Riverside Saga 1

This place I am working at now is A TRIP! They hired me to staff a certain unit, however, it really feels like I am working a float pool position. I understand floating, however, again, HIRE ME UNDER THAT POSITION! But I have gotten over it...the place I am hired to work is any ICU nurses worse nightmare.....

ER Holding

So this is the hospital's purgatory....Your not in ER hell...but you haven't quite made it upstairs to the units. You are assigned 2 ICU patients (required ratio by California state law) which are brought over from ER. But this is killing part, they are RUTHLESS!!!! How you ask!? For example: the 1st night I worked there off of orientation I was given report on a patient that was to be brought over to holding...they arrived as expected. 30 seconds later I learned I was admitting another patient...2 minutes later the other patient rolled up! YES! Without a report being given or any prior notice! Of course the ER nurses were like "so what!?" I was like every where else in America before you transport a patient to a different unit or area proper report needs to be given! How can I set up a room and prepare equipment if I have no prior notice or report? Yes its a nightmare, but it gets worse!!!! This ER holding area is set up like the ER!! Supplies are spread out every where, noting makes sense, very scattered brained! For example, to get central line dressings you have to walk over to main ER to get it! ITS RIDICULOUS! It gets worse....so I asked the charge nurse for an IV pump and she LAUGHED IN MY FACE! I thought I was being punked! Is it so much to ask for a couple IV pumps in a HOSPITAL!? I didn't know it was so BLASPHEMOUS! Its something else! You can't be expected to preform at a maximum capacity if you don't have basic equipment! To safe guard myself, I definitely let my recruiter know who passed it on to the clinical liaison at my company. A great fellow traveler told me "you don't communicate things like that directly to the facility, the company acts as the liaison and fights your battle". Not to mention you have these patients behind curtains and can't see your monitors. Its a trip yall. The lengths hospitals go to make money. In the main ER its worse they actually line people up in the hallways and separate them by cloth dividers...you know the kind from the 1920's....

Night in ICU

Aside from the ER holding hell, I had the opportunity to work in ICU there and it was pretty nice. Because of the mandatory ratios there is no tripling! I told those nurses of how I was tripled and treated in New York they were shocked. Hell this one nurse almost had a panic attack thinking about it. The unit was well stocked with supplies the nurses were extremely sweet and knowledgeable it was a little slice of heaven. As far as acuity goes, I don't think I will ever encounter the high levels of the Texas Medical Center in Houston. The unit took care of post op heart and trauma/neuro patients. Only level II trauma, and your average cardiac surgeries. No devices and no transplants. They DO transplant kidney and pancreas at this facility. At 1st the idea scared the heck out of me, but im sure due to financial circumstances everyone can't move to the big city to go get their transplants. The most seemingly "complicated" patient on the unit had a balloon pump and a swan catheter. Nothing special to me. CVRR at S.L probably has the sickest patients in the nation hands down.

Worthless charge nurse

OK I experienced the dumbest charge nurse in Temple Texas and I have just experienced the laziest worthless charge nurse in the history of nursing on this med/surg floor last night. Strike 1: I asked her to assist my patient with wound vac change. She ignored me. I am not well versed in wound vacs! I AM A CARDIAC CRITICAL CARE NURSE!!! She didn't offer any alternatives nor take any real interest in the fact the patient needed help. Strike 2: Cops were on unit investigating an elder abuse charge. The cop approaches me and was like "well the patient gave verbal consent for us to review her medical record". WRONG! A new grad would have accepted that, however my license is more important to me than that! HIPPA violations can END your career! Therefore, I needed something in writing! I called the charge nurse to inquire and she cut me off exclaiming "Im in a MEETING". Whoa! Lol of course i pissed her off...in so many words I was like I don't care what you are doing, the cops are on the unit! LOL! She then throws this piece of paper at me that I was not familiar with...so staying true to Brandon lol, I looked at the paper and told her "I don't know what this is, I don't have time to deal with this...I need to give meds to my other patients". Strike 3: I had a patient in respiratory distress and where was she?! Sitting at the nurses station! If looks could kill!!!! I am going to report that incident to my recruiter also! Its ridiculous! Of course I knew exactly what to do with my patient in respiratory distress but its the principles!

More to come!!!

BS RN

Coast to Coast

Greetings readers! I am now working on an assignment in Riverside California!

Working the burn unit wasn't so bad after training my stomach to deal with looking at burned flesh and the pain people suffer during dressing changes. That took a few weeks...lol. Well everything was wonderful on the burn unit until 10 weeks in when the manager was asked to give me a reference. I thought sure why not, I haven't had any real issues on the unit...the staff is pretty nice, so I shrugged it off. This asshole gives me the equivalent of "needs improvement" in all of the categories and reasoning included "we have talked about him about issues multiple times, he is a diva". Ok lets get some things straight, I was never approached about ANYTHING working on this unit! Usually as a travel nurse, if you things people don't like working on a unit YOU ARE MADE AWARE IMMEDIATELY! Not 10 weeks into an assignment, hell if its the 2nd day you are made aware! 2nd off, how professional to call someone a diva? Ok, how about some proof and documentation. There was none because it was fabricated in this guy's imagination! I am an adult and I will own up to my mistakes but this guy here just had it out for me. So to conclude New York and the burn unit: Night staff was great, Managers can kiss some dirty assholes. How unprofessional and conniving!

California!

To be honest I don't know how in the hell I ended up out here! The original plan was to stay home for a few months and chill then travel...then the plan changed to stay home and try to get a position on at the hospital I started at then apply for grad school, then the plan changed to I am leaving Thursday to start work on Monday.My recruiter was very pushy but I had to break it down for him that I am doing this on my merit and I will leave when its my time and lets just say my time came. My recruiter has been almost fired at least 5 times within the past 10 months but always manages to make up for things before I can compose the email!

I did 2 telephone interviews and was given 2 offers. One in Riverside close to LA and Mountain View, south of San Fransisco. I went for the higher paying job with the night position. Mountain View sounded great but they wanted day shift ICU and I don't like working day shift at all! The position I am currently working is officially titled "ER holding" however, we are taking care of the critical patients there. To describe ER holding it would be like purgatory. You aren't quite in ER hell but you haven't made it up to the floor yet lol!

This unit will be very hard to work in because there are no unit norms, you have to deal with ALL of the doctors (WHO ARE NOT ON TEACHING SERVICE) there are no supplies or IV pumps! However, it will be interesting because I will probably be taking care of all kinds of different illnesses. I will say this, I will not rush nor will I be pushed to make a mistake because they are trying to "move beds". I can already see the time coming where everything and everybody will be rushing except me! Somebody is going to be pissed off but frankly I won't give a damn because i'll tell yall like I told one of the supervisors out there: When im sitting in unemployment line because of a lack of a license this hospital isn't going to help pay my bills.

The computer charting SUCKS! Whats is it, Meditech or something! ITS SO SLOW AND IT LOOKS LIKE MOS DOS! Its horrible! I can say this about NYC, the computer charting at that hospital was impeccable! Everything was computerized, orders, vitals...hell everything except consents! It was wonderful! At this place you have to interpret MD chicken scratch and guess on scribbles! Its a nightmare and I have very little patience for it! Thank goodness for unit secretaries!

Well I have already had a semi run in with one of the trauma surgeons. He was being a smart ass-asshole telling me of what the nurse before me should have told me and so on and so forth. In the true Brandon way I told him in an ideal perfect world things would be the way you said it, unfortunately thats not the way of the world. What these people will learn about me is I am in the business of taking care of people. When I hit the door, me and how I feel is left in the streets! It all becomes about the patients! So if I have to make a call 2am that is what I am going to do! If the physicians don't like it then they should go work at a teaching institution JUST LIKE I PLAN TO DO IN 12 MORE WEEKS! I WILL NEVER EVER WORK AT A SMALL NON TEACHING COMMUNITY HOSPITAL IF I CAN HELP IT!!!!! Also they will learn regardless of what they do at this little community hospital, I am a world class nurse and give world class care. No short cuts, no laziness! The foundation I stand on as a nurse is a strong one and I will never ever compromise it for some crazy doctors, nurses or charge nurses. Didn't do it in Texas or New York WILL NOT DO IT IN CALIFORNIA!

So get ready folks! I am sure to have plenty to blog about working in the little hell hole! At the same time I will be open minded and make it work! LOL!

BS RN

Pause of a Saga

Greetings folks, I know it has been a while since my last post but I really had nothing to rant about these past three months! Lol, which was a great THING!

So I started on the burn unit back in October and I thought to acuity was low in the CT ICU, these fools are staffed lavishly with these cake patients! Some of the burns are really severe and can take up to 2 hours for burn care...its just a different state of mind there.

In normal ICUs they would staff based on the patients, how many are on pressors and drips...this unit it staffed on some imaginary grid made up in nursing heaven...THE ICU SIDE OF THE UNIT ANYWAY. They have a total of 40 beds which include 20 ICU beds and 20 step down beds, and pediatrics are included in the step down unit. At any point in time you are assigned patients on the "ICU" side or on the step down side. One the the great/horrible things about this unit its usually not full of burn patients. Granted when the ICU side has non burn patients its great because its in my comfort zone BUT when the step down side has non burn patients ITS LIKE WORKING ON MED/SURG. The worse night I had in the past 3 months I was assigned to 6 patients with a LPN taking vitals and handing out pills. Your probably thinking, hmmm thats not so bad, however, I had never had to take care of 6 patients even in my career including nursing school! Its hell remembering and charting on 6 dang patients! I'll finish up the night which shall remain in infamy a little later...

After about a month, I was able to stomach doing burn care and making the spandage "garments". Burn care can basically be broken down into 4 different (if not less) categories. IT IS NOT ROCKET SCIENCE AT ALL LOL! I'm pretty sure a nurse coming from burn ICU into a cardiac ICU the transition might not be so simple...(I can hear burn nurses scuffing now...) Most of the patients were vital signs every 4 hours, with out any prior medical histories! IT WAS CAKE! Thats why I haven't anything to complain about!!! LMAO! I would have extended on this contract but I haven't been home since September/October and among other things.

I did everything anyone who had never previously lived in New York City would do during the holiday season! Visited all of the holiday windows, went to the Thanksgiving parade, statue of liberty, broadway shows, the lighting of the Rockefeller Christmas tree, went on a dinner cruise for new years etc etc. My time in New York City has been invaluable! Native New Yorkers gave me the "are you serious, ewww" look when I would tell them of my exploits during the holiday season. BUT HEY! It was nothing like I have ever experienced before in my life!

BS RN