Today's Gripe:Some travellers ain't got what it takes to be a "traveller"!

[CaLLaCoDe, BSN, RN]

Does it anger you as it does me--and I Know full well that I will get royally burned for this thread--with the unfortunately ill prepared travellers who venture into your hospital not knowing a blessed thing about the department they're assigned to?!

Of course, my hospital doesn't give travellers much time to get up to speed on things...ONE Blessed day of orientation, that's it! Now, I don't know anyone, great nurse or not, who could get it with such a short orientation.

But to all those who desire to become a traveller, please know your stuff well, and be prepared to get burned here on a miserably below the belt thread if you just don't got enough experience to handle the job but do it for the swank pad you're placed in and the moolah.

[Mulan]

So what are you saying? That travelers are coming to a cardiac floor and don't know cardiac?

[bagladyrn, RN]

Tele - no flames here! I'm a long time traveler who has had the unfortunate experience of "following" a traveler who was not prepared for the position and dealing with the staff who had serious "reservations" (not to say attitudes) about all travelers as a result. There are some out there who definitely shouldn't be traveling. I definitely try to discourage new nurses from trying for a few years.

Do keep in mind though, when spreading the blame that some of it falls on the agencies who send inexperienced travelers, new nurses, or those who have limited experience in your dept. to that contract - believe me that used car salesmen have nothing on some recruiters in selling a traveler on a position! Staffing and supervisors at hospitals who insist on floating travelers to departments where they have no experience are also to blame. Some travelers arrive at a contract to find out their assigned department has been completely changed! Not all travelers are assertive enough to stand their ground and say no, especially when threatened with termination of their contract, leaving them possibly thousands of miles from home, with no job and at most 48 hours to be out of that apartment. That's the reality of being a traveler.

Oh and in spite of what you may have heard, the money isn't that much different than what staff earns and while sometimes the housing is great, other times it's barely liveable.

So while you certainly should expect a traveler who is familiar with the type of care your patients should receive, give us a hand, tell us where you keep the supplies, clue us in on the doc's quirks, and please - tell me where the staff bathroom is my first shift!

[ukstudent]

While in nursing school one day during clinicals one of my fellow nursing students announced that she was going to be a traveller when she graduated, when we all talking about the different areas we wanted to work. I talked her out of it, but the crazy part was that she had already contacted an agency that was going to be willing to hire her as a new grad RN. How scary is that!!!

The problem is unethical agencies that will hire anyone (no or limited experience) and administrators/managers that will hire anyone (just another warm body).

Nursing schools should talked about this aspect of nursing. I have been told it takes about a year to get the basics down and another couple to be considered experienced in whatever specialty you are in, including med-surg. Only start traveling once you are that experienced nurse.

[suzanne4, RN]

Just because an agency is willing to hire them, that does not mean that a hospital will take them; or that they will make it thru a week of work at the facility. Then they will owe a large sum of money to the agency for the housing for the remaining weeks of their contract.

I am sure that the agency never informed this person about that at all and can cost them several thousand dollars that they will need to pay back and very quickly.

[MarySunshine]

I'm a traveler and you didn't offend me. I worked for two years in my specialty before becoming a traveler within that speciality, so I think I'm very competant in the area. I do have to ask where things are located or how to chart something on the computer system or what the procedure is for certain things at times though... I'm almost 100% independant now but needed some help with the hospitals-specific stuff at first. I could totally handle the patient care aspect though, which I think is what you're refering to. I would also expect travelers to come to the job with knowledge and experience in the area they're going to be working in! That's kindof the whole point of having them.

[canoehead, BSN, RN]

Most travellers I've met have had the best skills and lots of experience. There was one who worked the ER, and I swear she had never started an IV before- took her 2 weeks before she actually got one on her own.

[cmo421]

Most agencies that hire nurses are pure profit driven buisnesses. References are very black and white due to lawsuit fear. The check list for experiences do not show knowledge and safety,just exposure. Very few make critical thinking a part of the process. The people that hire u must make a quota,so they do what they have to do.They meet the JACHCO requirements and CTA with the fine print they have u sign. The powers that be know they have insurance to fall on if anyone proves that bad out on the road.

I have worked with so many great travelers. God Bless them! They get the worst assignments,float all the time and many staff people treat them real bad. Its the few that travel for a reason that scare me. They have histories that are hidden and only peek out after time. Once a pt put on their call light in the ICU and when answered asked to have his nurse changed and replaced with a sober one! It's like anything else, u get the good with the bad. and u hope the place u work weeds out the bad,sooner then later.

[oramar]

Tele - no flames here! I'm a long time traveler who has had the unfortunate experience of "following" a traveler who was not prepared for the position and dealing with the staff who had serious "reservations" (not to say attitudes) about all travelers as a result. There are some out there who definitely shouldn't be traveling. I definitely try to discourage new nurses from trying for a few years.

Do keep in mind though, when spreading the blame that some of it falls on the agencies who send inexperienced travelers, new nurses, or those who have limited experience in your dept. to that contract - believe me that used car salesmen have nothing on some recruiters in selling a traveler on a position! Staffing and supervisors at hospitals who insist on floating travelers to departments where they have no experience are also to blame. Some travelers arrive at a contract to find out their assigned department has been completely changed! Not all travelers are assertive enough to stand their ground and say no, especially when threatened with termination of their contract, leaving them possibly thousands of miles from home, with no job and at most 48 hours to be out of that apartment. That's the reality of being a traveler.

Oh and in spite of what you may have heard, the money isn't that much different than what staff earns and while sometimes the housing is great, other times it's barely liveable.

So while you certainly should expect a traveler who is familiar with the type of care your patients should receive, give us a hand, tell us where you keep the supplies, clue us in on the doc's quirks, and please - tell me where the staff bathroom is my first shift!

That is what I thought, the travel nurse is not the only problem. Agencies and supervisors bear a lot of the blame for mismatched placements.

[EmmaG, RN]

Baglady said it well.

I was very lucky. My recruiters are nurses themselves; they are careful to make sure their nurses are matched to the job. I once had them question one of my choices, because they thought I didn't have the experience. We talked about my past experience caring for those type of patients, what I knew of that type of floor, and so on. It worked out well, I was even asked to re-enlist lol.

There was a travel nurse who left abruptly from one of my assignments. I'm not sure if she quit or was asked to leave. I do know that, while it was obvious she was trying to do her best, she was in way over her head. I talked about it in general to my recruiter; specifically asked her what they did to assure a 'good fit' and not place nurses in areas where they don't have experience. She told me that on more than one occasion, she's refused to place a nurse because she knew they were not right for the job, only to have them insist and demand to be placed, then go to another agency to get what they want. I picked an established company, one with a good reputation and that I knew wouldn't fold and leave me hanging.

All that said, it's the NM of the unit accepting travelers who has the final say. Before you place too much blame on the travel nurse, look at your own manager and ask why she contracted with someone who obviously didn't have the experience necessary to work your unit. My work history and previous references and evaluations are available to these managers; they call me for interviews. I've had some who gave some damned good in-depth interviews, and then others who simply called and said "when can you start." Even though I might have looked 'good on paper', I wanted to be interviewed; to those who just jumped in with an offer, I'd slow them down and make them interview me lol.

[LibertyBellPN]

Not really travel nurses but agency....We have a few agency nurses come to our facility, and I am disheartened to often hear that they don't do IV's, wound vacs,etc.

My question is WHY would a brand spanking new grad apply for jobs that really do require some experience??

(Great assessment skills, the ability to work independently--the ability to perform routine skills!) I just don't get it!

I see new grads take LTC positions where they are alone on a large floor at night. Yikes!

[llg, PhD, RN]

I agree that there is a lot of blame to go around, here. Nurses who are willing to take ANY job for the money, even those for which they are not qualified ... Agencies who recruit and place these nurses using sales questionable judgment and sales tactics ... and Hospitals who are willing to fill holes with "just anybody" with an RN behind their names.

As we all seeem to agree (and this may be the important thing here) ... traveler's are expected to be able to jump right in and provide competent care with only a minimal orientation to show them the particular hospital's specific routines and organization. A nurse without considerable experience in an area of nursing is not sufficiently skilled to do that. Minimal competence is not enough for a traveler.

All the research shows that it takes at least a year for a new grad to become truly competent in her field. A traveler needs more than basic competence to perform well in a strange environment. We all need to take a stand on the issues that result from those cold, hard facts.