Warning regarding seasonal travel assigment in Palm beach county Florida

groundedandrooted · Jan 6, 2010

Hi!

Totally agree with you on this!

Be very very careful, and require an increase in $ for mental anguish if you take an assignment at Del Ray. Really still can't believe how bad things were at that hospital!

caroladybelle, BSN, RN · Jan 6, 2010

You can review the many Florida threads, I and others having been saying this for years.

I went in with the "I can deal with anything for 13 weeks" attitude, and learned truly in Boca Raton that there are things that I cannot handle 13 weeks of. It was positively the worst job of my life. I was literally counting the Hours until I left.

Runman1914, MSN, RN · Jan 7, 2010

You can review the many Florida threads, I and others having been saying this for years.
I went in with the "I can deal with anything for 13 weeks" attitude, and learned truly in Boca Raton that there are things that I cannot handle 13 weeks of. It was positively the worst job of my life. I was literally counting the Hours until I left.

When i started my contract at Del Ray Hell Ray, i started with 11 other travelers. Only me and one other finished our contracts. I worked as a traverl nurse for 10 years and have never seen that many travel nurses quit a contract.

PureLifeRN · Jan 7, 2010

Why was Delray so bad (besides the patient's attitude)? Did you have a high number of patients to deal with? I am figuring out what hospital to work at in PB County and everyone says all the hospitals suck, but I need to pick one! lol. I have heard bad bad things about JFK, that their ratios are unrealistic on the floors and have heard that Columbia hospital is very unprofessional. But I haven't heard as many bad things about Jupiter Medical Center and St. Mary's, from hospital RN's and travellers alike.

Runman1914, MSN, RN · Jan 7, 2010

I have never worked at Jupiter or St Mary so i cant say. Of the 4 hospitals i have worked at there Bethesda in Boynton Beach was the most tolerable. It was still crazy busy but the lesser of the 4 evils i experienced in Palm Beach county.

The patients and families are bad but not the worse part in my opinion. The hospital are very bad with support services and supplies. It was an act of congress to get basic supplies and zero help from the charge nurses. I would spend most of my day looking for supplies all over the hospital. Also the charge nurses offered zero assistance. The only time you would see a charge nurse is when they were giving you another admit. The ratio on the day shift was 6 to 8 on day shift. With a high turn over of patients. You can expect to do 4 to 5 admits a shift.

caroladybelle, BSN, RN · Jan 7, 2010

This was not Delray, but another of the facilities in that area.

They staff poorly, there is rapid turnover, there is little to no support staff.

The pts are entitled and rude to the point of psychotic. and some facilities tend to put psych pts on the med/surg floorswhen they really need a psych unit (if you are rich, you can't possibly be put on the psych floor - the stigma, what will your friends/other club members think?).

The MDs are not much better. They tell pts verbally that they are DC'd but write no orders/notes/cannot be bothered to TELL any staff, the pts get ticked at the staff when they can't just leave, or that there are no scripts. The MDs usually have several offices (Delray/Ft.Lauderdale/Boca/WPD) and you end up chasing them all over flipping creation to get orders. The hand writing is not legible and we literally had 8 MDs, some in the same family owned office, with the same last name -try figuring out which one wrote the orders. It would take hours to do the simplest DC, and the families would be calling the nurse every 5 minutes for updates.

MDs would admit family members (their mother, their father) to floors where they had control (no matter that the admitting problem doesn't belong on that floor and the nurses aren't familiar with the disorder) and run staff ragged for days. Med Reconciliations - an MD would only sign the drugs that HE ordered and you would be calling around to every blooming specialist that the pt saw to get the med rec (which MDs should be filling out themselves) filled out to DC them.

Chemo orders are required to be filled out fully and written or faxed -NO VERBAL or INCOMPLETE ORDERS. An MD fills out a chemo order "Drug X - 200mg IV for one dose". NO INFUSION RATE! Nurse talks to pharmacy who need to know the rate of infusion as it variable for the drug, depending a expected cell kill rate. Nurse calls MDs officenurse, who doesn't listen and requests pharmacy to "research it and not bother them", hanging up. After several attempts charge nurse finally gets ahold of MD, who gets angry that we "don't know how to give chemo" and he doesn't have time to be bothered with knowing the rate. He then tells the charge nurse to call such and such researcher at "X big name research hospital on the other side of the nation", find out how it is given, call him back, so that at great inconvenience to him, he will deign to fax us the corrected order.

The irony, is that the very same MD had a coniption fit, because just the prior week, he had written a similar order and the chemo was given as a bolus rather than as an infusion as it should have been.

They put our link phone numbers on the pts board - which meant that every relative, country club member, golf buddy/MD friend called the nurse repeatedly for updates, which with HIPAA we cannot do. There would be one tech for 20-30 pts, so if the tech took more than 30 secs to get to the room, they called the nurse to open the curtains/bend their straw/fluff their pillow. I clocked about 50 calls in one 12 hour shift - around 6 of them were things that I could do anything about/were useful.

The hospitals tend to be about customer service, NOT HEALTH. On a 35 bed unit, there were no pts on isolation. Now if routine screenings are done, as a general rule for that population of pts, probably 10-25% will be positive for some sort of illness requiring some isolation. Add in that while there were the hand sanitizers outside of each door, there were no hall sinks. There were 3 sinks total for the unit outside of the pts personal BR sink. When I asked why there were not adequate hand sinks (do you really want to wash your hands using the pts bathroom sink, if they are CDiff positive), they said that the hand sanitizer was there (not effective for CDiff, and you still need to wash your hands if they get soiled) and that extra sinks would look messy and "hospitally". I would routinely get pts that were not listed as contact iso, but when you reviewed their meds and then checked the chart, one would find that they were VRE/MRSA/CDIFF. And some pts would rip the signs, if they got flagged at all, because that was "violating HIPAA rights" or "embarassing Mama" to have that up.

I had pts that lied routinely, manipulated, threw things, had screaming fits if they did not get what they wanted. I had a few episodes of elderly women, that would insist on getting their insulin, then refuse to eat, pulling out IVs (by accident) so you couldn't push D50W, and then call their families with stories about how they nearly died, and that we can't get anymore IVs in and no one would bring them food. Then there was one that kept demanding to leave, then refusing to leave, hit her MD with a phone, would refuse meds and then when shift changed, say we forgot them. When she was finally DC'D, she refused to leave so we had to get the police involved. When she left, she deliberately took her manicured fingernails and lacerated herself, which was witnessed by the PD. She then of course told the receiving facility that the staff did that to her, who then filed a complaint against the facility. The pt also demanded to be brought back....to the same facility that supposed did this to her.

And the truly scary part ....most of my pts were not that physically ill.

Now it is one thing, when one or two pts a shift are like this, or one or two days a week are like this. But WHEN EVERY SINGLE SHIFT, and half your pts are like this....it is unmanageable and intolerable.

NurseJacqui · Jan 7, 2010

What are the emergency rooms like?

PureLifeRN · Jan 8, 2010

Has anyone worked a "non bedside" position at any south florida hospital? Bedside is tough because of the obnoxous patients, but I would think that something like OR, ER, endo, cath lab, etc. would be a little better because you are not dealing with the patients and their families. But then again you have to deal with the doctors....:icon_roll

groundedandrooted · Jan 14, 2010

What are the emergency rooms like?

The nurses that worked in ER didn't seem so unhappy, I know they were always short on staff.

As far as other non-bedside- I really could not say.