trouble getting first travel assignment in L&D!

[ljb]

Hello all,

I've just begun looking for a travel position as an L&D nurse in the last couple of weeks, and am not having much luck. I wondered what any of you might be able to offer in terms of advice or your personal experience, especially anyone who has been in my particular position.

I have 18 months of L&D experience, just shy of 4 years total nursing experience (my first job was in a SICU--good experience, but not for me). I work at HUP in Philadelphia, a large teaching facility. The nurses here (except for a handful, cross trained for our triage area), DO NOT do cervical exams. My first choice of location to move to has been San Francisco. Large teaching facilities there, as I'm told, do not want to hire first time travelers. So I've expanded my search to outlying areas, other small towns. This is where I've discovered (as many are community hospitals), that all the nurses do cervical exams (and place FSEs and IUPCs), leaving me unqualified!

So basically I'm stuck with the catch-22 situation of: can't get a job at a large teaching facility in the city (as a first timer), but can't get a job at a smaller or community hospital b/c of my sheltered existence at a large teaching facility! It's kind of funny really.

Is my hospital as outside of the norm as it seems in that we (the RNs) don't do vag exams? (or place internal monitoring instruments)

Just wondering if anyone else has had this same combination of situations, and if they were ever successful in finding a travel job?

Thanks for any input/ideas

[Selke]

I suspect the managers want a traveller L&D RN to have more years experience than you have.

If you do night shift, you will have a much easier time finding a job.

My most important suggestion for you is for you to find a job in a non-teaching hospital, perhaps a community hospital, in your area in which the RNs, not residents or CNMs, manage the patients and triage the patients -- and learn how to do lady partsl exams. This is where you will learn how to be a real L&D nurse. Teaching hospitals can be interesting and you will see cases you won't see anywhere else, but you will be relegated to the role of assistant, more or less -- watching the monitors, assisting with epidurals, going to get stuff for the residents. No labor management, no triage assessment, no exams, no running pit, no labor support, no higher critical thinking skills. Not every state allows RNs to place FSEs, IUPCs, or do sterile spec exams (Cali does) so you don't have to know how to do those; you will be able to learn how to do them as a traveler (they are simple procedures, not brain surgery, and entirely within AWHONN's scope of practice for L&D RNs). Stay in that job for at least several months before looking again for a travel position. Or look for a travel position in another big teaching hospital, maybe just not in San Francisco. For example, I know the L&D RNs at teaching hospitals like Univ of Chicago Hospital and Yale New Haven Hospital don't do much of anything, in between the med students, residents, and SNMs.

[ljb]

Thanks for your response.

I think you're right in that I need to gain more experience overall. I've begun to work with the residents at my hospital and started doing cervical exams with them to learn.

I recently interviewed with a hosptial who was hiring for nights, and who said that they have hired travelers who hadn't done many cervical exams before, but who they had allowed to learn on the job. Sounds great, but it sounds a bit scary too, b/c as a night nurse, she said you'd be working with no doc, would do all the checks/fetal tracing monitoring yourself, and just call the doctor at time of delivery, or in case of need for a c-section. Also that I'd work in the triage area, and post partum, both of which would be new areas for me! Hard to believe that she'd even consider me, but she said I could take the next few months and try to get more experience at my current position before considering taking her travel position in SD.

It's tempting, b/c I know I'd be forced to learn on my feet, but could go really wrong, and I'm not sure I want to take that chance.

This was maybe more detailed info than I needed to post here, but thanks again for your response. I agree with what you wrote.

[Selke]

Girl, you can do it! Go for it. Push your boundaries. Learn all these skills you can. You're capable!! What that manager describes is the norm outside of teaching hospitals with residents or OB/CNM hospitalists or 24 hour unit coverage. There's lots of L&D jobs out there, especially at night shift, across the country, so you have an opportunity out there to experience living and working anywhere you want in the US -- the beach, desert, forests, cities, small towns, mountains, gov't facilities, Indian Health Service, &c. It's quite an education working in different places across the country, in different types of hospitals and communities.

[ljb]

Oh, you think I sould go for it! I was surprised to see that your post was from the same person as your previous post, only b/c i sort of thought you were saying that i should get way more experience before trying traveling.

I definitely want to get the experiene, learn the skills, etc., but I thought it might not be a good idea to try to get this experience on a travel position, where you're sort of expeced to know what you're doing already, and where you get only 2-3 days of orientation. I don't want to be the lame travel nurse who has no skills and needs help all the time!! At the same time, if I knew people were willing to work with me, help me with certain things, I'd go for it. It's hard to know from a distance, and I'm just afraid of getting myself into a stressful (more so than the normal stress), or unsafe situation.

I do appreciate your encouragement, and believe me, I will seriously consider her offer. She seemed pretty sure they'd need a second travel in a few months and maybe I can learn more of a base of what I'd need to know to function on her unit and then I can take the job!

(It's in Poway, Pomerado Hospital, outside of SD. Anyone have any experience at this hosptial?)

thanks again

[Selke]

I apologize for not being clear. I can't speak to South Dakota. Did you ask about the community? It might be a small, community hospital in a remote or rural area. These places are very different from big city teaching hospitals and you will have a bit of culture shock or cognitive dissonance, but that's not a bad thing! It's all a cross cultural learning experience. Have you tried to SD forum here? Have you checked out Delphi Travel Nurse Forums? You will get your questions answered there.

What I meant was, if the residents at your hospital will teach you vag exams, maybe other things, take advantage. If the hospital where you might get a travel position is willing to teach you other skills (they know not all L&D RNs know these things), then go for it and take it as a learning experience. Also, if you can find a per diem job in your present community where the RNs manage and triage the pts in the meantime, before travelling, take that job.

Best of luck to you on your future adventures.

[ljb]

oops, now I wasn't being clear. When I typed SD, I meant San Diego. I'm looking to travel in CA!

thanks again for your posts, and positive encouragement!