Blog Title: Travel Nurse Aim

Hilarious Email about Discharging a Patient

Read this hilarious email that was sent to me today:

Hospital regulations require a wheelchair for patients being discharged. However, while working as a student nurse, I found an elderly gentleman already dressed and sitting on the bed with a suitcase at his feet---who insisted he didn't need my help to leave the hospital. After a chat about rules being rules, he reluctantly let me wheel him to the elevator. On the way down, I asked if his wife was meeting him. "I don't know," he said. "She's still upstairs in the bathroom changing out of her hospital gown."

Travel Nurse Aim Ranked Among Top 100 Blogs for Nursing Students

There is nothing like a shout out from fellow nurses to make you feel appreciated. I would like to thank RNCentral.com for ranking Travel Nurse Aim No. 78 among its "100 Best Blogs for Nursing Students." Check out the complete list of 100.

Also, if you haven't already seen them, take a look at these checklists before signing with an agency:

(1) Contract Items to consider;

(2) Housing Stipends;

(3) Benefits and Insurance; and

(4) Workplace Facilities.

Our House Flooded

Some of our readers have e-mailed asking why we are settled in South Georgia again this school year. The answer is becoming less and less clear given what happened the weekend before last and what is going on right now.

The weekend before last we were visited by Tropical Storm Fay which decided to stick around for two and a half days before moving on. The storm moved through at about 4 mph and dropped 25 inches of rain in two days. I felt like it would never leave. By the time it left our living and tv rooms had an inch of water on the floor.
See all that red just above the Florida line where the arrow is pointing. Yeah. That's where we live.

Too Busy To Post Right Now

I missed posting about our trip to Camp in North Carolina. But given the myriad of things that have happened since then I don't really have time to go back and do it justice. Suffice it to say we had a blast, the boys came back feeling like little men (ha ha) and, best of all, no kids were seriously injured while we were there.

Here are some pictures of the boys and me at Camp.

Stephen and Jacob and a week of hiking, camping and the great outdoors.

Aim and Stephen go canoeing.

Jacob takes it easy.

Countdown to Camp

We are headed to camp in just over a week.

In the meantime, check out a couple of my checklists if you are looking for an agency this summer. I have had a number of e-mailers tell me the checklists are helpful. Hopefully you will too.

Travel Nurse Aim Goes to Boys Camp

Eons ago (before husband, kids, career, etc.) I found a summer job teaching horseback riding at a boys camp in North Carolina. The pay wasn't great but the view from the top of the mountain was breathtaking and I couldn't pass up the chance to spend hours every day riding around the mountainside on horesback. I even helped birth a colt while I was there. Even though I was only 19 years old I often wondered "how cool would it be to one day bring my kids to this camp."

Several weeks ago we went on vacation to North Carolina and I visited the camp. Not much had changed. The lodges and stables were still as I'd remembered them and the lake still had the same diving boards and docks. Even though the camp wasn't open I decided to knock on the office door. To my surprise, the lady who answered the door was the same person who ran the camp 17 years ago.

While catching up on each other's lives, I told her I had become a nurse. She said they were looking for a nurse to fill one of the weeks of boys camp. I told her I would love to send my boys to the camp but didn't want to afford the $1,000.00 per week tuition for each of them. We decided to trade my nursing skills for tuition and now, as the title to this post indicates, I am going back to boys camp. Only this time I will be armed with Ritalin and Hypodermic needles. Look out boys! Nurse Ratched's coming to camp.

Just kidding. This should be a lot of fun and I don't need an agency for this type of travel nursing.

A Week in the Smokies

After months of begging, my kids finally prevailed upon us to take them on vacation to the Smoky Mountains for Spring Break. I'll skip the drive to Gatlinburg, Tennessee but suffice it to say the kids drove us crazy most of the way until we found the right DVD. The right DVD happened to be Underdog. I still haven't seen the movie though I've heard it half a dozen times. The funniest line in the movie from what I could hear is when Underdog tells his teenage master "I'm not taking advice from someone who keeps peeing in my white porcelain drinking bowl." Now that is wisdom at its finest.

When we arrived in Gatlinburg we checked into a log cabin complete with hot tub and stream running through the back of the property. The kids spent the first three days playing in the creek and hiking up the side of the mountain. Despite some rather chilly weather the first two days the kids continued to insist on playing in the creek. Blue lips and chattering teeth never hurt anyone. It usually ends up costing less when we take a trip like this because instead of paying for a week's worth of expensive theme parks all the kids want to do is hike. Healthier too. Instead of cotton candy and junk food, trail mix.

The second night we were there we went to the Dixie Stampede. We loved it! The kids especially loved eating all that chicken, potatoes and ham with their bare hands. The pre-show featured the funniest four part "redneck" band I've ever seen with a banjo, bass, guitar and fiddle player. The guitar player was a cute little redheaded girl who was introduced as the youngest person ever to win on Star Search. My girls danced in the aisle during their show as we sat and ate peanuts and popcorn.

After the pre-show we went into a huge comfortable indoor stadium. We had front row seats and watched as the horses and riders came rumbling into the performance area. The performance area is decorated like a southern plantation and the audience is divided into North v. South. They have contests between the riders to decide the winner. It was amazing to see how fast the riders would go in such a small area.

At one point a girl dressed as a falcon was lowered down from the roof on a rope. The lights were turned off and her costume glowed in the dark. A guy on a horse would ride up to her, grab her by the wing and race her around as she hung from the ceiling. He would then let her go and she would fly through the air like a giant bird. Pretty cool.

There is a lot more to this vacation than I've written here but my youngest daughter is calling for my attention.

Travel Nursing Agency Suggestions?

I have received a lot of e-mails lately asking for my opinion on finding the right travel nursing agency, but none more compelling than the one about a mother who wants to try travel nursing for the health of her child. The following is her e-mail with the name redacted:

"Hi Amy,

I am interested in traveling nursing. My 5 year old daughter has Cystic Fibrosis. We live in Illinois and she is sick all winter. I am considering traveling nursing so I can see how she does in other climates. I would be traveling with my husband and 2 daughters. How is traveling with families? How does the insurance work regarding coverage for your family? Do you have any advice for me? I am overwhelmed with how many agencies to choose from. Do you use the same agency every time? Have you found an agency that works better than others with families? I would appreciate any advice for me.

[Name Redacted]"

If you have any advice for this mother/nurse you can leave it as a comment to this post or e-mail me and I will pass it along to her. Please, no agency e-mails. And, YES, I can tell when I am being spammed by an agency.

Is the Whole Country Sick?

About three weeks ago my husband came down with what we thought was some type of flu/pneumonia hybrid. The local physicians gave it a technical name. They call it "The Crud." His head was clogged and he started one of those nasty sounding croupy coughs. His other symptoms were a little nausea, sore throat and an intermittent fever. A week after the symptoms started we thought he was getting better. After several days of moderate wellness, however, the coughing started back up and the bouts with fevers returned. This has been going on for nearly three weeks. He feels better for a few days and then sick again.

We went to church two weeks ago and almost 3/4 of the congregation was out sick with the same symptoms. I have spoken to friends and relatives of ours in Phoenix, Dallas, Provo, Utah and Orlando and they all know someone with the same symptoms. We were listening to one of the national radio talk shows and people were calling in talking about the same type of illness.

This has led me to ask: Is the whole country sick with this illness? Leave a comment and let me know if you have seen the same thing.

Travel Nurse Aim is a Nurse, Not a Vet

File this story under things my husband will never let me forget. About two weeks after starting a nursing assignment in Tallahassee, Florida I was asked to give a seven-way vaccine to a lab/chow mix in our neighborhood named "Bear." Simple enough.

A Crowd Gathers
I brought my nursing bag to our neighbors' house, knocked on the door and my husband and I were invited in. Unexpectedly, a small crowd had gathered in the living room (call it morbid curiosity) to watch me give the shot; my first real shot to a non-human. When I walked into the room Bear came up to me wagging her tail. She seemed to enjoy being the center of attention. I sat and pet her for 10 minutes or so to let her get used to me.

***Note to animals: Don't trust a strange human with a black medical bag showing you an unusual amount of attention.***

When Bear finally seemed to be calm enough for me to administer the shot, her owners took her in their laps and held her as I got everything ready. She was extremely calm. I quickly ran through the following in my mind:

Subcutaneous Injection 101: Pull out syringe. Stick pointy end into vial. Suck medicine into syringe. Remove from vial, and (my favorite part) stick pointy end into the dog.

My next thought was that I could use this as a teaching opportunity for those in the crowd who might be considering a job in the medical field. I started explaining the different types of medical equipment in my bag and began to walk them through each step in the injection process. My head swelled as one of the girls in the crowd started asking medical questions. As I answered the questions I could feel myself becoming the neighborhood expert on veterinary medicine.

A Teaching Opportunity
I continued answering questions as I prepped the patient for her shot. Reaching forward, I grabbed the lose skin and hair around the scruff of Bear's neck, raised it away from her body with my left thumb and index finger and inserted the needle with my right hand. Still explaining the process to my new student, I began to press the plunger into the syringe. When all of the medicine was adiminstered, I pulled the needle out and said "See, its that simple."

Back Down To Earth
Just then, one of the owners said "What is all of that wet stuff on Bear's neck? Is it blood?" I looked down at the dog and immediately turned bright red. I had stuck the needle into one side of the dog's scruff and out the other and squirted the medicine all over the dog's back. Not a drop reached the patient. So much for my veterinary expertise. In my defense, the dog was extremely hairy and had a lot of excess skin.

Two Things I Learned from the Experience
(1) I just love teaching opportunities; especially when they completely blow up in my face; and
(2) My husband can be a real jerk. He was the first person in the crowd to make fun of me saying "Oh yeah, you can give me a shot anytime." Now when he tells the story the dog ends up blinded by the medicine which somehow shot from the scruff of the dogs neck into its eye.

I hope my readers realize that I use a lot of sarcasm in my writing and that, in fact, my husband and I have a great relationship. We do LOVE giving each other a hard time though.

Travel Nurses Beware!

My readers come first! Like many of you, I am an avid blog and forum reader. I have recently come across a strain of posts on a nursing forum that have caused me a little heartburn regarding certain travel nursing agencies. The forum is located here. I am not in any way affiliated with the forum other than being a reader.

To be honest, I have not had any experience with the agencies discussed on the forum, nor have the agencies I am contracted with caused me the problems experienced by those on the forums.

Although I do have nursing ads on this site, my first loyalty is to my readers. If any of you have experienced problems with the agencies who advertise on this site, please contact me. I can't do anything about the agency's actions but I can make all of my readers aware of the complaints. To date, I have not had any complaints.

Travel Nursing Questions

I recently received the following e-mail from a nursing school student with questions about travel nursing:

Hi Amy.

I *really* appreciate your blog. I have been looking for something like it for a while. Once I graduate, I am going to put in a year in the ER at one of the local hospitals. After that, I plan to jump straight into Travelling. So I have a question for you. When I see all those ads that say, "Make $XX,000 per year", or "$XX per hour", what do they really mean? Is this gross pay before benefits, or does it *include* benefits? For example: "Earn over $90,000 per year." Does that include the cost of benefits? And does that include planned overtime, or is that all straight pay? Same with the, "Earn up to $45 per hour." Gross pay? Or gross pay + housing costs + milage expenses + etc.? I know you are a busy person, and if you can't answer directly, that's okay. But hopefully you can at least blog an answer. I know there are others at my school that would love to have those answers, so I am sure there are many around the country that would too. Thanks for what you are doing!

[Name redacted]
Tacoma, WA

Let me see if I can answer most of the questions in this e-mail.

First, congratulations on your decision to go to nursing school. I didn't know when I decided to become a nurse almost two decades ago how much it would allow me to see the world. I'm sure you will find nursing much more flexible than most any other occupation you could have chosen.

Negotiate Your Package
Second, although each agency offers its own version of payments and benefits most of the packages are negotiable. For instance, you can choose to be paid hourly with or without benefits. If you choose not to have benefits you will receive a higher hourly rate of pay. If you choose to have the agency "provide" benefits then your rate of pay will be reduced. The same is true with the sign-on bonus. If you choose to have a sign on bonus (usually up to $3,000 for a 6 month assignment) your salary or hourly rate of pay will be decreased.

It has been my experience that when the ads say "Make $XX,000 per year", they are talking about the entire package (i.e. gross pay, benefits, sign-on bonus, moving and housing allowances, etc.).

Salary vs. Hourly
Most agencies will encourage you to stay with them long term by offering a higher yearly salary than you would make being paid hourly. I usually choose to be paid hourly because I like the freedom of going where I want when I want and don't like to be tied to one agency. It is really a matter of preference.

Overtime Usually Not Included
However, the ads are usually not calculating money you can make working overtime in their yearly figure. A standard work week is 36-40 hours. Most facilities will allow you to work overtime which is over and above what the ads are including.

I personally know of several travel nurses who work 5 twelve hour shifts per week for 3 months and then take two months off between assignments.

Congratulations
I offer my congratulations to all those who are graduating nursing school this semester. Good luck in the future and keep travel nursing in mind.

P.S. if you haven't found a nursing dress for graduation, check out these nursing dresses for sale.

A Mistress A Day Keeps the Doctor Away

I'm no Dr. Laura, but I can only guess what she would have to say about a male patient I had to take care of the other day. He had injured his back and right leg after falling off a latter at work.

His wife had slept on the pull out bed in his hospital room the night before my shift and was giving him a sponge bath when I first visited his room. Later she spoon fed him breakfast and lunch even though he was able to feed himself. After spending the entire day waiting on him I heard her say she needed to go home to fix dinner for the kids. I can only assume she meant THEIR kids. Although appearances can often be misleading, she seemed to really love her husband and when she left I thought to myself "what a wonderful relationship they have."

About thirty minutes after his wife left I overheard him on the phone telling someone "She left already. Come on up." As I walked out of his room ten minutes later I passed a skanky dressed woman walking in. On my next visit to the room the woman was sitting on the bed next to my patient with her hand in his lap. The man didn't even seem a little embarassed by the fact that I knew his little secret.

Maybe his wife knows about his mistress. Although I usually try not to make judment calls about my patients, it sure was hard to look at him the same way after finding out about the other woman.

As my shift came to an end the two asked me if I wanted to use some tickets they no longer needed to a show at the Civic Center that night. I took the tickets, but I still don't approve of their relationship.

How I Select A Travel Nursing Assignment

This post is in response to a number of e-mails I have received this week asking me about how I select my travel nursing assignments.

Let me start by saying I am currently registered with more than a dozen travel nursing agencies although I have used only two or three of them during the last year or so. I keep my paperwork up to date with all of the agencies. This allows me to receive e-mails from all of the agencies detailing the available travel nursing assignments . I have previously posted one of the e-mails I received last summer with a listing of assignments on it here. That e-mail is typical of all of the agencies.

Select Your Location First
The first thing I do is select where I want to take an assignment. Being registered with so many travel nursing agencies increases the likelihood of finding an assignment in any location I choose. So far the only difficulty I have had in finding an assignment has been when I have wanted to work in smaller towns with smaller facilities. I have never had a problem finding assignments in cities with more than 30,000 people.

My husband and I have used a number of methods to choose a location. We have picked some locations after visiting them on vacation (Knoxville, TN), some because we just wanted to see what it would be like to live there (Bellingham, WA), some to be near relatives for the holidays (Jacksonville, FL) and some for the money (Orange County, CA). It has been my experience that anywhere you choose there will be at least one medical facility that hires travel nurses.

If you are not sure you will like the location you have chosen ask your agency for a shorter 3-4 week assignment. It is my understanding that some agencies will work with you on the length of the assignment. Most assignments I have taken have been 6 weeks or longer.

Select An Agency
You do not have to limit yourself to one agency. I have come up with several checklists I use when registering with an agency. The checklists deal with Contract Terms, Housing Stipends, Medical Facilities, Benefits and Insurance.

I hope this e-mail has answered the e-mails I have received this week.

First Field Trip of the Year and No Emergencies

I've always thought it was interesting how states appropriately spend so much time making sure we keep our seatbelts on and our kids buckled, but allow 60 students and 5 adults to cram three people to a seat on a little yellow bus with no seatbelts and limited supervision. But that is not the subject of this post.

Yesterday was a lot of fun. I took a day off work and traveled with my oldest son and two 5th Grade classes to the Little Grand Canyon on a geology field trip. Don't worry. I didn't make him sit with me on the way up. I really don't think he would have minded, but I remember when I was that age what it was like to have a parent chaperone school activities.

I rode on the bus on the way up because one of the kids has juvenile onset diabetes and another severe ADD. The child with diabetes had to have a specific low calorie meal and diet drinks and had to check his blood sugar periodically. The child with ADD needed medication. Nothing a concerned mom could not handle but the school wanted someone with medical training. I also brought along inhalers and epi pens just in case. We didn't need them.

The Canyon was beautiful. There were a ton of dogwoods, chestnut oaks, hickory, wax myrtle and magnolia trees. Their leaves were turning red with the change of seasons and the acorns on the chestnut oaks were huge. The soil was a combination of red Georgia clay, sand and lava rock. I still don't know where the lava rock came from as Georgia is not really known for its volcanic activity.

One of the kids found a perfectly intact arrowhead made out of Kaolin (I think that is how it is spelled) which is the main ingredient in Kaopectate and cat litter. I wonder if the Native Americans of yesteryear knew about its medicinal properties. They probably did. In any case, the State Park would not let the kid take the arrowhead out of the park. Instead, they took a picture of the kid holding the arrowhead and they are going to mount the arrowhead on a plaque with his picture and put it on the wall at the visitors center. The arrowhead was apparently a rare find given the park ranger's reaction to it.

Well, it is back to work today. My shift starts at 2:00 p.m.

A Trip to the Mini Grand Canyon

Well. The summer came to an abrupt end this week. Overnight the temperature dropped 20 degrees, the wind blue in and the jackets came out of the closet. Those of you who live in the northern part of the country (or at least north of south Georgia) may say it's about time.

Gone are the four day getaways that come with having the kids out of school. Replaced by homework assignments, mad rushes out the door to get the kids to school on time and the oft used phrase around our house during the school year "Mom, I can't find my shoes." But with school back in session I also have a chance to accompany my kids on field trips as a parent/nurse. I am going on one such field trip with my oldest son (the one holding the aligator in the picture at the top of this page) to the "Little Grand Canyon" this week.

The Little Grand Canyon is a naturally created miniature replica of the real Grand Canyon. It's official name is Providence Canyon and it is located in Western Georgia.

I have been asked to accompany my son's class on their excursion because several of the students have medical conditions that require a nurse to be with them at all times. Although I hope my nursing skills are not required it is nice to be able to help out his class in this way. I will post some pictures of our trip when we get back.

Travel Nurse: Summer Agency Assignments

The summer is almost here which means I am receiving numerous e-mails from several travel nurse agencies with their summer assignments and positions. I thought I would attach one of the e-mails I received today with a list of the available assignments. Enjoy!

AN E-MAIL FROM ONE OF MY AGENCIES:

Hello Everyone

My needs are finally here for spring and into summer for OR Techs, LPN's and
RN's nationwide. I have listed the top money positions, a couple with bonuses,
and some that are accepting one year contracts.

In addition to these I have a ton of positions in TN, IL, FL, CO, AZ , TX and
WA opening up. And as usual we have needs in all areas of California for summer.
Come work per diem for 4 weeks and stay by the beach. Let me know if you are
interested ASAP, as these jobs are going fast . Where do YOU want to go?

Hospital: Tucson Medical Center Tucson, AZ
Location: Tucson, AZ
ICU
Days and Nights
Pay: 30's
other areas include completion bonuses up to $6000

Hospital: St. Francis
Location: Lynwood, CA
ER & Labor and Delivery
Night
Pay: High $30's

Hospital: Mendocino Coast Dist Hospital
Location: Mendocino
L&D
Night
Pay: High $30's

Hospital: Eisenhower Memorial
Location: Indio, CA
1. OR RN
Evening/Day shift
Pay: 35 hour
2. CCU/ICU RN
Days and Nights available
Pay: 35/hour (1-2 year contracts also available)

Surg Tech positions $20-23/hour
Englewood, CO
Bristol, CT
Albuquerque, NM
Fort Pierce, FL
Kingman, AZ
San Fran, CA

LPN positions $20-24/hour
Easton, MD Med Surg

Sincerely,

[NAME REDACTED]

Travel Nurse: Checklist (Work Facility Follow-Up )

As I come to the conclusion of another travel nurse assignment I feel I need to write a follow up to my Work Facility Checklist. This follow up was prompted by a number of aggravating experiences I have had while working at my current facility. One such aggravating experience deals with the facility removing the cap on the number of patients facility nurses were required to tend.

Here is my revised checklist with questions you will want to ask about your travel nurse assignment before you sign with your travel nurse agency. You may also want to look at my travel nurse housing stipend checklist and my travel nurse salary, insurance and benefits checklist.

YOUR FUTURE WORK FACILITY
Questions for the agency:
1) Has the Agency previously provided travel nurses to the facility?
2) Has the Agency received any negative reports or feedback about the facility from travel nurses who have previously worked at the facility?
3) What is the nurse/patient ratio and is there a cap on the number of patients you will be required to handle? You will definitely want to have a cap included in your contract with the Agency. If the facility subsequently removes the cap you will at least have your Agency contract cap to fall back on.
4) If there is a conflict in your Agency contract and facility policies which takes precedent?
5) What type of scheduling is done (weekly, monthly, quarterly)?
6) Will I work in 4, 8, or 12 your shifts and am I required to work weekends and holidays?
7) What are the facility's orientation procedures?
8) Do I need any special licensing to work at the facility?
9) What type of charting system is used?
10)Will I be required to be "on call"?
11)Will I be able to or required to work overtime?
12)Who do I contact (the facility, my recruiter, my employer, other) if I have a problem or an important issue to discuss?
13)Is there an agency representative available 24 hours a day, 7 days a week?

Most Travel Nurse Agency representatives I have worked with can answer these questions over the telephone, but you will want to make sure the answer you get is included in your contract. I have heard other travel nurses say "If it isn't in writing the conversation never happened."

Travel Nurse: My Heartfelt Condolences to Family and Friends

Like most of the people I know, I have been struck with horror since first hearing about the shootings at Virginia Tech yesterday. To those who may have been in some degree directly impacted by the tragedy I offer my heartfelt condolences. You are in my prayers.

With Love,
Amy

Travel Nurse: Long Time No Blog

It has been awhile since my last serious post...and for good reason. Work has been hectic. You may recall me posting about the conflict between my travel nurse contract provision limiting the number of patients I am required to handle and my assignment hospital's new policy of an unlimited patient load. Since that post I have had several run-ins with hospital administration. Anyone who has had a similar run-in knows that you never really win. It is a constant battle. Every other shift the issue comes up and every other shift I am required to look like the bad nurse who doesn't care about the other nurses on the floor. All I can say is "I didn't sign on to be worked to death. I signed on for the fun of travel."

On a more pleasant note, our family took another mini-vacation. This time to Navarre Beach, Florida. You may recall that Navarre was wiped out by multiple hurricanes the year before Katrina hit Nawlins. Even though several years have passed there is still a lot of work left to do. The most popular beach in Navarre is on an island. You have to travel over a half mile long bridge to get to the island. On one side of the island the waves were about 2 to 3 feet high. Our boys had a great time swimming in the surf. My husband went to Wal-Mart and bought one of those blow up sleeping beds for the boys to play on. We have found that those beds are larger and much tougher than your average kids raft and cost the same in most cases.

We were in Navarre for three days. Each day we would spend half of the day on the side of the island with the waves and the other half on the side facing the Navarre coastline. On the Navarre coastline side the water is as flat as if it were in a lake. The girls are younger and enjoyed swimming without being turned upside down by waves. The flat side was also much clearer than the other side. We caught minnows with a net, hermit crabs and some tiny blue crabs. There were also black birds with long necks diving under the water. Every now and then we would see one of the birds come up with a fish in its mouth.

You could also see huge chunks of asphalt in the water. The asphalt had apparently been a part of a huge parking lot that is now sunk underwater due to the hurricane. I would insert pictures here, but we forgot the camera for this trip.

I will try to do a better job of posting and keep sending the e-mails.

Travel Nurse Aim

Travel Nurse: Change of Shift is Up at Codeblog

I just read the latest edition of Change of Shift at Codeblog and I must say some of the most creative blogs I've read are those written by nurses. A limerick for St. Patty's Day is a nice touch.

Travel Nurse: He Jumped Out of A Moving Car!?

This morning a 35 year old man with more head, neck and you-name-it injuries than I can count was moved to my floor from the E.R. The man had jumped out of a moving car going 75 miles per hour on the interstate. A Dare maybe? No. Something wrong with the car's brakes? No. Drunk perhaps? Well, that has something to do with it even though it was 7:00 in the morning when he jumped out of the car.

Apparently the man and his girlfriend had been drinking throughout the night. When dawn finally came they decided to climb into their car and drive home on the interstate while still intoxicated. During the course of the drive home the man and his girlfriend got into an argument and she told him she was through with him. This was the straw that broke my poor, alcoholic patient's back (literally). In a fit of passion (or stupidity) he flung open the passenger's side door and jumped. The man cracked his skull, broke his back and lost much of the skin on his body. He is likely not going to survive past the weekend.

Now you may think I am being a little flippant with my treatment of this patient's current medical state. But consider this: I found out from his relatives that this was the third time he had jumped out of a moving car (though not going quite so fast) after being dumped by the same girl. Combine that with the fact that he and his girlfriend were intoxicated while flying down the interstate and maybe my attitude in writing this post can be understood; though maybe still not justified.

Travel Nurse: Thank Goodness I'm with an Agency

Yesterday the hospital administration decided to break the news to the nurses. I had just clocked in and was about to start my shift when the nurse manager asked the nurse on the shift before me if she could stay 30 minutes longer. She then told me that an "emergency meeting" had been called and that I was to report to the conference room immediately. When the nurse manager walked away the nurse on the shift before me said "It's your turn to hear the good news." I asked her what she meant by that, but she just said "Oh, you'll see." I have been at this assignment long enough to know that meetings in the conference room are rare, and often mean something drastic is going to happen.

When I walked into the conference room the nurse manager, several people in suits and ties and about a dozen other nurses and nurse techs were already seated around a long table. The nurse manager started the meeting by saying "Now PROMISE me you won't quit once you've heard what I have to say." An ominous way to start any meeting. She then went on to say that the hospital's patient census is higher than it has ever been at the hospital, but that the hospital does not intend to add any more nurse/nurse tech positions. She said that the cap of 7 patients maximum per nurse had been a cap set by the hospital and that the hospital was now changing it. There would no longer be a cap on patient load. Nurses immediately started mumbling under their breaths.

The meeting was short and I could tell the nurse manager had been forced to make the announcement by the suits and ties. She didn't seem any happier about the decision to remove the patient cap than anyone else.

So what does this mean to me as a travel nurse? Fortunately, I have a contract with my travel nurse agency that limits the number of patients I can be required to tend to 6. The problem I now face is enforcing that provision. I now have to deal with the nurse manager's reaction when I remind her of the patient load limitations in my contract. That will probably be something I do tomorrow. And then there are the other nurses' reactions when they find out about my contract. Just one of the things you have to deal with as a travel nurse I guess.

Oh, and by the way, as for the nurse manager's request not to quit. I saw two nurses thumbing through the employment section of the newspaper yesterday during our shift. This should get interesting.

Travel Nurse: Change of Shift

Change of Shift is up over at Emergiblog. Check it out and, as Kim says, bring your kleenex tissues.

Americus, Georgia: Another Tornado Disaster

The devastation is incredible. My husband went to Americus, Georgia with a group from our church today. For those of you who don't already know, Americus was devastated by the same system of tornadoes that hit Enterprise, Alabama. Around 17 tornadoes hit Americus and wiped out the hospital, several large businesses and hundreds of homes.

I have heard that as many as 8 people were killed in Americus, but I don't know for sure.

The crew said the pictures just don't do the magnitude of the destruction justice. The first picture is a picture of the first house my husband and his group worked on. The owners of the home were elderly. One of the problems with their situation is that they were told insurance will not pay for their yard to be cleaned. Not even if trees are completely blocking the entrance.

The man in the picture below is 74 years old. My husband said he worked harder than anyone and didn't slow up all day.

The crew at the end of the day. My husband is the one at the end on the right.

These elderly ladies live in the first house the crew cleaned. Smiling faces after the clean-up.