Stanford First Travel Assignment

PacoUSA, BSN, RN · Mar 21, 2015

I'm considering Stanford for my next assignment in California in the fall, so I'm interested to hear feedback as well. I have heard that they like to recruit perms from their travelers, so that may be good for you. I'm not in a position to relocate to the West Coast anytime soon but certainly happy to work there a little while for the experience.

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DatMurse · Mar 22, 2015

I'm considering Stanford for my next assignment in California in the fall, so I'm interested to hear feedback as well. I have heard that they like to recruit perms from their travelers, so that may be good for you. I'm not in a position to relocate to the West Coast anytime soon but certainly happy to work there a little while for the experience.
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Honestly, everything is surreal. It's not even the name that is attracting me. its the technology, ranking of and quality, of care for oncology.

Trjl · Mar 22, 2015

At a year in Oncology, there is still much you have to see and learn. However, I think if you take an opportunity to ask questions at your new job and continue to study, being a Travel Nurse in oncology you will certainly learn a lot. I am also not sure about Stanford, but I have worked a few oncology floors as a Traveler and I am basically out on a med-surg unit with only a little oncology. I hope that is not the case for you. I am sure you will do well, and you are naturally a little nervous being your first assignment. Two weeks seem a little long for orientation for a Traveler, but since they know you are only out one year and a new traveler, they may know it is in their best interest to give you a little extra time. But you can certainly call the mgr that hired you to get that question answered. Usually a week is pretty standard.

I hope this is not your case, but often the first travel assignment is not the best. You are often working at places that just need to put a warm body to work and you may find a high nurse-pt ratio, and hard working conditions. But do not despair, it does get better. As you get more experience in travel, it will open up more opportunities to other places that normally will not even look at a first time or new traveler. As far as extension, I would suggest when you are about half way through the assignment, if you like where you are working, ask you recruiter to inquire about the possibility of extending. I see jobs at Stanford a lot, so I assume that it is highly likely they will still need travel nurse on going. And if they also like you, they will extend the offer to extend. If you don't like where you are, don't feel obligated to stay. California is one of the states that uses the most Travelers and so you will have other options to choose from. Maybe even near where you will be staying to work at Stanford and you may not have to move.

I have only worked Oncology, and my last 3 assignments I went to out-pt clinics. I have a lot of experience giving chemo and find that the working conditions are much better than on the floor, and I think the staff have been much friendlier. I also use to think the more travelers on a unit, the worse off the place must be. But I once worked at a hospital that I would guess 50% of it staff were travel or agency. This was an in-pt unit, and they were the friendliest group of in-pt nurses I had run across. I guess we all came from the same place and had instant connections.

Best of luck. I am sure that you will do fine. You might feel like a deer in the headlights your first few weeks of your first assignment, but it will pass and you will catch on and be just like the rest of the staff.

DatMurse · Mar 22, 2015

You are often working at places that just need to put a warm body to work and you may find a high nurse-pt ratio, and hard working conditions. But do not despair, it does get better.

I give chemo sometimes 5x per week. so it will vary.

The ratio there is 3-4:1 based upon acuity. They said they try to keep it 3

PacoUSA, BSN, RN · Mar 22, 2015

So what agencies staff Stanford? I heard AMN has an exclusive but I have also heard other agencies staff there too.

Trjl · Mar 22, 2015

Wow, an oncology floor with a 3:1 ratio. I worked a BM transplant for a few years and we had 4-5 pts/nurse. What I have found on oncology units in Florida is a ratio of at least 6:1 and in one hospital 7:1. (they are not always 100% oncology) I have not worked Calif, and I know they have unions, so I say 'good work unions!' So I hope that means that your first assignment will be pretty good. You should have plenty of time to do your charting and give your patients good quality care. Have a great time!

DatMurse · Mar 22, 2015

So what agencies staff Stanford? I heard AMN has an exclusive but I have also heard other agencies staff there too.

If you want my recruiters number let me know. Its an AMN network and then they branch it off to the smaller companies.

Wow, an oncology floor with a 3:1 ratio. I worked a BM transplant for a few years and we had 4-5 pts/nurse. What I have found on oncology units in Florida is a ratio of at least 6:1 and in one hospital 7:1. (they are not always 100% oncology) I have not worked Calif, and I know they have unions, so I say 'good work unions!' So I hope that means that your first assignment will be pretty good. You should have plenty of time to do your charting and give your patients good quality care. Have a great time!

I think the highest is 4:1 but they try not to reach that point. Pay is lower even for core staff but it may be worth it if they like to teach. I honestly dont care, I have just been hungry to learn.

NedRN · Mar 22, 2015

Wow, an oncology floor with a 3:1 ratio. I worked a BM transplant for a few years and we had 4-5 pts/nurse. What I have found on oncology units in Florida is a ratio of at least 6:1 and in one hospital 7:1. (they are not always 100% oncology) I have not worked Calif, and I know they have unions, so I say 'good work unions!' So I hope that means that your first assignment will be pretty good. You should have plenty of time to do your charting and give your patients good quality care. Have a great time!

The California Nurses Association (CNA) which also operates as the largest union in the state organized and got the first state mandated staffing ratio law in the country passed through the legislature. So all hospitals (not just union ones but most hospitals in California are union) have a staffing ratio that maxes out at 5:1 and goes down according to acuity.

California has perhaps the strongest labor protections in the country. Overtime after 8 (exceptions at many hospitals for 12 hour shifts), double time after 12 (no exceptions), a fully relieved break every 4 hours, and a fully relieved meal break within 5 hours of shift start. Missed breaks and meals, or late meals all pay one hour base pay each. One of the travelers I work with got 7 missed breaks last week at a rate of over $50 an hour!

Anyway, Stanford in particular is diligent about providing breaks every four hours. They had to pay out big in a class action suit about 15 years ago to their employees.

NedRN · Mar 22, 2015

So what agencies staff Stanford? I heard AMN has an exclusive but I have also heard other agencies staff there too.

American Mobile is the vendor manager as they also are at Kaiser hospitals. Despite being the largest agency in the country, there is no way they can staff all these hospitals with their own travelers. So many, many other agencies also staff Stanford and Kaiser. Against what might seem obvious, you can often get much better contracts going with other agencies. But if a particular hospital is a must do right now, American Mobile brands will have first crack at available assignments.

DatMurse · Mar 22, 2015

The California Nurses Association (CNA) which also operates as the largest union in the state organized and got the first state mandated staffing ratio law in the country passed through the legislature. So all hospitals (not just union ones but most hospitals in California are union) have a staffing ratio that maxes out at 5:1 and goes down according to acuity.
California has perhaps the strongest labor protections in the country. Overtime after 8 (exceptions at many hospitals for 12 hour shifts), double time after 12 (no exceptions), a fully relieved break every 4 hours, and a fully relieved meal break within 5 hours of shift start. Missed breaks and meals, or late meals all pay one hour base pay each. One of the travelers I work with got 7 missed breaks last week at a rate of over $50 an hour!
Anyway, Stanford in particular is diligent about providing breaks every four hours. They had to pay out big in a class action suit about 15 years ago to their employees.

It's weird hearing stuff about unions. My nursing school was very Anti-Union, but then again.. I came from Texas. They said the TNA and ANA should be able to protect them well enough.

NedRN · Mar 22, 2015

Go ahead and compare employee protections, pay, staffing ratios, management and physician attitudes, board of nursing sanctions, blacklists and just about any criteria you might think of.

Heck, just comparing the cost of professional liability in Texas compared to any other state may give you a clue about how effective Texas protects nurses!

Take a look at the history of labor unions at what you might think is your God given right to a minimum wage, 40 hour week, and overtime and you will get an idea of how important they are. Look at wages in Texas and the south to see how not having unions works for nurses there.