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I haven't traveled myself, but based on friends' experiences: For your first assignment, use a recruiter, go with a well-known company with lots of reviews, and look for contracts of 12x3 with options to pick up rather than 12x4 or more. After you have your first travel assignment under your belt, you'll have a better idea of what to look for and what works for you. Get that money!
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Feb 10, 2022 23:23
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Avian Pneumonia posted:I quit my job! Been travelling for a year now so my 2 cents: I like Trusted and their blog has some good advice on it. I worked with a Stability first, had a recruiter I liked, and then had one I barely heard from. I don't particularly see what value a recruiter adds to the whole process. I left them when I realized I was looking at the same contract from 2 different agencies, 1 was 3 days and the other was 4, for essentially the same pay. Contracts are made up out of your hands and offered to you, but negotiation is possible. I have been cut once this year, at Inova Fairfax because they had taken on a ton of travelers for last Januarys COVID surge and it didn't really materialize. A lot of travelers live out of hotels or short term housing only on the days they're working, I prefer to stay in one place for longer stretches, but I also have very little tying me to my tax home beyond what's legally required(ie no kids or spouse and its on the other side of the state.) It's up to you if the additional comfort is worth being trapped in a lease, but furnished finder has a lot of places that will do month to month. Evaluate what you want from a contract. Prestigious, well staffed hospitals and nice locations pay less. Good units (usually) pay less. Do you wanna be more picky and work in your specialty (easy if you're ICU or ED, somewhat harder for others) or do you just wanna pick up the first med-surg tele contract you find? Everybody's short right now, and I've heard even Cali isn't keeping their ratios. You have options though. I just resigned at my current hospital with a different unit I liked more by talking to the manager and getting them to do all the backroom stuff with the travel liaison, because I'd made a good impression with that manager and her staff. Like most subreddits, /r/travelnursing is pure poison and full of people who have wound themselves up on the idea that they absolutely deserve to make 200k+ and have 3 months of vacation a year while turning in substandard work. Rates are likely going to fall, even if there has to be legislation to do so and frankly we are all likely participating in the gutting of american healthcare and a profound transfer of wealth from the aging middle class into the coffers of hedge funds and for-profit systems. The government is by far the largest single payor in healthcare and it is definitely legal and probably obligated for them to exercise some sort of price control. I do not feel good about the ethics of the current situation but I'd also feel foolish to not take advantage of it. I left a terrible job at a for-profit inner city hospital that gave me PTSD, more than doubled my take home pay, and have lived in some cities I probably wouldn't otherwise. Actual, actionable advice: Use a recruiter for your first gig. Aya is one of the biggest agencies and they have the most options. Pick a University hospital, a level 1 trauma or a Magnet, they're at least gonna have enough people to have their poo poo together. Go for a 3x12 if you can like what Lovelyn said. That'll let you test the waters and see if it's for you. If you've been in the same place for 8 years you're gonna be surprised by how much of what you took as gospel is simply convention. Travelling isn't for everyone, you've gotta be flexible and adaptable. You're the first to float, probably to the worst units. Most of the core staff appreciates you, some will resent you for your absurd pay rate. If you're not a social person (and you're a goon soooooo) it can be really hard to make friends in a new place every 3 months. If you have a spouse consider getting on their insurance. Most agencies offer it but it ends as soon as your contract does. Get umbrella insurance, you're working in unfamiliar systems, mistakes will happen and it'll take a weight off your mind. Start a ROTH IRA if you haven't, being mindful that if you go for high level contracts you'll possibly make enough in a year to exceed the income limit. Trusted has a 401(k) with no matching now, most agencies need you to run with them for a year for any kind of retirment account. If you were thinking about buying a house, shelve it, mortage lenders won't even look your way without at least a year of paystubs.
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Feb 12, 2022 18:30
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Applying to grad school for a masters in Nurse Leadership and they require three essays. One is "why school X". (The truthful answer is because I went there for nursing and it seems like it will be easy to use the few grad credits I have and I don't feel like researching other schools, and this is a somewhat last-minute decision and I'm lazy. But I know how to bullshit.) The other two essay prompts are: quote:What are your career interests and goals? Address your reasons for pursuing advanced practice nursing, your reason for selecting the specialty track (if applicable), and your goals upon graduation. and quote:Why have you decided to pursue this degree? What are your plans for the future? HOW ARE THEY NOT THE EXACT SAME QUESTION. I asked in my informational interview, very gingerly, if they could please clarify what they were looking for with each essay. The program director was like "huh, they are very similar, isn't that funny. No one's ever mentioned that before! Uh, do your best." Someone who's good at playing these games tell me how to write two essays saying the same thing. I've been staring at my google docs trying to figure out a distinct approach to take for each essay and I cannot loving figure it out for the life of me. xposting
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Mar 16, 2022 11:17
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Your reason for pursuing advanced practice is to contribute to the profession. Are you a minority or somehow disadvantaged? This is your sob story essay, too. Your reason for choosing the master's is more straightforward, as it's the next step in the academic ladder. You could relate this to the clinical ladder structure of nursing, too. Do you need the master's because you want a doctorate, or a specific position? Know anyone with a master's who is an inspiration to you or used the degree to advance their practice?
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Mar 16, 2022 11:47
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Make the first specifically about your professional goals (what you hope to do with the degree, fairly narrowly focused) and make the other more about broader life goals like a story about why you find doing X actually important, or why this represents something important about nursing. Admissions people love hearing about how great nursing is and nurses are, imo.
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Mar 16, 2022 11:54
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Eat My Ghastly rear end posted:Pay in Denver is atrocious. I love it here but at this rate I’ll never be able to buy a place. As someone who moved from the PNW to Northern Colorado, I am not sure you are aware of what the cost of living in the PNW is going for, even with the higher wages. I mean, I wish you the best of luck, but I got absolutely turbo gently caress priced out of central Oregon, and it's gotten even worse per my buddies who are still up there.
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Mar 16, 2022 21:14
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On top of all of this: Why the gently caress hasn't UCH/UC Health in general unionized yet? It seems like that entire system is primed and ready for some poo poo to go down but there isn't a single thing happening..
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Mar 16, 2022 21:17
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Fun Times! posted:Your reason for pursuing advanced practice is to contribute to the profession. Are you a minority or somehow disadvantaged? This is your sob story essay, too. Ravenfood posted:Make the first specifically about your professional goals (what you hope to do with the degree, fairly narrowly focused) and make the other more about broader life goals like a story about why you find doing X actually important, or why this represents something important about nursing. Thank you both!
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Mar 17, 2022 15:45
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Nice and hot piss posted:As someone who moved from the PNW to Northern Colorado, I am not sure you are aware of what the cost of living in the PNW is going for, even with the higher wages. Yeah, I think I’m gonna stay here for the time being. I’m working on an informatics degree and have about a year left, gonna wait and see where that takes me. Speaking of, aren’t there a couple informatics goons in here? I’m interviewing for a position this afternoon and realized I don’t really know what a normal day looks like.
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Mar 17, 2022 15:59
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Eat My Ghastly rear end posted:Yeah, I think I’m gonna stay here for the time being. I’m working on an informatics degree and have about a year left, gonna wait and see where that takes me. Yep, I was an informaticist and Epic analyst in a former life. Hopefully you nailed the interview, let me know if you have any specific questions.
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Mar 18, 2022 16:20
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The Radonda Vaught verdict is terrifying. Yes, she made an egregious error, and it should've been handled by the board of nursing, not the criminal justice system. This does not make me want to return to bedside nursing. What the actual gently caress.
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Mar 26, 2022 09:17
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boquiabierta posted:The Radonda Vaught verdict is terrifying. Yes, she made an egregious error, and it should've been handled by the board of nursing, not the criminal justice system. This does not make me want to return to bedside nursing. What the actual gently caress. The part that is really getting my hackles up about it is that they apparently used her internal process improvement statements in court against her. You know, the thing where she didnt have a lawyer with her and and cooperated openly about her mistake to make it not happen again.
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Mar 26, 2022 12:12
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I hadn’t even heard that part. That’s so hosed up. It’s almost like the powers that be aren’t actually interested in best practices for improving safety and patient outcomes.
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Mar 26, 2022 12:35
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boquiabierta posted:I hadn’t even heard that part. That’s so hosed up. It’s almost like the powers that be aren’t actually interested in best practices for improving safety and patient outcomes.
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Mar 26, 2022 12:47
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boquiabierta posted:The Radonda Vaught verdict is terrifying. Yes, she made an egregious error, and it should've been handled by the board of nursing, not the criminal justice system. This does not make me want to return to bedside nursing. What the actual gently caress. Fantastic. Can't wait to come into the shitshow at my hospital when they start upgrading to Cerner this summer.
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Mar 26, 2022 14:52
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Then again, I literally still have the vial top from the first time I paralyzed someone in my glove compartment. 
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Mar 26, 2022 21:06
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Bedside nursing, even pre covid was absolutely sketchy for new nurses that went into areas where the focus was to get them off orientation ASAP and have them running with oversight limited essentially to charge nurses/lower leadership...Some of those who have only a couple years of experience over the new nurses. Now it just sucks in general for anyone who's in nursing, save maybe 1-2 departments where it's almost impossible to stretch nurses even more. I figure that I'm going to give this ICU gig a solid year before I apply for flight again. If I can't land a gig doing that then I'll be happy to step away and do something non clinical, but that seems to be harder and harder these days unless you jumped on the informatics/UR pipeline pre COVID. Even those require degree's now which is lame. poo poo, I even looked at going back to school for a comp-sci degree but going back to school for 2+ years to end up back in tens of thousands of dollars in debt seems like it's own prison there. Not to mention the stigma associated with new computer touchers having no experience and a bachelors almost turning 40.
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Mar 28, 2022 20:17
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Nice and hot piss posted:On top of all of this: Why the gently caress hasn't UCH/UC Health in general unionized yet? It seems like that entire system is primed and ready for some poo poo to go down but there isn't a single thing happening.. Denver Health made a push in recent years but it got squashed. Don’t think the hospital really had to concede much in the end either. My system in the Denver area has given me a 15% raise in the past year and a $15,000 2 year retention bonus along with other peripheral benefit increases. My hourly 2 years post grad is pushing 35$ base before differentials. Not amazing, but the situation is improving I guess? Long overdue for sure. UCHealth has an infinite supply of new grads wanting to work for a “university hospital”, on locked in 2 year contracts. I think that keeps wages low there hobbez fucked around with this message at 19:17 on Mar 29, 2022 |
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Mar 29, 2022 18:56
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I honestly don’t understand anyone defending Radonda and I don’t see how how the verdict is terrifying. She could have done about one of thirty different things different and not killed the patient. She gave a god drat paralytic instead of versed. Look at the medication vial before giving a drug and you won’t make the same mistake she did. Five rights of medication administration y’all. She paralyzed a fully awake patient and then left immediately, what an awful way to die. Even if she gave the patient versed she should have stuck around to see how the patient tolerated it. I’m completely fine with the charges and verdict. Please don’t just focus on the nurse, the patient Charlene Murphey needs to be thought of too. Now I think it’s bullshit Vanderbilt seems to be getting off without any charges for the coverup. Whoever helped cover it up needs to be hit with charges as well. B-Mac fucked around with this message at 01:32 on Apr 3, 2022 |
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Apr 3, 2022 01:28
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Not sure that anyone is defending her so much as incensed that she is obviously being used as a scapegoat so Vanderbilt doesnt have to suffer consequences. Also the fact that her very open and clear cooperation with the internal investigation without a lawyer present being used in her trial is a loving travesty that is going to immediately shut down any kind of voluntary cooperation in terms of medical errors. Was the loss of that trust nationwide worth jailtime (against the wishes of Murphey's family) for someone already stripped of her license? Really, who is defending her actions? Its "Vanderbilt failed her" and "Vanderbilt threw her under the bus" everywhere I see, with a lot of "she shouldn't be a nurse anymore but given her immediate cooperation and honesty it's hard to not be sympathetic".
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Apr 3, 2022 01:51
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I worry about the legal precedence of the whole thing. This never would have seen the light of day in court if Vanderbilt didn’t try a cover it up.l
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Apr 3, 2022 03:00
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B-Mac posted:I honestly don’t understand anyone defending Radonda and I don’t see how how the verdict is terrifying. She could have done about one of thirty different things different and not killed the patient. She gave a god drat paralytic instead of versed. Look at the medication vial before giving a drug and you won’t make the same mistake she did. Five rights of medication administration y’all. The craziest thing is which no one has mentioned even if she somehow missed every single warning and confused the drugs, skipped every warning, reconstituted the powder which is never done for versed. The order was still for 2mg. The vial said 10mg of vecuronium. She still gave FIVE TIMES the ordered dose even it was the right drug. Just open palm slammed a vial. Grandpa might have been weak and gasped from 2mg of Vec. Bum the Sad fucked around with this message at 03:46 on Apr 3, 2022 |
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Apr 3, 2022 03:42
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It's terrifying from a patient's perspective too because it disincentivizes nurses to come forward if they make an error. Radonda immediately reported her mistake after it happened so Vanderbilt could make changes to ensure it doesn't happen again. Now a nurse who makes a fatal or harmful error will think twice about reporting it because they could face jail time. It's especially infuriating when you compare it to something like the Rittenhouse verdict or that rear end in a top hat North Dakota AG who got off scot free after he killed someone while driving drunk. Lastly a friend of mine pointed out how it highlights how the US justice system is designed to be punitive rather than rehabilitative. Radonda lost her license. She is not a danger to anyone and will never be in a position to make that mistake again.
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Apr 3, 2022 13:27
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I'm starting my first travel nursing assignment tomorrow and I'm unbelievably nervous  I've been away from the field of med-surg for a few months and I hope I haven't gotten rusty.
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Apr 3, 2022 16:04
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dude789 posted:It's terrifying from a patient's perspective too because it disincentivizes nurses to come forward if they make an error. Radonda immediately reported her mistake after it happened so Vanderbilt could make changes to ensure it doesn't happen again. Now a nurse who makes a fatal or harmful error will think twice about reporting it because they could face jail time. It's especially infuriating when you compare it to something like the Rittenhouse verdict or that rear end in a top hat North Dakota AG who got off scot free after he killed someone while driving drunk. I understand where you’re comparing from and I respect your and everyone’s opinion but I fundamentally disagree with a few points. I’d be more terrified as patient knowing my nurse didn’t even look at the vial of medication that they pulled before giving it to me. She took the time to look at the reconstitution instructions but decided she didn’t need to look at what medication it was. I can’t say it doesn’t exist but I’ve never seen versed need to be reconstituted. Secondly even if she had correctly pulled versed the patient wasn’t on any monitoring equipment. So she even if she administered a benzo she immediately walked away without even monitor the patients initial reaction. I also see your points about Kyle Rittenhouse or the South Dakota AG but whether or not they were a miscarriage of justice has nothing to do with what happened at Vanderbilt and just seems like whataboutism to me. I guess don’t know what the clear cutoff should be for criminal charges in a medical error case is but this seems to cross that line for me since it was so reckless and many preventable errors were made. If Radonda did the bare minimum in administering a medication Mrs. Murphy wouldn’t have died alone and scared that day, paralyzed while awake. I’d encourage anyone to read the CMS report if they haven’t. Page 19 is where the details of what happened start. https://hospitalwatchdog.org/wp-content/uploads/VANDERBILT-CMS-PDF.pdf B-Mac fucked around with this message at 18:12 on Apr 3, 2022 |
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Apr 3, 2022 18:04
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B-Mac posted:. Secondly even if she had correctly pulled versed the patient wasn’t on any monitoring equipment. So she even if she administered a benzo she immediately walked away without even monitor the patients initial reaction. My understanding is that she had a written order saying this was acceptable. Now, I will freely grant that I dont think writing that order should be acceptable and that she shouldn't have followed it even if it was there, but that the order was written and not immediately questioned and refused does speak to institutional flaws that may have seriously warped good practice.
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Apr 3, 2022 18:25
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djfooboo posted:I worry about the legal precedence of the whole thing. This never would have seen the light of day in court if Vanderbilt didn’t try a cover it up.l Agreed. Would it have been policy to double check meds prior to administration? I've questioned many a prescription even with senior rgns - albeit not in the ITU setting. I had to look up what the drug she was supposed to give was (versed) - and are people seriously getting Midazolam as sedation for a scan? To someone with a brain injury?
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Apr 3, 2022 19:47
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She definitely deserves to lose her license. This really shouldn’t be a criminal matter.
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Apr 3, 2022 20:09
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McFlurry Fan #1 posted:Agreed. I skimmed the CMS report to see the context, seems like the patient requested medication for anxiety. At my hospital, it's not uncommon to give patients a little bit of lorazepam, which is stronger than midazolam, on request, especially if the patient has a history using the medication (as the victim did, according to the report). What really speaks to me is the apparent lackadaisical workplace culture at Vanderbilt. I bet this nurse didn't just decide to give a bigtime med like midazolam without the order being verified by pharmacy just in this one isolated incident. It seems like this poo poo probably happens all the time which is the scary part.
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Apr 3, 2022 20:15
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rosenritter posted:I'm starting my first travel nursing assignment tomorrow and I'm unbelievably nervous Pretty cool! Hope your first day put your nerves to rest and you breezed right through. Any new place is bound to have some stress. I'm still toying with the idea of travel nursing myself. We had our annual skills fair recently and I was so restless through the night that I barely slept. I don't know if I was nervous about "failing" or just sleeping in or making a mistake or what. Of course it went off generally pain-free so my nervousness was for nothing.
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Apr 4, 2022 00:59
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I was talking with my friend today that does travel nursing in the US today and he said yall need a co-sign for Foley insertion? The gently caress?
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Apr 6, 2022 05:07
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We needed two nurses even for a straight cath as a CAUTI prevention measure 
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Apr 6, 2022 08:24
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DeadMansSuspenders posted:I was talking with my friend today that does travel nursing in the US today and he said yall need a co-sign for Foley insertion? The gently caress? Very variable from place to place. I never did. Also never had to cosign insulins, but the place my wife works at they have to do both. On the other hand I had to have someone there with me doing central line dressing changes and the nurses there don't. And that's not a state thing, it's just facility.
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Apr 6, 2022 11:53
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Ravenfood posted:Very variable from place to place. I never did. Also never had to cosign insulins, but the place my wife works at they have to do both. On the other hand I had to have someone there with me doing central line dressing changes and the nurses there don't. And that's not a state thing, it's just facility.  seriously??
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Apr 6, 2022 13:47
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Zipperelli. posted:
Most of that was driven by the shift towards pens instead of multi-use vials, but a few still needed to be drawn up and we never had to sign. Only medications I can remember having to cosign or witness were either trial drugs, blood, or chemotherapies. And yeah, they have to cosign every insulin administration where my wife works. Not sure why, assuming they had a rash of people slamming full vials into people. Ravenfood fucked around with this message at 14:26 on Apr 6, 2022 |
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Apr 6, 2022 14:11
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Very weird. We don't cosign insulin unless it's an infusion. I'll ask for one if I'm giving a weird dose like 70u of glargine but that's more for my comfort. Then again when I started they used to wardstock benzos and now you have to sign them out so..
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Apr 6, 2022 14:21
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HCA asks for a double check for subq insulin, but it just asks for initials. So part of my charge nurse speech at the beginning of shift if I had a new nurse: “my initials are SJ, just like this place, St. Joseph’s. Don’t fuckin ask me to check off your 1 unit at HS.” I do usually ask someone to double check if I’m giving large insulin doses. 45 units of levemir for bedtime - someone else is going to glance at the syringe with me.
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Apr 6, 2022 16:40
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at the facility where we did our med-surg clinicals they had to do dual sign-offs on tube feeds. turns out there's a reason!quote:OAKLAND — The 66-year-old cancer patient whose death has become a flash point during a Bay Area-wide lockout of nursing staff may have succumbed to the most basic of treatment errors: A replacement nurse apparently gave her a nutrient solution intravenously instead of through a feeding tube.
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Apr 6, 2022 17:18
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scribe jones posted:at the facility where we did our med-surg clinicals they had to do dual sign-offs on tube feeds. turns out there's a reason! I'm thinking about the feed bottles and wondering how you even spike that.
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Apr 6, 2022 17:33
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Yeah they must have really wanted to give it IV. Maybe they jury-rigged and adapted and connected it to a luer-lock on the patient side. Weird. Still the idea of signing off tube feed is funny.
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Apr 6, 2022 19:00
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