Bedside Hiatus

Since returning to the Hoosier State, I've made a big career change. I recently took a job that has no clinical contact; it's more of a health informatics position. Was this a big mistake? Only time will tell. I sure feel a lot less stressed at work right now, and I think working with electronic health records could be a resume boost...to a point. 

However, how will this move affect my ability to travel in the future, if I would decide to do so? One of the companies I am signed up with states on their website you must have clinical experience within the last year to apply for travel contracts. I noticed this caveat when I was updating my profile (hey, I like to be ready to hit the road at a moment's notice!). I tried to call my recruiter from that company to see if a year away from the bedside but within a healthcare/documentation role will preclude me from traveling with them; she's on vacation this week. I'll check back with her next week. I like to leave as many doors open as possible.

You can't leave every door open all the time, though. 

Does the travel bug ever go away?

Maybe it's because the weather here in Indy is dreadful, or because I'm disappointed with my new staff job, but the idea of taking "just one more" travel nurse contract has been niggling at the edges of my brain. There's a computer conversion at SUNY in Brooklyn that's coming up soon; I've never been to New York! That particular assignment is coming up too soon for me to realistically be able to go, but it does put thoughts into one's head.

So I've Taken My First "Permanent" Job After Traveling

"Permanent" is in quotes because there's no such thing as a permanent job, right? Downsizing happens, people stay home to raise kids, nurses burn out in one specialty and learn another, and workers leave a job for any of these reasons or one of a hundred others.

But...I've taken an RN job that I have assumed will be a job I'll work at for at least a year or more. For me it's been strange to orient at a permanent job after working as a travel RN. My anxiety level is much higher! When I was traveling, if I didn't like the charting system or didn't feel the MDs were available enough, I could always console myself with the mantra: "It's only 13 weeks!" Now, when I'm finding less-than-desirable aspects of my new job, I'm forced to recognize that I'll be dealing with those aspects for the duration of this job. And there's no "Hey, it's only 39 shifts" to make me relax.

Priorities in Hospitals

One of the truly eye-opening parts of travel nursing is seeing how differently hospitals around the country are run. A friend and fellow travel RN has just started an assignment at a New England-area hospital. She was shocked to discover that although each lovely private patient room in her new facility has a 42" flatscreen TV, the nurses still administer and document meds using a paper MAR system. "Sometimes I think, 'How can all these hospitals be in the same country and be so different?'" she remarked to me.

Day Trip

One of the best things about being a nurse is the flexible schedule. Right now, I'm in the middle of a four-day-off stretch. I've used my time off for such glamorous things as a trip to the dentist and runs around the lake. But I also took a day trip to Leavenworth, WA with another nurse to go tubing on the Wenatchee River. It was so great! In the summer, the weather is hotter in the middle and eastern parts of Washington than it is in Seattle. So what was a pleasant day in Seattle was a hot one in Leavenworth, and floating in the cool water of the river felt great. My friend and I met and had beers prior to (and after) our float with two nice kids from California; one was working as a whitewater rafting guide in town for the summer, and the other was celebrating her recent college graduation by traveling around the country.

As a traveler, there are so many adventures waiting for me on my days off. Some may be in the actual city I'm working in, and others may be a few hours' drive away. Having new and different entertainment options every few months will be something I'll miss as I once again take a permanent position.

"Back Home Again...

...in Indiana" is where I'm headed. I've decided. I'm headed back to Indianapolis to test out my relationship. Will it last? Will it be worth giving up the West Coast for?

These are questions I just don't know the answers to. I had a crying, panicky fit a little more than a year ago, before I left for Seattle. I was extremely worried that I was making the wrong choice. I never give into this feeling anymore; my chronic anxiety makes every choice seem like a potentially terrible idea. Still, it would be nice to be able to trust one's instincts. 

My instincts are saying that going back to Indy is a losing game. But to quote John Cusack in High Fidelity, "my guts have shit for brains."

So, here goes nothing. After 12 more shifts here in Seattle, of course. 

Float On

If you work in an inpatient setting, you've probably floated to another unit when census was low on your unit. In some hospitals, nurses float frequently; in others, it's fairly rare. Some RNs really dread floating. I've learned that here on the west coast, some hospitals have an hourly premium for floating to another unit: you make a few dollars more an hour for working on another unit. That wasn't the case at my Indianapolis hospital. 

In Indy, I worked day shift, so if I had to do the split shift float, I floated to another unit for the last 4 hours of my shift, from 3p-7p. In a way that seems easier, in that you're not scrambling at the beginning of your shift to pass meds and assess everybody and chart within four hours. 3p-7p isn't usually the busiest time in a day shift, while 7p-11p is usually the busiest time in a night shift. And so now that I'm a travel nurse working nights and I'm the first to float, I do frequently float to another unit from 7p-11p, and then back to my home unit from 11p-7a. It's a chaotic way to start my shift, and it's a pain in some ways, but at least it makes the shift go fast. And it's increased my flexibility and my ability to streamline my charting.

If you're intimidated by floating, being a travel nurse will cure you of that for sure. And if you like seeing a variety of units in addition to a variety of cities, then that's another reason to take the leap and try a travel job. 

Decisions, Decisions

Travel nursing has been a cool way for me to try out new cities, meet new people, and become less rigid in my work life and personal life. Always moving and never really feeling settled isn't the life for me, though. I'm ready to take a "permanent" (hey, it doesn't come with a ball and chain, you know) job, at least for a while. But where? I love the city of Seattle, and I have a great job here. My unit has openings. What's the catch?

My boyfriend and my family, to whom I am close, live in Indianapolis. My job there was okay. The jobs and insurance are better on the West Coast, at least in general. And Indianapolis has plenty to do, but no mountains, no Puget Sound, no constant grunge band vibe.

I'm ready to feel rooted again, but where?

Can You Commit?

You might say I have a problem with commitment. In fact, you could say it right out to my face, and I wouldn't really be able to take offense (just then I wanted to type "offence;" I've been reading a novel by a British author, and I guess I can't even commit to UK or US English).

I don't own a house, I'm not married, and I don't have children. Whenever I start a sentence with one of those statements, whether I'm talking to another person or just thinking to myself, I'm quick to add "yet!" As in, "I don't own a house yet," etc. But let's be real. I have a problem with commitment, and that "yet" may not have any place in a sentence about my future.

That's part of the reason why I'm travel nursing, right? Because even though the cons of being a travel nurse can be a pain --no PTO, not much say over my weekly schedule, currently working nights when I prefer days--the big pro is: no commitment. I'm committed to the terms of my contract, and that's it. If I don't schedule myself to be on assignment during a certain holiday, I don't "owe" my unit working it or any other holiday. I'm not on a hierarchy to determine when I get vacation; I can take an unpaid vacation between assignments, or not at all. I'm not stuck in any one city.

Well, I'm not stuck in any one city due to job responsibilities, that is. But I've given my word that I'll come back to the Hoosier state when this job is done. And I'm looking forward to it. My old unit will likely be happy to have me back, if I so choose. Still...hmm. It's hard to commit to a permanent job again. I keep dragging my feet on sending that email to my old manager, confirming that I'll be back for sure. Because once I do, and once they offer me a job if one is open, I'll be in the position of making a commitment. And I don't relish that.

Fighting that Lonely Feeling

Unless a nurse is traveling with a spouse/partner or friend, moments of loneliness on the road are inevitable. In general, I enjoy solitude, and I need to have time alone to recharge, especially after the constant interaction that is being a floor nurse. Still, I'm human, and I like to socialize. Fellow travelers can be a lot of fun to hang out with; on both my last contract in Seattle and during my time in LA, I met other cool travel nurses who were great companions with whom to explore, hike, or just grab a beer.

This time in Seattle, though, I've been hired before the wave of travelers that will come in during the summer months. I didn't need to attend an orientation, because it's been less than a year since I left the same hospital, so I didn't meet any new travelers that way. The three RNs I hung out with the most last summer in Seattle are all on different assignments currently (in Alaska, Delaware, and Florida, respectively). The other nurses on my floor are very welcoming, and they have included me in group outings, but they have their own permanent lives here and aren't necessarily looking to form a friendship with me.

One resource that's worked for me is Meetup.com. It has groups for so many interests: book clubs, running, hiking, wine tasting, singles, volunteering, and anything else you can imagine. So far I've found running buddies using the site, and it's helped stave off the feeling of isolation that can hit any one of us.

Back in the Emerald City

It's a been a while since I've posted. No excuses, just trying to survive LA.

I hung in there for my entire 13-week assignment. It was rough, a lot of the time. I never really did get the hang of the disparate paper-and-three-separate-computer-programs charting/MD orders. The support systems of the hospital were not as...um...supportive as I would have liked, due in part, I think, to their being understaffed and overworked. And while the beach and the weather and my apartment and some of the other (travel and permanent) RNs I worked with rocked, overall, life in LA wasn't for me. Tough three months. 

When a former co-worker from my Seattle hospital called while I was still on my assignment in LA and told me she thought they'd have a need for me due to some upcoming maternity leaves and RNs leaving, I called both the unit manager and my travel company. At the same time, I asked my recruiters to continue submitting my application to other hospitals, including a teaching hospital near San Francisco where I've really been wanting to take a contract. The Nor Cal teaching facility called me back the day after I accepted the offer from the Seattle hospital. Bummer, sure, but it's great to be back at a great facility, working with professional, hard-working, pleasant staff and up-to-date computer systems. And I love Seattle. If it weren't for home obligations, I would definitely think about making a permanent move here. 

If You Don't Have Your Health...

...you don't have anything, right? Isn't one of the benefits of bedside nursing to force us, almost on every shift, to silently given thanks for our own health? I know I sometimes find myself thinking things that non-healthcare-professionals might find strange, like, "I'm lucky to be able to shower on my own, whenever I want."

So, when taking report for my upcoming night shift the other night I became SOB and dizzy and had to be taken down to ED (dx: elevated WBC, probably a virus making its way around the hospital, and a heretofore undiagnosed heart arrhythmia), I was forced to take a hard look at my own health and its impact on my ability to provide for myself.

It can be scary out there as a single person doing contract work of any kind. If I don't work, I don't get paid. I've never had any significant health problems, and although I'm scheduled to follow up with a cardiologist, I'm (naively?) hopeful the EKG change will turn out to be nothing. Still, this work incident has reaffirmed my belief that health is the greatest of possessions, and it's caused me to consider: is traveling still a financially reasonable option for me?

Working on My Night Shift

Last year, I took a class in which we had to write a descriptive scene using all five senses. At the time, I was a day-shift RN, working 7 a.m. to 7:30 p.m. I wrote a paragraph about the experience of waking up early and the joys of coffee. It started with "Every 5 a.m. is the worst thing thing that has ever happened to me...."

It was in the middle of winter in the Indiana, and I truly felt horror and misery at having to wake up at 5 a.m., scrape the ice and snow off my car, and hit the frozen roads of Indianapolis. Maybe I have a little Seasonal Affective Disorder?

So, now, it's one year later, and I'm what I never thought I would be: a night-shift RN. And although I do think the night shift is wreaking havoc on my skin, I'm actually relatively at peace with the night shift, especially as a traveler. Who wants to have to learn how to utilize the crazy, disparate paper-and-BASIC-computer-charting system to learn how to, say, discharge patients?

I do, apparently. Well, want is not the right word. For the upcoming schedule, I'm being moved to days. Now the 5 a.m. wake-up call looms again. However, this time I'm in SoCal, not the Midwest. Will that early morning be as gruesome without a frosted windshield? I guess we'll see.

On one of my days off this week, I spent an afternoon stuffing envelopes for an LA-area children's literacy program. It was a nice way to talk with some other people in the area and feel like I was doing something productive with my time off. While we worked, I got recommendations for yoga studios and restaurants near my apartment. Volunteermatch.org was an easy way to find a volunteer opportunity that was close to me. When I was in Seattle, I didn't really take the time to find volunteer work. I kept thinking that I would do it "soon." These contracts go fast, though! I'm glad I stopped thinking about it and just did it.

Work is killing me. I genuinely believe it will get a little better, as I adjust to the archaic computer systems and strange paper orders and paper MAR. Still, working the night shift while trying to double and triple check paper med orders, lab orders, and procedure orders against three different computer programs is nuts. Hopefully, when the hospital upgrades their computer charting/order entry system, which should be done during this assignment, I will feel less constantly anxious about making an error. For now, all I can do is be as thorough as possible, and ask questions when I have them.

Again, though: Los Angeles! Today, in the dead of winter, I took a pleasant walk through my neighborhood, wearing capris, flip-flops, and a short-sleeved t-shirt. The sun shone down through the leaves of the palm trees and warmed the air to 77 degrees. On the way back to my apartment, as I ate my frozen yogurt, a man sitting on his front porch smiled as he played his guitar. This is a Midwestern girl's paradise.

Work is only three days out of my week. I will give work 100% while I'm there, but life is what counts.

What in hell have I gotten myself into?

Before I start the complaining/panicking, let me say: wow, Los Angeles. This was my view on my run this morning:

My apartment is quite lovely, and the people I've met so far have been friendly and fun (people are different all over, but head to a sports bar during a day-airing playoff game, and well...you're going to run into my kind of people).

However, the assignment...gulp. We had one day of on-boarding yesterday, during which we signed paperwork and received scrubs and a brief tour of the hospital. And, that's it. I'll get two shifts of floor orientation, and off I go. No computer training, no policy review, no exposure to any of the equipment.

Experienced travel nurses may think, "Big deal, you knew this was a possibility." And I did, I really did. It's just that my orientation in Seattle was so comparatively hand-holding. I knew during that entire assignment that I was being spoiled, and now it's time to deal with the consequences.

So, here I go. I'll survive, but I'm not going to lie, it's going to be rough at first.

Sometimes, the "travel" part of travel nursing is a pain. Spending Wednesday, Thursday, and Friday of this week jammed into airplane seats and crammed into my car has been wearying. So, having the opportunity to frolic about in the sunshine of LA/Santa Monica today was a real delight. I walked down to the beach and touched the Pacific. I bought some grapefruit at the farmer's market. I felt grateful for health and good weather, especially after the seemingly never-ending rain of Seattle and the blizzard conditions of Indianapolis.

California License

It came down a little close to the wire, but I'm officially an RN in the state of California, whew. Santa Monica, here I come (after 3 more days in Seattle and a detour to the Hoosier state)!

FYI, for those of you who might be applying for a California RN license by endorsement: it took the Board almost exactly 5 weeks to process my application. 

Even considering the kick I took to the chest last night, my shift was still one million times better than the night before it. And that's why my job is crazy.

Move It!

Being something of a TV connoisseur ("junkie" sounds sad, you know?), I end up seeing my fair share of commercials. The residents of the Pacific Northwest are known for being active, and even the commercials reflect that attitude. When watching TV here in Seattle, compared to the Midwest, I sure see fewer commercials for fast food and more commercials for sportswear, hiking trails, etc. The culture of moving it is pretty pervasive here, and it's a nice fit for me.