Pros and Cons of registry work?

SICU Queen · Aug 16, 2007

I've always loved the flexibililty and lack of staff responsibility when working agency. My problem was motivation!! It's so easy to say I'll work X number of shifts per month, but then when I'd get cancelled I'd be like "oh well" and not make it up.

I need the accountability of being staff, lol... :lol2:

SICU Queen · Aug 16, 2007

Also, when it comes to patient assignments, unless you're at a facility where they know you and don't want to screw you, you usually get stuck with the patients no one wants to take care of...

It's a trade off, really... choose your days and no staff meetings, or get cancelled a bit more and get the worst assignment. You can look at it either way

MA Nurse · Aug 16, 2007

Also, when it comes to patient assignments, unless you're at a facility where they know you and don't want to screw you, you usually get stuck with the patients no one wants to take care of...
It's a trade off, really... choose your days and no staff meetings, or get cancelled a bit more and get the worst assignment. You can look at it either way

Yeah, makes sense. now I know why hospitals like registry, they're cheaper than regular staff!

Bala Shark · Aug 16, 2007

Pros:

No office politics, facilty dont expect too much from you

Cons:

Disorientated, CNAs might not work for you because you are registry, not too much respect because you are not a regular employee

MA Nurse · Aug 16, 2007

Pros:
No office politics, facilty dont expect too much from you
Cons:
Disorientated, CNAs might not work for you because you are registry, not too much respect because you are not a regular employee

There aren't any CNA's in the NICU.

RNperdiem, RN · Aug 16, 2007

I like setting my own schedule. Where I work, the charge nurses always give me good assignments. I used to work full-time at my hospital and am well known, so that might be part of it.

I have only been canceled once in 5 years.

There are no benefits per diem, but the pay is higher. Some nurses work per diem as a second job. The first job has the benefits, sick time etc, and the per diem job pays a higher rate. One per diem a week for a lot of people pays the child support, the debt, the vacation money, and all other things.

The downside is not really belonging. A fluency of skills and speed is lost if you work less than full time.

Daytonite, BSN, RN · Aug 16, 2007

i know a bit about this because i did a lot of agency work to earn part time money and because i did a little work as a clerk for an agency so i can give you a little insight as to how assignments to nurses are made.

many agencies won't tell you this, but they are scrounging for work most of the time. a hospital will cancel out agency nurses if they can come up with one of their own staff nurses to work a shift. the reason is because the agency charges the hospital 1.5 to 3 times what they pay you. (if they pay you $25/hour they are charging the hospital $38 to $75 an hour for you.) they take hundreds of applications from hopeful workers. however, like any business, they want to keep the workers who are proven to be reliable (translate that to "don't call off at the last minute") on a string and available. so, to appease the proven agency nurses they do have, they give the primo work out to them first. the newer enrolled nurses get whatever is left over. this means that at first you will get called and set up to work at xyz hospital only to get cancelled 2 to 4 hours before the start of the shift. i know of one agency who specifically tells it nurses that they can cancel them up to two hours before the shift. and, they do it all the time. they will tell people they are scheduled for a shift at xyz hospital knowing full well that at that 2-hour deadline they are going to cancel you because they already had someone else booked for it. it's called double booking and it's how they are able to give the hospitals the illusion that they are reliable. meanwhile, they are trying to play a game of keeping their older, reliable nurses working as well as test out newer ones who have signed up with them. so, don't be surprised if you find yourself getting cancelled out a lot when you first sign up. it you stick with them and prove you are reliable, you will get more work as they get it. but it takes time for this to happen. if you start refusing shifts your name drops to the bottom of their list of available nurses. also, don't let the lavish offices of some of these places fool you into thinking they have work coming out of their ears. many of these agencies are owned by large corporations that are making tons of money doing temporary employment placements in other industries beside nursing. many have a bigger side line doing travel nursing placements.

another little trick they like to employ is to get you to go into nursing homes as staff relief. nursing home staff relief are opportunistic bones for them. these are often last minute replacements. they will call and cancel your shift at xyz hospital, but tell you that they can offer you a shift at abc nursing home. many times, if you've been cancelled enough, you become so desperate for the money that you take one of these assignments. but, again, they'll cancel an rn to put an lpn in place because the ltc might specify they want and lpn rather than an rn in order to save money. they'll only accept an rn when they are getting down to minutes before the start of a shift and need a body desperately. ltcs will typically call 3 or 4 agencies trying to get a staff relief nurse at the last minute and they will often accept the agency that comes up with the first offer for a staff replacements. some unscrupulous agencies will tell them they have a nurse for them hoping they can scrounge one up before the start of the shift. this is a cut throat business, let me tell you.

as far as the actual work. most hospitals require some little bit of orientation of you before they let you take a shift in them. you don't usually get paid for this orientation until you've worked xx number of hours for the agency. however, in most of the places i've worked no one ever expects any more of you than to carry out the doctor's orders (meds, ivs, treatments) and handle any patient emergencies that you might have. you will sometimes get blamed for things and hear about them from the agency coordinator long after you have gone home. it's just something that happens in agency work. the only way you have of defending yourself is your documentation, so double and triple check your medication sheets and doctor's orders in particular. if you miss signing off and carrying through a doctor's order for a patient you were assigned to, you will hear about it, so have a system for yourself to double check these things. know who your charge nurse and supervisor are for each shift you work, notify them and use them to collaborate for any questions or problems you run into in order to cya. that's what they are there for. report any problems you might have had during any shift you worked to your agency coordinator when you get home. i've also been assigned to one unit only to be pulled (floated) to another unit 2 hours into the shift. while some staff may seem to be friendly to you, believe me, when a scapegoat is needed, a agency nurse always comes in handy whether they liked you or not. it's not personal. it's passing the buck.

have you tried talking with the supervisors and other head nurses at the hospital where you work? when i was a nursing supervisor and we needed staff because of call offs, we had a handful of part time and prn nurses that we knew we could give a call to and see if they were interested in an extra shift. some always had a clean uniform ready to thrown on and come in to work. if your facility has a staffing coordinator, let them know you are looking for extra shifts. they'll remember you. sometimes the communication between the nurse managers, supervisors and staff coordinators is not as good as you would think. make yourself known to these various people and that you are available to work open shifts. start getting friendly with the various nurse managers and approaching them about filling holes in their work schedules. most facilities would rather use one of their own staff nurses than call in a agency nurse, even if it means paying overtime.

when i got sick and tired of the games the agency played, i would just suck it up and go to a nursing home to work part time. as much as some people have a real aversion to ltc, i always found it to be challenging to my organizational skills. as a hospital nurse you are bringing acute hospital skills and newly needed blood and ideas to the staff as well. ltc is always short of help, particularly on weekends and nights and suffers from an acute problem of attendance. some will let you work out a deal with them. i had a part time job keeping the nursing care plans up to date at one ltc. at another, i had a part time job as a weekend supervisor. it involved making sure there were enough cnas and charge nurses there and making the assignments. once the shift got started i was just helping stamp out fires. occasionally, i would have to take a charge nurse assignment. you could find 4 hour stints to help pass medications, do treatments or just help out the other charge nurses. ltc facilities are often very, very flexible in what they will allow with part time workers. and, if you get into a good facility, it will grow on you. they have so many laws and regulations that they have to follow that any nurse who is willing to help them be in compliance with these laws is usually a most welcomed staff member.

MA Nurse · Aug 16, 2007

Thanks for the info. I am getting extra hours in a different unit other than NICU, so I was trying to check out other NICU's in other hospitals through registry work. The pay would be almost $15 less an hour if I worked registry! So I don't think it will be worth it. The other unit I'm working in is busy, so I will get hours...but I miss NICU.

Thanks for the warnings!