Highway
Hypodermics: Travel Nursing 2007
Chapter
One
How Did We
Get To This Point?
There is a crisis in nursing which you can take advantage of. That
crisis is called a "nursing shortage," and you can capitalize on it by
offering your services as a traveling nurse.
The decision to step into the world of travel nursing is
big and sometimes frightening, but it can be a very rewarding and
adventurous way of life.
This book will take a look at the nursing shortage, help
you decide if travel nursing is right for you, help you with the steps to
become a travel nurse, and explore other adventures by the telling of
stories from other nurses.
We will take a look at the rewards and drawbacks of
travel nursing, how to choose a travel company, hints for a successful
interview with the hospital, and what to do once you get there.
This book will help you understand the process of taking
an assignment, what to take with you, help with your taxes, and what to do
when the times get rough and tough.
The first book, Highway Hypodermics: Your Road Map To
Travel Nursing, touched on the basics, but a lot of things have changed
in two years. This book not only touches on those basics, but also includes
information about state qualifications, compact states, quality assurance
through Joint Commission (JCAHO) certification, and a look from the other
side: nursing recruiters telling their story.
It is my hope that after reading this book, you will
understand the travel nursing field. You will be able to make informative
decisions about your nursing career, and that it will be as rewarding as my
career has been.
Why I Chose To Be A Traveling Nurse
On my first job after graduating from nursing school, I worked with this
very interesting nurse who came to help out from South Dakota. After hearing
about all the excitement and freedom of travel, I started making my plans
towards a career in travel nursing.
For the next several years I spent my time floating
between medical, surgical, skilled, rehab, and psychiatric units in Oklahoma
and Idaho. Wanting a warmer change from Idaho, I then took a job in Southern
California, where I worked mainly on the rehab unit, and then in the
emergency department with several shifts floating between medical, surgical,
telemetry, intensive care, and relief house supervisor.
During all of this, I realized that even as a permanent
staff member after a year on the same unit, I was ready for a change. In the
movie business some say that they were born to be a star… well, I was born
to be a travel nurse!
I had originally planned to be ready once my son
graduated from high school in the year of 2008, but that opportunity came
early when my family and I decided to hit the road in April of 2003. We
haven’t looked back since.
What are the chances that someday I won’t be needed as a
traveling nurse? I would say slim to none, related to the fact that the
field of nursing has a major shortage of nurses that has been brought on by
the fact that nurses are retiring faster than new nurses can be trained, the
lack of faculty at nursing schools, working conditions, the nursing
profession “eating their young,” nurse burnout, job dissatisfaction,
government changes and new disease challenges.
Not any one entity caused the shortage; several factors
are included in this crisis, which we will explore in the following pages.
The Baby Boomers
The age of the baby boomer is upon us and as these middle-aged Americans
age, so does the demand for nurses to take care of them. The only problem
with this demand is the supply, since not as many young men and women are
entering the field of nursing as a career.
The median age for nurses in a 1990 study was about
forty-five. Not that these nurses are invaluable in their more experienced
years, but who is going to take their place when they decide to retire and
travel fulltime without having to work?
In today’s society, the numbers of retiring nurses
outnumber the nurses who are graduating from nursing school by 20%. I also
know plenty of more experienced nurses who now use their knowledge to the
best of their ability by consulting. Just because they are older and their
legs don’t work so well after forty years of running up and down hallways
doesn’t mean that their brain is lame also!
Working Conditions
After all, why would someone want to go into a profession where you are
begged to work overtime so you can hear from the families a confirmation of
the fact that nurses don’t have time to take care of patients the way they
should. Although families are somewhat more tolerant of it because they know
that “all hospitals are short-staffed.”
Why would you want to run around “like a chicken with
it’s head cut off” for six hours before you get time to stop long enough to
get a drink, go to the restroom, and grab a sandwich on your way back
because we can’t waste time for lunch—that abscess has to be drained!
Why would someone want to get into a profession where
your feet are abused by all the long hours spent traipsing down the
corridors of illness? If you are not one of the lucky ones to marry a foot
masseur, you’d better learn self-message techniques and get some comfortable
shoes.
Why would anyone want to spend time wiping butts, giving
enema’s, taking blood, then giving some back, cleaning up vomit, and my
personal favorite…cleaning up that stringy sputum!
I am expected to work long hours, contend with ridiculous
staffing circumstances, be treated like a dog by the administration, be
yelled at by the physicians while dodging the clipboard, and be ridiculed by
my nursing colleagues because I am definitely not working as hard as they
are and I am not as good as they are.
I never could understand the old saying, “Nurses always
eat their young,” but that is what exactly we do. The new graduates are
inexperienced and “stupid” because they haven’t been around the block like
we have.
But I drag myself out of bed at 4:00 a.m. every morning
because I care about the patients I take care of. I don’t know why anybody
wouldn’t want to live the dream of being a nurse!
Career nurses are nurses because we are dedicated to our
profession; because we really are concerned about patient care and the
health of others. It is just hard to convey to someone else that this
profession really does have its high points.
If only they could see the patient’s son who gives us a
hug because we took care of his mother so well as she slipped from this life
to the next. If only they could visit with the patient who went into
ventricular fibrillation before my eyes, and told me “thank you” ten minutes
after I had defibrillated her. Making a difference in someone else’s life,
that, my friend is what nursing is all about.
Another concern for professional nurses is the issue of
mandatory overtime. My colleague Melissa James stated, “After working a
twelve-hour day shift at the nursing home, the night shift nurse called in.
I was then informed by the director of nursing that I would stay or be
turned into the state for patient abandonment.”
Once being coerced into working those extra shifts, the
nurses recognize in their hearts that they should not be touching syringes,
handing out medications, or providing medical treatment, but they carry on
as instructed because they have family to feed at home and a nursing license
to protect.
Investigative reports show that insomnia has some bearing
on more than just a few aspects of nursing implementation, leading to
sluggish responses, delayed reaction times, failure to make a start when
appropriate, erroneous functions, decelerated thoughts, and a diminished
recollection of nursing actions already performed.
Another factor influencing the nursing shortage is the increase of
government interventions. With the rules and regulations of Medicare,
medical treatment is ruled by money, and not by patient need. This also is a
factor with insurance entities, including HMOs, PPOs, and private insurance.
The patient’s length of stay is governed by the patient’s
DRG (Diagnostic Related Group). If you have a hernia surgery, the
government, not the physicians, tell your when you time is up. As a nurse,
this bothers me terribly, because I see repeat patients that should have
been taken care of longer the first time, who have been discharged only to
return two weeks later with a severe infection and wound dehiscence.
Who wants to work with people who have new diseases like
vancomycin resistance enterococci (VRE), methicillin resistance
staphylococcus aureus (MRSA), AIDS, HIV, tuberculosis, hepatitis, and other
life-threatening contagious diseases?
Educational Factor
It does take money and time to get a nursing education. You find
yourself having to work at least part-time and fitting study time in at
10:00 p.m. after everyone else is tucked in.
The year I went to nursing school, I drove an hour and
fifteen minutes to school, stayed all day at school, and then drove back
home. Once home, I would change into my nursing assistant uniform just in
time to help feed thirty patients and put them to bed. It was only after my
job was finished that I went home and studied. Working only four hours a day
was a major cut in pay, but I worked the weekends also to bring home enough
money to pay the bills and keep my insurance by working at least thirty-two
hours in a week.
Even if you do find the money to attend nursing school,
thousands of potential nursing students are turned down from nursing schools
every year, not because they aren’t smart or can’t make the grade, but
because there is no one to teach them. The fact of the matter is that a
staff nurse with an associate’s degree makes much more than a teaching nurse
with a master's degree.
According to www.salary.com, a staff nurse in my hometown
makes an average of $54,479, while an Instructor of Nursing makes $42,408.
That is a 33% decrease in salary after you go to school for four more years.
What part of this makes sense? It doesn’t, and that is why we can’t get good
instructors in our colleges to help provide more nurses for the working
world.
Legal groups are in the process of advocating better
salaries and benefits for nursing instructors. These groups are involved in
the long process of working with state and federal government to pass laws
that will give additional money to schools to increase the salaries of
teachers. Health related corporations have campaigns to encourage people to
go into nursing and supply scholarships. Other schools are networking with
more hospitals to make room to educate nurses; still, not enough is being
done to help make a big difference in bringing nurses into the field.
Burn Out and Job Satisfaction
Burn out in nursing is very common. Nurses get in a rut of working the same
hospital for years and years and get to the point of being so stressed out
that they start to blame others for things that go wrong, have a depressed
affect, feel very irritable and frustrated all the time, and even have a
short temper, a sense of powerlessness, and a very negative attitude about
their work. They hate their work, and the literally have to “drag”
themselves to work everyday.
What makes the situation even worse is that for the every
one burned-out nurse, there are three others that are around her. The
burnout feeds itself into a raging fire that can destroy a unit and a nurse
if it isn’t carefully contained. Nurses are very dissatisfied in their jobs,
and misery loves company. Soon staff morale is at an all-time low.
As a traveling nurse, things change with enough frequency
that you don’t get burned out, related to the fact that a fire can’t get to
raging stage if you are moving your fire every thirteen weeks. It doesn’t
have a chance to grow from a small campfire into a gigantic bonfire.
If you don’t like the position that you are in, travel
nurses just pick up camp and move on. Staff nurses have a tendency to stay
in the same job for years and fight the burnout because they have settled
into that geographical location because of family or friends. Most commonly,
the way out is to leave the hospital or clinical situation and go into
management, education, home health, or a physician’s office. When they leave
the floor, the nursing shortage then increases.
Conclusion
Let’s face it…without a nursing shortage; there would not be travel nursing.
I’m all for better patient care and easing the nursing shortage, and that is
why I take my turn helping out those hospitals in need. I don’t get bored in
the same old routine because I change hospitals, and even floors, every
three to six months. No, travel nursing is not for everyone, but after
reading this book, you can make a more informed decision on whether or not
travel nursing is right for you.
By Epstein
LaRue, RN, BS, Travel Nurse
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