June 12, 2015

18906 Views

CA License Delays: Continues To Be A Hurdle For Travel Nurses

Posted on June 12, 2015January 16, 2023 by The Gypsy Nurse

CA License delay update:

CA is still experiencing extreme delays in licensing for RN’s. I’ve attempted contact with them to no avail to obtain additional information for you – the potential CA RN candidate – to move this process forward in a more expedient manner. If/When I receive any additional information, I will update you.

In the meantime, some of our Facebook Network Group members have suggested some of the following to help those experiencing issues or with questions on how to proceed with CA license delays.

Cali License Tips:

Kristen Bowles @ TaleMed gives some tips on “How to get a CA license in 7-8 weeks”:

1. Print out the application

2. Do NURSYS verification online

3. Have colleges send official transcripts directly to CA BON

4. Have 2 sets of hard fingerprints done at local police station (they have the same that CA requires and sends out) . Send in 2 sets because California BON sometimes reject a set.

5. Have a passport picture taken at CVS

6. Send in application , passport picture , both sets of fingerprints and check all together

7. Register for Breeze

Anonymous Member From post dated 01/09/2015:

Temporary license received in 2 weeks total time following these steps:

1. Print out California licensure by endorsement pages and fill it out.

2. Order All sealed Student Transcripts to yourself (overnighted) or to the BON at the following address:

BON 1747 North Market Blvd., Suite 150

Sacremento, Ca 95834

3. Go to verify licensure ($30) at https://www.nursys.com/NLV/NLVTerms.aspx (it does not have to be your original state of licensure, if they do not participate in Nursys)

4. Obtain 2 by 2 photo for application. Attach to application where indicated on all 4 sides with clear tape. (Costco, Walmart, Sams club)

5. We called to inform them we were on our way. 1-800-838-6828

6. We arrived and turned in the application, (and transcripts if you have them) paid the fees for temporary and whole licensure ($150). Obtained the fingerprint card (FD258)

7. Go to the UPS store the BON indicated (1 mile away) and have prints scanned ($75)

8. Return the fingerprint card to BON office retrieve email address from person at window for a reference.

If you want some personal assistance, Steven Swan @ Valley Healthcare Staffing offers the following:

“We are happy to walk your application to the window and through the process. Our office is two blocks away and the license will take 2-3 weeks TOPS. We go to the window 2+ times per week and check status in person. You don’t have to work for us – it’s a service we offer and are happy to help.”
Steve Swan
Valley Healthcare
steve@valleyrocks.com
(916) 505-7744

Contact the CA Board of Nursing

Physical Address

Board of Registered Nursing
1747 North Market Boulevard, Suite 150
Sacramento, CA 95834

Mailing Address

Board of Registered Nursing
P.O. Box 944210
Sacramento, CA 94244-2100

Phone Numbers

Main Phone: (916) 322-3350

Hearing impaired individuals can call our TDD number: (800) 326-2297

If you have any additional tips for our CA applicants, please let us know in the comments!

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By Lori Boggan

May 8, 2015

29676 Views

A Nurse in Sweden

Posted on May 8, 2015November 10, 2023 by Lori Boggan

How it all began……

Hi there! My name is Lori. I’m a neonatal nurse in Sweden who began traveling over eight years ago. For my first contract, I stayed close to home in Florida (as some travelers do) to test the waters. After my first thirteen-week contract was complete, I headed to San Francisco. In the eight years and many miles since, I have somewhat rooted myself in a country known for gender equality, meatballs, and Aurora Borealis.

I moved to be a nurse in Sweden five years ago in August. It has been both challenging and amazing. You learn so much about yourself when you step completely out of your comfort zone, learn a new language, eat new food, and experience new traditions. From finding baking powder (bakpulver) in the grocery store to learning to calculate exchange rates, the brain is on overdrive trying to absorb and register all the new experiences that we take for granted when we are in our own environment. There are days where it is super exciting and there are days when you want to pack your bags and go home out of sheer longing for the familiar.

Sverige (Sweden)

What brought me to Sweden? I get this question often from both Americans and Swedes alike. It was love. My boyfriend, Fredrik, is Swedish. We met while I was on a travel assignment in San Francisco and he was working at a startup in Silicon Valley (engineers galore for any single travelers out there). Neither of us planned to stay permanently in California and had no idea that when we met, we would be inseparable. Just shy of our third year together, we packed our things and headed east. I was lucky to get a temporary work and study visa on arrival because Fredrik is a citizen of Sweden.

I live in the second-largest city in Sweden, Gothenburg.

It is a beautiful walkable city on the south-west coast with a population of over 900,00 including both urban and metro areas (Gothenburg).
Was a trading city that also has a rich history of fishing.
Is home to and the birthplace of Volvo.
It has two major universities.

Culturally, Gothenburg claims Jose Gonzalez as one of their own! It is the Seattle of Sweden. Can you sense the pride I feel living in this city?

I spent the first year I was here studying Swedish intensively at the University of Gothenburg. After fulfilling the language requirement, I started studying for my Swedish nursing boards which were a written exam (in Swedish). By May 2013, I had taken and passed my boards!! All that was left was a three and half month internship in the Swedish medical system followed by a little one-semester course in medical Swedish law (nightmare).

I started working and actually getting a paycheck just over a year ago 🙂

I work in the second largest NICU (neonatal intensive care unit) in Sweden. It is a university hospital (Sahlgrenska University Hospital). Like the U.S., they are short-staffed (more on that soon), so I am able to work contractually and go home when I want. I am surrounded by some of the brightest doctors, nurses, and techs from around the world. While it is super challenging thinking, speaking, and charting in Swedish (especially in an emergent situation), I have the constant support and encouragement from a great group of coworkers. Now on to the next adventure……….my Swedish BSN!!!! Follow my adventures on Instagram and through my blog, Neonurse.

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By The Gypsy Nurse

April 5, 2015

15037 Views

Why Nursing Is Still a Great Career Choice for Women

Posted on April 5, 2015May 13, 2021 by The Gypsy Nurse

Historically, nursing has been considered a great career choice for women not just because it’s respected and well-paid, but because the career path has been a relatively easy one. During the early and mid-20^th century, nurses received two to three years of training through either hospital-administered programs or the military; later, community colleges began to offer two-year nursing degrees or ADNs. Even today, many nurses take advantage of the two-year ADN path to becoming a registered nurse (RN).

But the basic requirements to enter the nursing career are getting tighter. Many hospitals are phasing out licensed practical nurses, or LPNs, nursing professionals who don’t have a college education of any kind. They’re also requiring RNs to earn at least a Bachelor of Science in Nursing (BSN). While LPNs and RNs with ADNs will still be able to work in non-hospital settings, the highest-paying jobs with the most room for advancement are to be found in hospitals. The good news is that nursing has not stopped becoming a great career option for women; for those who are willing to spend a few more years in nursing school, nursing still offers a high salary, plenty of opportunities, and a flexible work schedule.

Opportunities for Well-Trained Nurses Abound

It’s true that nursing isn’t as easy to get into as it once was. According to the Wall Street Journal, it’s harder than ever for nurses without BSNs to get hospital jobs, and there are few opportunities for nurses to advance outside of hospitals. Nevertheless, if you’re a nurse with a BSN or an MSN, you’ll find plenty of opportunities.

Registered nurses still command a healthy salary of $65,470 a year, according to the Bureau of Labor Statistics. That’s enough for a single mother to support her family on her own, or for a married woman to contribute to the household finances and enjoy some degree of economic independence. Over the next decade, the health care industry is expected to add 526,800 new registered nursing jobs, and if you go ahead and spend the extra time to earn a BSN, you’ll qualify for all future nurse job openings.

For nurse specialists, the news is even better. When you earn an advanced degree in nursing, you’ll be qualified to become a nurse midwife, nurse anesthetist, or nurse practitioner. These positions are compensated at an average of $96,460 a year and the Bureau of Labor Statistics expects 31 percent job growth over the next 10 years. For women who want a well-paying job with lots of room for advancement and a great job outlook, a nurse specialist position is the way to go. An MSN will open doors to these positions, or you can earn a Doctor of Nursing Practice and maximize your potential for advancement and job security in a field that offers the flexibility modern women need. With a DNP, you can even transition into a nurse educator role later in your career, and help to educate the next generation of young nurses.

Nursing Offers Flexibility and Endless Opportunities

Many women need a career that allows them to support their families both financially and emotionally. Nursing salaries are high enough that, even as a registered nurse, you can pay the bills and keep your family comfortable, whether you’re a single mother or a partnered one. You’ll be able to choose to work days, weekends, or nights. You can even work three 12-hour shifts and have a four-day weekend every week. When you choose nursing as a career, you’ll have plenty of time to spend with your family.

Nursing also offers plenty of opportunities around the country and the world. No matter where you go in the United States, you’ll be able to find a job. You could even work overseas, or give back by helping the homeless or working with an organization like Doctors Without Borders. You could become a travel nurse and see the country or the world. You’ll have the skills to care for ailing family members and to protect your own health. You can choose a quiet, relaxed work environment, such as in a nursing home, or a fast-paced, hectic work environment, such as in a hospital emergency department. No matter what you want from your career, nursing can give it to you.

Since the nursing profession first emerged, it’s been considered an ideal way for young women to earn a living. Today, nursing offers women more opportunities than ever. Choose a career that offers independence, respect, flexibility, a high salary, and a chance to challenge yourself and grow professionally and personally — choose nursing.

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By Joseph Smith @ Travel Tax

January 20, 2015

11516 Views

ACA Tax Implications for Travelers

Posted on January 20, 2015January 26, 2023 by Joseph Smith @ Travel Tax

Guest Article provided by: Joseph Smith @ Traveltax.com

ACA (aka “Obamacare”) requires all individuals carry health insurance starting with the 2014 tax year. Here is some information on ACA tax implications for travel nurses:

Since travelers are highly susceptible to gaps in employment, they are more likely to be subject to the penalties assessed for the lack of coverage. Additionally, travelers who intend to use the health insurance exchanges and associated tax credits will have difficulty predicting their subsidy due to the income swings that occur with their various contracts.

ACA Tax Implications

The next series of articles will look at the ACA mandate and its impact on travelers by first focusing on how penalties for non-compliance are assessed. In the next installment, we will look at the mechanics of the tax credits that are available to those who procure health insurance from the exchanges.

Penalties

The penalty for not carrying qualified health insurance coverage starts in 2014 at 1% of income or $95, whichever is greater. In 2015, the penalty rises to $325 per person or 2% of income; and in 2016, $695 or 2.5% of income. The penalty applies for any month that an individual is not covered and is prorated if the individual fails to carry insurance less than 12 months of the year. Since travelers run the risk of losing employer based health insurance during the periods between assignments, they are subject to the penalty unless they procure another policy or continue the policy provided by the last employer through COBRA.

GAPS in Coverage

Under the ACA regulations, if an individual has coverage for one day in a month, they are credited as having coverage the entire month. This potentially allows a traveler to gap coverage for nearly two consecutive months so long as the coverage ends and starts in each month. Some health insurance providers follow a calendar month cycle, meaning that coverage continues until the last day of the month even if a traveler finishes an assignment in the first week of the month.

Exemption for Gaps in Coverage

Though the penalty applies for any month an individual does not have coverage, there is an exemption available for those whose coverage gap is less than three consecutive months. This exemption is only allowed once a calendar year so if the exemption is used in the early part of the year, it cannot be used again in the latter part. If there is a second gap in coverage during the calendar year, a separate “hardship exemption” can be requested. “Hardship” exemptions include a number of specific situations including a death of a family member or bankruptcy filings; however, most all of them require some form of documentation. Hardship exemptions are filed separately from the annual tax return unlike the regular exemptions.

Since the ACA regulations incorporate a one day = one month convention, a traveler could have almost 5 months of coverage gaps and still qualify for the exemption, so long as the coverage ended sometime during Month 1 and coverage with a new policy began in Month 5.

Coverage gaps that extend through one calendar year and into the next have a specific counting rule.

If a traveler does not carry coverage the last two months of the year, when they file their tax return for that year, they report a two month gap in coverage which would qualify for a regular exemption. The counting for the second year incorporates the previous year end gap.

EXAMPLE: If the traveler continues without coverage for the first two months of the second year, they will be considered to have a gap in coverage for 4 months in that year and be subject to the penalty. A peculiar situation can arise when a traveler gaps coverage in November, December and January. For the first year, there is a two month gap which is covered under the regular exemptions. For the second year, the gap is a three month gap, again, covered under the regular exemptions; however, since the regular exemption is used, a subsequent second gap in that calendar year requires a hardship exemption.

Filing Taxes

Since ACA compliance disclosure is incorporated in the annual tax return filing, it adds another layer of complexity to set of forms required with each return. Most taxpayers will receive Form 1095 that evidences health insurance coverage. An additional form currently being developed will be used to report the information on the 1095 series forms when the return is filed. Search and download forms HERE.

Would you like to learn more?

Check out the TOP 10 Questions for Travel Nurses on Taxes.

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By The Gypsy Nurse

January 9, 2015

9047 Views

Things To Do in San Antonio

Posted on January 9, 2015April 20, 2022 by The Gypsy Nurse

When you’re in a new City, finding the ‘Best’ things to see or do takes a bit of research.

Avoid the time-consuming research by taking these suggestions for Things to Do in San Antonio from one of the Network group members, Deana.

Restaurants

Kimura – Ramen downtown by pecan street and Riverwalk (Great food)
Rita’s On the River- Riverwalk, Great food and Pitchers of Margaritas less than $30
Vegeria – vegan tex mex (didn’t try)
Mi Tierra’s – off the market square (awesome experience and great food)
La Margarita’s – also off the market square. Liked Mi tierra’s better
Green Vegetarian Cuisine – Pearl District, Didn’t try
LaGloria – Also in Pearl District, didn’t try, but it gets rave reviews
Bun n barrel –didn’t try
Roberto’s taco shop-didn’t try
El Chapparal- In Helotes off of Bandera Rd. – Live music in the evenings, wonderful atmosphere and food.
The Grist Mill in Gruene is great!
There are quite a few restaurants off the riverwalk. Joe’s crab shack is one, Dick’s bar is another. Sometimes there’s coupons in the current magazine.
Big Lou’s Pizza- Awesome pizza. Has wagon wheeled size pizza for around 99 bucks. Get a much smaller one if there’s just 2 people. Will feed an army.
Lots of chains – Whataburger started in Corpus Christi, Taco Cabana is a san Antonio starter, Las palapas is great!
Umai Misa is an awesome Asian restaurant. There’s a few shops in the little shopping center too. Also has a painting class similar to Pinot’s Pallette, Latin Dance Lessons, and a cool coffee shop.
Chocolateka off of 1604 is a chocolate bar!

Things to do

Riverwalk – There’s riverboat tours until 9pm.
TheMissions including the Alamo- there are 5 I think. Takes all day to see every one.
Visitor’s center on the Riverwalk close to Alamo has lots of pamphlets.
The governor’s palace is downtown.
There is also a church downtown that is awesome.
Pearl Brewery District.- The brewery has been closed for a while but they are building a nice hip area with shops and food. There’s a cool coffee shop down there.
The Buddhist temple by mission ranch is Chua Phuoc Hue, 6292 Lockhill Road, San Antonio it has an awesome garden with statues
There is a Japanese Tea Garden next to the Zoo.
Of course Sea World and Fiesta Texas (six flags are here) they may have some Christmas stuff going on.
If you want to learn salsa, Arjon’s Dance Studio is a nice little Cabaret. Sundays for $5 cover from I think 7-9 there is salsa lessons. Drinks are $1. This was a cool activity for me and another travel nurse.
Incarnate Word put their Christmas lights up last week. I haven’t been able to go yet.
Tejas Rodeo Awesome!! Rodeos run from March to early November. Dancing included.
Tons of festivals are usually going on somewhere.
New Braunfels and Gruene are nice little towns. Live music in Gruene. There’s also 2 wineries there.
There is Floor country store dance hall in Helotes close to El chaparral.
Cowboys dance hall has concerts, dancing and other stuff like pbr going on.
Schlitterbahn, New Braunfels in the summer- biggest Water Park I’ve seen.

Shopping

The shops at La Cantera are good.
Ingram mall
There is a couple of shopping centers down Huebner. Take a right onto Huebner from Babcock.
Past HEB and around I 10 there’s a Walmart, Sam’s, Specs (Nothing but liquor) and some other chain favorites. There is also a couple of small Walmarts on Bandera on the way to Helotes.
Ingram Mall I think that’s the one on 410 has a decent mall.
Market Square on Commerce-Like Little Mexico, Can Barter with shop owners.
Buc-cees’- New Braunfels, Biggest Gas Station Ever!

Movies

Alamo draft house (you can order food and drinks from your seat in the movie).
Paladium has a nice bar and restaurant in it. Alvin and the chipmunk statues are there.
Bijou Cinema- similar to Alamo draft house, but has independent films.

Bars

Little Woodrow’s-on Babcock. Nice sports bar.
Moses Roses Hideout next to jimmy john’s on Houston by the Alamo- awesome burgers
There’s chains like Bar Louie’s and Stone Werks and YardHouse and some others that are pretty nice to go to.
There is a bar in the Tower of America’s. Like the space needle. $8 cash to park in their lot. They have a happy hour.
Friendly Spot is downtown and is family and pet friendly.

Parks (Dog Friendly)

Phil Hardberger Park, There are two Sides.
Spend a weekend morning at one of San Antonio’s dog parks. Come on out and meet puppies, dogs, and people of all breeds.
Great way for both you and Fido to make lasting friends! See a full list here: http://www.sanantoniodoglife.com/dog-parks

A Huge “Thank You” to Deana for sharing this list. Do you have other suggestions for san Antonio? Have a similar list for another city? Please share! If you would like to have your City To Do list published, get in touch!

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By The Gypsy Nurse

October 16, 2014

9647 Views

Diagnose Ebola vs Flu vs Other: Is it Ebola or Flu?

Posted on October 16, 2014September 20, 2024 by The Gypsy Nurse

How do you tell if it’s Ebola or Flu? Is there a rapid test to Diagnose Ebola?

**Please Note: This is the most current information that I can find. If you have updated information, please feel free to post it in the comments. Just trying my best to answer questions.

There is a rapid test that can rule out or diagnosis the FLU. For Enterovirus D68, the CDC states, “EV-D68 can only be diagnosed by doing specific lab tests on specimens from a person’s nose and throat. Many hospitals and some doctor’s offices can test ill patients to see if they have enterovirus infection. However, most cannot do specific testing to determine the type of enterovirus, like EV-D68. CDC and some state health departments can do this sort of testing.CDC developed, and started using on October 14, a new, faster lab test for detecting EV-D68.” Read more about what CDC was doing about EV-D68 in 2014.
“….but, What about Ebola?”

Diagnosing EBOLA

Several blood tests can diagnose Ebola. It’s important to note that according to WHO, “Samples from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions.” According to the information found on Wikipedia, Ebola is included in the Level-IV Viruses; there are a limited number of facilities in the US that are even qualified to deal with a ‘Level-IV” virus.
According to the CDC, “Ebola virus is detected in blood only after the onset of symptoms, usually fever. It may take up to 3 days after symptoms appear for the virus to reach detectable levels. The virus is generally detectable by real-time RT-PCR from 3-10 days after symptoms appear.

Specimens ideally should be taken when a symptomatic patient reports to a healthcare facility and is suspected of having an Ebola exposure. However, if the onset of symptoms is <3 days, a later specimen may be needed to completely rule out Ebola virus, if the first specimen tests negative.”

For additional information on Collection, Storage and Handling of Lab Specimens: Printable factsheet: Interim Guidance for Specimen Collection, Transport, Testing, and Submission for Patients with Suspected Infection with Ebola Virus Disease.

Diagnostic Timeline for Ebola

Unfortunately, according to the information that I’ve been able to find, there is no rapid test, nor can you diagnose ebola via lab tests before the patient is symptomatic. The recommendations state that testing should be done on the first sign of symptoms but further state that an initial negative should be re-tested.

(graph below obtained from WHO)

Timeline of Infection	Diagnostic tests available
Within a few days after symptoms begin	Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing IgM ELISA Polymerase chain reaction (PCR) Virus isolation
Later in the disease course or after recovery	IgM and IgG antibodies
Retrospectively in deceased patients	Immunohistochemistry testing PCR Virus isolation

What is a ‘Level-IV’ virus

According to Wikipedia: Biosafety level 4

The Galveston National LaboratoryBSL-4 (P4) lab on the Campus of theUniversity of Texas Medical Branch

This level is required for work with dangerous and exotic agents that pose a high individual risk of aerosol-transmitted laboratory infections, agents which cause severe to fatal disease in humans for which vaccines or other treatments are not available, such as Bolivian and Argentine hemorrhagic fevers, Marburg virus, Ebola virus, Lassa virus, Crimean-Congo hemorrhagic fever, and various other hemorrhagic diseases. This level is also used for work with agents such as smallpox that are considered dangerous enough to require additional safety measures, regardless of vaccination availability. When dealing with biological hazards at this level, a positive pressure personnel suit with a segregated air supply is mandatory. The entrance and exit of a level four biolab will contain multiple showers, a vacuum room, ultraviolet lightroom, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors from opening at the same time. All air and water service going to and coming from a biosafety level 4 (or P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.

ACCORDING To The CDC: BSL-4

BSL-4 builds upon the containment requirements of BSL-3 and is the highest level of biological safety. There are a small number of BSL-4 labs in the United States and around the world. The microbes in a BSL-4 lab are dangerous and exotic, posing a high risk of aerosol-transmitted infections. Infections caused by these microbes are frequently fatal and without treatment or vaccines. Two examples of microbes worked within a BSL-4 laboratory include Ebola and Marburg viruses.

Centers for Disease Control and Prevention	United States, Georgia, Atlanta		Currently operates in two buildings—one of two facilities in the world that officially hold smallpox.
Georgia State University	United States, Georgia, Atlanta		Is an older design “glovebox” facility.
National Bio and Agro-Defense Facility (NBAF), Kansas State University	United States, Kansas, Manhattan		Under construction. Facility to be operated by the Department of Homeland Security, and replace the Plum Island Animal Disease Center (which is not a BSL-4 facility). Planned to be operational by 2015, but likely delayed.
National Institutes of Health (NIH)	United States, Maryland, Bethesda		Located on the NIH Campus, it currently only operates with BSL-3 agents.
Integrated Research Facility	United States, Maryland, Fort Detrick		Under construction. This facility will be operated by the National Institute of Allergy and Infectious Diseases(NIAID). It is planned to begin operating in 2009 at the earliest.^{[needs update]}
National Biodefense Analysis and Countermeasures Center (NBACC)	United States, Maryland, Fort Detrick		Under construction, it will be operated by the Department of Homeland Security.
US Army Medical Research Institute of Infectious Diseases (USAMRIID)	United States, Maryland, Fort Detrick	1969	Old building
US Army Medical Research Institute of Infectious Diseases (USAMRIID)	United States, Maryland, Fort Detrick	2017?	The new building, currently under construction
National Emerging Infectious Diseases Laboratory(NEIDL), Boston University	United States, Massachusetts, Boston		Under construction by Boston University, building and staff training complete, waiting for regulatory approval.
NIAID Rocky Mountain Laboratories	United States, Montana, Hamilton		National Institute of Allergy and Infectious Diseases
Kent State University, Kent Campus	United States, Ohio, Kent		Operates as a clean lab at level 3 for training purposes. Scheduled for conversion to a hot level 4 lab in response to a bioterrorism event in the USA.
Galveston National Laboratory, National Biocontainment Facility	United States, Texas, Galveston		Opened in 2008, the University of Texas Medical Branch operates the facility.^[28]
Shope Laboratory	United States, Texas, Galveston		Operated by the University of Texas Medical Branch (UTMB).
Texas Biomedical Research Institute	United States, Texas, San Antonio		The only privately owned BSL-4 lab in the US.

The U.S. Centers for Disease Control and Prevention (CDC) now maintains 20 quarantine stations in the United States, which can detain and examine people — and animals — believed to be carrying dangerous infectious diseases.

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By The Gypsy Nurse

October 15, 2014

7906 Views

Ebola Fear

Posted on October 15, 2014February 24, 2022 by The Gypsy Nurse

There is a ton of Ebola fear and controversy in the media. Blame is being placed on the CDC, the Hospitals, the Nurses. When HIV/AIDS broke out in the 80’s we as a society experienced many of the same things that we’re seeing today with Ebola. Fear, Panic, Media sensationalism.

The NY Times has a run-down of the news from that time-period that you might say is being replicated now with Ebola

The AIDS Epidemic:1981-1987

1981: Unusual Outbreaks

June 5
The Centers for Disease Control and Prevention’s newsletter Morbidity and Mortality Weekly (MMWR) makes a reference to five cases of an unusual pneumonia in Los Angeles.

July 3
Rare Cancer Seen in 41 Homosexuals
The C.D.C.’s MMWR publishes its first description of a outbreak of 41 cases of Karposi’s Sarcoma, a rare skin cancer.

August 29
2 Fatal Diseases Focus of Inquiry
Two rare diseases have struck more than 100 homosexual men in the United States in recent months, killing almost half of them, and a medical study group has been formed to find out why.

December 10
Researchers report in The New England Journal of Medicine that harmless viruses and bacteria can often cause fatal illnesses in homosexual men.

By the end of 1981: 121 deaths

1982: Anxiety, Confusion
447 deaths

May 11
New Homosexual Disorder Worries Officials
A serious disorder of the immune system that has been known to doctors for less than a year – a disorder that appears to affect primarily male homosexuals – has now afflicted at least 335 people.

August 8
A Disease’s Spread Provokes Anxiety
The New York Times reports about the growing anxiety among gay men.

December 10
Infant Who Received Transfusion Dies of Immune Deficiency Illness
The C.D.C. reports that an infant died of acquired immune deficiency syndrome (AIDS) after receiving multiple transfusions.

The Ebola Fear

This fear is real and warranted. Hospitals are being criticized for not providing proper PPE (Personal Protective Equipment) and nurses are being criticized for not utilizing the equipment properly or not following protocol. i.e. the recent discussions of the Dallas Nurse diagnosed with Ebola after flying commercially.

In July of this year TedTalks had a conversation about the drawbacks of the US being a ‘reactive society’. Being reactive isn’t necessarily the right way to respond but it is a response. Fortunately, here in the US we at least have this option. As policies and procedures are modified, staff are being trained and proper equipment is being provided. These are all late in coming but they are coming and for this, we should be thankful. It’s not the pro-active response that many of us would have hopped for or expected but there are things being done. There are several items that can be addressed that take some of the ‘blame’ away and put information and education in the hands of those on the frontline dealing with this deadly virus and we are now beginning to see hospitals and health care facilities begin to implement and deal with these items.

Positive Responses and Implementation of Change

In a recent discussion via the Gypsy Nurse Network on Facebook, the question on ‘positive response’ was asked. What are hospitals and health care facilities doing to manage this virus? We got some great responses and proof that the Hospitals and Health Care systems are beginning to work on the issues at hand. (Note: The following quotes are from actual nurses working in the mentioned hospitals)

EQUIPMENT, TRAINING, SUPPORT, EDUCATION
“I work in an ED, we have a new cart with all the equipment on it that would be needed. It includes instructions for putting on the PPE and removal of it, and we have all been oriented to this cart. The 2 isolation rooms in this ED are also the first 2 rooms closest to the lobby.”

– North Shore Medical Center in Salem, MA

“I’m in ER. We have had frequent updates in our shift change huddle for a couple of months. Inserviced on isolation transport module. Maps of Africa and information posted in all triage rooms. Recently because of circumstances have increasing education including donning and doffing equipment and PAPPER respirators.”

– MMC in Portland, ME

“At John Peter Smith hospital in Fort Worth, TX we have now added a question on the triage and admission assessment asking about recent travel. I don’t work in ED but I know that they have been doing drills in case of a case coming to us.”

– JPS Fort Worth, TX

“At St. Louis university hospital a town hall meeting was held . Protocol set up for the Ebola pts. A strict PPE with N95 and suits not plastic gown will be wore special training for the nurse only two MD will handle all the cases.”

– St Louis University Hospital, St Louis , MO

“Policy in place, memos posted, online training including how to take special PPE on & off. Hazmat suits ordered by Infection Control. new “first contact” screening tool (specific questions about travel & symptoms) house wide. And this is an HCA hospital! Designated area of care here in Reston that includes most remote room, limited staff, & ICU goes to them with portable equipment should the need arise. We’re as ready as anyone can be, I think!”

HCA, Reston, VA

“Also at an HCA in LaFayette, Louisiana. Had a mandatory meetings Mon and Tues where we got handouts and questions answered, online review of donning PPE and focusig on the taking off. Implemented a “buddy system” if/when working with EVD patients to help hold each other accountable with keeping precautions clear. Special carts created. And HCA is having pts being treated as air born and staff is to wear n-95’s instead of just surgical masks.”

– HCA Hospital Lafayette, LA

“Numerous CEUs on Ebola and new policies in place on PPE, discussed contamination of the OR equipment and how an isolation area being set up on another floor, ready for the worst. Doubt very much the OR stuff will come into play since unlikely a pt would survive any procedures when hemorrhaging is a key component of the disease.”

– Undisclosed Hospital in Miami, FL

“We had a staff meeting today to discuss how to properly wear PPE and we are wearing the gear they wear when doing total joints and will have a buddy watch us put it on and take it off to help prevent accidental contamination”

– Inova Fairoaks 

Education is Key

For those of us in the medical field, education is KEY! Not only to educate ourselves but our patients, families and communities.

The Following guidelines are copied from: http://www.cdc.gov/vhf/ebola/

Guidance & Recommendations

Infection Prevention and Control of Ebola Virus Disease in US Hospitals
Posting date: Wednesday, August 20, 2014
Faculty: David T. Kuhar, MD

Patient Evaluation

Laboratory (specimen collection, transport, testing, submission)

Protecting Healthcare Workers

Diagnosis

Case Definition for Ebola Virus Disease (EVD)

General Information

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By The Gypsy Nurse

October 14, 2014

9253 Views

A Travel Nurse Volunteer in Cambodia

Posted on October 14, 2014April 20, 2022 by The Gypsy Nurse

The following was contributed by Kaitlin, a Travel Nurse volunteer in Cambodia. She recently completed a volunteer medical trip to Cambodia and shares some highlights of her experience below. If you have a volunteer trip that you would like to share, please send us an email!

About Kaitlin

“I’m from St. Petersburg, Florida and have been working as an ICU nurse for a number of years. I recently took up travel nursing this year to see more the country and schedule time off to volunteer abroad. I’m currently residing in Scottsdale, Arizona.”– Kaitlin Shanklin RN, BSN, CCRN

We’ve all experienced burnout in the nursing field, even if we switch specialties and take a vacation. For me, nursing in the states started becoming very corporate, and I was taking care of patients and families who were self-entitled and always right, leaving me with little autonomy and emotionally exhausted.I love nursing. I love the opportunities that nursing has given me. I love the patient care. I love learning about someone else’s life. I love watching my critical patients come back 1 year later to thank me. Nursing is a beautiful career, and I couldn’t picture myself doing much of anything else. But after five years at the bedside, I decided to take my nursing abroad. I decided to be a travel nurse volunteer. International Medical Relief is an organization that I stumbled upon while looking to vacation in Thailand. I decided to base my vacation in Southeast Asia and end it with a medical mission to Cambodia. I put down my deposit and gathered donations for my big trip. A year later, in September 2014, I found myself traveling throughout Thailand and Cambodia with a friend for 2 weeks, and then I was solo for about a week while I waited to meet up with everyone from the mission.

Who is International Medical Relief?

International Medical Relief partners up with the Song Saa Foundation, a part of Song Saa Private Island in Cambodia. The Song Saa Foundation assists several villages of the Koh Rong Islands with environmental restoration and education. International Medical Relief is one of the first medical teams to come to these islands to assist these villages with medical care. Each day we would bring around 15 suitcases packed full of medical supplies to a boat & ride to a village, unpack, and start our day. International Medical Relief is there to provide medicine and care and educate the population on oral health care, hand washing & women’s health, a focus for this current mission. Public health education is one of the most important things International Medical Relief brings to the table. The most common problems encountered as volunteers on these islands consisted of arthritic type pain, malnutrition, oral decay, high blood pressure, and dehydration. We saw a handful of HIV positive adults and children, scabies, fungal rashes, bacterial vaginitis, and burns.

Promoting Education

The people that come to the clinic to seek a check-up all left with a multivitamin or something as simple as Ibuprofen or Tylenol, and you know what? They were so incredibly thankful. We taught the children how to wash their hands properly, drink more water, and brush their teeth. We taught women about safe sex and provided condoms.

Any serious issues encountered went to our wonderful doctor. It was hot, and I was sweaty, but we are all so busy assisting the village people that it’s amazing how quickly you don’t care anymore and how the entire experience changes you. The children are adorable, the adults are thankful & I am in awe at their impact on these people’s lives.

This trip changed me.

It made me less materialistic & brought back my empathy as a burnt-out nurse. It had changed my course of life to changing my masters from anesthesia to public health/ NP with international studies included. But not until I go back to Cambodia and make a bigger difference in April.

Just remember what Brad Pitt said;

Until next time…

If you are interested in more travel Nurse volunteer stories, please check out the recent Travel Nurse in Liberia series. Again, if you would like to share your volunteer experiences, please send us an email!

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By The Gypsy Nurse

September 9, 2014

7923 Views

Remembering September 11 -A Look Back

Posted on September 9, 2014April 20, 2022 by The Gypsy Nurse

Where were you? Remembering September 11 – A Look Back

I was sitting in my kitchen, feeding my daughter breakfast in her highchair; it was about 8:50 in the morning, September 11, 2001. The TV was on, playing a childs program I can not even remember now. The phone rang and it was my husband; he asked if I had the TV on. I said, “yes, why?” He was working for a construction company, as a crane rigger, building the new parking garage at Norfolk International Airport, in Norfolk, Virginia where we live. He told me to turn on the news, he didn’t know what was going on but it was crazy there. I turned on the television to the local news and my stomach sank. Terrorists had flown airplanes into The World Trade Center in New York City. I was glued to the television watching the events unfold. It was tragic and also very personal for me.

At the time I was a Reservation Agent for American Airlines in their local office in Norfolk. I was scheduled that day off, like every Tuesday and Wednesday. I honestly can’t remember if I knew right away if any of the planes were my airline. I watched for what seemed like hours, but it wasn’t. It was long enough to witness the first tower fall, and the chaos in the streets. People running, the clouds of dust and debris rising up and barreling down the streets, as if chasing those fleeing.

My telephone rang again. It was my team Supervisor calling me in to man the phones. The call queue was over 300 holding. Families, friends and the curious were calling. I called my babysitter, and made arrangements to bring my daughter to her. I threw on some jeans and shirt, threw my hair in a baseball hat, packed my daughter’s diaper bag and left a note for my husband ( no cell phones yet).

I got to work about 10:45am. The call queue was well over 400 by this point. I got to a desk, plugged in my headset, logged into my computer to go live and instantly I heard the beep in my ear signaling that I was getting a call. My computer screen came up blank, where usually it had the existing reservation information, or the route they wished to travel. I was not prepared for this. Not mentally, nor emotionally. I had just lost my grandfather the day before and was supposed to be leaving to travel to my grandmother’s in Northern Virginia, with my mom and my daughter. Emotionally I was already in pieces. We usually answer our line with “Thank you for calling American Airlines, my name is Michelle, where are you traveling to?” I couldn’t say that, I just couldn’t. I simply said, “Thank you for calling American Airlines, my name is Michelle….” and I almost stuttered saying my own name.

Some of the voices I heard were panicked. They wanted answers, and information that I could not give them. Some calls were the curious. One call I took- the last one will be forever in my mind. It was a concerned family member of a passenger on Flight 77. The flight that was flown into the Pentagon. They wanted me to confirm whether their loved one was on the plane. How do you do that?? I don’t know. I was unable to deny, nor confirm.

We had been instructed to route those calls straight to our Customer Service desks, where Supervisors were manning the lines. What those callers were told, I am not sure. You could hear crying in the “res center”. Coworkers were breaking down. We all stopped looking at the queue marquee on the walls. I know I never looked at the clock. There was no laughing and whispering across the panels that separated our desks. You didn’t see people standing up to stretch their legs and back while waiting for the next call. The calls were relentless. They just kept coming.

I can not even remember how long I worked that day. But that was the last day that I worked because I was scheduled to be off on Bereavement Leave due to my grandfather’s death. I was leaving the next morning with my mom. Which I did. However, we had no idea that we would have to wait days to lay my grandfather to rest. While waiting I stayed at my grandmother’s where we all were glued to the TV downstairs in the den, on CNN. That is where I found out 3 days later that American Airlines was closing reservations centers. Mine specifically. I found out across the ticker on the bottom of the screen that I was losing my job. No warning from the airlines. Just a ticker that read, “American Airlines to close reservation center in Norfolk, Va”. Too much loss. I lost my grandfather on September 10. Our country lost 2,977 people on September 11.I lost my job on September 14. My job could be replaced….eventually. But the lives of those 2,977 people. They were mothers, fathers, sisters, brothers, sons, daughters, aunts, uncles, friends, girlfriends, boyfriends, wives, husbands, and children. Passengers, crew, firefighters, police, EMS and others.

September 11: Truly the greatest single tragedy our country has ever experienced.

thegypsynurse.comhttp://www.thegypsynurse.com

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CA License delay update:

Cali License Tips:

Anonymous Member From post dated 01/09/2015:

Contact the CA Board of Nursing

Physical Address

Mailing Address

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If you have any additional tips for our CA applicants, please let us know in the comments!

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