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    L Jane Acree

Nursing Job – Observation Unit – HA!

Do not believe it! Hospitals are trying to recruit nurses by saying they have an opening in their “Observation Unit”. But their “Observation Unit” is just another med-surg unit. Do not get sucked in!

roses and plants apr 2013 007What is a true Observation Unit? This is an out-patient unit, sometimes called a “CDU – Clinical Decision Unit”, where stable patients are intended to – like a rose -“just be here for a little while” and then either get admitted, dismissed, or transferred in under 24-48 hours.

The most perfect observation unit I’ve seen (where I used to work in MS) had 10-15 cubicles around the perimeter of the big room/unit, each having a curtain for privacy; and the nurses’ station was in the center.

The furnishings were basic and sparse. Supplies were limited. The TV’s were small. Patients had to share a bathroom. The nurses were cheerful, sharp, and very attentive.

Our documentation was minimal. Care concentrated on achieving diagnosis and watching for patients to meet criteria to be either dismissed or admitted fast. Official observation, in-patient, and discharge criteria had to be handy at the nurses’ station.

Ideal patients for an observation unit include:  stable, non-isolation medical, trauma, or surgical adults that can be discharged or moved in under 24-48 hours.

The majority of our patients came to be prepped for, and to recover from, procedures. They were alert, usually ambulatory, and anxious to meet criteria to be dismissed. The few patients who got admitted upstairs were truly sick. That obs unit justified itself financially and medically, and had a stellar reputation.

Here are a few reasons many hospitals lose money on observation patients: admin mixes obs and in-patients on same unit, greater than allotted 48 hours stay, obs patients neglect to bring their home meds, insurance pays less for obs and does not cover home meds – resulting in a large, unpaid hospital bill.

Obs patients need to nicely educated that the insurance industry has determined that they are not sick enough to be admitted as an in-patient – so they will be in the observation unit. Patients who understand their actual status, and are treated respectfully with a positive cheerful attitude, are generally more satisfied with treatment and motivated to go home sooner – especially if the hospital has a pro-obs admin.

There absolutely is a valuable place for Observation Units in hospitals, if they are run effectively. If done right, they could make at least as much money for hospitals as the regular medical floors by rapid patient turnaround. And they should increase patient satisfaction.

So if any hospital calls and tells you they have an opening in their “Observation Unit”, do not believe them without getting ample proof. Take a tour. Ask a lot of questions. After all, it you wanted another med-surg job, you could find one easily enough.

Observation unit nursing takes a special skill-set and is fast-paced and focused. If you are an obs nurse, you deserve to work in a REAL observation unit. Its fun and rewarding. Hold out for the real deal!


Nurses Needed in Saudi Arabia

Why consider a nursing job in Saudi Arabia? Tax-free salary, free furnished accommodationsislamic hijab black and blue and utilities, two-ten weeks of annual paid vacation, free relocation transportation, free medical coverage, free work insurance, free uniforms and laundry, and some hospitals offer substantial sign-on bonus.

Length of contract? The typical contract is for one or two years, and is often renewable with a bonus. You go on “single status”, and only senior-level personnel can bring their spouses. Your family can visit, at private expense, for up to 90 days at a time.

How much do they pay? SA hospitals base their salary and benefit package on the applicant’s country-of-origin’s prevailing rate.

Work hours? Nurses work an average of 44 hours per week – rotating between day and night shifts.

Are there many jobs open to “foreigners”? There are dozens and dozens of Saudi jobs listed for nurses, physicians, and ancillary health care professionals online.

What are the requirements? Saudi Arabia hospitals require a valid three-year or four year RN degree, a valid nursing license in the country of origin, possess at least two years of recent nursing work in the type of nursing for which the nurse is applying, and fluent English.

Language? English is the working language. Arabic is what most of your patients speak. Arabic classes are taught in hospitals and are encouraged for foreigners.

Is there a culture shock? YES! LOL – and get this! In SA, the patients tell the nurses when its time to do assessments and administer meds! Wow! Crazy! This is especially true of the Royal Family when they are admitted. They bring their own servants and private nurse.

There is apparently a lot of racial prejudice – and SA eagerly seeks White nurses from America. They do not aggressively seek Americans of any ethnicity other than Caucasian.

The internet tells us that the Royals live such a pampered life style that they become unhealthy at an early age. However, nurses are required to allow, and even facilitate, their self-sabotaging behaviors while they are hospitalized.

What about the burka? Yes, when women are out in public, they are safer if covered from head to toe. Sharia Law is the law of the land. You should become very familiar with all that this entails for you well before deciding to go.

The free housing (possibly shared with another same-gender person) is in a complex/compound, which is huge and offers all the amenities of a small city inside. Burkas are not required inside the compound, and Americans, Canadians, Europeans, etc. can be free to relax inside there.

Gender segregation is a big deal in Saudi Arabia, so you might need to adjust your thinking and habits.

An interesting tidbit, from an American nurse who worked in SA for three years, said that the hardest working nurses in Saudi Arabian hospitals are the foreigners. So, will it be worth it? Only you can answer that for yourself.

I hope this is helpful. Please leave a comment if you have more input.





Nurses Needed at Disney!

apartment bldg trees in redding 063There is good news about working at Disney – and bad. Some say the pay is great (for a new grad) and that the schedules are fair and that they even offer per diam shifts. Others complain that the pay is low and there is no flexibility with the schedule.

I reviewed many ads and forums for Disney nurses. As usual, posts of negative experiences can sometimes get more attention than those of satisfied individuals. But there were some of each.

From what I gather, Disney hires RNs to take care of visitors at the Parks. And they also hire RNs as Occupational Health Nurses at Disney locations. Obviously, the duties and expectations of each would be vastly different.

Disney requires a valid nursing license of course. And they request BSN with three to five years of med-surg experience and CPR certification. They prefer a certified person for the OHN positions. The COHN expectations are specified at: http://www.nursezone.com/Nursing-News-Events/more-features/Nurses-Aren%E2%80%99t-Goofy-Working-at-Disneyland-is-a-Blast_21308.aspx .

Disney also has a cruise line that hires nurses as well as Disneyland resorts. And from what I’ve read, the Disney Resorts hire RN’s or LVN’s.

For those nurses caring for visitors, there are clinics for patients. But for true emergencies, the nurse has to carry the 30-pound emergency pack (along with the AED) to each emergency call on the grounds. But maybe a security guard will carry it if you are nice.

The Disney nurses who treat guests are expected to make even their medical treatment experience a magical one. (Sometimes – easier said than done I would imagine!)

Stories vary if you read the forums. Some nurses complained that they were hired as part time (with no benefits), initially, to see if they would fit in. Some were unhappy with rigid and demanding schedules.

Other Disney nurses reported that they loved it there and plan to stay. So, maybe to each their own on this one. But if you love variety, serving, making people smile, and don’t mind that part of your work will be outside, then maybe this is for you.

Anyway, Cheers!

Meantime, to help me keep this blog up and running, please consider starting your amazon shopping through one of the three stores (tabs) above. Entering amazon, via a product link or search, within the store will tag me as the advertiser that got you there. It won’t cost you any more, but it might help me pay for my internet hosting.

Thanks bunches!

Nurse Job Cruise Ship

oceanSerious as a heart attack! Don’t believe me? Google it. See? The demand is high for cruise ship nurses!

What types of medical personnel are typically assigned to a cruise ship? Larger ships may staff a Chief MD, surgeon, dentist, NP, Chief Nurse, one or more Ship RN, paramedic and others. Smaller ships will require a smaller medical staff.

What are the qualifications? The RN must have a valid nursing license, valid passport, and be able to travel for three to four months at a time at sea. They must speak fluent English and be teachable.

BLS is, of course, required. ACLS is strongly encouraged by some cruise lines, and required on others –  along with experience using it. ICU and/or ER experience, as well as routine nursing and first aid, is needed.

What about the work? If you think about a typical cruise liner as carrying a few thousand passengers, you can imagine how busy the nurses can be at times. There can be an unlimited array of chief complaints – some very serious.

You might have a day where your only patients’ complaints are minor – and then a day where you see a CVA, MI, and AA back to back. It can be stressful. Thankfully, the nurses rotate and do get days off.

Other duties as assigned? Yes, the cruise ship nurse cares not only for the passengers, but is also the occupational health nurse for the crew. The nurse may be expected to learn to run basic lab tests and shoot simple x-rays as well.

In addition, the ocean liner nurse is usually the one to order medical supplies, be in charge of lifeboat drills and exit drills, test water samples, dispose of hazmat, keep the clinic clean, and do lots and lots of paperwork.

What will you get for all your hard work? You get free uniforms and meals plus competitive salary and benefits. You can expect free private accommodations, and some ships allow the spouse to stay as well. The cruise lines generally provide free transportation to and from the ship. And they pay for your malpractice insurance.

So if cruise ship nursing sounds like your thing, but you lack critical care experience, quickly get transferred and trained in your hospital’s ICU or ER. You could also arrange to volunteer some time with your local ACLS ambulance unit for more experience. Do the above for two or three years, and then prepare your resume!

The information provided here came from various online cruise liner ads for qualified RN’s and from related blogs on the subject.

Cheers! and Bon Voyage!

Travel Nurses Needed STAT

Bethel and grounds 074How many travel nurses have you worked with or known? What would entice you venture out and try travel nursing yourself?

During one of my dad’s hospital stays, he had a travel nurse who talked to him about some of the advantages she enjoyed by traveling. Her story was intriguing.

She and her husband were both nurses in their late 20’s. They were unencumbered by too many possessions. They had no children yet. They were 100% free to earn money while traveling as much as they wanted to.

His parents lived in Wyoming, and they were able to work two 13-week stents there. Most of her family members lived in southern California, and they were able to extend their time there to almost a year.

She said she and her husband stuck pins in their USA map at home, after each work assignment there, and they planned to visit all 50 states before starting a family and settling down.

What a life! They always tried to work the same shifts so they could enjoy the region together on days off. And they loved it!

I knew a 30’something years old traveler in the Clear Lake area of Texas, and she loved our hospital so much that she said she kept extending her assignment as many times as her agency would allow.

She did not, however, plan to go to work directly for our hospital because her travel nurse benefit package was far superior to ours.

I have also met a couple of middle-aged nurses, who had become single, and decided they wanted their lives to be more interesting. And they accomplished this by travel nursing.

One even took in and fostered a few different cats from the humane society until they were adopted by families.

I say – why not?

What are some reasons to choose travel nursing?

Get paid to travel

See many different parts of the country

Experience people of different cultures in the various states

Enjoy the famous sights, foods, and people of each region

Excellent benefits packages

Enjoy typically higher pay than stationary workers

Free, fully furnished and supplied, housing – or housing stipend

Get paid while you spend time in regions near family and friends

Learn new ways of doing things

Improve your comfort level with meeting new people

Improve your self confidence at dealing with change

Enjoy how others envy you

Travel expenses to each new assignment are paid in full

Visit famous landmarks that you might not otherwise see

Plan your work assignment areas according to the type of weather you enjoy

Work in unpopular areas, for extra money, if you want to

I could go on and on about the advantages of travel nursing. But what advantages do you see in travel nursing that could benefit you?

Its fun to dream, eh?  Imagine this ad: “Urgent! Travel RN Needed in Honolulu (or your favorite city) STAT!” And who knows? Your dream might become reality!



Safe Drinking Water After a Disaster

pics from phone 005Let’s pretend that a natural disaster befell your city. If you live in the Gulf Coast area, it would likely be a hurricane. Some other places might experience volcanoes, avalanches, tornadoes, floods, fires, earthquakes, tsunamis, or other catastrophes.

Whatever your region, most people will rush to the stores when they learn something is coming (or just after it hits.) Am I right? I know. I have done it. And I have found store shelves nearly bare.

But some prepare in advance. They pack a go-bag with their most important documents, medicines, photographs, clothes, food, and other essentials.

If you are a nurse, and most of the readers here are, then you probably prioritize your disaster preparing a little differently than others.

As plumbers and electricians scramble to save their favorite tools, you rush to make sure your first-aid kit is stocked with life-saving gear for any calamity that comes along.

You, as nurses, know that safe drinking water is often one of the biggest problems people face after a disaster. And you know how important safe water is for drinking and washing the inevitable injuries that always seem to accompany such situations.

So of course, you will, of course, have some type of water purification device in your kit – sufficient for your own family and probably extra for neighbors. After all, you are the nurse. Family, friends, and neighbors depend on you to help them with problems that are overwhelming to them – but are a piece of cake for you.

So go ahead and drink that nasty water. LifeStraw Personal Water Filter and LifeStraw Family 1.0 Water Purifier will make it safe. I know. It sounds unappetizing now. But when all heck breaks loose, you’ll be glad you are prepared – and so will all those that you save alive.

After all – that’s what you do. You’re a nurse.


Calling All Nurse Preppers

026Nurses, like all people, watch the news. And we don’t like to think about it, but local and national disasters are always possible. And we all know that economic collapse and utter chaos have been predicted for the near future.

Some believe societal breakdown is imminent. (Probable) presidential candidate, Ben Carson, states that this country might not even have a presidential election in 2016 because we may be under martial-law by then.

Whether we reach that level or not, hurricanes, earthquakes, fires, and floods are always possible. When Hurricane Rita came through the Houston area, most of us had not stocked up, and stores were shut down. So what will you do, as a nurse, to prepare?

If your family found itself in a position where supplies and utilities were cut off for an undetermined amount of time, and if medications and gasoline became unavailable – do you have a plan?

As flight attendants say: “put on your own oxygen mask before helping others.” In other words, prepare for yourself and your family first. Then consider banding together with your best friends/neighbors so they can add their strength.

Before the store shelves are empty and utilities are out, Maslow has already taught us how to prioritize our prepping as to – fresh air, potable water, food, shelter – in that order.

Your network of family and close neighbors will likely count on you to treat injuries and illnesses. So what will you want to prepare along the lines of basic first-aid supplies and a way to clean wounds?

People have learned a lot about how some essential oils and other elements can substitute for medications to bring down blood pressure or fever and to heal cuts and prevent infection, etc. So that could prove helpful.

You may be the only one around with any real training to treat the sick and injured. You may not have ever done certain procedures before, but you know the A&P and may have to do the unfamiliar.

People panic in a crisis and begin to loot and pillage those suspected of having food and supplies. So you might want to consider obtaining weapons and ammo in order to respond and save your family alive.

I know. “First, do no harm.” But, in desperate times, danger is a genuine possibility that needs to be thought through and discussed in advance. And if they are trying to harm you or your kids, you might have no choice.

There is a lot to learn about getting and staying prepared – especially for people in the healthcare field. And I have a new website coming soon which will address the various aspects of what prepping looks like for nurses and other humans – especially for small home or apartment dwellers.

I hope you will stop by there and take a look. As soon as it is “born”, its name will be http://www.apartmentpreppers.com .I’ll keep you posted here and on my facebook page: http://www.facebook.com/whatmotivatesanurse !



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