few hours, they wished they hadn't sent anyone home.

People do travel nursing with spouses frequently. Someitmes Spouses go along, sometimes they stay home, it all depends on what you want and need and your spouse's wants and needs. For some people it works out well, for others clearly it would be difficult. However, apparently you are still in school for 3 semesters. After that you will need at least one year of experience before you can start to even apply for positions in the travel arena. I'd recommend more than one, especially if you are wanting to do anything other than Med Surg. If you peruse this area you'll find lots of people want to start traveling right away, and of course, the reason hospitals pay more money to travel nurses is that they can step into a unit and go to work with minimal (like 4 hours most itmes for me) orientation. As far as I am concerned, I travel because the pay in my home state is very very low. travelpay has not been spectacular for me, but it has been adequate. Accomodations have been hit or miss as well, but mostly they have been fine, nothing exciting, but fine. First things first, graduate and get some experience under your belt, and then see if traveling still appeals to you then!

Dave I think you may have misread my post. clearly your nurses have enough patients etc. What I was suggesting is not that you continue to cajole them to take another patient, but that you simply put one of them in charge of dealing with the ambulance patients. this is really something any nurse with experience should be able to handle and would free you up to do the millions of other things you are doing.

From reading the thread it says you wouldve been interested in night shift, but, i think you meant to say you wouldn;t be interested? I would find out from your recruiter what reimbursement you will be getting for cancelled shifts. it's simple enough to ask. in addition, i would consider trying to work a few night shifts. i used to turn green around the gills working nights, then I bit the bullet and took a nights contract, and was somehow able to do it. on my last contract (nights) the nurses were shocked to find out that I try to do primarily days. you might find you can't do nights at all, but....if you try it, you can really tell the agency you gave it the old college try... This is one reason to have 3 months of living expenses saved when traveling, so that when wacky stuff happens you can feel a little confident with your cushion. And a lesson to those of us going to "vacation locations" I'm headed to florida and my sister wants to bring her kids and do a disney weekend...I think I'll have her wait a few weeks before making any plane/hotel reservations. I hope that your company finds a position for you soon. it sounds like a stressful, yukky situation. I do think with the copy of your contract in hand, you might be reimbursed for quite a bit, but probably not your moms plane tickets etc....

If you are really interested in Flight, i really recommend getting a strong ICU background, as those patients are going to be sick, possibly on multiple drips etc...while i take care of patients on drips in the ER, it is no where near the frequency that I did in the unit. You really want to be familiar with what happens with each of these drips in a variety of situations...etc.... One thing you can do if you have the time, is to take a Monitor technician class, that certifies you to read the tele monitors on a telemetry unit. I took this class in nursing school and it probably helped me land a job in the iCU right out of school (Back when they only took like 1 new grad per unit...) Plus you will be waaay more confident with that under your belt. I'd also take ACLS and PALS as you are an EMT-B, you might be allowed to take the classes. (I was allowed to take ACLS without a nursing license, so i am not sure what the req's are). best Wishes!

Recruiters are really not that big of a deal. For some people, I guess though, they are. The recruiter is your link between the company and the hospital. They submit you, sign you, and continue to be your touch point for just about everything. Not hard to find jobs in the OR. Some companies have the recruiter as the person to tell you what actual positions they have (which I dont like because you never know whats available, and those on line lists are rarely up to date), then they make sure your paperwork is in order, and work with hospitals to find you a job. A good recruiter is going to be aggressive, so that you get the best possible placement for you. this means they may even call hospitals in an area you want to go that aren't posting needs currently, but they will do that in a way that doesn't annoy HR (quite a talent). They will not push you to take assignments that might be "too much" or out of your scope, or out of an area you want. They will follow up on details and make sure all the "promises" of the company come true. Some recruiters will call you constatnly to 'provide support" etc. I must admit, i am not one who wants hand holding and I finally had to tell one of my past recruiters to simply stop calling unless there was something I needed to do- a form to fill out etc. One of the best ways to find a good recruiter is to ask other travelers. Yes you can change your recruiter, but I found when i wanted to do that, ti didnt work out very well. Since i rarely talk to my recruiter, it doesnt seem to matter to me how nice or fun she is, we talk when I am working on getting a new contract, and then after that, pretty much i dont hear from her for 13 weeks unless there is a problem....my main concern is that she secures me the contract I want, and so far she has done that. So many people try to make their relationship with their recruiter more personal , but if you keep it strictly business, things tend to work very very smoothly.

As far as Santa Fe, the big hospital there is St. Vincents. They pay for travelers there is not going to be that much higher than you are making as staff. Your company has to pay a fee to the New mexican Hospital Association (Or something like that) for you to work there, so it will cut into your take home. in addition, housing in Santa Fe is very very expensive, again cutting into your take home. I like Santa Fe, and will probably return there, but if you really want to make more money you'd be better off heading up toward the North East, or California.

I also disagree about new grads in the ER. Personally i prefer to work with ER nurses who have ICU and M/S experience because they are able to handle a busy load (Med Surg) and handle a critical unstable patient (ICU). my home ED has now been hiring new Grads for 6 years. it is a Huuuge 60 bed level one trauma center. our new grads have all stayed except for 2 who went to traveling. I think if there is such high turnover in your new grad population, you might want to look at your orientation. For the original poster (OP) As far as having to take a lot of patients, this will happen in the ER too. If ther eis a nasty trauma or some guy needing to go to the cath lab, that nurse is going to be completely tied up, meaning that suddenly their 5-6 other patients are going to be someone elses responsibility, which you will pretty much have to assume without getting some sort of detailed report. So I wouldnt count on not having a lot of patient load in the ER, the acuity of those inherited patients can also be pretty high. Still, I recommend the ER if its what you want to do. if you hate it, you know you will have a place on the tele floor....:wink2:

florida really does not pay well. But i like florida, so one thing i do is just contract with the companies that Vendor managea certian hospitals. This has gotten me a rate at 36.00 an hour. In general, i simply do one overtime shift a week at my assignment, as the OT rate with my company is really quite nice, and thus I find i dont have to be trying to juggle two hospitals, two agencies and two schedules. in some hospitals if there isnt enough need in my unit for one extra shift a week, I've found by asking round they can usually use me in ICU, which is the other place I am qualified to work. my florida housing stiped though is ranign from 1500 to 1700, not 1000.

I dont know Medic, I understand your example, and I partly agree with it, but usually those winter states get all the Skiiers, and can pretty much dictate all sorts of things. A contract in Steamboat springs this year had a start date of December 22nd, and they filled it. Had 8 applications with people willing to start on that date. I really think places really only ask for years of experience when they need it. Its not about alienation, its about getting the right fit. If they know the traveler may be the only RN on duty for hours say on night shift, they must have someone with more than one years experience. If they want a traveler that will function as Charge, again, its better to ask for more than one years experience...best to ask for someone with charge experience. And I'll say that a traveler with only one year experience will be competing with those with more experience if they do want to do to some of the more popular assignment areas. However, after one or two assignments with good reviews, no one will care....

Agree with bag lady, this is not true. At some point in time, so question about a tax home etc may come up, or othere situations may occur that make this impossible for you to continue (Some hospitals suddenly stop hiring travelers etc), but certainly, you can return to hospitals, I get calls from places I;ve been at often asking if I want to do another contract. The other thing is that some travel companies have a clause that says if you do a travel contract at a place and they then hire you, they must pay a headhunter type fee to the agency, or you can not be hired. so perhaps thats what someone was trying to communicate. If you only want to go to the two hospitals, I think I'd look into getting seasonal contracts with the places, rather than going through an agency. Probably would save you some money, or rather, make you more in the long run!!:wink2:

Putting in a few more good words for driving! SInce I travel with my dog flying is not an option. (non heated airconditioned cargo bays are not for my 80 pound sweetie). I have nevere really thought too much about the very find safety precautions because of my dog. I did stop once at a motel that was a big stopover for truckers. I recall one of them coming up to talk to me, very friendly, not at all threatening, and then backing waaay off saying, "Well, thats a biiiiig dog there"... :) I do not however, drive at night. At times, I will leave early early, but will not drive say past 8 pm. Also if you will be driving, lookinto "trip rewards" and other hotel discounts. They really add up and save.

I am personally very very fond of the Wellsoft system. Have used Meditech and was rather unimpressed, it has a lot of redundancies. Have also now used electronic T an dwhile it looks funny when you are doing the charting, it preints out a very coherent looking chart, I was more impressed after I printed a chart than before. But I wont go so far as to hate the thing.

sounds like a bad situation, in which you are stretched too thin. Charge should be available to resource other nurses or lend a hand when a situation gets out of hand and you would simply not have time to do that. Wondering if you could delegate some of the more mundane things. One nurse on the shift could do the ambulance assignments and check them in. And the situation with the house Officers wanting to see patients in the ER is intolerable. No one wants to be in the ER any longer than needed. I would simply document the incidents of making the patient stay in the ER longer than needed by the House Officers and then take it to the Management. They know that lengthy stays in the ER increase the Left without being seens and decrease some sort of revenue (If ER ever really generates any of that!) and decrease patient satisfaction both on those waiting for beds and those waiting in the Waiting room. Thus, it seems management could put a fire under the behinds of the House officers. Those are my only suggestions... that and to wish you best of luck...in your er... difficult situation! hang in there.

5:1 is a pretty high ratio in the ED, though I just finished a contract at a place where I was regularly 6: 1...low acuity though. I was part of a move into a bigger ED last year. It was maddening, and we had ratios of 4:1. Part of the problem is that we spent a great deal of time looking for stuff that we used to know where to find easily. I remember wandering through all the areas once just looking for the nasal cannulas. One thing to remember is that many many people do not deal well with change, even positive change. Many times unfortunately these people are totally unaware of this and simply get snappy and upset. Thus, the move is probably causing some stress just by being what it is. Our move was also gradual. We opened the new area and closed the old area for renovation, giving us time to hire more nurses to cover the new beds... Personally I think you need to bring the ratio down to 4:1. Also look carefully at assignments, so that they are somewhat balanced. Most ED's tend to have one area they like to do Chest pains in and then one nurse may end up with 4 chest pains which means someone is not getting the best care they could have. Be sure the aides are doing what they are supposed to be doing, so the nurses can concentrate on doing their job. Instead of looking at your needs and such to justify more licensed personnell, you may want to simply get ratios from around the country to ustify the new hires, because 5:1 is not really the norm anymore.

VS, your template sounds more like an initial assessment. I've done triage with a variety of systems. I suggest your ED look at the plain old T-system triage. It does not include things like breath/bowel sound assessments nor assessments of cardiac rhythms. Most of this sould be done as an initial assessment by the primary nurse. If the ED is backed up (as is often the case) I might do a focused assessment to try to confirm a suspicion (ie get an ekg in triage to try to confirm that this persons "racing heart" is an abnormal rhythm, not anxiety) but otherwise, most of this should be done by the primary nurse.... I have noted though that it takes me and my working pal about 7 minutes to triage someone, and that it takes some of the newer nurses more like 15 to do the same kind of patient.

Sagent is one company that I keep a current on file application with. Unfortunately so far, they have come up empty in each area I want an assignment. however, I am hoping for the next assignment to possibly work with them. I can PM you my Sagent guy, he's pretty cool!!! I think they have a pretty good representation in the north east, so should be able to find you what you want. I just wanted stuff in areas that CCTC vendor manages, so made more sense to go to CCTC for those contracts.... But, I am also working for CCTC and have never had any issues. I rarely talk to my recruiters, but if they aren't on the ball, it could be disasterous. Best wishes.

I travel with my Golden Retriever, he's about 8o pounds. housing has been problematic for me over time. In part this is because I have chosen to go to smaller areas where housing in general is problematic, but in the end I have always had housing. Goldens are usually well accepted in apartment complexes, that sometimes restrict breeds. In general what I have done before I agree to even a submission to an area is to search for housing on line. I then give the company a choice of 1-3 apartmetns that accept pets, and they usually give me my first choice. My last contract the housing was HORRID, and when I looked for something different I couldnt find anything. Finally a friend at the hospital let me live in her house for the last month or so on the contract. As far as barking. Any dog can be trained not to bark incessantly. My dog had this porblem, and I worked with a trainer. a barking dog that is not just barking at passersby or some stimuli really can be a nusiance. I would simply tell the company that while you are interested in the assignment, you can not take it unless you have pet housing. One company actually called me once and said, "Well, you'll have to leave your dog home"!!! Oh that was the end of them.... Best Wishes!!! Travel with a Golden is really possible.

blended rates are confusing. In general it still ends up being alright, just be careful that they are taxing your pay appropriately otherwise in the end you may end up getting the heck taxed otu of you. Good luck, Rotating shifts sounds pretty rough.

there is not really a need for a travel nurse in africa, nurses there are leaving due to no jobs. having worked there as a supervisor for 2 years i think it would be extremely difficult for a us trained nurse to operate under the expectations in africa (one rn to about 25 acute med surg patients...in liberia for example.) as far as lpns and agencies, you will probably have to try the biggies, like cross country. i do not know much about it, but the issue is that some hospitals do not use lpns at all, so travel positions are fewer, or for some specalized areas where lpns are more utilized like ltc, or home health

BF can travel with you, but be aware if he isn't working he will probably get bored, unless he is a self starter. Travel nursing is not really the best way to gain experience. I just finished a contract at a small hospital. I worked with another traveler. In my last week, I was pulled out of triage to start Dopamine and levofed on a patient because the other traveler didnt know how. The charge then confessed to me that she had been assigning that traveler to triage the entire time because she felt the traveler didnt have the critical skills. The other traveler had been in a very low acuity ER for years and this was her first travel assignment. I had been at a Level One, so this was sort of a break for me. She didnt gain experience, instead, she got a lackluster recommendation and was not asked to extend. I have seen some travelers do well in learning situations for them but really, not that many. Hospitals don't want to hire someone they have to teach, you get paid more to simply walk in and perform, not be oriented to something you have not done before. Yes there will always be some new and different things (Last assignment, sternal IO caths for me, ick), but your basic skills needed should be very solid. (When the agency sends you a skills checklis, the majority 90% of it you should be able to check off "Highly proficient" without any qualms. I am sorry, I just have a thing when people say they want to travel to gain experience, as most hospitals want a traveler to bring experience.... I hope everything works out for you!

Like Gypsy, I recommend doing what interests you the most. Simply because you will probably not be a traveler for your entire professional life, and you will always be working your specialty. Never pick an area based on the demand for travelers, as that demand varies from month to month and year to year. Congrats and enjoy your first year.

Never had a skills day with sheep or rabbits. We have started IO catheters on Chicken bones, not live chickens. Seems to me if a nurse is unable to start an IV, then they might need to go spend a day putting them in at day surgery, rather than putting them into rabbit ears. Eeek. Our residents dont do this either.

Waiting to get to my new travel assignment to order the Med-Ed disks, will be listening to them in the car to and from work... 92mxmom, if you have no trauma experience, I highly recommend getting the TNCC book and goinig through it, it will get you through I imagine most questions about managing trauma on the CEN... (COurse what do I know, I will test ether on this assignment or the next depending on how my study goes. Lucky you, living near where there s a class!