By Health Providers Choice

September 25, 2018

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Travel Nurses: What To Do About A Toxic Work Culture

This article is provided by: Health Providers Choice.

If you’ve dealt with a toxic workplace, you know how quickly passion can turn into dread. Unfortunately, bullying doesn’t stay confined to the schoolyard. Today, even adults are known for this type of harassment. However, their tactics are often more refined. Bullying is usually the leading cause of a toxic work environment in health care facilities. For travel nurses, toxic environments can feel particularly stressful.

The environment

Sometimes bullying occurs overtly, like when someone shows hostility. Other cases of bullying happen when the victim isn’t present to fight against it. Some workers describe being “thrown under the bus,” or blamed for mistakes that they didn’t make.

Workplace bullying has become relatively common in health care. One survey asked health care workers why they quit their jobs, and nearly half cited abusive behavior. Travel nurses in particular can become easy targets. Resident nurses may feel threatened by travel nurses. Some may think of travel nurses as “outsiders.” Every workplace has its own culture, and when a travel nurse has to learn the culture, other people in that workplace may be quick to point out mistakes.

☣ The impact of a toxic work culture ☠

As a travel nurse, your job is already stressful and emotionally charged. It carries so much stress that you certainly need a supportive environment. How can you find respite when other nurses and physicians want to add more stress to your workload? A toxic environment will erode your self-esteem, confidence, and attitude. In fact, stress can even impact your physical appearance and the way in which you carry yourself.

These changes rarely go unnoticed by your patients. They even feel residual stress, especially since many of them have to deal with stressful situations of their own. Furthermore, it causes you to have far less care and focus than you should have while caring for your patients. The results of this can be detrimental in many cases.

A few solutions

As a travel nurse, you have options to help you deal with toxicity. First, distance yourself from the problem. Of course, the term “distance yourself” doesn’t mean ignoring the problem. Instead, firmly let the bully know that you won’t play games, and then only interact with this person if you must.

Second, maintain positivity. Bullies thrive on control and they love knowing that they affect the surrounding environment. When you stay positive, you take away their control which helps everyone in the workplace.

Third, focus on your patients. Remember why you pursued nursing in the first place. This tactic helps you provide the care that your patients need. It may also remind you of all the things you enjoy about your job rather than all the difficulties.

Fourth, give yourself a mental detox. Think about why you chose your location. Did you take a job in the Pacific Northwest for the hiking? Take a hike on your day off. Did you move to a big city because you love culture? See a musical. Avoid burnout by enforcing a no-work policy on your off days. Time off is for rest, not for thinking about work.

Finally, keep in mind that you don’t have to stay forever. If you want to leave after your assignment, then, by all means, tell your recruiter. Sometimes the promise of change is enough to help you power through your current situation. Furthermore, your recruiter is also your advocate. If a situation has become overwhelmingly toxic, do not hesitate to tell your agency.

Toxic workplaces do exist and working in one can affect your morale. Just because you are a travel nurse doesn’t mean you have to put up with a toxic environment. By taking steps to protect yourself, you can make the most of a difficult job until you can finally move on.

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Since just recently joining The Gypsy Nurse, I have had so many questions answered about the world of travel nursing. This has been an excellent resource!
—Meagan L. | Cath Lab

By The Gypsy Nurse

September 23, 2018

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Where Will You Go? Locations That are Great for Travel Nurses

The research is in!

Recent research from WalletHub took a close look at the nursing industry across the United States. Some of these parameters are exactly what we look for when searching for locations that are great for travel nurses. The research information sheds light on the current employment environment. This information could be useful for your journey as a travel nurse.

Two key dimensions were examined using 14 relevant metrics.

— Opportunity & Competition

— Work Environment

The Top 5 in several categories are:

Most Nursing Job Openings per Capita

More nursing jobs means locations that are great for travel nurses to start looking.

  1. District of Columbia
  2. New Mexico
  3. New Hampshire
  4. Massachusetts
  5. Alaska

Highest Annual Nursing Salary (Adjusted for Cost of Living)

It’s important to note that just because a location has a high annual salary, it’s not necessarily translated to locations that are great for travel nurses. Sometimes the travel pay isn’t commiserate with the staff pay.

  1. Nevada
  2. Wyoming
  3. Idaho
  4. Michigan
  5. Texas

Most Healthcare Facilities per Capita

Wherever there are a lot of healthcare facilities, there are bound to be nursing shortages and thus, locations that are great for travel nurses.

  1. Oregon
  2. Maine
  3. Minnesota
  4. South Dakota
  5. Iowa

Top 5 Nurse-Friendly Hospitals

More research from Top RN to BSN, lists the most nurse-friendly hospitals in the United States. Who wouldn’t rate a location with one of these top 5 nurse-friendly hospitals as a great location for travel nurses!

Winners of the top 5 spots are:

  1. Schneck Medical Center – Seymour, Indiana
  2. Johns Hopkins Hospital – Baltimore, Maryland
  3. Ann & Robert H. Lurie Children’s Hospital Of Chicago – Chicago, Illinois
  4. Baptist Medical Center – Jacksonville, Florida
  5. West Virginia University Hospitals – Morgantown, West Virginia

Other Considerations

Reports also note that travel nurses frequently request assignments in places where many people want to vacation. Hawaii, New York City, California, Florida, Alaska, and Las Vegas are popular picks. Therefore, it’s the opportunities for time spent outside of work that makes these areas especially attractive.

Above all, when you contact your agency, talk honestly about what you are looking for in an assignment. Therefore, let your recruiter know what activities you enjoy. Clarity in your needs will only help the travel nurse agency find you the right contract. Be upfront about the types of places you would like to go.

Most importantly, it’s essential to understand the licensing requirements of different states.  What are the costs to obtain necessary licensing and who will cover those expenses? The lead-time to start an assignment is also important. You will need adequate time to give notice to any current position. As you evaluate options, be careful not to assess only the salary. While some areas offer an above average salary, the cost of living can be very high and quickly offset any gains in your paycheck.


Are you looking for a travel nurse job at one of these locations? Did you know that you can search our Job Listings for specific hospitals, cities, and by specialty?

Check it out and find your perfect travel nurse contract today!


Join The Gypsy Nurse Nation

Discover new travel nurse jobs, subscribe to customized job alerts and unlock unlimited resources for FREE.

Since just recently joining The Gypsy Nurse, I have had so many questions answered about the world of travel nursing. This has been an excellent resource!
—Meagan L. | Cath Lab

By Jeffery Williams

September 22, 2018

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How to Take Care of Your Teeth on the Road

Being away from home is rough. On top of living remotely and dealing with distance from family, friends and loved ones you quickly realize simple tasks can be much more difficult away from home. Oral care is one of those, but dismissing it for 13 weeks simply isn’t an option. Below we’ll look at some handy tips to keep your smile in shape as you travel the world.

Avoid the Temptation: Don’t Give in to Junk Food

Eating right at home is tough enough. Doing it on the road is even harder. Depending on your accommodations, cooking for yourself might not even be an option and with long hours, the temptation for tasty but greasy fast food flares up.

We all know regular, proper brushing is essential to a healthy smile, but we often forget that diet is equally as important (if not more) to healthy teeth. Our teeth lose minerals over the course of the day due to the activity of bacteria in our mouth; our teeth rely on the nutrients in our food to restore the minerals lost during the day, which strengthens the enamel and protects the dental tissue. The most important nutrients for our teeth are found in fruits and vegetables, but unfortunately not in the simple and easy fast food you’ll find yourself presented with on a regular basis.

Injecting some fruit and vegetables into our diet regularly will not only help your waistline but it’ll help your gum line too. Challenge yourself to eat at least one vegetable per meal or at minimum choose the healthier of the two options you’ve got in front of you. Also, don’t forget the power of meal prep Saturday/Sunday. Even if you don’t have a great kitchen, a little bit of prep for the week can go a long way.

Get an Electric Toothbrush

Let’s face it: mornings can be hectic. Sometimes that extra minute of brushing is the difference between late or on-time and even if it isn’t, getting your not-yet-awake-zombie self to take proper care of your teeth can be tough. And that’s only if you get a morning, which oftentimes doesn’t even happen.

An electric toothbrush helps with this in two ways. First is the timer. Nearly every electric toothbrush on the market comes with a built-in two minute timer to ensure you’re brushing for the dentist recommended 120 seconds. Yes, an iPhone timer works just as well but it’s an extra step in the process and often times that gets left out in the wee hours of the morning, especially if you’re trying to multitask. Having that built-in timer makes things just a bit easier.

The second is technique.

Brushing properly with a manual toothbrush isn’t as simple as some people think. Using an electric toothbrush takes all the guesswork out of technique and is nearly guaranteed to give your teeth an excellent clean time and time again. Being on the road working crazy hours can cause you to forget or skip brushing sessions. Making sure that each time you brush you get a perfect clean can be the difference between healthy teeth and significant tooth decay.

If you spring for the fancier of the brush options you start getting some really cool perks like sonic brushing action, quadrant timers, and advanced brush modes. These often aren’t necessary for keeping your teeth clean, healthy, and white, but they can make the process a bit easier and more effective.

If you decide to up your toothbrush game with some electronics, make sure you remember to bring along an extra brush head. Brush heads for electric toothbrushes need to be replaced every 2-3 months, which will likely be a bit shorter than your time on the road.

Remember The Dentist

Constantly being on the road makes it really easy to forget your twice-yearly dentist check-up. If you don’t go when you’re home, you’re probably not going to go when you’re out on assignment. As such, it’s crucial to make sure you remember to schedule your visit when you’ve got time. It’ll only take an hour and it’ll ensure that your teeth are clean, strong, and in working order.

Smile More

Our last piece of advice isn’t focused on protecting your mouth but rather using it. Being away from home is difficult, working long hours is stressful, and living in a new and different place can be ostracizing. The life of a traveling nurse can be incredibly tough sometimes and it’s important to remember to find happiness wherever you can.

And smiling more isn’t just about trying to be happier or finding delight in unexpected places. Studies show that the more you smile, the happier you are. It’s not the result of happiness as much as it’s the cause.
There’s no doubt this can be tough sometimes, but if you’re a traveling nurse, you’re likely used to a challenge.

Conclusion

Even though you may have a lot of other things on your mind while you’re roaming the globe, it’s still important to take care of yourself, and your oral health is part of that. There are a lot of dangers for your teeth that are inherent to the travel lifestyle, so follow these tips to keep your teeth and yourself happy and healthy!

Join The Gypsy Nurse Nation

Discover new travel nurse jobs, subscribe to customized job alerts and unlock unlimited resources for FREE.

Since just recently joining The Gypsy Nurse, I have had so many questions answered about the world of travel nursing. This has been an excellent resource!
—Meagan L. | Cath Lab

By The Gypsy Nurse

September 19, 2018

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Hurricane Florence Resources

Over the past several days, Hurricane Florence has seriously affected the Carolinas with severe flooding and storm surge.  Unfortunately, thousands of North and South Carolina residents, both coastal and inland, need assistance in a wide variety of forms.  For those that would like to assist in some way or get more information on how to help, we have provided a list of agencies and options to make it easier to help those in need.

FEMA Donation Suggestions

The Federal Emergency Management Agency (FEMA) indicates that donations of cash offer the most flexibility for charities and nonprofits to address those with urgent needs. FEMA asks that people do not donate unsolicited goods such as used clothing, miscellaneous household items, medicine or perishable foodstuffs at this time.  FEMA also urges those wishing to volunteer to not self-deploy, as it could negatively impact first responders and their missions. Potential volunteers are asked to register with a volunteer or charitable organization. FEMA notes that unfortunately there will be volunteer needs for many months after the disaster, so those wishing to help should sign up now.

Note: this list is not completely inclusive and represents what we know to be available at the time and reported on by various news and media outlets.

  • General information from the Federal Government: USA.GOV
  • FEMA General information: up-to-date resources and information from FEMA
  • North Caroline Florence victims: anyone in the designated areas can start applying for assistance online at gov or by calling 1-800-462-7585
  • Charity Navigator: a resource that grades established charities based on transparency and financial health
  • Donations for medications and medical products: org
  • Food Banks for the Carolinas: direct donations to support those in need of fresh food
  • North Carolina direct donations: Gov. Roy Cooper of North Carolina announced that the state itself was accepting donationsto help meet the immediate needs of people affected by the storm. Contribute online or by texting FLORENCE to 20222.
  • South Carolina is soliciting donations for the One SC Fund, which supports nonprofits that help state residents recover from natural disasters.
  • The Diaper Bank of North Carolina, is collecting donationsfor diapers and feminine hygiene products for people displaced by the storm. (You can also buy items on the group’s Amazon wish list.) The organization is also asking for volunteers and donations of diapers, wipes and sanitary pads
  • GoFundMe: those interested in donating can also support the official GoFundMe Hurricane Florence Relief fund here. This is a “hub” that includes verified campaigns and individual fundraisers for victims.

This is just a shortlist of many Hurricane Florence relief/assistance options.

Unfortunately, in these situations, some unscrupulous people will try to take advantage of these disasters and create fraudulent charities for financial gain.  If you suspect that an organization (not listed above) or an individual is engaging in fraud, you can report it to the National Center for Disaster Fraud.

Thank you for your support of those in need.

Join The Gypsy Nurse Nation

Discover new travel nurse jobs, subscribe to customized job alerts and unlock unlimited resources for FREE.

Since just recently joining The Gypsy Nurse, I have had so many questions answered about the world of travel nursing. This has been an excellent resource!
—Meagan L. | Cath Lab

By The Gypsy Nurse

September 17, 2018

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Nurses Working Together to Build Camaraderie

I’ve been visiting my adult daughter for the past week or two in-between contracts.  She works night shift and when she got home the other morning; she left me a note that she was going to have an after-work breakfast with some of her co-workers.  When I woke up and found her gone and read her note; I became nostalgic.

Years ago, I worked a factory job on night shift.  We worked 8 hour shifts and 2 or 3 mornings after work, we would all go to the local diner and enjoy coffee and a bite to eat together.  We discussed work, our families, problems and joys.  We built a camaraderie by doing this that extended into our work hours.  I feel that this made us more productive and helped us work together a little better as a team.

I miss this camaraderie.  Nurses barely talk to each other during work hours, cut down each other and as many nurses state; we “eat our own”.  I have yet to figure out why we do this or how to fix it.

I recently read an article written by Lisa Gonzales, RN, who is President of Absolute Nurses.  Why Nurses Should Socialize Outside of the Workplace is an excellent article and may explain some of the reasons that we as nurses do not socialize outside of work.

…sometimes it’s just a matter of asking if a co-worker would like to do something after work or on a day off.

Ms Gonzales recommends 10 Things that you can do with your fellow nurses.  In addition to her suggestions, I would like to add a few of my own.

– Invite your co-workers for a weekend cook-out.
– Organize a carry-in lunch on the unit.
– Take cupcakes, cookies or a cake to work once a month to celebrate the Monthly Birthdays (suggest that this is rotated between the nurses on the unit).
– Get involved with a fund-raiser  for a good cause and invite your co-workers to join you.
– Find out what your co-workers interests are and find something in common.

Remember that sometimes it’s just a matter of asking if a co-worker would like to do something after work or on a day off. As a traveler, I do this frequently. During my first week or two on a new contract I will ask the staff what their favorite restaurant is, where they go on their off-time, if they can recommend an activity in the area. When they give me their recommendations, I ask them if they would like to join me. You might be surprised how often they say yes.  So next time, just ask!

Is anyone interested in a cook-out?

Join The Gypsy Nurse Nation

Discover new travel nurse jobs, subscribe to customized job alerts and unlock unlimited resources for FREE.

Since just recently joining The Gypsy Nurse, I have had so many questions answered about the world of travel nursing. This has been an excellent resource!
—Meagan L. | Cath Lab

By cheryl hurt

September 11, 2018

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So, You Want to go to Nome Alaska?

Guest Post By: Cheryl Hurt, co-written by: Kimberly Richter

alaskan travel nurseBeing an Alaskan travel nurse is an exciting and unique experience. Here are some tips from travelers that are or have been to Nome. These tips will help you prepare and know what to expect on a contract in Nome, Alaska.

Orientation

Hospital orientation is generally four days long. The first two days are focused on standard hospital business and Native Alaskan Culture. Day 1 your badge photo and fingerprinting will be done.(yes, you will have your fingerprints taken at the hospital)  Lunch will be provided for you.

Day 2, you will visit the cultural center in the afternoon and have the opportunity to try Eskimo salad (something that you really should try) or Seal.

Day 3 Healthstreams (Yikes, there are 44). Dress for days 1 and 2 are business casual. Days 3 and 4 are scrubs. This is only a guide and not set in stone as each department has its own schedule.

Tips and Suggestions:

Housing Tips

  • Nome is a very walkable town. Plan to walk!
    Cabs are available for $4 one way in town. (the town is not big!)
  • Housing is corporate female shared housing or Male Shared housing, No Co-ed, so plan on being a great roommate and respect each other.

Shipping and Mailing Tips

  • Ship as much as possible in flat-rate shipping boxes that you can get from the post office. You will ship them to:

(your name)
113 W. Front Street
Nome, Alaska 99762-9800
(This is general delivery at the post office)

  • When shipping items, remember the postal service is not gentle with packages. Pack accordingly.
  • There is a waiting list for P.O. Boxes. If anyone is going to ship items to you, use the address above and have them notify you when items have been shipped.
  • Remember, if you are landing on a Saturday or Sunday, the post office is only open M-F from 0900 – 1700. Make sure you have the essentials for the first few days.

Supplies / Food / Etc.

  • Food is expensive; gluten-free is even more expensive. There are only two grocery stores; Hanson’s and ACs.
  • Meal prepping is essential. The food here is expensive (12 oz. bag of fresh green beans is 4.99, Bananas are 1.29/lb., Strawberries/Blueberries 6.00-10.00). This also reduces wasted food. In words given to me, “suck it up and forget about the price tags.”
  • Restaurants are expensive. There are only a few. I highly recommend the Gold Dust Saloon at the Nugget Inn. The food and drinks are delicious. They serve sushi (and more) and have trivia on Thursday nights at 1900. The Polar Cafe is another great choice. They have a great breakfast.
  • Paper towels, toilet paper, spices, aluminum foil, zip-lock storage containers, and zip lock bags, etc., are expensive as well. Ship as many of these items as possible. (The items I shipped were items that I knew I would use and not have to ship back home at the end of my contract).
  • Ship teas/coffee; these too are expensive. Along with your favorite water bottle, tea/coffee cup.
  • Amazon Prime will be your best friend for toilet paper, paper towels, and non-perishable food pantry items. OR for anything, you have forgotten at home.
  • Reusable grocery bags are essential. This will keep you from buying more than you can carry while walking unless you want to pay for a taxi which is $4 one way in town.
  • There are no “Dollar Stores” in Nome.

Packing

  • Mud Boots (i.e., Bogs, Muck Boots, Extra Tough Boots) are also a must in Alaska. There is only approximately 1 mile of paved roads; all other roads are dirt/gravel. There is a lot of mud when it rains, and you can walk in the surf (my favorite part).
  • Bathing suit for the Suana, which is located in the Rec center.
  • Sunglasses: Lots of sun into the wee hours of the night and back up in the wee hours of the morning. (It does not get dark during Spring and summer)
  • A good raincoat. Why? It rains, and you will inevitably be walking in the rain. We walk here regardless of the weather.
  • Ear Band, Gloves, Hat, Scarf. It still gets cold even in June. Not to mention the wind and rain. You will want to go outside, explore and enjoy the pristine beauty of Alaska and stay warm doing it.
  • A good knife (particularly a pocket knife or survival knife for cutting things.)
  • Lunch Bag — Obvious reasons. The cafeteria is tiny with limited hours. Restaurants do delivery; however, they charge at least 8.00 as your food is delivered by taxi.
  • Ship or pack vitamins, medications, and supplements-you most likely will not be able to find them here, and if you do, they will be expensive. The exception to this is some over-the-counter medications and vitamins are available at the hospital pharmacy, and they are cheap (i.e., a Bottle of Tylenol 2.00).
  • Chargers for phone, tablet, laptop. Also, make sure that if you are bringing electronics, you put them in your carry-on. Airlines are not gentle by any means with luggage.
  • House Shoes – floors get sandy/muddy.
  • Bath towel, hand towel, and washcloth. They should be provided, but just in case.
  • A notebook – Sometimes, you just want to write/journal.
  • A good book – There is a beautiful library. It is located at the cultural center.
  • Bring clothes you can layer. Some days it actually does get warm, and most structures (houses, apartments, restaurants, hospitals, etc. are kept warm).

Other

  • Wells Fargo bank is here and a local credit union.
  • Money-Cash is nice to have, especially if you have to take a cab (they do not accept credit/debit cards). I brought 50.00 in singles. Everywhere else accepts credit/debit cards. ATMs are available.
  • Make sure to notify banks of your travel. The worst thing that could happen is they block/lock your card because they thought someone had stolen them. Contact your credit card companies as well. They usually do not block/lock cards without notification unless you are leaving the country.
  • Check with the wireless service providers to see if they have service coverage in Nome. GCI is the provider here in Nome, but it is expensive. Trac Phones are available, and I’m told that they get good service. I have Verizon, and I have had ok service so far. (Turn your phone off and then turn it back on when you get to Nome.)
  • Nome is Rural! You cannot drive to Nome as there are no roads that lead to Nome. 2 roads go about 50 miles out east and west. Fly in and Fly out!
  • You can rent a car, but it’s very pricey, like 175.00-200.00 per DAY.
  • There is a movie theater in Nome, Sundays at 4 pm are $9.00 (it’s in the Subway.)
  • You have to have a fishing license to fish in Nome, Alaska. I think they said it is $150.00/175.00 for the season for nonresident/non-Native.
  • Animals- Musk-ox, Moose, Bears, Reindeer, Eagles, Huge Ravens. Polar bears are rare in Nome. We have found a baby seal on the beach. You might see Beluga whales passing thru, but with the position of Nome, it’s Rare, they say.
  • Do Not bring a firearm as they are NOT allowed in Corporate housing.

Things that others have shipped OR put in an extra suitcase and paid for the extra baggage:

(believe us, it’s worth the extra fee!)

  • Spices/Salt and Pepper
  • Oatmeal
  • Shampoo/Conditioner
  • Body Soap/Lotion
  • Razors/Shaving Lotion
  • Qtips/Dental flossers
  • Dish Soap
  • Hand Soap
  • Laundry Detergent/Fabric Softener
  • Toilet Paper/Paper Towels
  • Crackers Cereal
  • Feminine items
  • Hot Sauce/Condiments
  • Canned Tuna
  • Canned Chicken
  • Protein Powder
  • Dry packaged food
  • Zip-Lock Storage Container/Bags of various sizes.

***Tips- Place plastic wrap under lids of liquids to keep from spilling. If you have a Food Saver, seal liquid containers. If not possible, place liquid containers in Zip-Lock bags.

Did I mention you will be walking everywhere?

alaskan travel nurseMost importantly…

Bring an open mind. When you are flying into Alaska take in the beauty of this land from the sky. It is gorgeous! But wait until you land; then it becomes breathtaking!

Directions for once you have landed:

At the first opportunity, stop and take it all in. “Shut your mouth (sorry, be quiet), close your eyes, take a deep breath and let it take hold of you. Listen to the sounds, feel the warmth of the sun, the gentle breeze of your skin, smell the world coming to life around you and taste the saltiness in the air. Take a deep breath and open your eyes-she “Mother Nature” has never been more beautiful.”

Alaska will change your life if you let it.

Words cannot describe the majestic beauty of this land/sea. The culture and the history are intriguing. The unspoiled and untouched lands are home to some of the most beautiful animals.
Finally, you will have arrived in one of the most amazing places on earth. Keep an Open mind and enjoy Nome. But be careful. A lot that lives here was once travelers and fell in Love with Nome. There is No Place like Nome!

P.S. Don’t forget scrubs, stethoscope, trauma shears, a watch etc. as you will be expected to work a little. So, You Want to go to Nome Alaska?

Join The Gypsy Nurse Nation

Discover new travel nurse jobs, subscribe to customized job alerts and unlock unlimited resources for FREE.

Since just recently joining The Gypsy Nurse, I have had so many questions answered about the world of travel nursing. This has been an excellent resource!
—Meagan L. | Cath Lab

By The Gypsy Nurse

September 10, 2018

32823 Views

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Remote Control Your Mail

Working as a travel nurse has its unique problems. One of which is the question of what to do with your mail?

When you’re moving every 13 weeks, it’s easy to lose your mail with traditional USPS mail forwarding. If you don’t arrange it soon enough, it may arrive after you leave. If you don’t know what your new address is, you can’t forward it. It’s common for travel nurses to not have a forwarding address until a week or two at the most before a contract start. So what do you do?

There are many different services that you can actually ‘view’ your postal mail online.  With these types of mail systems, you view all of your mail online via an online ‘mailbox.’ This is similar to email but offers multiple other services that benefit the travel nurse or traveling professional. Your mail (unopened) is initially scanned and placed in your box. You can then determine if you want it opened and scanned, shredded, or sent to you at your selected forwarding address. This service is great for the tech-savvy and doesn’t want to deal with a pile of paperwork. All of your scanned documents can be saved and filed electronically for your future reference or printed if needed. Many of these companies also offer other services like virtual check cashing, and most cater to business travelers, so they understand the unique needs of the Travel Nurse.

Here is a list of some other mail services that you might want to check out:

I personally use UPS for forwarding. I have a street address, handle packages, and set up a forwarding schedule that meets my needs. When I am out of the country for long periods, I generally have my mail sent twice a month to a friend’s home, and she will notify me if anything of importance is received.

What are your solutions to controlling and forwarding your mail? Have you used any of the online or forwarding services? If so, what was your experience? Good? Bad? Would you recommend them?

Join The Gypsy Nurse Nation

Discover new travel nurse jobs, subscribe to customized job alerts and unlock unlimited resources for FREE.

Since just recently joining The Gypsy Nurse, I have had so many questions answered about the world of travel nursing. This has been an excellent resource!
—Meagan L. | Cath Lab

By The Gypsy Nurse

September 8, 2018

22594 Views

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The Art of ER Triage

Guest Post By: Richard D Ramsey

Triage is quickly becoming a lost art.

The Art of ER Triage

For those of you who don’t know, triage is the art of adding degrees of urgency to medical matters. For highly trained medical personnel, it’s a rapid process.

I can look at a room full of about 50 people and tell you if any of them are critically ill in about ten seconds. It’s the way ER nurses are taught to think and process information. Secondarily, we’re trained to take vital signs and ask the right questions to determine if a medical matter deserves immediate attention or not.

But, this skill is being eroded under the paradigm of patient satisfaction, that grim specter that’s killing healthcare from the inside out. Let me take you back to an emergency room twenty years ago. You go to the ER for whatever is ailing you, and the first person you encounter is the triage nurse. This person makes note of your chief complaint, takes your vital signs, and gives you a quick once over. Your treatment plan starts right then and there.

Emergency Rooms aren’t just spaces with cubicles. They’re set up in verities of ways to accommodate different needs. In fact, most ERs have minor care areas where you can be seen for bumps or bruises without having to compete with the critically ill. Also, they have different rooms with capabilities. Some rooms are larger than others, giving more room to work on more critical people. Some rooms have oxygen, some rooms have toilets, and some rooms are even better suited for pelvic exams. In a majority of hospitals, rooms are assigned to nurses in bundles. When a nurse comes on duty, they’re assigned a bundle of rooms, and they rotate patients in and out of those rooms throughout the day.

The triage nurse and the charge nurse (which is my role in the ER) must have a good working relationship and line of communication. Together, we determine where patients can be placed to maximize outcomes and efficiency. Knowing my team of nurses is important in determining this. I need to know everyone’s experience, particular skill set, strengths, and weaknesses. These factors are an important part of where I’m going to place you in the ER. Sounds logical, right? You would think so.

Let’s skip forward to today. Third-party payer systems (Medicaid, Medicare, insurance, HMOs, etc.) have warped competition between healthcare companies. When you choose which gasoline to put in your car, you usually chose the cheaper option. That’s why fuel stations post their prices on their signs. With emergency care, you don’t care how much it costs. Your third-party payer covers it, and you’re just responsible for the copay. Even if you’re not covered, you can still be seen and opt to get a bill in the mail. There is NO INCENTIVE for hospitals to lower their cost of goods and services. I’ll say that again. There is NO INCENTIVE for hospitals to lower their cost of goods and services.

So where does that leave us? Hospital A still wants your business over hospital B. So, how do they compel you to use their service over the competition? Simple, they’re going to gratify you.
There’s so much we could discuss about how the paradigm of patient satisfaction has changed healthcare, but we’re here to talk about triage. Remember the triage nurse we were talking about earlier? A recent development in the race to the bottom of patient satisfaction is called immediate bedding. Immediate bedding is exactly what it sounds like. You walk into an ER and they immediately place you in a bed. This has come about as a result of satisfaction metrics, like “door to doc” time. That’s the time it takes you to see a doctor after you walk in the door. Metrics just like that are the new driving force behind how healthcare is run. This has even become such a big deal that Medicaid and Medicare reimbursement is being attached to it under the pretense of “quality indicators” as implemented by laws like Obamacare.

Just look at the billboards in your hometown. Signs that tell you how long the wait at Emergency Room X is have sprung up left and right! This sounds like a great plan, and in some respects, it is. It’s practical to get patients in front of doctors faster. That is why they come to the ER, and we shouldn’t arbitrarily hinder that process. But, the devil is in the details. When we “immediate bed” patients, we’re not taking those critical five minutes to find the best place for them so we can maximize outcomes for everyone. A child with an earache is placed immediately in a critical area because that’s where the open beds are poor stewardship of resources, and it’s highly inefficient.

In the dawn of the 21st century, when people are living longer, and those with chronic illnesses are surviving them, our ER clientele as a whole is getting larger and sicker. Skipping steps in their health care plan to improve satisfaction metrics is both inappropriate and dangerous. Be relieved if you have to wait a few minutes in the ER. It’s the people that go ahead of you that are in the worst shape. They had a competent triage and charge nurse that made that decision based on objective data.

About Richard Ramsey:  I’ve been in nursing since 1995 and full-time ER since 2000. I live in Deep East Texas with my wife and my teenage son. As well as nursing, I play music, write (having many fiction books published) and appear on TV shows from time to time; most notably “Untold Stories of the ER,” where I wrote and acted in episodes for seasons 9 and 10.

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By The Gypsy Nurse

September 5, 2018

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Best Road Trip Stops from LA to Seattle

So it’s that time again; your next adventure awaits! We saw some of you lovely people reaching out for the best road trip stops from LA to Seattle and based on your responses we made you a quick little cheat sheet! Here’s a list of the best attractions, nature and grub for your next 13 week adventure on the West Coast.

Redwood National Park-

There’s just not many things that can make you feel as small on this big planet then standing next to a mammoth tree in California’s Redwood forests. This park for instance is home to tallest of all the redwood trees. For the Instagram savvy, you may want to stop at the Drive-Thru Park and pay $5 to drive through one and get to snap a quick picture to prove it!

Cannon Beach –

Cannon Beach is truly like a dream come true. Celebrated as one of America’s 10 most beautiful towns on the West Coast, there’s a little something to captivate everyone. Personally, I like exploring and taking in the sights, so Haystack Rock would be a must for me to enjoy the landscape, the areas Tufted Puffins and the beautiful marine life in the tide pools. For those more adventurous, you should check out the zip-line tours, surf classes or even a helicopter ride!

Yosemite –

Found in California’s Sierra Nevada mountains, Yosemite and it’s indescribable beauty is on most adventurers  bucket list. It’s best known for it’s breathtaking waterfalls, but has nearly 1,200 square feet of landscape to roam and explore. Camping sites are available for tents, as well as RV’s, if have a few days to unwind and enjoy in the great outdoors.

Crater lake-

With it’s crystal clear and nearly pristine fresh water, Crater Lake is a must-see for those traveling through Oregon’s,Cascade Mountain Range. This beauty was created nearly 7,700 thousand years ago from volcanic eruption that caused a mountain peak to collapse. The water gets it fascinating beauty from rain and snow, and is the deepest lake in the United States!

Monterey –
Best Road Trip Stops from LA to Seattle

Roll down Highway 1 and take in all that Monterey has to offer. Like the rest of these sites, there is so much beauty in nature that it’s hard to make a short list! Some of the top attractions are famous Bixby Bridge on the way to Big Sur, hang-gliding above Marina State Beach and diving deep with the scuba team at Seven Seas Scuba. If you’re lucky enough to travel with your significant other, you have to check out Lover’s Point in Pacific Grove.

Do you have any other suggestions? Places I’m crazy to have not mentioned? Drop a comment below and let us know! We love hearing about your experiences so we can share them with our growing gypsy community!

Join The Gypsy Nurse Nation

Discover new travel nurse jobs, subscribe to customized job alerts and unlock unlimited resources for FREE.

Since just recently joining The Gypsy Nurse, I have had so many questions answered about the world of travel nursing. This has been an excellent resource!
—Meagan L. | Cath Lab