Tuesday, August 29, 2006

Travel Nurse: Four Reasons to Consider Travel Nursing

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.

Monday, August 28, 2006

Babies Babies Babies!

Just a quick update...

I will be doing my Obs rotation (6 weeks) at St-Mary's Hospital. I am not a big baby person... I mean, yes they are cute, but I prefer a toddler any day! Ah well, we'll see, I may change my mind about it all after this rotation!
I am glad that my good friend Marta will be with me! Yay, someone I know in my group!

Tuesday, August 22, 2006

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

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.

Oh Man! What was I thinking?

OK, note to any and all future nursing students... you may think you are stressed in your first year, but let me tell you, NOTHING compares to second year! We are so much more on our own. I mean last year we were "spoon fed" our class notes, answers to readings... NOT ANY MORE! We showed up to our first class yesterday and BAM! No "welcome to 2nd year", it was "hi, my name is... and I will be teaching this section of learning material". And we started. A 3 hour lecture on pregnancy. This is the first of three classes on pregnancy. I am already behind in my readings... having had to read 5 chapters for this one subject (I read 3 of them and gave up! I had no idea what I needed and what I didn't need to retain.)

Then there is Biology (Anatomy & Physiology III). OK, I admit, you start talking about chemistry and I am lost. The last time I did chem was in 1994! And this was just the begining. We had the 2nd bio class today, and nope, still not getting it! This time though the prof noticed (she is actually a really cool teacher) and backed it all up and re-taught it. Yippee! I now feel as if I understand somewhere between 50-60% of what we talked about.

On the plus side, I got credit for 2 of my university courses and now no longer have to take Human Dev. II (psych) and Sociology of the Family. (YAY, 6 hrs less of class time... I still have 26 hrs though, for 2 CLASSES!)

2 days down... how many more to go? (for those who are curious, 73 for this semester)

Monday, August 21, 2006

Nursing Administration Quarterly issue devoted to Evidence-based Practice

Nursing Administration Quarterly v 30(3) July-Sept 2006 devotes the entire issue to Evidence-based Practice: impact on nursing administration. Saint Joseph Hospital of Orange,California and Children's Hospital of Orange can access this issue full text via Burlew Medical Library's website. Find out whether your library has access to this important issue.

Table of Contents
Evidence-based Practice: Impact on Nursing Administration.
Brown, Barbara J. EdD, RN, CNAA, FAAN, FNAP, Editor-in-Chief[From the Editor]

pg. 191-192Evidencing the Value of Nursing Practice.
Porter-O'Grady, Tim EdD, APRN, FAAN[Guest Editorial]

pg. 193-202Quantifying Patient Care Intensity: An Evidence-based Approach to Determining Staffing Requirements.
Beglinger, Joan Ellis MSN, MBA, RN, FACHE, FAAN[Article]

pg. 203-210Using Diffusion of Innovation Concepts to Enhance Implementation of an Electronic Health Record to Support Evidence-based Practice.
Geibert, Robert C. EdD, RN[Article]

pg. 211-220Constructing a Team Model: Creating a Foundation for Evidence-based Teams.
Porter-O'Grady, Tim EdD, APRN, FAAN; Alexander, Daniel R. MS; Blaylock, Jo MS; Minkara, Nazem MS; Surel, Dominique MBA[Article]

pg. 221-227Patient Care Transformation: The Plan and the Reality.
Drexler, Diane RN, MBA, CNO; Malloch, Kathy PhD, MBA, RN, FAAN[Article]

pg. 228-235On the Scene at Banner Estrella Medical Center, the Hospital of the Future.
Dobson, Christina MSN, RN, FNP-C; Meythaler, Denise BSN, RN; Wong, Paul BSN, RN, CCRN, CEN, CPAN; Ramirez, Chuck BA, RRT[Article]

pg. 236-242Diffusion of Innovation: The Leaders' Role in Creating the Organizational Context for Evidence-based Practice.
Crow, Gregory EdD, RN[Article]

pg. 243-251What Goes Around Comes Around: Evidence-based Management.
Williams, Lauren L. EDM, RN[Article]

pg. 252-265Evidence-based Practice: How Nurse Leaders can Facilitate Innovation.
Shirey, Maria R. MS, MBA, RN, FACHE, CNAA, BC[Article]

pg. 266-272Perceptions and Characteristics of Registered Nurses' Involvement in Decision Making.
Mangold, Kara L. MS, RN; Pearson, Kristina K. MS, RN, OCN; Schmitz, Julie R. MS, RN; Scherb, Cindy A. PhD, RN; Specht, Janet P. PhD, RN, FAAN; Loes, Jean L. MS, RN[Article]

pg. 273-284Perceptions, Knowledge, and Commitment of Clinical Staff to Shared Governance.
Frith, Karen PhD, RN; Montgomery, Meryl MSN, RN[Article]

pg. 285-290Comparison of Native Versus Nonnative English-speaking Nurses on Critical Thinking Assessments at Entry and Exit.
Whitehead, Tanya D. PhD[Article]

pg. 291-294Evidence-based Practice: How Nursing Administration Makes IT Happen.
Simpson, Roy L. RN, C, CCMA, FNAP, FAAN[Nursing Informatics]

pg. 295-299SBAR and Nurse-Physician Communication: Pilot Testing an Educational Intervention.
Hamilton, Patti PhD, RN; Gemeinhardt, Gretchen PhD; Mancuso, Peggy PhD, RN, CNM; Sahlin, Claire L. PhD; Ivy, Lea MA, RN[Research Abstracts]

pg. 300Handbook of Diabetes Management.
Falter, Betty MS, RN, CNAA, BC[Book Review: Books
for Nursing Administrators]

Resources for Evidence-Based Nursing from McMaster University

McMaster University has created a terrific Resources for Evidence-Based Nursing which is based on the Haynes model.

Friday, August 18, 2006

The Only Ones Who Can

"I'll need help getting this one to take a bath. She swears and refuses every time I come in the room."

I agreed to help the other tech with her difficult patient.

The woman in question was slouched in her chair. When the other tech asked if she was ready to bathe yet, the woman swore and pleaded to be put back in bed. The tech looked at me with smug "I told you so" eyes.

The nurse came in and told the patient she had doctor orders to stay in the chair for another 3 hours. The woman yelled and demanded to be put back to bed.

I leaned down to look at the woman. "You look pretty uncomfortable. Here, why don't you let me put your feet up? Here, you dropped your PCA button. Why don't you give it a push? Your gown is all twisted. Why don't you let me put on a fresh one? While we're changing, why don't I wash up under your arms? I'll wash your legs too. We can save the rest for when you get back in bed."

The woman grasped my at arm and said "You're not made for this, honey."
"What do you mean?" I asked.
"You don't walk away."
"I can't walk away until I get you a little more comfortable, can I?"
The woman didn't swear the rest of the shift.

I'm not saying that all problems can be solved by a little extra attention. But if nothing else can be gained from my short little story, I want to impress upon anyone who reads the idea that anger and rudeness in patients is often misdirected pain. Humans aren't naturally mean-spirited; we care too much about what others think of us to be coarse. We want to be thought well of, so we treat people politely. A patient who is less than polite has either been treated poorly, or is hurting.

Spending a few minutes to make a person more comfortable can make all the difference. Sometimes all people need is a sympathetic ear. I have won over more disagreeable people than I can count simply by listening. It works with coworkers. It works with superiors. It works with perfect strangers. The key to solving the problem lies in not taking things personally. It is important--essential!--for nurses and techs to try to approach patients with a firm respect for their inherent worth as individuals. If we can't try to see where they're coming from, we are not fit to serve them.

It frightens me to think of how that woman's day would have gone if I'd not agreed to help bathe her. She was in absolute agony sitting the way she was, and the other tech was too insulted to see how it needed fixing. That's why I think nursing isn't only my calling, but my duty. If there aren't people like me out there to advocate the patient and listen carefully to their needs... who will?

Nothing is worse than a dismissive or judgemental caretaker.

Thursday, August 17, 2006

Housing Stipend: Buy an RV and Retire Early

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.

Wednesday, August 16, 2006

Registered Nurse Jobs

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.

Monday, August 14, 2006

One Week Left

OK, so school starts in exactly one week. This time next Monday (4PM) I will just be getting out of class.

I went grocery shopping today (BTW, NEVER go when you are hungry! I was starved and so, bought a little more than need be). Spent an hour and half going around the store trying to figure out what I wanted for lunch for school for the next few weeks and all I came up with was salami and granola bars!
I also ran into one of my first year teachers (for those in the know... the one who speaks softly and calmly and tends to drive us nuts in the process!). When I mentioned that I would see her in a week, she was urprised. Seems that she didn't realize that we started fall classes IN ONE WEEK!!!

Ah well, one more week. All I have planned so far is working tomorrow. Let's hope I can find something fun to do with the rest of my last week of summer vacation (might be my last summer off after all. I plan on working as a nurse extern next summer, cross your fingers!)

Winter Travel Assignments Appeal to RN, Ski Bum

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.

Friday, August 11, 2006

Getting Ready...

Some of my MGH "Family"
Well today I accomplished one more important thing... Getting my leg brace (KAFO) re-adjusted. I have been having problems with too much clonus since I got it last December, but figured it was because I was walking more/doing more on clinical days. (This is when I noticed the increase in clonus).
Turns out part of the problem was that the velcro strap at the ankle/foot was too loose, letting my foot move too much = clonus! By keeping the strap tight, I can reduce the amount of clonus I get. So hopefully this will help... it better, I now have 2 days in a row of clinical!
(the brace, articulated AFO in the pic above is one I use when I am getting ready in the morning or when I go do activities like biking/sailing and I have my wheelchair with me)

I go to the IRM (Institut de Readaptation de Montreal). I really like them there, they are thorough and friendly and always available. Funny, when I was first told I was to be transfered there after being in acute care at The Montreal General Hospital, I cried! For TWO WEEKS I was a complete mess! I did NOT want to go, no way. But after 10 weeks at the MGH, who could blame me? It was my second home and the team (nurses, doctors, physio and OT) was my family too now.
Once there though, I quickly realized that I would improve by leaps and bounds. Learning how to shower and get dressed independantly. Learning how to use my wheelchair indoors and out, how to stand and walk without the support of people, but by using a walker/crutches and a leg brace.
I made friends at the IRM, people I am still in contact with today, mostly by email, but when we have MD appt. we try and meet up. My closest friend was a 60 year old man believe it or not. He is a wonderful caring person and is always ready to support me. (Merci Yvon).

After the IRM I went to Centre de Readaptation Lucie Bruneau. Where I did more PT/OT( yes I can now use the oven without falling in! Merci Dominique), worked out in the gym, went on outings (which helped me in a big way to see that I could still do the same things I had done before, though with more planning!). I met more nice people there, staff (Marie-Claude, Elene, Dominque, Isabelle un gros merci!) and patients alike.

So all that to say that I am slowly gearing up to start school... psychologically AND physically!

Thursday, August 10, 2006

Travel Nursing Jobs in California

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.

New Clothes

Just wanted to show off my new sweatshirt... we had them made.Dawson College Nursing
(on the front), this (see right) on the back

Freaking out already!


School will be starting soon and along with less sleep and studying comes stress... I will have to figure out a way to deal with it, maybe this blog will help, let me vent at times!

I already have 30 pages of bio (A&P II) review notes JUST on the digestive system to go through, then another 30 odd pages of metabolism notes that my prof put up for us... keep in mind school has NOT YET STARTED! I should really start reading, give myself a heads up, but frankly I just can't seem to get to it. I should go sit in a cafe and read through it, that would work! Now I just need to find another person to do this with... less dull, haha, (also great distraction).

Picked up the course pack for nursing 312 (peds/obs). Reading through it is scary. Last year we were guided more, had to fill stuff out, homework that went with the readings... now it's just readings that are listed along with what we are supposed to know from that section.. no more "hand-holding" for us. And our lecture are each 3 hrs long, 2x a week for a total of 6 hrs. Then there are 2 days of clinical. I was excited about it, but now am getting freaked out. I read that we learn how to suction babies/children... I'd be less freaked if it was an adult. AND our OSCE has to be done in uniform this year and they are worth more. It feels more real I guess, 2nd yr. More "real" nursing skills.

Sometimes I get scared thinking about the future. I want to be a nurse, that is not the question, but I wonder how I will ever get enough knowledge in the next 2 years to pull it off. I know you learn more as you work, do your last semester working with a preceptor and all, but still...
I just have to take it one day at a time and study my ass off in the process.

Figuring it all out

I still have to figure a few things out when it comes to this blog thing... like how to post pics and edit.. so far it's by accident I manage to do this! If anyone can give me a clue, LOL, let me know. :)

OK, took 5 tries but I managed to get a link working! YAY! I am not totally useless in computer "programming". Irene would be proud! hehe...

now... how the heck to post a pic on the page...

Nurse-to-Be in 2008 *INTRODUCTION!*

I have always wanted to try to do this so here goes...

A bit about myself...
I was born 3 months premature, and because I was born breach I got stuck. The doctor pulled to get me out and damaged my left brachial plexus. (spent the first 3 months of my life in the NICU). Due to that I have Erb's Palsy of my left arm. I have had 3 surgeries (all before I was 17) and have spent much time in the hospital as a patient (both when I was a kid and as an adult!).
When I was 28, I was paralyzed from the mid-chest down due to an autoimmune reaction. I recovered much of my function, though my left leg is still mostly paralyzed and spastic. (I walk with the aid of a long leg brace and a cane).
I am now 30 years old (sson to be 31)
Started nursing school a year ago and will be starting up again August 21st. Most of my decision to go to nursing school was due to the wonderful nurses who cared for me during my 2.5 month stay in hospital. They are my inspiration and my biggest supporters.
I deal with a few extra challenges in school and life that others don't and at times this means I have to prove myself to others and to myself!
Despite all this I am DETERMINED to do what I want to do, and now that is NURSING!
thanks for reading!

Tuesday, August 8, 2006

Travel Nursing Goes Rural

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.

Monday, August 7, 2006

Travel Nursing - Flexible And Diverse Opportunities

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.

Saturday, August 5, 2006

How To Get An Exciting Career In International Travel Nursing

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.

Friday, August 4, 2006

Travel Nurse Employment: Tax Advantages of Per Diem Deductions

When you are a travel nurse, then you need to have a pretty good understanding of per diem rates and how they might lower your taxes. Many travel nurses believe that per diem is only a tax benefit that staffing agencies offer and yet, surprisingly, others do not. This misunderstanding about what per diem is and how it may affect your taxes is an important financial issue that you need to understand. How you report your per diem earnings could mean the difference in thousands of dollars in tax savings.
Weather you are looking to maximize deductions, reduce taxes, or increase your returns, travel nurses should take the time to learn as much as possible about the IRS per diem tax rules. Certainly, one way to learn is to go to the
IRS home page, download publication 1542 and read the rules so that you have a working idea of what to expect by tax time next year. Another great resource, especially, now a days is to do your taxes yourself, if you have a personal computer or laptop.Turbo Tax is a great software program. Not only is it inexpensive and tax deductible itself, but it is very easy to work when you use the step-by-step wizard. You can walk through your entire tax return, and file it electronically. You can get your refund deposited directly into your checking account in a matter of days.
A couple of travel expenses to have a heads up about include:
The travel nurse has a permanent tax home
The travel nurse takes a temporary (less than 12 months) assignment away from their tax homeAny travel nurse meeting the requirements outlined by the IRS can claim deductions for certain travel expenses or receive tax free reimbursements and tax free per diem allowance payments. These tax benefits are one of the great perks of being a travel nurse.
Unfortunately, one of the most common tax mistakes that a travel nurse makes is not being educated or even aware of the tax advantages to per diem deductions. Now that you are are aware that savvy travel nurses are eligible for per diem deductions for every day that they are on temporary assignment away from their tax home, pass on the work to your co-workers, or email them this article so that they can bookmark this overview and take advantage of these tax benefits themselves.
It is important to be aware that some companies don't pay per diem allowance, pay too little per diem, or only pay per diem as a function of hourly pay. You can learn what these scenarios mean for you personal tax situation by consulting with a tax advisor or researching the IRS rules. You deserve to to get every dollar of per diem related deductions that you are entitled to, and we hope that this article has helped you.
Note: while much care has been taken to make this article accurate, tax rules do change. Please be sure that you are up-to-date on the latest IRS rules. This article is meant for informational purposes only and is not meant to replace the advice of a skilled tax advisor.
About the Author: Jeff Morrow
Learn more about Travel Nurse Deductions and Financial Issues at the
Travel Nurse Employment Portal. Or, to find Travel Nurse Jobs that updated every two hours from around the web . . . let us help you find your next travel nurse position.

Thursday, August 3, 2006

Finding the Right Travel Nursing Placement Agency

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.

Wednesday, August 2, 2006

Tips On How To Start A Career In International Travel Nursing

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.

About the Author: Jim Johnson

You can find travel nursing companies and info on international travel nursing and more by visiting our health care website or by clicking on the links below the pictures at the top of this page.

Tuesday, August 1, 2006

Start Spreading the News! Nursing Jobs in New York

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.

So I'll ask you. Should I go to New York as a traveling nurse? This is not a picture of me in Central Park, but in a couple of months I might be able to take my own picture there. Thanks to my traveling nurse job I can travel the United States (and Europe if I ever get up the courage) and make a great living at the same time.

Now a shout out to my traveling nurse agencies. If you are interested in the traveling nurse lifestyle contact one of the agencies below or at the top of this page. See ya in New York City.