USIJurgy

I've worked here at Yale since January- I am at a satellite facility. I have really liked the assignment. Keep in mind Yale has a contract with NursesRx, which is owned by American Mobile. So, if you arent working for an American Mobile company your pay rate will be lower (your company will have to skim some off the top from what Yale pay's NursesRx who pays your company who pays you.) The orientation was pretty thorough for a traveler- 12 hours of hospital orientation, 8 hours of computer training, 16 hours on the floor. Parking is around $300 a contract so make sure that is in your contract. Also, you have to wear royal blue scrubs- nothing else- so you might want a little money for that. If you take the company housing AM puts you up in Stony Brook Apartments in East Haven. I have always felt safe and the neighborhood is quiet. I am definitely looking forward to the pool opening up this summer! Good luck!

They can play opossum all they want- no reason to shove ammonia in their face. A trick we use to determine if someone is "faking" is to place their arm above their head, bend their elbow and have their hand in front of their face. Once you let go of the arm gravity should do it's job and their hand should hit their face. If the hand, after multiple attepts, continues to fall above their head or below their face it is a good indicator that they have voluntary muscle control- who wants to hit themselves in the face?!

Hmmmm. I don't know these abbreviations but if I had to take a guess.....youre wanting to get a medically sterile urine sample from an indwelling catheter? I don't think it is possible to get a totally sterile specimen without taking out the catheter and replacing it with a new one and getting a sample then. I suppose it would be possible to clamp the catheter distal to the sampling port, clean it well, then draw your specimen from there. I don't think it would be even close to sterile if you get it from the drainage bag.

Our door to CT time is 20 minutes. There is no delay for IV or EKG (unless an unsafe rhythym is identified once the patient is placed on a portable monitor). It is OK for an RN to activate the stroke code and transport to CT with ACLS meds and equipment as long as the patient has no seizure history and has a stable blood glucose if the MD is not at the bedside within 10 minutes of presentation. CT results should be availble within 30 minutes and thrombolytic therapy should begin within one hour of presentation. I work in a 60,000 visit per year ER. We activate a stroke code for any patient presenting with a positive Cincinnati scale (droop, drift, or slurred speech) within 8 hours of arrival (even though IV thrombolytic therapy can only be given within 3 [i think thats the new guideline] hours of onset of symptoms). Just because they arent eligible for IV tPA doesn't mean they aren't eligible for Merci Clot Retrieval or something similar. Patients who wake up with the symptoms are not considered stroke codes because you don't know the actual onset. A good question to ask family is "When was the last time you saw him normal?" Hope this helps!

As the charge nurse your job is to "man the ship." Typically charge should assign patients to nurses either on a round-robin basis or an acuity basis. Charge should also be responsible for getting a provider to the bedside for the patient who is actively dieing. He or she should also be a resource for all the nurses working i.e.- if no one else can get an IV on somebody your charge nurse should be someone who can get an IV on the diabetic renal hypotensive one-armed patient without batting an eye. Most hospitals have a triagen nurse to do just that: triage. The triage nurse shouldn't also be responsible for having a patient assignment as they are technically responsible for every patient in the waiting room and at a minimum should be performing "across-the-room assessments" (thats in the ENA core curriculum, I didn't make it up!). There is no way someone could be checking in every front door patient, every EMS patient, supervising a waiting room, and actively providing care for a patient load. Well, I suppose it is possible but I dont think it is safe. My facility uses 1 triage nurse, 1 ambulance triage nurse, and 1 charge nurse. If staffing/acuity is low the charge nurse may also act as ambulance triage. If staffing is REALLY low then a manager will cover charge so that the charge can cover the triage nurses break.

Mine took a little under a month but I was waiting a long time for verification from California.

Thats awesome! I would love to travel with a large group. I am an ER nurse, just started an assignment in CT but would like to go to California again (I did the bay area and had a blast.)

I took my third travel assignment in NYC and ended up staying in the city for 2 years! While I came to conclusion NYC was not for me, travel nursing is perfect for giving the city a shot- you dont have to pay ridiculous rent prices, everything is set up for you! I started as a traveler at Lenox Hill on the Upper East Side then became full-time. They dont have travelers in their ER any more but I hear there are still some up in CTICU. I know some hospitals require a BSN for travelers (NYU). Also, for your first NYC experience I would insist on a hospital in Manhattan. You should also insist on a building with a doorman. The first building they put me in was a fifth-floor walk up with no doorman and it was craaaaazy old. I complained and they moved me into an excellent place on East 51st between 1st and 2nd. I travled with American Mobile. Good luck!

My first job was at Kaiser Walnut Creek. I showed up on the first day and they said, "Who are you? Youre a nurse? Youre working here? Oh, ok, go follow her." So yes, stay away from Kaiser hospitals for at least your first assignment. Califronia is a great place to go for your first assignment (mandated ratios). I found it easiest to fly into Sacramento and get my license and all that in person instead of trying to do it all through mail. Good Luck!

While I cant speak to the severity of pain associated with an ovarian cyst; As an ER nurse I can speak to the slightly inflammed appendix. In my ER the surgeons are not quick to operate on an otherwise healthy individual who has a normal white count and no fever. In these situations we do usually send the patient home with instructions to come back in 24 hours if they develop fever or increased pain. We would never send someone home who didn't have their pain and nausea under control first. As for the lack of education provided to your husband and daughter regarding lab tests and all the different treatment options- it sounds like both the ER nurse and ER MD could have done a better job. While 1 in 3 patients who aren't admitted go home from an ER without a definitive diagnosis, a patient should never leave wondering if everything was considered. I hope this helps!

What I was saying was that if I was going to only be in New York City for 13 weeks, I would want to live in the thick of it all- Manhattan- not 45 minutes away from the night life of NYC on the north side of the Bronx if I was doing a travel assignment.

I worked an ER contract at Kaiser Walnut Creek and there was many a shift where the only people who weren't travelers were charge and the two triage nurses. While it was nice knowing that all of the people you were working with would help you out- it did become a little bit difficult to figure out some of their whacky protocols!

I am currently at Lenox Hill on the upper east side and it is great. I would recommend the ER to anyone for sure. The housing was a bit rough at first (think smelly smokey apartment in prewar building) but then I got moved to a great place with a doorman and an elevator and couldnt have been happier! I have hear good things about Bellevue if you loooooove trauma. Also, I really wouldn't recommend going to the Bronx, Brooklyn, or Queens. I figured if I am going to travel to NYC then I want to be in the city not a burrough!

Definitely avoid Kaiser at all costs- ESPECIALLY for your first travel assignment. I took my first travel job at Kaiser Walnut Creek in the bay area in the ER and it was a nightmare. It was terrible working a 12 hour shift while all the other nurses were working 8 hour shifts- you would get shifted around- having to take report on brand new patients multiple times. The ER was terrible for many other reasons but I am sure it is just at WC and not every Kaiser ER. However, Kaiser is notorious for being management top heavy and that presence is constantly felt while working there. There is always something new coming down the pipeline that just gets piled onto the nurses. Isnt it interesting that we are all expected to do all the new tasks, while no task is every taken away?

My company paid for my rental car for 2 of the 3 travel assignments I did in California. I still made over $30 an hour and had private housing in a 1 bedroom apartment. Don't settle for anything less! While I love working with my recruiter and think she is great- it is important to remember that if you don't work, they don't make money! I always picture her as a used-car-salesman trying to drive a hard bargain =)

I agree that times are definitely tough for travelers right now. I work at a hospital in Manhattan and it seems the economy has finally taken its toll on the hospitals- no overtime for staff, no more travelers after January 31st and a hiring freeze (I hear mid management is next to go). Luckily my dept's mgr is allowed to fill the five vacancies she has now so I have opted to stop traveling and stay in NYC. I am sad to stop traveling but this is a great ER. Good luck in your search!

Absolutely! It is much easier for security and the police to find someone wandering around in a hospital gown! Also, if someone comes in drunk or OD'd or otherwise not competent to make medical decisions their belongings should be secured so that they do not have access to materials for self harm. I have had many a drunk come in with a bottle hidden in their jacket or a tylenol OD come in with a purse full of pills.

We have also started bedside report. I work in a busy emergency room and the patients are sometimes literally only separated from each other by six inches. It becomes difficult when you need to convey information such as the pt is HIV positive, has Hep C, has needed frequent doses of dilaudid, has family involved in a discussion on DNR status. It just seems silly to let three separate people hear this information (the other pts) when report could be given in the RN station, then the nurses and aides changing shift could just do a quick walk to introduce pts to the RN. Ugh, this is something that will just make its way everywhere though- like whiteboards in the ER, and 47 people needing to sign off on your heparin before you give it.

Oh man, I am usually one of those people who just browses, but this one caught my eye! So I was working triage one day when a gentleman came in who had been in the ER 3 days ago for urinary retention secondary to BPH. We sent him home with a leg bag and told him to follow up with the urologist. On the sign in sheet for his chief complaint he put, "Here to be decathinated." Just thought that was too funny!

I worked in the busiest Kaiser ER in Northern California and it was torture. I was a traveler and I would say the department was about half travelers half staff. While they only broke ratios once while I was there, the waiting room consistently had 20+ people waiting and the ER was usually half taken up by people waiting for beds upstairs. **sigh** A terrible experience. I am not sure if this is every Kaiser, but the way things were run just don't work.......I say go with your other options.

We have the same problem...and even another one. Whenever we have a pt go to the floor because theyre admitted, we have to chart, "Pt to floor with NS continuing to infuse." Or else we don't get to charge for it at all. It is ridiculous on our ICU admits when we have to chart, "Pt to floor with NTG, Propofol, and Levaquin continuing to infuse." Ugh. Charges.

In nursing school we wore all white from head to toe. The shirt was this this terrible tunic with buttons going down the center. We begged and pleaded to be switched to a polo shirt but it just didnt fly. We had to wear all white shoes as well. For psych we wore business casual. At the state hospital we could wear jeans...which was scary when you were walking down a hallway and had no idea if the person walking towards you was a pt or a staff member!!! At the hospital where I work the uniform requirements are quite strict. Nurses must wear royal blue or white. Techs wear red, medics wear black, radiology wears black, RTs wear caribbean green, MDs navy blue. We are allowed to wear crocs, just no holes on top. I couldnt live without crocs!

Our management got us a T-shirt with or new ER motto "Sharing the Sacred Gifts of Our Hearts" The ER docs bought pizza for day shift on Tuesday, night shift on Thursday. The Levaquin lady (love her!) brought in a hot breakfast Wednesday morning at 0600 that the day and night shift got to enjoy. Last year we got some pretty nice work bags. At least it wasn't the junk the hospital gave us for nurses week (a popcorn bowl and plastic license plate thingy)

Hmmmm, I think an interesting sidenote to this post would be: when are you no longer legally responsible for a pt? I think we have all heard the horror stories of people coding in the waiting room with no one noticing. But lets say I have a pt that is discharged- a CP pt with normal markers, d/cd to follow up with cardiac doctors within the next week for stress testing- so, I d/c the IV, wheel him out to the waiting room, where he is awaiting a ride. Is that it? Am I done? Or does my responsibility for that pt remain until he is out the front door and into a ride with his family? What if he asked to wait outside for his ride so I wheeled him out the front door to wait for his ride? I love playing EMTALA games =)

Uh oh..... So I thought it would be a good idea to get started on the California License process so did two things: 1) Paid the $30 to Nursys to have my Indiana license verified (right?) 2) Went to the CBN website and paid $50 to get the process started on my application. Well...........just hours after I did this my friend who is currently working as a travel nurse in California said that I totally messed up- that I should not have done anything! She stated since I was from Indiana all I should have done was just shown up in Sacramento and gone through the walk through process. I am hoping to start a travel assignment November 26th- did I mess up? Can I still just do this walk-through thing even though I started online? I SWEAR it was much easier in Indiana =)