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Specializes in Cardiac & Vascular.

Hi everyone, long time no post. I'm on my 2nd week on a travel assignment for CV stepdown. And this is what I encountered, I had 2 insulin drips one day. One of them was getting blood and had a peg. I think the other ones were an AKA and a man who doesnt have a pulse in his foot and is awaiting surgery. I find out 3 hrs into shift I wasnt supposed to have 2 insulin drips.There were 3 drips on the whole floor and I managed to have 2 of them. Luckily a nurse switches with me. I'm a little frustrated because I just feel they're expectations are unreasonable. No real support. Techs can't do alot of things. Charge always has 4 pts (full load). Are there repercussions for wanting a contract elsewhere?

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As you are only in  your second week , you should continue with the assignment.  It appears that the  inappropriate assignment was corrected.  Start documenting any unsafe issues with your recruiter. You should be having at least weekly conversations and emails. But document, document, document any safety issues. 

I had several travel assignments. Quit one @ 8 weeks in because the whole place was unsafe. The agency (sort of) was okay with it .. because I documented the main problems on a regular basis.

You most likely have signed a 13 week contract to staff that unit.  There will be plenty of repercussions if you do not fulfill that contract. Re- read that contract. The only way out of the contract , would be to prove it is unsafe... through your documentation to your agency.

Let us know how it's  going, feel free to PM me.

 

 

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The other way to go, and required if true by your license, is to refuse assignments because you are not able to handle the workload. Same potential contractual penalties.

I find I'm not really warmed up by week 2 of an assignment, and start getting more efficient with a hospital's work flow in week 3. Of course my work flow in the OR is very different than yours and really requires more time usually than bedside specialties.

But as every hospital has different staffing and support ratios not to mention acuities, I think warming up is an important part of becoming efficient at a new hospital. Imagine some extreme but actual examples: an ED nurse from California used to 4 patients to nurse ratio travels to New York City and now has 10 to 15 patients!

A medsurg/step down/ICU nurse from anywhere travels to a Kaiser hospital in California on a 12 hour shift and floats to a new to them unit every 4 hours. Things are doable, you just have to learn how to be efficient and safe. Watching to see how staff does it and their charting (not necessarily what you learned in orientation) can be helpful to free up time.

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Specializes in Cardiac & Vascular.
On 10/29/2020 at 6:30 AM, Been there,done that said:

As you are only in  your second week , you should continue with the assignment.  It appears that the  inappropriate assignment was corrected.  Start documenting any unsafe issues with your recruiter. You should be having at least weekly conversations and emails. But document, document, document any safety issues. 

I had several travel assignments. Quit one @ 8 weeks in because the whole place was unsafe. The agency (sort of) was okay with it .. because I documented the main problems on a regular basis.

You most likely have signed a 13 week contract to staff that unit.  There will be plenty of repercussions if you do not fulfill that contract. Re- read that contract. The only way out of the contract , would be to prove it is unsafe... through your documentation to your agency.

Let us know how it's  going, feel free to PM me.

 

Hey Been there! I see your posts here and you always give good advice. The same thing happened to me last night with no switches. I was one of the two who had two insulin drips. The other nurses and charge had 5 pts (4 is max, especially with LVAD pts). The day charge said she went to the head of the hospital with this and was told "That's how it will be tonight ". They said they didn't have any staff to fill the holes. Per day charge, we could write up occurence reports but she said she tried to be as fair as she could.

I'm not lazy by any means. I don't mind working hard but I feel like the load is impossible. I didn't leave until 930 am this morning. I spoke with my recruiter and she says she could most likely find me another assignment. 

 

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Specializes in Cardiac & Vascular.
On 10/29/2020 at 7:23 PM, NedRN said:

The other way to go, and required if true by your license, is to refuse assignments because you are not able to handle the workload. Same potential contractual penalties.

I find I'm not really warmed up by week 2 of an assignment, and start getting more efficient with a hospital's work flow in week 3. Of course my work flow in the OR is very different than yours and really requires more time usually than bedside specialties.

But as every hospital has different staffing and support ratios not to mention acuities, I think warming up is an important part of becoming efficient at a new hospital. Imagine some extreme but actual examples: an ED nurse from California used to 4 patients to nurse ratio travels to New York City and now has 10 to 15 patients!

A medsurg/step down/ICU nurse from anywhere travels to a Kaiser hospital in California on a 12 hour shift and floats to a new to them unit every 4 hours. Things are doable, you just have to learn how to be efficient and safe. Watching to see how staff does it and their charting (not necessarily what you learned in orientation) can be helpful to free up time.

Hey Ned, I appreciate you chiming in. You mentioned some good points. I agree that getting warmed up make take some time, but I do have safety concerns. I feel the workload is just impossible. Most nurses leaving at 830 or 9 after their shifts. I left at 0930 today!

It's kind of hard to refuse since who else is going to take the patients? I know the assignment isn't just because I'm a traveler because everyone's assignment has been heavy. Nurses are constantly complaining about the acuity, lack of assistance, and safety issues. We're told there is no extra staff to help and we just have to do our best. Based on what I'm seeing, I'm concerned for these patients. They deserve better. ?

 

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Definitely better for patient care for you to stick it out. What is sad are the bean counters not hiring enough staff to be safe.

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Specializes in Cardiac & Vascular.
Just now, NedRN said:

Definitely better for patient care for you to stick it out. What is sad are the bean counters not hiring enough staff to be safe.

Yeah, I know if I leave staffing will only get worse . But I'm worried because ultimately everything falls back on the RN.

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My first travel assignment was nights on a M/S unit. I had 13 patients nearly every night. I lasted 5 weeks and my recruiter was happy to find me another assignment. 

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On 11/1/2020 at 10:41 PM, ADN_Is_Complete said:

 

Oh yeah, get outta Dodge. The unsafe staffing is the norm.   Good luck, push for a new assignment. The recruiter is sitting at home and not in a hurry to move you.

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Specializes in Cardiac & Vascular.
On 11/4/2020 at 4:56 AM, Been there,done that said:

Oh yeah, get outta Dodge. The unsafe staffing is the norm.   Good luck, push for a new assignment. The recruiter is sitting at home and not in a hurry to move you.

Update: Last day in this facility is 11/20. Thanks for the advice. I'm not sure how I feel about taking another assignment . Haha.

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Specializes in PACU travel.

Just wondering to those experienced travel RNs, when you say document to the recruiter, do e-mails suffice? Or do you lodge some sort of form? 

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Email is fine. 

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