Travel Nurse Aim

Travel Nursing Contract - Always Get it in Writing!

2012-01-17T20:05:00.000-08:00

I recently received an email from an upset travel nurse who had been shafted by her travel nurse company during her first (and last) travel nursing assignment. She said her recruiter tried to talk her into taking a "weekend option" position at a hospital working two 12 hour shifts every Friday and Saturday night. Her pay would be $37/hour. After a little research she decided she really liked the hospital and location, but not the idea of working every weekend, and only 24 hours per week. She eventually reached an agreement with her recruiter to work every other weekend for 36 hours per week for lower hourly pay ($30/hour). Her recruiter also agreed to allow her to take her daughter's birthday off.

Get Every Detail In Writing
After verbally agreeing to the terms of employment, this nurse signed a contract with the travel nursing company. However, instead of stating exactly what she and the recruiter had agreed upon the contract stated: "Travel Nurse will be expected to work every other weekend if needed."

When she arrived at the hospital, she was given a work schedule which had her working every weekend instead of what she had agreed upon with her recruiter. When she told the unit manager she was contracted to work every other weekend, she was told the only way she could get full time hours would be to work every weekend. She was also required to work on her daughter's birthday, Christmas Eve and Christmas Day! All in violation of what she had discussed with her recruiter.

She contacted her agent at the travel nurse company, but couldn't reach her agent for over a week. When she did get her agent, she was told nothing could be done about the work schedule except to get another travel nurse to cover the days she wanted off. She was irate.

We all know that travel nurses are brought in to fill scheduling gaps, but let's be honest...this nurse was given the old "bait and switch" by her recruiter. The moral of the story is: Make sure you get every detail in writing. Read the contract over. If there is more than one way to interpret a provision assume the agency or hospital will interpret it different from you.

Know Your Recruiter
Also, don't contract with a travel nursing company unless you have an excellent relationship with your recruiter. Go with your instincts on this. My instincts have served me well when dealing with recruiters. If you have trouble reaching him or her before the assignment, chances are, you will have more trouble during your assignment.

A Seizure A Day Will Keep the Nurses Away

2012-01-11T10:45:00.000-08:00

Let me see you fake another seizure!

Some guys will do anything to get a woman to touch them. Last night while on shift I noticed several nurses running into a patient's room. Feeling my help might be needed I too ran into the room. When I got there I saw the door to the patient's bathroom open and the patient lying naked on the floor of the tub having an apparent seizure. The nurses had turned off the shower and were patting the patient down with towels to dry him off.
I started to ask what I could do to help when a male doctor walked in. Sensing something wasn't quite right about the patient's "seizure," the doctor called out the patient's name and asked him what was going on. The patient temporarily halted his seizure and turned and looked at the doctor. He then went back to his "seizure," apparently hoping everyone had just missed his seizure "time out." Too late. The doctor had called his bluff.

All of the nurses, myself included, were in a state of shock. Who fakes a seizure just to have a bunch of nurses touch your naked body? One of my male co-workers says "It depends on the nurses." One of the nurses responded "Next time you get to dry him off."

Crazy stuff.

Being a Travel Nurse Near the Beach

2012-01-11T10:41:00.000-08:00

St. George Lighthouse

South Georgia certainly has it's perks. The biggest one, at least to me, is the close proximity to Florida's panhandle beaches. Some of the nicest beaches I've ever been to are located in the panhandle. My family took a winter beach trip this past November. At first when my husband approached me about going to the beach during the winter, I thought he was crazy. The beach? Really? You can't swim, or even wear a bathing suit this time of the year. Why would I want to go there? I couldn't have been more wrong.

St. George Island
We decided to rent a beach house on St. George Island, Florida. St. George Island (or SGI as the locals call it) is just off the coast of Apalachicola in Franklin County, Florida. As soon as we pulled up to the beach house my girls tore off their clothes, put on their bathing suits and headed straight for the freezing cold water. For most of the day they ran in and out of the surf with their blue lips and chattering teeth. We got a few strange looks from some of the older people at the beach. Apparently a lot of snowbirds go to St. George Island during the winter months because the rates on beach houses are 1/4 the normal rates. Some couples spend months on the island during the winter. It is also apparent that they are not used to seeing kids spashing around in the freezing cold surf.

St. George Bayside

We brought a golfcart with us so we could cruise on the beach with the kids. We found all kinds of cool conch shells and even saw a large dead octopus! As the sun was going down, the kids used the golfcart to gather drift wood for a bonfire. My husband was able to light the bonfire despite the fiersome wind. It was amazing. There's nothing like a night beach bonfire. All that was lacking was a guitarist for a little Cumbaya. :)

Tax Free Travel Nursing Benefits

2012-01-10T08:44:00.000-08:00

Tax Free Travel Nursing Benefits - In conjunction with my post on keeping a Permanent Tax Home, this post deals with what is required to have your reimbursement for travel costs (like meals, transportation and housing) be non-taxable. You have to start by looking at the way the IRS views travel related payments from your travel nursing company. The IRS views travel related payments from your travel nursing company as either (a) income (and, therefore, taxable) or, (b) non-income reimbursement (and, therefore, non-taxable). By way of example, if I am a non-travel nurse and I drive 20 miles to work each day and my hospital agrees to pay for my costs to make the trip, the IRS will deem that payment to be taxable income and not a non-taxable travel reimbursement. Why? Because 20 miles is a commuting distance which the IRS does not view as a travel expense.

How do I Qualify my Travel Expenses for Tax Free Treatment?
The IRS uses three primary factors in determining whether a travel nursing company can reimburse you for nontaxable travel expenses.

Do you have a permanent tax home? You can read more about a Permanent Tax Home here. The travel nurse must have a permanent tax home.
The travel nursing assignment cannot be within commuting distance of your Permanent Tax Home.
The travel nursing assignment (including extensions) cannot extend beyond a one year period.

What if you don't meet these requirements?
Permanent Tax Home - If your situation is such that you do not have a Permanent Tax Home then all of the travel related payments you recieve from your travel nursing company are taxable. This includes all meal per diems, mileage reimbursements, housing allowances or company paid housing costs. These items would be subject to payroll tax withholding.

Commuting Distance - The same conclusion as that in the above paragraph is reached if you live within commuting distance between your Permanent Tax Home and your healthcare facility. Most travel nursing companies will not even offer reimbursement if you live within commuting distance.

One Year Time Limit - At the time you become aware that your assignment will extend beyond one year, all of the travel related expense reimbursements you recieve become taxable income.

Most travel nursing companies have a recruiter who can assist you in determining whether you qualify for non-taxable travel reimbursement. You may also want to contact your accountant if you are still not sure.

Travel Nursing in Alaska

2012-01-08T22:39:00.000-08:00

A Long Distance Travel Nursing Relationship

Last week at the hospital I met a guy who's wife was travel nursing in Anchorage, Alaska while he stayed behind to work in the Southeastern U.S. Now that is a long distance relationship! His wife had always wanted to go to Alaska and she didn't care whether he went with her or not. He said the two of them didn't really mind living apart from each other for a few months because the travel nursing company she worked for paid for him to fly out to Alaska once every month to visit. The travel nursing company was happy to do this because by keeping her in town (and, therefore, at work), she was able to make more money for herself and her travel nursing company. A win-win proposition.

Salmon Fishing and Travel Nurses in Alaska

He also said that there is a real need for travel nurses in Alaska. One reason for this need, he said, was due to the seasonal shortage of nurses around salmon fishing season. Apparently during salmon fishing season a lot of the local nurses decide it is more lucrative to catch and smoke salmon for the year than show up to work. Many Alaska hospitals then have trouble getting the nurses to come in to work.

Northern Lights
One thing he and his wife got to experience this past March was seeing the Northern Lights (Aurora Borealis). He said it was something she will definitely never forget. Since she worked twelve hour shifts, she was able to do a lot of sightseeing on her days off. On some wildlife hikes she got to see mountain goats, caribou and moose, etc. I absolutely love being out in nature and seeing unusual animals I have never seen before. I can't imagine how cool it would be to get to go on an assignment like this where the wildlife is so abundant and unusual. Alaska is on my list of places to travel nurse.

Benefits/Pay
He couldn't remember the name of the agency his wife was working for, but he did say that the pay was really good, they had great medical benefits and even provided her with a rental car for the entire assignment. The housing was top-notch and they paid her utilities, among many other things. Alaska is starting to sound really good to me. Kids, start packing your bags. School's out in June.

Cirrus Medical Staffing

2012-01-07T15:33:00.000-08:00

Several recent e-mailers have asked me whether I prefer larger travel nursing companies to smaller ones. My take on the size of the company is that it depends on what you are looking for. I have felt lost in the shuffle at times working with a larger company, but sometimes the benefits outweigh going with a smaller company.

I have decided to start critiquing different agencies starting with Cirrus Medical Staffing (smaller), Freedom Healthcare Staffing (JCAHO Certified), American Traveler, Cross Country Travcorps and Expedient Medstaff.

Expedient Medstaff Travel Nursing Company

2012-01-06T18:15:00.000-08:00

Maclay Gardens, Florida

Expedient Medstaff is a Michigan based travel nursing company run by registered nurses. You can read my article on Exedient Medstaff as part of my series on travel nursing companies at TravelNurseAim.com.

Permanent Tax Home and Travel Nursing

2012-01-02T13:03:00.000-08:00

Nebraska Windmills

One major benefit to being a travel nurse is the tax free treatment given to travel expenses and housing. When you take a travel nursing assignment away from home, any payments you receive from your travel nursing agency are viewed as reimbursement by the IRS and not as income. But this is only the case if you maintain a Permanent Tax Home separate and apart from where your travel assignment is located.

What is a Permanent Tax Home?
A Pemanent Tax Home is the city or area where the travel nurse maintains his or her regular place of business. It is important for a travel nurse to maintain a separate Permanent Tax Home because without doing so, any travel or housing related payments received will be taxed by the IRS as income.

For example, if I have a Permanent Tax Home in North Carolina and I am on assignment in California the payments my travel nurse agency gives me are non-taxable. The IRS views these payments as reimbursement for travel and housing. However, if I decide to pull up roots and leave North Carolina then my new Permanent Tax Home is likely to become California or some other subsequent travel nursing assignment. In this situation, any payments I receive from my travel nurse agency will be viewed as taxable income and not reimbursement.

Questions Used to Determine Permanent Tax Home
At least two of the three following questions must be met in determining where your Permanent Tax Home is located.

First, does the travel nurse perform at least a portion of his or her work near the home and use thathome for lodging while working in the area?

Second, does the travel nurse have living expenses (mortgage, rent, utilities, etc.) at the permanenttax home that are duplicated while the traveler is on assignment away from home?

Third, does the travel nurse have members of the family living at the permanent tax home, use the home frequently or otherwise not abandoned the home?

Failure to satisfy at least two of these factors will render the travel nurse an "itinerant worker" and the tax home will be deemed to be where the travel nurse is working. Itinerant Workers are never viewed as working away from home.

Satisfying two of the three factors, however, does not automatically mean a permanent tax home exists. If two of the three factors are present, the IRS will look to the following factors in determining the existence of a permanent tax home:

The travel nurse's tax home address is the same as that used for his or her professional license.
The travel nurse's tax home address is the address of record for filing income tax.
The tax home has phone service or is the travel nurse's primary mailing address.
License plates and driver’s license are registered in the tax home city.
The primary banking relationship is in the vicinity of the tax home.
The travel nurse is registered to vote in the tax home precinct.
The travel nurse belongs to a church, club, or other associations in the tax homevicinity.

For more information on the importance of establishing a Permanent Tax Home, contact your travel nursing agency.

How I Became a Travel Nurse

2011-12-26T19:01:00.001-08:00

St. George Island, FL

I am often asked whether there is more schooling required to become a travel nurse than a non-travel nurse. My answer: Not usually. The amount of schooling is not what travel nurse agencies really care about. Instead, most travel nurse agencies prefer that you have a certain amount of work experience before taking a travel nurse assignment. When I first started as a nurse 16 years ago most travel nurse agencies required one year of experience in your nursing field. It is probably less than that now.

I Met a Travel Nurse Living in the Hospital Parking Lot

One evening after one of my shifts I walked with several other nurses out to the parking lot. When we reached the lot I saw one of the nurses walk over to an RV, open the door and go inside. At first I thought it was the Blood Mobile. Curious as to why the Blood Mobile was still drawing blood in the parking lot at 10:00 p.m., I walked over and knocked on the side door of the RV. The nurse opened the door and I asked her if she was giving blood. She smiled and said "No. My mom and I actually live here while I complete my travel nursing assignment."

Over the next six weeks I got to know the travel nurse well and was able to pick her brain about life as a travel nurse. She told me she had never married and that her father had passed away a few years earlier. Not wanting to sit around while life passed them by, she and her mom decided to hit the road to see America. Kind of a bucket list deal-e-o. She had become a travel nurse to fund their sight seeing. They decided to buy an RV because her travel nurse agency gave her a housing stipend, but allowed her to spend it any way she wanted. She chose to buy an RV and put the money toward paying for it. She projected she would have the RV paid off in three years. Not a bad idea.

After she left our hospital, I decided to look into travel nursing myself. The rest is history.

Travel Nurse Aim Named Top 20 Nursing Website By Jacksonville University School of Nursing

2011-12-09T14:18:00.001-08:00

Travel Nurse Aim was recently named a Top 20 nursing blog by Jacksonville University School of Nursing. Thanks for the recognition JU.

Travel Nurse Aim Responds to Nursing Student Query

2011-11-29T07:51:00.001-08:00

I Love Riding Horses

I recently received an e-mail from a first year nursing student asking about becoming a travel nurse. I thought other nursing students might have the same question so I asked her if I could post her e-mail for everyone to see. She agreed. The following is her e-mail and my answer:

Nursing Students E-mail

"Hi Amy,

I'm Japhia, currently a Year 1 nursing student. I'm really interested in knowing what a travelling nurse does! I'm going obtain a degree in 3 years' time, but what I would like to know is that did you have prior experience in the hospital before you become a travel nurse? Is it advisable to become a travel nurse straight out of school? Thank you for leaving your contact for people like me to ask you stuff :)

Best Wishes

Japhia"

Travel Nurse Aim's Response

"Japhia,
Most travel nursing agencies require you to have several years of nursing experience before they will give you a traveling assignment. They spend a lot of time developing relationships with their host hospitals and want to make sure the nurses they are placing can do the job they are assigned to. In most cases, travel nursing agencies prefer that you have some type of certification in an area of specialty. I did not start travel nursing right out of school so I do not know whether excellent grades or something else might substitute for the desired certification.

I would suggest contacting a travel nursing agency and asking them whether they will take you right out of school. If they won't, I would suggest contacting a hospital in the area where you would like to work once you graduate to see if they will pay for a portion of your schooling if you commit to work at their hospital for a certain number of years once you graduate. This will give you a chance to become certified in an area of specialty and have at least a portion of your schooling paid for. I make this suggestion based on my own experience. I graduated from nursing school owing nothing and then was paid a good starting hourly wage just for commiting to work for a hospital for three years.

Thanks for reading,

Travel Nurse Aim"

Travel Nursing Checklist

2011-11-21T18:32:00.001-08:00

Even a seasoned travel nurse like me can forget to update the certifications and licenses needed for my next travel nursing assignment. The last thing you want to do is show up at a new assignment and find out your new state requires you to take an exam to get a nursing license rather than by endorsement. The following is a checklist of the documents I bring with me to each new assignment:

(1) A nursing license valid in the state you are going to be working in. Without this you will be the most overqualified janitor at your hospital until you get your license.
(2) Any Certifications you may have in the field you want to work in. Certifications may not be required to work in your field at your current hospital, but many travel nurse agencies prefer that you get certified in your field before starting an assignment. I think this is so the travel nurse agency can show they properly vet their nurses.
(3) Your Basic Care Life Support card.
(4) Your Immunizations.
(5) Driver's License (or ID Card) and Social Security Card.
(6) References. It is a good idea to get a written reference from a supervisor at each of your past hospitals. I tend to collect them. If one of my supervisors is particularly pleased with my work I will ask them to put it in writing. That way I can take it with me and use it for my next assignment.

Travel Nurse Payscales

2011-11-14T12:50:00.001-08:00

Camp Rockmont, NC

The following is an exerpt from an interview I did with Payscales.com some time ago about what it means to be a Travel Nurse. Take a look.

What is the average traveling nurse salary?
Depending on your location you can earn an hourly wage of $30 to $40. Typically, California pays more, but the cost of living is higher. Sometimes the benefits are a major part of a traveling nurse salary. For example, you can negotiate with your agency to pay for your relocation, utilities and a sign-on and renewal bonus.

Traveling Nurse Job Description:

The duties of a travel nurse are very similar to those of a non-traveling nurse. I am currently on an Orthopedic and Neurology floor where I attend 5 to 7 patients per 12 hour shift. When I first arrive at work, I am given a report of the status of the patients I am going to attend from the nurse on the shift before mine. The report generally includes the name, age, current medical problems and medical history. After the report I visit each of the patients to introduce myself and assess their conditions.
During a typical shift, I am required to administer medicine (oral, via injection, etc.), document medical information, receive and discharge patients, coordinate patient care with other departments such as physical therapy, respiratory therapy, speech therapy and others. Sometimes a patient will “Code” which means they go into respiratory and cardiac arrest.

For instance, last week a patient on my floor stopped breathing after a tracheotomy was removed from his throat. The patient stopped breathing and did not have a pulse. I started CPR on the patient and had to do mouth-to-mouth resuscitation using a plastic device that has a valve to allow air into the patient’s lungs, but prevents the patient from exhaling back into the nurse’s mouth. After thirty minutes of CPR, the patient’s pulse returned and the patient recovered.

In addition to the traditional nurse duties, I also have to deal with several traveling nurse employment agencies I work with. That can require filling out paperwork, moving from assignment to assignment, negotiating contract provisions, etc.

What were your steps in choosing a traveling nurse career?
The schooling required to become a travel nurse is the same required for a non-traveling nurse. However, most agencies require you to have worked as a nurse for a certain amount of time before taking a travel assignment. When I first started as a nurse 12 years ago, the time required was one year. It is probably less than that now, given the need for nurses around the United States.

The way I found my first agency was word of mouth from another travel nurse I worked with. I have also searched Google and clicked on Google ads for travel nurse agencies. I find it best to contact a number of agencies before making a decision. Not all agencies have contracts to provide travel nurses to all facilities. It is best to pick a facility and then see which agency supplies that facility. Also, three of the agencies I use send me updates of jobs and locations via e-mail and some call me.

What are the drawbacks and benefits of a traveling nurse career?
Some of the benefits of working as a traveling nurse include being able to visit different parts of the country every 6 weeks and going on little mini-vacations. I also have my agencies pay for my relocations, utilities, housing and bonuses. Depending on the length of my assignment, my agencies will pay up to $3,000 to take an assignment.

One of the biggest disadvantages is having to deal with two different employers (my agency and the assignment facility). The provisions in my agency contract often conflict with the rules of the assignment facility. I recently ran into a problem when the facility I am now working in required me to attend a larger number of patients than the number outlined in my contract.

Also, when a non-travel nurse finds out I am a travel nurse they automatically know that I am being paid more to do the same job they are doing. This can result in resentment, but often creates an interest in the non-travel nurse to check into travel nursing.

What advice would you have for those interested in a traveling nurse career?
The job outlook of a travel nurse is GREAT. There are now numerous travel nurse agencies recruiting travel nurses. The competition among agencies has driven travel nurse salaries and benefits up. I would advise anyone who wants to be a travel nurse to start out by taking a shorter assignment; maybe 6 weeks or so. Also, make sure you have everything in writing that you discuss with your agency representative. Remember: if it isn’t in writing, it never happened.

Name: Amy Robbins
Job Title: Traveling Nurse
Where: Tallahassee, Florida
Employer: Multiple Agencies
Years of Experience: 12
Education: Darton College in Albany, Georgia
Salary: A traveling nurse salary depends on where the assignment is located. (High hourly wage of $40, low of $30)

Travel Nurse Aim Gets Her Teeth Pulled

2011-11-07T19:51:00.000-08:00

It isn't easy for a nurse to be a patient. At least not this nurse. Just ask my husband who has tried to take care of me the past few days after having my four Wisdom teeth pulled. Of course, he hasn't exactly helped his cause. He told me I now look like a chipmunk. I do, but he doesn't have to say it. He told me my "Wisdom" teeth weren't working anyway so why not have them taken out. That may have been funny at one time, but not right now.

Me Several Days After the Surgery

In response to his "jokes," I have retaliated by getting him up at all hours of the night the past few nights. He gets my medicine, mixes and warms salt water for swishing, wraps ice packs in handkerchiefs (the ice packs are just too cold on my face), and runs various other odd jobs for me.

Brian Regan Comedy
While I was being prepped for surgery my husband reminded me of the Brian Regan comedy routine "Say Eight" where Brian goes to the ER with some kind of stomach pain or something. When the nurse asks him to rank his pain from 1 to 10 the first thing that came to his mind was what he had heard about giving birth being the most painful thing anyone could experience. He figured that the number 10 must be reserved for giving birth. He then remembers that a broken femur was also at the top of the list for pain so he figured a broken femur must be a 9. He also thought that if he didn't give the nurse a high enough number she would give him some Tylenol and tell him to get out of the ER. He figured he would go with the number 8.

He said the drugs they gave him for saying "8" made him feel so good he walked out of the ER yelling "Say Eight" to everyone.

I told the nurse I was an 8.

I hope the pain ends soon.

Travel Nursing: Stone Mountain Park Georgia

2011-10-29T14:34:00.000-07:00

Oh how I love a good vacation! Last weekend we went to Stone Mountain Park near Atlanta, Georgia where the same guy who carved Mt. Rushmore also carved a nine story high mural of three leaders of the Confederate states into a giant granite mountain. The carving is located in the middle of a cliff that drops straight down. My kids and I rode to the top of the mountain on a Swiss cable car. It was awesome! My husband wouldn't go because he is terrified of heights. He kept saying "I'll just stay here and watch you plummet to your deaths." I think he was trying to convince us not to go up. At least I hope so. Otherwise he is the meanest person on the planet.

You can see in the above picture how high the mountain is in relation to some fairly large trees. There is a train track running through the trees in the picture that goes all the way around the base of the mountain. We took a train ride around the mountain and most of my kids fell asleep.

The picture was taken from an adjacent mountain that slopes gently until it meets up with a river that separates Stone Mountain from the mountain where we took this picture. On Saturday evening people began pouring into the park and laying out blankets and chairs for the 45 minute lazer show they project over the carving. The lazer show was the highlight of the trip for me. It is actually more like a 3D movie than a lazer show. They play patriotic songs and songs written by Georgia artists like Ray Charles, Amy Grant, Gladys Knight, Little Richard, Ludacris, and Travis Tritt. At one point the lazers make it look like you can see into the mountain. They show dinosaurs, lava and other cool stuff that might be hiding in the mountain. They show the carved horses break out of their granite encasing and start to run. They shoot off fireworks during the show and end the show with fireworks. Really really neat.

A Potential Travel Nursing Assignment

Stone Mountain Georgia would be a nice place for a travel nursing assignment. It is near Atlanta and clean with nice shopping and beautiful jogging and walking paths. While we were there I thought to myself "What other profession guarantees you a solid job in the area and hospital of your choice, and an opportunity to take a vacation at the same time?" We'll have to see.

Travel Nursing Job: Licensure Requirments

2011-10-28T20:00:00.000-07:00

I have had a number of readers e-mail me with questions about what the licensure requirements are to become a travel nurse. I thought it might be helpful to put a fairly typical licensure section from a Travel Nurse Application on here for those who might be interested. This application was for a Travel Nursing Job in California.

Travel Nurse Application-Licensure

You can enlarge this picture and view it better by clicking on it.

Travel Nursing; An Idyllic Vacation?

2011-10-28T15:53:00.000-07:00

A fellow travel nurse wrote the following article for Travel Nurse Aim and asked me to publish it on my site. I told her I would, but without including the name of the author or any hyperlinks. She agreed. I am not sure if she is just new to blogging and wanting a critique of her writing style or if she is just trying to advertise travel nursing. The article appears to be more of an advertisement for travel nursing to me than stories of her own life. With her agreement, I have removed all hyperlinks to her commercial sites. Let her know what you think by posting a comment:

Her Article

Whenever I consider going on a nice, fancy vacation, all I can do is dwell on the costs. How much money I am going to be spending on this? What will I will have to show for it at the end of the trip? Sure, I might come back with some good memories, but am I willing to gamble $5,000 - $10,000 over it? Usually guilt takes over and I opt to stay at one of my parents' vacation rental houses since they let me go there for free. Don't get me wrong, they are pretty nice, but I've been going to these places since I was in the 2nd grade, and to me, a real vacation involves exploring new, exciting, long anticipated and never before seen (by me) territory...with as little cost as possible...of course!

What other profession guarantees you a solid job in the area and hospital of your choice, and an opportunity to travel to the vacation getaway destination at the same time? Oh, and you can take your family along too. And I forgot to mention that you can stay in a deluxe apartment for as long as you desire. Oh yeah, and you get paid well to do this.

Back to Her Article
If you don't want to be in an apartment, the company will give you a housing stipend (allotment of money) and you can stay whereever you choose. Some companies have just offered me a higher rate of pay. Just consider the tax breaks from housing reimbursements though.

I have known many travel nurses that have invested in $700,000 luxury RV's. They take the housing stipend and travel off to high paying assignments (like California) and get their RV's paid off in no time! The reason the pay is so high in CA is to compensate for the high cost of living in the area, but if you're providing your own housing (RV), then all the money you're making, plus the housing supplement (stipend) goes towards paying off your RV that you can take with you when you leave. Smart, smart!!

When I first started exploring the world of Travel Nursing, I came across statements like this:

Excellent Pay and Benefits
Free, Private Housing
Top Destinations
Work at the Finest Facilities

If you choose carefully and wisely, all of the above will become your reality. These benefits are just the tip of the iceburg as far as what some of these companies are willing to offer, but you'd better be sure you get it all in writing before you sign the dotted line.

Travel Nurse Aim: Plan or Scram?

2011-10-21T20:07:00.000-07:00

Okay, so "plan" and "scram" don't exactly rhyme, but if rock stars and rappers can get away with it why can't I? Besides, the two words seem to appropriately describe two different approaches taken by a couple of travel nurses I have recently met.

Plan

Wills

2011-10-15T20:05:00.000-07:00

Keeping Track of Your Will
Once you've taken the step to create a will and get your estate plan in order, you need to figure out what to do with the will itself. It is important to keep track of the location of your current will as well as any old wills.

Where to keep a will
The safest place to keep the original copy of your will is in a bank safe deposit box, but it may not always be the most practical. If the will is in a safe deposit box, it may be difficult for your family to access the box after you die. A better option may be to keep it at home in a fire-proof safe. Just make sure your family members know how to open the safe.

Some attorneys may keep the original copy of the will. But if you leave the will with your attorney, make sure the attorney receives updated contact information from you when you move. That way if the attorney moves offices or retires, he or she will know where to find you and you will know where your will is.

If you do use a safe deposit box or your attorney's office, you may want to keep a copy of your will at home with your other financial documents. It is usually not a good idea to give a copy to family members or friends because you may want to change the distributions at some point and may need the will back.

What do you do with an old will?
Once you have written a new will, your inclination may be to destroy the old will, but this may not be a good idea. If, for some reason, your new will is invalidated, the court may be willing to reinstate an old will rather than allowing your estate to pass intestate (according to state law). It is likely that your old will adheres more closely to your wishes than an intestate distribution. If the will is destroyed, it cannot be reinstated.

On the other hand, if you have made a major change in your will, by all means destroy the old one. Otherwise, someone who did better under the old will may argue that you were incompetent or under undue influence when you executed the new will. Also, their feelings may be hurt if they see a change in your sentiments towards them.

Making changes to a will
If you want to make changes to a will, do not mark up the will by hand, even if you have only small changes to make. A court could take a marked-up will as a sign that you intended to revoke the will. If you want to make a change, contact an attorney who can draft an amendment to the will (called a codicil).

Why Hire a Legal Nurse Consultant?

2011-10-02T15:56:00.000-07:00

I ran across this post titled "Why Hire a Legal Nurse Consultant?" and thought my readers my be interested. The post talks about how medical malpractice attorneys hire Legal Nurse Consultants to help them with their cases. Some jobs require the nurse to just review records and consult with the attorney and some require the nurse to actually testify in open court. I wouldn't mind looking over medical records, but open court just wouldn't be my thing.

Scorpions, Ticks and Seizures, Oh My!

2011-08-11T15:53:00.000-07:00

Another summer and another week spent playing camp nurse. This time in the backwoods of humid, muggy, mosquito ridden North Florida at an all girls camp where drama and intrigue were the rule and not the exception. It is amazing to see how quickly teenage girls can go from trying to scratch each other's eyes out to hugs and kisses and everything's fine.
The Scorpions
I spent most of my week dealing with stomach aches (aka I'm homesick but they don't send you home for that), PMS, insects and passing out ADHD and asthma meds. Until camp I had never had to deal with a scorpion bite. One of the counselors who was staying in my cabin decided to take a dip in the pool one afternoon. After going swimming she placed her shorts out on the front porch rail to dry. When she brought them back in later that night and put them on she felt a sharp, sudden pain in between her thumb and forefinger. After a loud shriek, she looked down and there was a large scorpion clinging to her shorts!

All I could think was "that sure is a big scorpion and Indiana Jones says the bigger the scorpion the less likely it is to kill you." That was the first time I had ever turned to a big screen action hero for medical advice. The picture above was taken just minutes before she stomped the guts out of it. Yikes!

I disinfected the area that had been stung, applied some antibiotic ointment and a band-aid and gave her 50mg of Benadryl. She was fine by the next morning.

The Ticks
I could not believe all the ticks! There were a lot of deer in that area which may account for why there were so many ticks around. Ticks apparently love deer. The only thing that surprised me more than the number of ticks was the way these southern girls acted when they saw one. Many of them were just terrified. Of course, when I think of the fact that ticks look like tiny spiders that latch onto you and suck your blood until they are the size of a small red grape maybe I should cut the girls some slack. Who could ever really get used to that?

The Seizures
I made a lot of friends. One in particular was a young girl with a history of seizures who just about scared me to death. The first night she seemed to be having an aura of symptoms that made me suspect that she was about to have a seizure. When I phoned her mother, she told me that she was "probably about to seize." Oh, great! Needless to say...I did not let this child out of my sight the entire week, and thank goodness she never did seize.

I'm glad I got to go. I may go again next year!

Travel Nurse: Checklist (Insurance and Benefits)

2010-08-21T10:53:00.000-07:00

We need to make sure we find out all we can before we're on the road. Before we sign that contract, pack our bags, and wave good-bye to friends and co-workers, we need to ask a lot of questions. I mean, who wants to put their license in jeopardy, or get stuck in a crappy situation with incompetent or no help?

My next three posts will include a series of checklists that some of you might find helpful to utilize before taking on a new assignment. I recommend printing this and the next two posts (about checklists) out so you can have them in hand before you call or interview with your potential agencies and facilities. Here are some questions or FAQ's every travel nurse needs to ask :

INSURANCE

Ask the agency:
* Will I have insurance coverage (malpractice, life, medical, dental)?
* What are the cost and coverage for each type of insurance (maximum out-of-pocket expense, date of eligibility, premiums, and deductibles)?
* When does coverage begin for each? Who's covered? What's covered? Are existing conditions covered? If not, when will they be covered?
* Will I have a choice of health care providers and hospitals?
Can I use the insurance when I travel to other states or countries?
* Will I lose the coverage if I take a break between travel nursing contracts?

OTHER BENEFITS

Ask the agency:
* Are there other benefits and bonuses? 401(k)? Loyalty program? Continuing-education or travel reimbursement? Sign-on bonus? Completion bonus? Larger bonus for longer stay or for hard-to-fill position? Bonus for referrals?
* Does the agency offer meal allowances? Travel awards? Vacations? Special payment arrangements for items or conveniences important to me?
* If the agency pays bonuses, when would I qualify for one? What conditions must I meet to qualify for it? When would my bonus be paid? Would it be taxed?
* If the agency offers a retirement plan, when would I become eligible to contribute to it? Does the agency match my contribution? If so, when would that begin and what would the contribution consist of? When would I become vested? Into what investments would my funds be placed? Would I have control of my investments? Is there a penalty for withdrawing my money if I stop traveling?
* Will I have typical mileage reimbursement when I travel for the agency or hospital? Will the reimbursement cover a portion for transportation to the assignment and then reimbursement for return to my home (or to my next assignment)?
* Can travel reimbursement be arranged to meet my individual needs?
* How long has the travel agency been in business?
* Does the agency provide support and assistance with license processing, licensing fees, and other credentialing needs?

Asking these questions probably won’t make you the most-liked, but it will certainly help you become well-informed and better prepared. So, get out your pad and paper, and get to asking. If you conduct these simple interviews, it will assist you in deciding which agency and facility you should choose, and give you some peace of mind knowing you will be going into an assignment as a well-informed nurse.

The Busiest Summer Ever!!!

2010-08-02T14:38:00.000-07:00

This has absolutely been the busiest summer our family has ever had. It started in March (Spring Break - not technically summer) with a week long trip to Pigeon Forge, Tennessee. Then five days at St. George Island Beach, Florida. Then I (as camp nurse), Stephen and Jacob spent a week at Camp Rockmont in Black Mountain, North Carolina (hometown of Brad Johnson). That same week Caroline, Katherine and I went to Wild Adventures in Valdosta, Georgia with Jason, Traci and family. Then we drove out to Utah on a three week trip. We went up through St. Louis, hit I-70 through Independence, Missouri, across Kansas, into Colorado and finally into Utah.

When we got to Utah our first stop was Moab, then up to the Provo/Orem area. We took roughly the same route back. We have now been home a grand total of 8 days and Traci and Jason have taken our boys scalloping this weekend. I have never looked forward to school starting so much in my life. I love my kids, but 6 and a half days in a mini van can test any mom's sanity.

AND NOW FOR THE PICTURES AND NARRATION.
The boys decided to go hiking in Pigeon Forge. They saw some old rusted out cars across the river from where we were staying. It appears that years ago the cars ran off the canyon road that runs higher up on the mountain and crashed into the valley below. The boys said they saw the skeleton of a body in one of the cars. I didn't believe them, but was too lazy to go check for myself. I'll let Robby take a look the next time they go to Tennessee with us.

Try not to get wet Caroline.

My son Stephen and I, along with a bunch of the nerds from his school went on a trip to St. Augustine, Florida as part of the EXPLO ("Gifted") program. I find myself constantly reminding Stephen to NEVER, EVER put academics above sports. For those of you who don't know him very well, Stephen received the Presidential Physical Fitness Award and about a dozen other athletic awards at the end of school year awards ceremony.

Travel Nurse: Checklist (Work Facility)

2010-06-10T11:14:00.000-07:00

This is my second post with checklist questions you will need to ask about your travel nurse assignment before you sign on the dotted line. The following questions are what all travel nurses should ask their travel nurse agency to avoid any unpleasant hidden surprises. Check out my travel nurse housing stipend checklist and my travel nurse salary, insurance and benefits checklist.

YOUR FUTURE WORK FACILITY
Ask the agency:
1) Has the facility used travel nurses before?
2) What is the nurse/patient ratio per shift?
3) Will there be unlicensed staff or other ancillary staff in the unit?
4) What type of scheduling is done (weekly, monthly, quarterly)?
5) Will I work in 4, 8, or 12 your shifts?
6) What are the facility's orientation procedures?
7) Are study guides provided and testing required?
8) Are there any licensure issues?
9) What type of charting system is used?
10)Do travelers float first and, if so, to what areas?
11) What are the expectations regarding being "on call"?
12) Will I be able to or required to work overtime?
13) Who do I talk to about time off, and what are the requirements for having it granted?
14) Who do I contact (the facility, my recruiter, my employer, other) if I have a problem or an important issue to discuss?
15) Is there an agency representative available 24 hours a day, 7 days a week?
16) What if my recruiter is unavailable?

Just An Observation

2010-03-15T14:15:00.000-07:00

Pigeon Forge, TN

Fifteen years ago I interned in a mother/baby unit while I was in nursing school. Back then most of the mothers I attended were married (or at least had a significant other who wasn't a one night stand) and most of the mothers were adults. But things seem to have changed over the years.

I am once again working in a mother/baby unit for the first time since nursing school. The hospital I work in has the same or similar demographics to the one I worked in in nursing school. But now married mothers seem to be the exception and not the rule. For that matter, mothers with a significant other who even shows up for a baby's birth are not as common as I would have thought. I am startled at the number of teenage girls having babies. Babies having babies.

Is this an irreversible trend? Does anyone besides me even think this trend should be reversed?

Travel Nurse Aim: Has Anyone Claimed the Body Yet?

2009-09-30T23:33:00.000-07:00

It's strange how an old memory will just pop into my head without anything triggering it (or at least nothing I can recall). Just out of the blue. Pop, there's an old memory. It's even more strange when it's a memory of something that happened years ago that didn't seem very significant even at the time it happened. I’m one of those people who has difficulty brushing this type of memory aside without some sort of analysis as to why it came into my head in the first place. So here’s what I’ve come up with.

First, the Memory
Tonight I was sitting here minding my own business when a crotchety old patient I attended several years ago popped into my mind. I was working as a travel nurse at a rehabilitation clinic at the time. The patient had apparently spent most of his life alienating all of his family members and would-be friends. It took him mere hours before most of the nurses in the rehab hated his guts. Every word that came out of his mouth was rude, hateful or derogatory. Even still, it was surprising that not a single person visited him the entire two months he was in the rehab hospital even though it was common knowledge that he had a large family living nearby.

One day while taking report I was told that the patient had died several days earlier. His body was bagged and placed in the temporary holding morgue where it remained unclaimed. His family was notified of his death, but none of them would agree to dispose of the body. I caught myself asking at the beginning of every shift “Has anyone claimed the body yet?” I wondered what kind of a family could be that cold and heartless. Surely that decrepit old man couldn’t have been so bad that no one cared what happened to his remains.

Finally after almost two weeks, the hospital was able to get an acquaintance to claim it. The situation made me wonder just how bad this guy had to have acted during his life to make what seemed to be the entire world turn against him.

Now the Analysis
This is the best I can come up with as to why this memory popped into my head. It might be a reminder that as a nurse I only get a snapshot of what a patient is truly like. Most of my patients are not used to spending time in a hospital. Some get scared when they are normally brave. Some get shy when they are normally outgoing. Some get angry when they are normally calm. A reminder not to judge people by how they act in the hospital (even though the crotchety old man in the hospital was apparently a crotchety old man most of his life).

Or…it could just mean that if I treat my family like crap, my body will be stuffed in a black bag, stuck in a refrigerator and left unclaimed when I die. Sometimes the simplest explanation is the best.

Travel Nurse Aim's Advice

2009-09-29T23:31:00.000-07:00

I received the following e-mail from the husband of prospective travel nurse:

"HI Aim,

I enjoyed reading your blog. I stumbled across it because my wife is a nurse and she is thinking about traveling, so I was poking around the internet looking for info on it. I'm wondering what to do with myself as she is working. We both love traveling and adventure, and I have many skills, but my question to you is, does your family travel with you? Does your husband work? I'm just trying to "feel" out this lifestyle. Any of your insight would be very much appreciated!

Thanks!

[Name Redacted] "

My Advice
Dear Reader,

First, let me thank you for reading my blog and hope you find the information and stories interesting. Second, yes my family travels with me. My husband has a job where most of his work is done over the internet and he does not have to go into an office every day. You might be surprised at how many of those types of jobs are available. He is a corporate attorney who spends much of his time reviewing contracts, drafting legal opinions and doing other lawyer stuff that doesn't require face to face contact with clients. He is also a small business owner and entrepreneur.

Thanks,

Travel Nurse Aim

Honest, the Patient Was Dead When I Started My Shift

2009-09-28T16:42:00.000-07:00

Yesterday's shift started with something straight out of CSI. I had barely finished taking report when a page came over the PA system "CRT 235". For those non-medicals reading this post, CRT 235 means anyone who is not already working on someone "GET IN HERE NOW!" I happened to have been working on someone at the time.

Nurses, doctors, RT's, LPN's, CNA's, a guy pushing a crash cart and even one of the janitors came racing down the hall past me and into the coding patient's room. I finished working on my patient and then ran to assist with the code. When I reached the room there must have been a dozen people working around the patient. Several nurses were taking turns leaning over the bed doing chest compressions and another was bagging the patient. I looked over and saw a nursing student in the corner with his eyes bugging out like that Guinea Pig, Bugsy, on Bedtime Stories. All I could think was "Welcome to the world of nursing!"

Once my initial adrenaline rush had subsided I looked down at the patient and noticed that she was already blue. The technical term is cyanotic. I also noticed that her arms and hands had already begun to stiffen. A sure sign that rigor mortis was setting in. But if that was the case, then the patient had to have been dead for awhile. Why wait so long to call in the code? duh...duh...duh...dum

The thought crossed my mind "What must that nursing student be thinking?" One week he's sitting in class learning about nursing. The next week he is finding out where he will be doing his clinical rotation. The next he is standing in a room full of people banging on a woman who has probably been dead for at least an hour and thinking "what kind of sick twisted people think this is a good idea for a job?"

When all of the commotion subsided and I was back on my rotation, I overheard the Charge Nurse say the patient had likely been dead for a couple of hours and that the morning shift nurse had called in the code. I also heard her say the night shift nurse had put on the patient's chart that the patient had been visited at the end of her shift. Either that is the fastest rigor mortis in the history of the world, or the night shift nurse is "mistaken" about when the patient was last visited, or the night shift nurse visited the patient and discovered she was dead but didn't bother telling anyone. Either way, tomorrow should be interesting.

Sleep well tonight my student nurse friend. Tomorrow will bring a new trauma all its own.

Travel Nurse Aim Ranked Among Top 100 Blogs for Nursing Students

2009-09-28T10:00:00.000-07:00

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.

Travel Nurse Aim's Reader Seeks Tax Advice

2009-09-24T23:54:00.000-07:00

I recently received an e-mail from a travel nurse reader with the following income tax question:

"Amy,

I have been a travel nurse in CA for 6 years. I am currently in the Sacramento area and have been at the same hospital since 01/08. Now, at eleven months I take 30 days off, then return.The hospital I work at continues to renew my contract and my employer continues to give me the full stipend in my check every week. How long can I remain in the same situation and stay within requirements set by the IRS? I have read the IRS publications but can not find anything to address my situation.

Any advice would be greatly appreciated,

[Name Redacted]"

Can Anyone Answer this Question?
Dear Reader,

I do not know the answer to your question as I have never been a travel nurse at the same location for more than 9 months. Can anyone answer the reader's question? If so, please post the answer as a comment to this post or e-mail me and I will pass it on to the reader.

Thanks,

Travel Nurse Aim

Hilarious Email about Discharging a Patient

2008-11-14T18:01:00.000-08:00

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."

Our House Flooded

2008-09-02T20:21:00.000-07:00

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

2008-08-05T19:39:00.000-07:00

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

2008-05-25T16:05:00.000-07:00

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

2008-05-08T22:39:00.000-07:00

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

2008-04-20T20:38:00.000-07:00

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?

2008-03-23T21:16:00.000-07:00

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?

2008-03-11T12:53:00.000-07:00

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

2008-03-01T11:26:00.000-08:00

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!

2008-02-22T12:27:00.001-08:00

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

2007-12-21T06:26:00.000-08:00

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

2007-11-26T09:16:00.000-08:00

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

2007-11-23T09:17:00.000-08:00

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

2007-11-02T09:30:00.000-07:00

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

2007-10-31T10:38:00.000-07:00

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

2007-05-16T15:13:00.000-07:00

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 )

2007-04-24T16:23:00.000-07:00

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

2007-04-17T09:59:00.000-07:00

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

2007-04-12T21:39:00.000-07:00

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

2007-03-22T09:42:00.000-07:00

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!?

2007-03-14T20:19:00.000-07:00

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

2007-03-08T09:32:00.000-08:00

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

2007-03-08T05:16:00.001-08:00

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

Americus, Georgia: Another Tornado Disaster

2007-03-03T16:38:00.000-08:00

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.

Below is a picture of my brother-in-law chainsawing away. He loves to use his chainsaw and I am told he is really good at it.

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

This is the first house after the crew had finished.

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

My husband said when they first rolled into town there were Army helicopters flying all over the place. He found out later that most of the helicopters were securing the air for President Bush and other dignitaries to view the destruction from the air. Later that day he was crossing one of the major streets on foot when he overheard one of the police radios say President Bush would soon be coming down the street. He asked the officer if he could stay there to take a picture of the entourage when it came by. The officer okayed it with the Secret Service, so the pictures of the black SUV's are of President Bush's entourage.

While the Cat's Away the Mice Will Play

2007-02-26T19:46:00.000-08:00

I agreed to work the night shift Friday night leaving my husband, two sons and two daughters to fend for themselves. Not something I particularly enjoy doing, but the hospital was short staffed and I am a sucker for hard luck situations. So what did my family do while I was working all night? They went camping. At least the boys did.

Friday afternoon could not have been more perfect. Warm enough for shorts and a t-shirt, but too cold for the gnats and mosquitos to make being outdoors unpleasant. While I was getting into the car to go to work, my husband was packing up the tent and sleeping bags to take the boys to a lake just south of Tallahassee with some friends. Can you say jealous? On my way out I told them to "have fun" but secretly hoped it would pour down raining on them. Just kidding boys. They did have fun.

Check out some of the pictures from their trip. Apparently someone brought one of those paddle boats with them. The boys are crashing into one of our friend's boats in this picture. They ended up soaked.

The only solace I have since I missed the camping trip is that we are planning a trip to St. George Island, Florida in the next few weeks. The island sits off the panhandle of Florida and is accessed by a long bridge. Fishing, laying out, swimming. It should be great. I love the beach. Yeah!!!

Travel Nurse: ALWAYS Wear a Seatbelt

2007-02-14T20:25:00.000-08:00

I saw the saddest situation at work last night. As I was taking report at the beginning of my shift I overheard one of the day shift nurses talking about a 40 year old male patient who had just had major reconstructive surgery done on his head and face. She said the doctors at Shands (a world renowned hospital in Gainesville, Florida) had done an incredible job based on the "Before" pictures she had seen. She also said she didn't know why they had bothered doing the surgery since the patient was almost certainly going to be in a persistent vegetative state for the rest of his life.

Although he wasn't going to be my patient, I had to ask what happened. She said he had been driving west on I-10 near one of the Tallahassee exits when a car pulled into his lane causing him to swerve out of control. He wasn't able to regain control of his car and it began to roll. At some point during the roll he was thrown out of the car, landed face first on the pavement and skidded to a stop about 70 feet from where he had first landed. She said the pictures of him taken prior to his surgery showed an almost bare skull where his face had been and his jaw and right cheek bone had been fractured. I don't say this as an "I told you so" by any means, but he had not been wearing a seatbelt.

Partially out of curiosity, but mostly because I had some spare time and thought I'd help some of the busier nurses with their patients, I decided to look in on the 40 year old patient. The nurse was right. The reconstruction was incredible. She was also right in that he will probably never come out of his vegetative state.

I was told that he has a wife and four teenage kids. When I heard that all I could think of is that I personally would rather have died in the accident than to live like that for the rest of my life. I would hate to put my husband and kids through that.

Let me just say here that I know many of my posts may seem cold and without feeling when it comes to my recounting the facts of what I have seen at work. But I have seen nurses who get too emotionally involved with their patients. They don't usually last very long in this field. I, on the other hand, have chosen to divorce myself (as best I can) from the natural emotions of seeing someone suffer physical and mental anguish of body and soul. For the most part I think I am successful at it. Sometimes it gets to me though. This situation sure got me thinking about how much I need to look back over my Living Will to make sure it says what I want it to say.

Travel Nurse: Change of Shift

2007-02-08T09:24:00.000-08:00

Change of Shift is up at Nurse Ratched's Place. Get over there and read all of the saucy details in this Harlequin Romance version of CoF. How apropos for a Valentine's Day theme.

This year I have a slightly jaded view of Valentine's Day. Maybe more on what brought this about later. In the tone of someone with such a jaded view I offer this little aside. Every year my husband wishes me "Happy VD" on Valentine's Day. He thinks he's funny. Not something that would put any sane woman in the mood for romance. Even if he did get me roses and chocolates. But this year his little "humorous" greeting will be even less funny than usual as I have had two patients in the latter stages of AIDS on my last two shifts (not something usually addressed in Romance novels).

Both of them contracted the disease via unprotected sex. At least that is what they told the day shift nurse. One of them appears to be an IV drug user too; but why lie about how you got AIDS when you're as close to the end as he is. Both seem to be at peace with their situations. Their families are devastated!

Their stories are so depressing it is hard to know how to finish this post. Sometimes there is just nothing else to say. I am about to peruse through some of my favorite blogs. Maybe they will lighten my mood. I apologize if this post puts a damper on your upcoming Valentine's Day!

Travel Nurse: A Trip To Silver Springs, Florida

2007-01-29T09:25:00.000-08:00

The weather in Florida is certainly interesting. One day it can be 80 degrees outside and not a cloud in the sky. The next day it can be 40 degrees and raining. In fact, one day last week started out 70 degrees and raining and ended up 25 degrees and clear. I have learned that anytime I leave the house I need to bring an umbrella; cloudy or not. Right now it is clear and cold.

Recently we took a little time off for what my husband calls a "mini-vacation." We pulled our boys out of school for a couple of days and took a short 2 1/2 hour trip southeast of Tallahassee to Silver Springs, Florida. My husband and I decided some time ago that when we get a chance to give our kids a little "hands on" experience with life (i.e. nature, history, etc.) that pulling them out of school for a couple days is a small price to pay.

Take a look at what I mean by "hands on" experience. Reading it in a book is fine if that is the best you can do. But holding it in your hands can make a lifelong impression.

Silver Springs has several different glass bottom boat rides you can take the kids on. The water is so clear and the fish so big it is almost unbelievable. You can see the kids in this picture looking through the glass bottom of the boat at a school of fish. I think the tour guide called them Bluegills.
The tour guide said that a number of old Tarzan movies were filmed at the springs, as well as some James Bond and other movies.

Across the parking lot from Silver Springs is a water park. It was closed for the winter. The kids were a little disappointed about not going swimming so we found a hotel with one of those indoor heated pools and swam until we were all prunes.

What a fun "mini-vacation."

Travel Nurse: A Cycling Near-Tragedy

2007-01-25T14:15:00.000-08:00

Last night I had a patient who competes nationally in bicycling competitions. I'm not sure what types of competitions he enters as I don't know much about the cycling world; other than Lance Armstrong owned the Tour de France before he retired and that the French hate American cyclists.

He had been biking without a helmet down one of the roads running through a local college campus when he was T-boned by a car going about 35 mph. His body went over the hood of the car, ricocheted off the windshield, over the roof of the car and onto the pavement. He said he recalled everything up until he hit the pavement. When he finally came to, there was a crowd gathered around him and blood was gushing from a deep cut extending about six inches from the side of his right eye upward to the edge of his hairline. The impact had almost taken his eyesight. His bike was about 40 feet away lying in a mangled clump of titanium.

All night he kept saying that if he had rotated just a few more inches while in the air he could have lost his eyesight or suffered sever brain damage. He said he never rides a bike without a helmet, but thought this one time as he rode on campus he would be alright.

All things considered, he was lucky. Very lucky.

Travel Nurse: Contract Items You Need To Address

2007-01-18T09:08:00.000-08:00

I have received quite a few e-mails lately wanting to know some of the nuts and bolts of signing up with a travel nurse agency. Apparently quite of few of you are worried about taking a travel nurse job in a new state, moving and then finding out that your hourly pay or your hours are not guaranteed and you are not able to make ends meet. A legitimate concern indeed. I debated between either addressing the e-mails I have received or writing about our recent visit to Wakulla Springs, Florida in today’s post. The e-mails won. I will recount the Wakulla Springs trip later this week when I get another chance to write.

Before I start any new travel assignment, I make sure I have a written (not a verbal) contract with my agency. It has been my experience that promises made over the telephone between me and the agency don’t mean much until they are reduced to writing. Agencies experience personnel changes and the person who made the verbal promise may no longer work for the agency when it comes time to enforce the promise. Also, people’s memories become foggy when you try to get them to honor verbal promises they no longer want to honor.

The following is a list of items you need to address in your written contract:
1) Is there a provision in the contract guaranteeing my assignment? The concern here is that you move to your new assignment and the position is no longer available at the facility. Your agency should then be responsible for finding you another similar assignment in the same area or paying you until they find an available assignment.

2) Are my hours and pay rate guaranteed? You do not want to get to your new assignment and find out that the pay you think you are going to receive only applies if you work as a charge nurse on the night shift when you were supposed to be working as a regular floor nurse on days. Also, because you will likely be receiving a higher pay rate than the other nurses, facilities would generally rather send you home first when the census is low. Make sure your contract contains guaranteed hours.

3) How often will I be paid? You will likely not have much control over whether you are paid every two weeks or every month as agencies pay you when they are paid from the facility. However, you do not want your agency to hold on to your funds once they have been paid by the facility. I personally have never run into this problem, but you never know.

4) Will I be paid by my agency or the facility? I personally prefer to be paid by my agency. It creates more consistency for me as I travel from one assignment to another. If there is a problem with my check I know who I need to contact.

5) If I am going to a large metropolitan facility, will I have to pay for parking? This may not seem like much, but some facilities seem to try to make a living off charging their employees for parking and other related items.

I think the above addresses the specific e-mails I have received. Other items you may want to address in your contract are: Will I be paid via direct deposit or bank check?; and what items will be deducted from my paycheck? If I think of any others I will try to include them in a future post.

Also, one final bit of advice, read through your travel nurse contract and make sure the above items are in there. Do not assume that because you have discussed an item the item is addressed in the contract. If you have a question as to where the item is located in your contract bring it up with your agency contact. More often than not she can show you where the item is addressed or add it if it has not been added.

Travel Nurse: Code Blue

2007-01-15T08:58:00.000-08:00

My last day of orientation ended in a whirlwind last night: I swiped my badge to clock out, got in the elevator, pushed the button for the parking garage, heard the words "Code Blue" over the speaker system, stuck my hand between the elevator doors just before they closed completely, jumped out of the elevator, joined a dozen other nurses running down the hall towards the coding patient and ran into the patient's room. When I got into the patient's room I saw several other nurses going into the bathroom.

I walked into the bathroom where the patient, a 350 pound woman, had apparently been sitting on the toilet when she began bleeding out of her femoral artery in her left groin. There were already four or five nurses working on her. I later found out that several days earlier she had had "an uncomplicated" heart catheterization procedure. Uncomplicated, that is, until she passed out on the toilet and nearly died.

I helped start IV fluids for the patient and hooked them up to her heplock. It took six people to lift the patient off the toilet and put her back on her bed. As we did so, one of the nurses kept a ball of gauze pressed against the slit in the patient's groin to keep the blood from coming out. I then backed away from the scene and watched as the cardiovascular surgeon climbed on top of the patient and while straddling her, pried open the slit in her groin with his hands and pressed directly on the artery. The patient and the doctor were then whisked out of the room, down the hall and into the elevator toward the operating room.

As I walked out of the hospital I thought to myself how consistent nursing is no matter where I have worked. In every hospital I have worked in there have been good days and bad days. Days where not much happened, and days, like today, where all heck breaks loose at the end of the shift and you have to react as quickly as you can. But in every hospital I have worked in "Code" always means "this is important, pay attention and react," "Code Brown" means "someone has dropped anchor on themselves" and "Stat" always means "move your butt right now."

Orientation is definitely over.

Travel Nurse: Do Agencies Pay for Relocation?

2007-01-09T17:16:00.000-08:00

A reader recently sent me an e-mail regarding whether travel nurse agencies will pay to relocate a nurse. I have received several similar e-mails in the past. As this may be a subject more of you are interested in, the following is the e-mail and my reply:

The E-Mail
"I have a question, if you'd be so kind. once you sign a contract with a agency, how do you get to the destination? does the agency pay for you to get to your assignment or do you? I live in texas, if I take an assignment in California, who pays for the travel out there?
Thanks
[Reader]"

My Response
[Reader], thanks for your e-mail. Some agencies will pay for the move or at least give you an alotment that you can spend towards the move. The amount depends upon the distance of the move. Some will even hire the moving company for you.

It has been my experience that if you do elect to have the agency move you they will lower your sign-on bonus or your monthly pay. I usually choose to move myself and keep the bonus and have a higher hourly pay rate.

I suspect there are quite a few other potential travel nurses who have the same question. I will probably post about it in the near future.

Amy Robbins, RN, BSN"

Disclaimer
One of my purposes in writing this blog is to provide information to readers who are thinking about becoming travel nurses. When I first became a travel nurse the fear of the unknown was almost too much for me. I am, however, glad I took the plunge as it has allowed me to visit places and see things that I would not have otherwise been able to.

I have used several nursing agencies during my time as a travel nurse, but have intentionally omitted their names on this blog. Why? Because I have decided not to endorse any specific agency over another. Nor do I allow people to publish comments on my blog endorsing an agency.

This blog absolutely endorses travel nursing, but has refrained from endorsing any specific travel nursing agency.

Travel Nurse: Not the Ideal Start

2007-01-08T13:08:00.000-08:00

What a weekend. Headache, nausea, vomiting. And that was just me. I don't know if it was the anticipation of starting a new job or what, but Saturday night around 9:30 p.m. a migraine headache started pounding the back of my head..."Somebody turn down the T.V. and turn off those lights!"... Shortly after the headache began came the nausea which crescendoed into an all out vomit-fest that lasted about an hour. The nausea and vomiting eventually subsided but the headache lasted until the wee hours of the night which meant I got about 2 solid hours of sleep before waking up and getting ready for the first day of my new travel nurse assignment.

I was a walking zombie all day long. Fortunately, I was just orienting and didn't have any patients... "Sorry about giving you that Estrogen shot, Mr. Jones"... I am now a little concerned about the doubtless whisperings that will come out of today... "Have you seen the new brain dead travel nurse"...Thank goodness I don't have to go back in until tomorrow.

Travel Nurse: Grand Rounds 3.14

2007-01-05T21:37:00.002-08:00

When my husband convinced me to start blogging about my travel nurse experiences he gave me a few words of advice that I didn't quite believe at first. He said that blogging is not like running a website where a person visits a site, buys something or downloads information and then leaves with no real attachment. He said bloggers, real bloggers, establish a connection (be it intellectual, emotional, psychological, etc.) with their readers. It made me wonder whether I was ready to take the leap from becoming a blog reader to a blog writer. You see, as solely a blog reader I was someone who could take shots at blogs I didn't like, enjoy the ones I did and not open myself up to criticism about my writing. As a blog writer...well, things are different. Suffice it to say that I'm not quite as critical of other blogs as I used to be.

My husband also said that bloggers have their own community pecking orders complete with Wise Grandparent, Sarcastic Uncle, Alcoholic Best Friend, Court Jester and Wet-Behind-the-Ears Newbie. Two guesses on where this blog falls into those categories (hint: Newbie).

Grand Rounds 3.14
One of the blogs that definitely falls in the medical blog heirarchy under Wise Grandparent is Blogborygmi written by Nick Genes. Nick has recently posted his self described "collection of the best posts in medical blogging" known as Grand Rounds 3.14. Nick's latest edition of Grand Rounds reminds me a little of Einstein's publication of the Theory of Relativity. No, the post doesn't provide any monumental breakthrough in science...but hear me out.

It is my understanding that when Einstein published his Theory of Relativity, he did so first as a footnote to a larger thesis he had been working on. When the scientific community pored over his thesis they found the obscure footnote and began to question him on it. From an obscure little footnote came one of the most important incites of our time.

On a smaller scale, Nick provides an incite into the medical blog community that may get lost in the pomp and circumstance of his Grand Rounds awards. He says that "Bloggers talk to each other enough, reading and commenting on posts so frequently, that when one of them disappears, it feels like we're losing a friend." This may be the most important statement in his entire post. For those of you who only read blogs, it is up to you to find the incite in his statement. I hate to end this post so abruptly, but it is late and I start my new travel nurse assignment tomorrow.

Travel Nurse: Three Shots In One Day

2007-01-04T14:51:00.000-08:00

Let me start with a quick Bon Jovi remake: "Shots in the arm and your to blame. Darlin' you give nurses a bad name." Okay, so most of you post 80's teenagers may not know who Jon Bon Jovi is but some of us still remember having his picture pinned to the inside of our locker doors.

So why the 80's music flashback? My travel nurse agency called yesterday to tell me that I needed to get updated tetanus, influenza and PPD (tuberculosis) shots before I can start my new assignment. What a bummer. Although I can administer shots with the best of them, I do not do quite as well when it is my time to be stuck.

My visit to the employee health clinic at the hospital this afternoon was no picnic. The nurse was rude and seemed to take pleasure in sticking me three times in the arm. On the bright side, after my hospital visit our family went to a local petting zoo in Tallahassee. The zoo is located beside a large marshy lake that reminds me of pictures of the Everglades I have seen. There were alligators, bears, panthers and a number of other animals the kids were allowed to pet.

My first shift in Tallahassee is scheduled for this weekend and I actually look forward to it.

Travel Nurse: Florida Tornado Victim

2007-01-03T19:11:00.000-08:00

Several years ago I started keeping a journal of my travel nursing experiences. Last night I decided to read back through some of my entries from last year and one incident in particular caught my attention. The names and places of the incident have been omitted to protect patient confidentiality, but all of the other facts are as I experienced them.

Patient with Multiple Contusions, Lacerations and Fractures
One evening while working on an orthopedic (bone related) floor a young man was brought into the unit with multiple contusions (bruises), lacerations (cuts) and fractures (broken bones). He had been stabilized in the Emergency Room after many hours of work by doctors and nurses before being transferred to my floor.

The young man had broken four ribs, one arm, one leg in two places and had a head injury. He was also clearly experiencing psychological pain from what had happened to him. My first thought was “why would anybody ride a motorcycle without a helmet?” But this was no motorcycle accident. In fact, it probably would have been better had the man actually been in a motorcycle accident.

No, this man had experienced what it is like first hand to be sucked into a tornado.

“It Was Just Like Being Flushed Down The Toilet”
Two nights before I had him as a patient, the young man, his sister, his niece and nephew were sitting in their mobile home watching TV when they heard a noise outside. He said the noise sounded “like a train engine barreling down” on them. The family jumped off the couch where they were sitting and began running toward the bathtub. He, his niece and his nephew made it to the tub before the tornado began ripping their mobile home to pieces.

The young man said that he watched from the tub as the ceiling of the mobile home was ripped off and his sister was sucked out and disappeared into the dark. He then tried to cling to his niece as she was pulled out of the tub. He was unable to hold onto her and she too was sucked out. The last thing he recalled was feeling extreme pressure pushing and pulling on his body and then he was pulled out of the tub into a swirling funnel.

When the rescue team finally found him many hours later he was laying in a ditch several hundred yards away from where the mobile home had been and a portion of the mobile home was on top of him. His sister and niece had been killed. I am not sure of the status of his nephew. The last I heard the nephew was still in intensive care.

In all of my years as a travel nurse, I don’t think I have ever taken care of a patient who has gone through anything as surreal sounding as what this patient experienced.

Travel Nurse: Assignment in Tallahassee

2006-12-30T11:45:00.000-08:00

It's been a long and relaxing break between assignments. I took a break for a month during the holidays to visit family in North Florida and South Georgia. The holidays were crazy. My oldest son, Stephen, found a "mud snake" and couldn't resist picking it up. I have included one of the pictures he made me take of him holding the snake.
We enjoyed our visit so much we've decided to take a travel nurse assignment in Tallahassee, Florida for the next few months. My husband is a big Florida State fan but I doubt we will be here long enough for the next football season to start.

I will be working at one of the two main hospitals in Tallahassee. The winter weather here is relatively mild compared to some of my other travel nurse assignments. The temperature has been in the 60's for the last few weeks (including Christmas Day) which is something I can certainly get used to.

We found a home in a suburb of Tallahassee to stay in while I complete my assignment. I am still working out the housing stipend details with my travel nurse agency.

I start work next week. Wish me luck.

Travel Nurse: Assignment in St. Augustine, FL

2006-12-08T13:37:00.000-08:00

Last year I worked as a travel nurse in St. Augustine, Florida. St. Augustine is generally recognized as the oldest city in the United States and is full of history. Downtown St. Augustine has old cobble stone streets lined with beautiful European style cathedrals. I took a picture of this cathedral during one of our family Sunday afternoon strolls. There are at least a dozen more similar cathedrals.

There is also a street near the cathedrals called "St. George Street" with a bunch of olde world Spanish styled specialty shops. At the end of St. George Street is an old schoolhouse with a sign reading "The Oldest Wood School House In The U.S.A. St. Augustine Florida." I told my two sons that if they didn't start doing better in school we are going to start sending them to that school house.

My travel nurse assignment in St. Augustine was easily one of the most interesting I have taken. As far as the work itself, most of my patients were elderly, retired people who were either extremely pleasant or extremely cantankerous. The work facilities were modern and the computer systems were state of the art. There is not a lot of traffic in St. Augustine which makes traveling to and from the hospital easy.

I would recommend St. Augustine to any travel nurse who likes visiting historical sites. I would be remiss if I did not at least mention the Spanish Fort across the street from St. George street. Students from the nearby Flagler College walk to the fort and lay out in the sun on the open green spaces surrounding the fort. My sons also want me to mention that the fort has a cool moat that they believe once held sharks and alligators at the same time.

Travel Nurse: Checklist (Housing Stipend)

2006-11-06T08:58:00.000-08:00

Another name for this post might be "Things I wish I'd known before signing with my first travel nurse agency." I have compiled the following checklist of housing related questions I now ask prior to taking any travel nursing assignment. Get stuck living in an apartment in Chicago next to a train station located 45 minutes from your work facility and you will quickly learn the value of the questions contained in the checklist. Trust me, it's no picnic. On the other hand, the "resort" condo in West Palm with fenced in pool, hot tub and spa was right up my alley.

HOUSING
Ask the agency:
1) What kind of housing is being offered, private or shared?
2) If shared, can I request a nonsmoking roommate or a roommate that works the same shift as I do?
3) Where is the housing located and when can I move in?
4) Can I get a housing stipend if I live in a home I have purchased in my new assignment area, live out of town with friends or relatives, or rent a home on my own while on assignment?
5) If the travel agency offers a stipend to pay for utilities, when is it paid and is it taxed?
6) Does the assignment I'm considering offer free private housing?
7) Can I take my spouse, significant other, children or pets without any additional charges?
8) Is the house or apartment furnished?

Finally, from all the research I've done, the most important bit of advice I can give is that everything should be included in a written contract. What sounds too good to be true probably is, and the only way for us to be sure we will get all the things we've been told we will get, is to have it put in writing. We should ask our recruiter and the facility to put down on paper the things that are most important to us (if they haven't already). There are lots of agencies and millions of facilities out there, we should be a ble to get what we are looking for and we shouldn't have to settle for less.

Travel Nurse: Bring Your Pets Along

2006-10-26T21:55:00.000-07:00

I am a dog lover, I just couldn't resist. Happy Halloween!

Travel Nurse: My Roots In Travel

2006-10-04T14:46:00.000-07:00

Some of my fondest memories of my youth are of family vacations. My Dad was (and still is) really into owning real estate. I think he felt like he needed to own a home in every state in the southeastern United States (and he just about did). He and my mom love to travel. When I was growing up, we had a mountain house in Tennessee. I am the one on the rock getting splashed by my sister. I love those cold mountain whitewater rivers, climbing on the slippery rocks.

Tennessee is on my list of places to spend a few months as a travel nurse. I have a looong list.

Travel Nurse: Have Husband, Will Travel

2006-09-25T09:26:00.000-07:00

You don't have to be single to be a traveling nurse.

While most travel nurses are single, my experience has been that there are also a large number of nurses that travel with their husbands. The majority of them that travel around do find some sort of work in the location the nurse is working in.

Some have "portable" jobs like an online or internet business, or a "work-from-home" type job. Others have been able to find short-term positions, that they arrange prior to relocating, that only last for the duration of the contract.

Your spouse could also explore working in the hospital you will be in. The demand for nurses is so great, that they may be willing to employ your spouse just to get you to their facility. Consider speaking to your travel nursing recruiter about negotiating this before you sign to work at any hospital. Many hospitals are glad to accomodate you and, depending on their needs, are happy to gain two new employees rather than one.
It is easy to find work in a majority of the areas you travel in, but if you are looking to relocate to be at travel nurse in a rural community, it may be difficult to find jobs for your spouse. In those types of isolated conditions there aren't usually many job availablilties, but if the pay is good enough to sustain both of you, then your husband could consider being a "house husband," which usually works out great, especially if he's a dad too.
If your husband finds it difficult to find a job that will allow only temporary employment, remember-you can always renew your assignment contract and stay for an extended period and if you end up liking the location, you can always take on a permanent position at the hospital there.

Advertise on this Blog

2006-09-13T09:29:00.000-07:00

More than 200 nurses and prospective nurses visit this blog every day. If this is the market you would like to reach and you would like to advertise on my blog please contact me at nurseaim@hotmail.com for rates.

Thank you,

Amy Robbins

Travel Nurse: Earn Money While Visiting With Family

2006-09-07T10:37:00.000-07:00

When my husband and I got married we decided we wanted to live near extended family so we (and our children) could remain close to them. The only problem was that my parents lived in Georgia, and his lived in Utah… so we had to pick. We chose Georgia.

After our son turned one, we decided we wanted to spend some time “out west” to let him get to know his grandparents, aunts, uncles, and cousins that live out there better, and to enjoy the sites. We didn’t have a whole lot of money with my husband in school so we knew that one of us would have to work if we wanted to stay for the whole summer.

That is where travel nursing helped out. My husband was not going to be in school for the summer, so we planned for him to stay home with our son while I worked. Most of the hospitals there wanted me to work three twelve hour shifts per week (which is what I preferred anyways). I had the choice of working either an 8 or 12 week assignment. We chose the 8 week one so we could have one month off to vacation. There were so many things to do out there that we enjoy (i.e. hiking, camping, rafting, and biking). All our travel (relocation) expenses were reimbursed (tax-free). We received a monthly housing stipend which was just an added bonus since we stayed with family. We ended-up making $12,080 in two months! Now try and beat that for a career! Now that my son is almost five, we often reflect back on that summer in Utah. What a great time we had, and how grateful I am that I chose nursing as a career.

Travel Nurse: Four Reasons to Consider Travel Nursing

2006-08-29T08:35:00.000-07:00

I found this picture of a lady lounging around in a hammock and decided to put it in a post because that is one of mis pasatiempos favoritos (to recall one of the only phrases I remember from Spanish I in high school). The main reason I decided to become a travel nurse was the opportunity to see new places and experience new things. But there are certainly other reasons to consider travel nursing.

Reason No. 2
Travel nursing has given me an opportunity to see how different facilities work in different parts of the United States. Most of the facilities I have worked in have been hospitals. I have noticed that many of the hospitals I have worked in are primarily about the "bottom line." How many patients can we put in how many beds to turn a profit? I would go to work like every other nurse, do my job and go home. Not much fun. However, I have worked in one hospital that was clearly more concerned about patient care and employee well being than turning a profit. At least that is how it seemed to me. Employees had access to onsite recreation facilities and patients had large, well furnished rooms and "gourmet" meals. If and when I decide to take another assignment in St. Louis that is the facility I would want to work in again.

Reason No. 3
Higher pay. I know that it is kinda' taboo to discuss pay at work, but everywhere I have worked it doesn't take long for me to find out how much everyone is making. Usually lunchtime conversation. It has been my experience that I make on average $10.00 to $20.00 more than regular nurses because I am a travel nurse.

Reason No. 4
If the job stinks, I usually only have to endure it for 3 months. And, if it is too bad, I just need to request that my agency find someone to replace me. I have not had to do this yet, but I have been told that it usually doesn't take very long.

Travel Nurse: Travel Nursing Career - A Dream Come True?

2006-08-22T20:04:00.000-07:00

A number of my articles somehow got deleted. Once I get the chance to look through my backup files I will put them back up.

Housing Stipend: Buy an RV and Retire Early

2006-08-17T20:43:00.000-07:00

One of my nursing assignments was at a hospital in Atlanta, Georgia. While there I met a travel nurse from New Jersey who's biggest goal was to retire by the time she was 40. She determined to begin by ridding herself of student loan and credit card debt and to pay off her vehicle. No easy task; especially considering her vehicle was a $90,000 RV.

One night after getting off work we rode out to a well lit staff parking lot where she showed me her RV. The hospital allowed her to park in their staff parking lot and use all their hook-ups for free. She told me her travel nursing agency had offered to either pay for her to live in an upscale apartment or receive a generous housing stipend of $1,000 per month. She chose the stipend and used it to purchase the RV.

Her RV was beautiful and, more importantly, nearly paid off. She liked being able to travel to her different assignments without having to pack up her things to move. No boxes, moving vans or damaged furniture.

Most of the travel nursing agencies I have used will pay a housing stipend like the one my friend received.

Registered Nurse Jobs

2006-08-16T10:42:00.000-07:00

A number of my articles somehow got deleted. Once I get the chance to look through my backup files I will put them back up.

Winter Travel Assignments Appeal to RN, Ski Bum

2006-08-14T06:14:00.000-07:00

A number of my articles somehow got deleted. Once I get the chance to look through my backup files I will put them back up.

Travel Nursing Jobs in California

2006-08-10T19:25:00.000-07:00

Shortly after I graduated from nursing school my husband and I got married. After a three day stay at a southern plantation style bed and breakfast in south Georgia, we flew to California where we were to spend the next week in Lake Tahoe. It was then that I discovered my husband is "Geographically Challenged." He booked us a flight into Los Angeles thinking it was somewhat close to Lake Tahoe. It's not. We ended up driving all day from Los Angeles to San Francisco to Sacramento then to Lake Tahoe. The trip was draining, but beautiful.

After arriving in Los Angeles we rented a car and traveled up Pacific Coast Highway toward San Francisco. The highway runs alongside the ocean (as the name would imply) for hundreds of miles; sometimes high up on cliffs overlooking the ocean and sometimes almost right at sea level. We were particularly impressed by the contrast in topography from southern California to Lake Tahoe. From sandy beaches and desert (Los Angeles) to high cliffs and hills (San Francisco) to thick forest and mountains (Lake Tahoe).

We now have a chance to revisit California as I am considering taking an assignment there as a traveling nurse. I have checked with one of my travel nursing agencies and they have made all of the areas (Los Angeles, San Francisco, Sacramento and Lake Tahoe) very enticing. They have offered me a $1,500 bonus to relocate to any of the areas in California and to pay the cost of relocation. They have also offered to pay for our rent while we live there and to match any other agency's hourly rate. It could be a much a $55 dollars per hour. We will likely be making our decision on where to live in the next few weeks. I will let you know what we decide.

Travel Nursing Goes Rural

2006-08-08T07:27:00.000-07:00

A number of my articles somehow got deleted. Once I get the chance to look through my backup files I will put them back up.

Travel Nursing - Flexible And Diverse Opportunities

2006-08-07T07:28:00.000-07:00

A number of my articles somehow got deleted. Once I get the chance to look through my backup files I will put them back up.

How To Get An Exciting Career In International Travel Nursing

2006-08-05T06:30:00.000-07:00

A number of my articles somehow got deleted. Once I get the chance to look through my backup files I will put them back up.

Travel Nurse Employment: Tax Advantages of Per Diem Deductions

2006-08-04T08:44:00.000-07:00

The way you report your per diem earnings as a travel nurse could save you thousands of dollars in taxes. Whether you are looking to maximize deductions, reduce taxes, or increase your returns, if you are a travel nurse you should take the time to learn as much as possible about per diem tax rules. Most travel nursing agencies can explain how these rules work.

Finding the Right Travel Nursing Placement Agency

2006-08-03T10:07:00.000-07:00

A number of my articles somehow got deleted. Once I get the chance to look through my backup files I will put them back up.

Tips On How To Start A Career In International Travel Nursing

2006-08-02T10:49:00.000-07:00

If you are a nurse who enjoys traveling, you may want to consider a travel nursing position. Many travel nurse placement agencies offer positions that range anywhere from four to thirteen weeks depending on the case. This type of position offers the opportunity to expand your horizons while obtaining more experience in your chosen field.

In terms of compensation, the traveling nurses tends to make anywhere between 10-15% more than the staff nurse with incentives and bonuses added to the package. For many nurses, being a travel nurse opens the opportunity to see parts of the country they would not ordinarily see in the course of normal employment. If you aren't able to travel because of children or financial obligations, you can still experience the thrill of being a travel nurse by accepting assignments closer to home. Of course, when you are able to do so, you can ask for assignments in other cities or states. That is one of the benefits of being a travel nurse with a placement agency: it leaves you in control of which assignments you accept. Unlike a staff position, you are not required to report to work every day as per a set schedule unless you are on an assignment. When you are in between assignments, the choice is yours to accept or decline, and often times with a travel nurse, bonuses are paid to those who complete assignments.

Are the assignments always in hospitals or nursing homes? That depends on the assignment, but the potential is also there for private duty. Some nurses prefer private duty cases, and in many cases, the pay is higher than it is in a facility-based assignment. Let the placement agency know if you prefer a particular kind of environment because they will try to accommodate you whenever possible. The key role is to meet the needs of both the patient or facility and the nurse. The more comfortable the nurse is with the position to which she has been assigned, the easier it will be for her to perform her job.

Travel nursing opens up many opportunities in the field, and for the nurse who is good at what she does, and not adverse to relocation, opportunities in other states as a staff nurse may be a thought to consider. This is a good way to feel the waters and see if you like different scenery before making the permanent decision to move to an unfamiliar place. This type of position is not for everyone, but if you like to travel and try different things, this is the kind of position you will love. Not only will you see other parts of the country, you will experience a completely different world of individuality in the new people you will meet.

Start Spreading the News! Nursing Jobs in New York

2006-08-01T04:22:00.000-07:00

If someone would have told me ten years ago that I could get paid to move to New York City, have my rent paid for me, make almost double my hourly rate plus a several thousand dollar bonus for commiting to live there for three months I would have said they were crazy. But that is exactly the situation I now find myself in as I consider my next assignment as a traveling nurse in New York City. Wow! New York City!

Before I take any new assignment as a traveling nurse, I always write down the pros and cons of the new assignment. This one was easy. Yankee Stadium, The Empire State Building, Central Park (I hear A-Rod walks around with no shirt on), Lady Liberty, shopping, restaurants. The list is endless.

Nursing Jobs - Insider Tips On Choosing the Best Employer

2006-07-31T06:15:00.000-07:00

The Author: Scott Knutson is an entrepreneur and writer.
Nurses are in high demand and that demand has created an excellent opportunity for those in the health care field. It's not only a chance for better wages than ever before; it's also an opportunity to choose your benefits. That means that you'll look more closely at the individual companies and what they can offer. So what benefits can you expect as a nurse? Take a look at some options you'll find from the various nursing agencies and health care facilities.

Favorable working conditions and hours - While there's no doubt that more nurses and other health care professionals are constantly in demand, many companies and facilities are offering nurses and technicians time off as an incentive to work for them. These companies do whatever it takes to keep working hours to a reasonable level, including hiring temporary workers from other companies. This means that there's less demand to work overtime, leaving even nurses time for themselves and their families. The goal is two fold. Not only do these companies want to attract and retain quality employees, they also realize that nurses and others health care professionals are more likely to be at the top of their game when they're handling reasonable working hours with adequate backup staffing.

The tangibles - Not only are nurses demanding higher wages than ever before, they're also being offered other benefits that haven't been necessarily associated with professionals in this industry in the past. Most are small incentives that carry little importance to some people, but may become big issues. Direct deposit is one example. Seem like a minor point? Maybe, until you're getting your paycheck on Thursday night, are too tired after working overnight to make the trip to the bank Friday and wind up with a check that still hasn't been cashed the following week.

Part-time, temporary and situational jobs - There are companies out there that offer placement for nurses to meet situational requirements. You may not want the responsibility of a full-time position in a hospital, but want to work only a few weeks at a time. You have plenty of options. Choose travel nursing and spend a few days on the road each month, or a few months out at a time. Pick up part-time work or temporary positions. You have plenty of options without working full time and there are companies that do nothing but placements for people like you. Be careful to choose a reputable company and be wary of signing a long-term contract that limits your work with other companies, but this could be a viable option.

Education - There are some real options available if you want a career in nursing or want to advance your education to make yourself more attractive on the marketplace. Take a year off to get some additional training or take a night class. You can choose online courses or pick up classes at your community college or university. You have plenty of options if you want to advance your career with education.

Pay - Most nurses will tell you they choose their field because of the good they can do other people, but there's no doubt that the money is attractive. And pay for nurses in all walks of the health care industry have never been better.

Top Ten Travel Nursing "Hot Spots"

2006-07-29T17:56:00.000-07:00

Janet Fikany works with HealthCare Staffing Network.
If you want to find a specific job as a traveling nurse just click on the links on this page. The great thing about being a traveling nurse boils down to one key component – it’s about the travel! For those of us who love moving around and seeing the world, travel nursing is the profession of our dreams. There are many travel destinations available, based on weather, activities, cost of living, and salary. Therefore, I have gathered a list of my “Top Ten” destinations that nurses choose, based on the number of travelers who inquire about each location every month. Are you a travel RN scouting a new assignment? Then I’d like to suggest the following ten “Hot Spots”:
HAWAII – It’s no shock that Hawaii generates over 500 travel nursing inquiries per month. The wide range of outdoor activities from snow-capped mountains to snow-white sandy beaches elevates Hawaii to one of those meccas where you can build a snowman or a sand castle all in one day. Nurses tell me that you’ll discover virtually every type of outdoor activity imaginable—hiking trails that wind through erupting volcanoes, secret beaches, and lush green ranchlands. Many travelers also hunt, mountain bike, go rafting, and golf on some of the world’s most extravagant courses.
ALASKA – Travel nurses are intrigued by the possibilities of Alaska’s rugged mystery. Alaska is a huge wilderness with beautiful scenery, and travel nursing assignments offer plenty of time to see and do everything you want, whether in winter’s darkness under northern lights, or the glorious spring and summer where it’s light most of the time.

Outdoor enthusiasts enjoy Alaska for its’ wildlife, spectacular natural landscape, and fishing expeditions where the fish really are as big as the stories about which they’re told. Countless day cruises and sightseeing expeditions abound, as well as opportunities to hike, kayak, canoe, ski… Need we say more?
MONTANA – Whether photographer, adventurer, or both, Montana is truly a state that beckons with open arms. River trips, fishing and camping, history, snowy mountain ranges, and waterfalls are what you’ll encounter, along with plenty of open space to explore. Assignments in Montana appeal to those travel nurses who just need some time to break away from their city grind to enjoy marching to the beat of an entirely different drummer. The Big Sky Country boasts some of America’s most famous mountains, canyons, river valleys, forests, grassy plains, badlands, and caverns, and many travelers find it just irresistible enough to keep coming back.
MAINE – Maine’s splendor has inspired artists like Georgia O’Keefe and three generations of the Wyeth family, since the mid-nineteenth century. Travel nurses can’t resist at least one adventure in this charming getaway. Whether you embark on outdoor adventures like skiing and snowmobiling, or if you prefer the cozy ambience of antiquing through charming villages or just strolling or riding horseback on miles of sandy beaches in the smell of salt air, Maine is legendary and offers some wonderful travel nursing experiences. Its’ unique culture is outdoorsy and quaint, and of course you get to enjoy lobster as the locals do—fresh from the ocean!
CALIFORNIA – Warm weather and world-famous beaches make California a favorite choice for traveling nurses. Nine-hundred miles of coastline gives nurses in all locations the chance to spend many hours near the waves; and for nature lovers, California is home to many wildlife parks, remote wilderness areas, and safe-havens for endangered animals. If you’re an excitement junkie, you can scout out a wide selection of theme parks; and no matter what your taste in music, concerts abound in every type of venue. Historic sites and museums invite, as do five-star restaurants and clubs in which to see and be seen. The shopping is unparalleled, whether it’s trendy Melrose Place, La Jolla, or the strand in Venice Beach; and of course it’s home to Hollywood, and, yes, movie stars. Whether northern, southern, or coastal locations, traveling nurses return to California time and again.
WASHINGTON – The Evergreen State boasts the gorgeous Pacific Ocean, the Cascade Mountains, desert experiences, rain forests, towering volcanoes, glaciers, and lush wine country. Washington State rates high on the list of many nurse travelers. Must-sees are the Space Needle and Coulee Dam. The culture here is incredibly diverse; sophisticated, outdoorsy, and loaded with resorts, history, parks, museums, and botanical gardens. Whether touring downtown Seattle for cozy antique and book stores, exploring ancient Indian grounds, or hiking and biking mountains or trails, Washington holds a strong allure for many nurse travelers.
SOUTH CAROLINA – Endless adventure, excitement, fun and exploration represent why South Carolina is always a favorite destination for travel nurses. America’s oldest landscaped gardens frame mansions rife with historical heritage, in addition to pristine beaches and legendary marshy wetlands. For all you golfers, with over 330 golf courses, there’s always a new place to swing your clubs. But what fascinates many traveling nurses is the rich heritage in which South Carolina has paved the roads of culture, art, and folklore in our past. You can visit several historical areas and discovery centers of American history, including the American Revolution and the Civil War.
COLORADO – World-class winter skiing and summer music festivals in the mountains are just two reasons that nurses love traveling to Colorado. Boasting four spectacular seasons, Colorado is where travel nurses get to explore the state’s 18 million acres of state and national parks, forests, and monuments for biking, hiking, fishing, mountain climbing, and kayaking, to name a few. Colorado has many cultural treasures, including ancient Native American sites and dinosaur fossil exhibits, historic ghost towns, and even award-winning vineyards in Grand Junction. And for those who enjoy city life, amid all this natural beauty lie wonderful metropolitan areas like Denver and Boulder, full of shopping, performing arts, and professional sports.
TENNESSEE – From energetic nights of blues on Beale Street, to gorgeous rolling acres of Tennessee Walker horse country, to peaceful Smoky Mountain sunsets, Tennessee is a vacation that offers many world-renowned attractions. Nurse travelers who visit Tennessee will find that they’re within a day’s drive of 75-percent of the U.S. population via quality interstates and highways. Attractions in Tennessee include the Jack Daniels’ distillery, Elvis’s Graceland, the Grand Ole Opry in Nashville, and lots of southern hospitality. And don’t forget the crown jewel of the southern Appalachians, the Great Smoky Mountains National Park.
ARIZONA – If you adore the outdoors, then the Grand Canyon State might just be for you. The nurses who go there just rave about Arizona’s landscape which takes in tall mountain ranges, swift rivers, grasslands, sand dunes, and cactus forests all set against a beautiful sky that glows pink in the sunset. The traveler nurses who enjoy history will find plenty of it here, including Old West reformations, Native American nations, and Spanish-influenced areas all in one state. Arizona is also home to the nation’s greatest golf courses, resorts, spas, cabins, and ranches.
As you can see, limitless possibilities exist for those nurses who want travel, fun, and adventure to be part of their daily lives. If you’re a nurse who travels and it's time for you to move on to a new location, try one of these top travel nursing destinations and see what new experiences lie ahead.

Travel Nursing - The Best Of Both Worlds. Find out how travel nursing can help your career and your life today.

2006-07-28T12:46:00.000-07:00

Because of severe shortages of nurses across the country, travel nursing has become "big business" If you're one of the nurses not familiar with travel nursing you owe it to yourself, and your bank account to investigate further.

Family Keeping You At Home?
Many nurses with children have the idea that travel nursing is off limits. Not necessarily true. There are advantages of travel nursing that can benefit you as well as your children. For example, as a travel nurse many recruiting companies will provide you with free housing. This provides you a place for your family without all the hassles of finding it on your own and moving your household items.
Another benefit to the children is the fact they have the chance to see other parts of the country and a variety of lifestyles. It's almost like vacationing while you're working. You and your family get to see the places you've always dreamed about visiting... yet you're still earning a regular salary.
You can also choose travel nursing and work within areas close to home. You'll be working in familiar areas, keeping the family in one location and earning more. That's right most travel nursing pay scales are anywhere from ten to fifteen percent higher than the pay of a regular staff nurse.

Pick and Choose
Another advantage of travel nursing is you'll get to choose the area you work as well as the type of nursing. If you're feeling a bit stagnant in your career, travel nursing is a great way to pursue other specialty areas of nursing without being locked in as a staff nurse. You'll get to try whatever you choose without being stuck if you find you don't care for that particular nursing specialty.
Most travel nursing companies assign you a recruiter. Your recruiter will work to find out exactly what you're looking for and find it for you. This includes salary, type of nursing, and geographical location. You can write your own ticket to wherever and however you choose to work.

Increase Your Skills
Travel nursing offers you the opportunity to increase your knowledge base. By choosing to work in a variety of settings and nursing areas, you'll build a long list of experiences that will make you in high demand. Travel nursing skills gives you unlimited opportunities and puts you in great demand. Investigate today for your future.

How to Maximize Your Potential as a Traveling Nurse

2006-07-27T14:24:00.000-07:00

The Author:Janet Fikany is a "Senior Placements Specialist" for HealthCare Staffing Network.
It never fails to surprise me how many nurses express their frustration with the world of travel employment. Most often, they wonder why they aren’t finding the assignments they want and deserve; they wonder why placements can take so long; and they wonder why their agencies aren’t doing more to help. It’s understandable nurses feel like this. Finding the right opportunity can be a timely, stressful, or ultimately unfulfilling process, especially if their placement agency isn’t putting in a lot of time on their behalf. However, what many nurses fail to realize is that to be successful as a travel nurse, there’s some work that should be done on their part, too! As with any job, you will get out what you put in -- your potential is directly related to your involvement in the placement process. In light of all this, here are some tips to help guide nurses in being proactive during a job search to help find the best possible assignment each time.

BE PREPARED
First, always be prepared to demonstrate your qualifications at any time. Nursing placement agencies will need copies of your current Nursing, Operating-Room Technician, or Allied Health Professional licenses. You will need to show experience in your specialized field. And you will need to verify all of your certification, education, and experience. Candidates who are not prepared to verify their qualifications often end up with the less-desired positions.

BE AWARE
Second, know what types of facilities are most desirable to you, and make your placement agency aware of this too. For instance, do you like teaching or non-teaching facilities? Large metro facilities or small rural hospitals? High or low volume staffs? If you make clear your preferences from the beginning, you are more likely to find placement in the type of work environment that best suits you.

BE TIME CONSCIOUS
Third, do your best to have a grasp of the time frame you are planning to remain. Although the industry standard for nursing assignments is a thirteen week period, many assignments may be shorter or longer. Know when you plan to leave, or if you’d like to apply for one or more extensions. When you give your placement agency this type of information, you give them the time they need to find you a position that fits your future and moving schedule.

BE REALISTIC
Fourth, understand the concept of pay rates in the travel nursing business. In many cases, the higher paying positions offer more money for a reason. Before you accept a big pay position, make an attempt to understand why it is big pay. For some nurses, a pay increase is not worth working at hospitals with low nurse-to-patient ratios, extended emergency hours or extremely needy facilities. If you do this research before you accept an available position, you are less likely to step into something unexpected.

BE INFORMED
Fifth and finally, read the entire contents of your contract. Although, in the past, many travel nurses often worked around verbal agreements, contracts are absolutely necessary. Read over yours carefully. Contact your recruiter with any questions or concerns before signing. If anything is not specific enough, ask for changes. The more specific you are on contract details, the more control you have over your job assignment.

If you supply all this information, you will give your placement agency the tools to be able to effectively go to work for you and be there every step of the way. They will have everything they need to ensure you the best travel nursing experience possible. Most importantly, you will be satisfied to know that your extra commitment to your job future did indeed help you to maximize your potential as a successful travel nurse.

Not Happy With Your Nursing Career Or Need To Start One? Travel Nurses Are In Great Demand!

2006-07-26T12:53:00.000-07:00

When I was in nursing school the thought of graduating and and starting work as a nurse was exciting. I watched my parents (small business owners) spend years working days and nights to make a living for our family. They worked 60-70 hours every week. The thought of working three days a week (12 hour shifts) and getting full time benefits (especially vacation!) seemed almost too good to be true.

After working at the same hospital for a half dozen years another job opportunity came along that also sounded too good to be true: Travel Nursing! I spoke to several travel nurses and even more travel nurse agencies. I learned that most travel agencies would assist with moving expenses and help find a suitable lodging for me and my family. I also learned that many of them provided free dental, health and life insurance, 401K's, licensing and NCLEX reimbursements and more pay than I was then making

As someone who loves adventure, I decided the 8 to 13 week travel nursing assignments would allow me to discover the United States and still earn a living. It has.