The last 10

And all of a sudden.....I am down to 10 shifts left in Seattle WA

The time seemed to slow down a bit since I moved out of the ghetto and into the forest,  then all of a sudden, BAM, time to start looking for a new contract. I was offered an extension here....on more than one occasion....and I had to give it alot of thought actually, because the unit has been so great! The staff here have all been very welcoming, and even though we are working short alot of the time (nothing new), everyone really pulls together to help each other out. This is something I have appreciated so much, since so much of what I was doing daily was just a little bit foreign. I do feel a pang of guilt leaving, knowing how short staffed they are, but it was that pang, my loyalty, that kept me tied to my own unhappiness in my past....I have to be loyal to my dreams, my own goals..... and there are still so many places I want to see.....they will find other bodies....

First of all the stuff that was the same:

the babies- a healthy baby in Washington state looks the same as a healthy baby in Canada, and when things start to go south.... samesies. 

they did team rounds here as well with all the multidisciplinary geniuses, and just like back home.... we never really knew when they were gonna happen. 

Alot of the action happens at the bedside and the RN is usually in the lead, or assisting....imaging, teaching, rounds, blood work, line insertions, intubation, extubation....the fun stuff

The nurses take care of each other. I never felt uncomfortable asking questions, or answering them when I was no longer the newest traveller. 

There was always a charge nurse on each floor (NICU is 3 floors here), or at least one for each Level of care...usually a "TAP" nurse, and an admit nurse...sometimes we went without a TAP if we were short

There were ALOT of travel nurses, some that have been there extending for a LONG time, and they utilize peds flex nurses who float between all the small human units and help where needed. I loved our regular peds flex, she was SUPER knowledgeable and very friendly and also a traveller.

As for differences, there were a few minor practice differences

measuring girth and residuals on all babies

feeding protocols were different and took a little bit for me to wrap my brain around

they use WAY more different types of formula, have milk techs to mix up feeds, rarely had a baby fed via pump, and the feeding pumps drove me a little batty on occasion.....milks were never co checked by another RN, that's what the scanner was for, and milk came up as a PRN med on the MAR. Every baby on level 3 had thier own milk fridge, and on level 2, the fridge was only shared within each pod. 

We did a shift huddle every morning where the charge filled us in on the all the stats of the entire unit, changes on the way, and anything significant that was going down that day... expected deliveries, discharges etc

Lately, it hasn't been totally uncommon to have 4 babies on Level 2 - this sucks and is not ideal, but they do try to avoid it all costs...

We change TPN lines every day, only clear fluids go for 4 days. I never saw a sterile line change.....

They do way more PICCs than umbi lines, and for blood work and IV starts, the go to is not hand or head, and never via drip

We did our own gasses at the bedside using I-Stat

The shift starts at 7, you go to huddle at exactly 7 and start getting report around 705....some days I didn't leave until 740 depending on the babies. Back home, your relief wanted to be walking out the door by 715 at the latest. 

Obviously the pay was different. As a travel nurse, I took home over 3x the money as I was making at home, but before you get all excited.... no benefits, no PTO, first to float (only 2 times the entire contract) and I still have to pay bills back home... duplicating expenses.

Would I recommend this facility? A million times, yes. I am usually dead by the end of my shift, BUT the one time my assignment felt unsafe (immediate post op gastroschisis closure on several drips, also NAS, split into a different pod with another NAS plus one more IUGR on resp support) vs just heavy.... my charge jumped in right away and shifted stuff around. It is a busy level 4 unit, with 70 something beds and a huge variety of patients....They care about the patients here, and they take care of each other. Swedish First Hill set the bar pretty high as my first US assignment, and even though I will be moving on at the end of my contract, I am so thankful to have had the opportunity to be here. 

I have loved Washington State. Seattle is not my favorite, but I am learning that I am not much of a big city gal. First of all....way too people-y... but the surrounding areas here.... Snoqualamie, Woodinville, Leavenworth, even  where I am currently living... are all VERY beautiful. I have enjoyed several hikes, lots of waterfalls, fun on the lake, and  a whole lot of fresh air. The weather reminds me alot of Vancouver BC....lots of rain, lots of grey, but when that sun comes out.....damn girl! The last few days have been mid 30's (celcius) and pretty humid. 

Whats next.....

Well the thing with having options is....I get to decide. I turned down that full time position in Hawaii because I wanted to travel, so that is the plan. I currently have my NY, TX, MN, WA licences, and have been granted EMSA authority in CA. My permanent licence for Cali wont be in for a while, and I am guessing a least a couple months for my temp by the time they get all my documents, so there are only a few hospitals accepting nurses on the EMSA....emergency licence  (which has been extended indefinitely FYI...."for the duration of the emergency") but with "flu" season coming up, I am pretty sure more of the hospital systems will be accepting it. Cali or NY for the fall?......TBD

I absolutely love my recruiter at Lead Health and he is WORKING for me these days. We connect every couple days, and he's watching postings daily. He knows what my goals, and must haves are, is always totally transparent about jobs, pay, and facilities......and I am very hopeful that we will continue to work together for my next contract and beyond. Right now I am closely watching the California coast, preferably somewhere beachy in SoCal, but am open to whatever comes up. Believe it or not, even though I only have a few weeks left, it is still too early to be looking for Sept starts. Another week or so, and things will start to line up. 

I have one more little road trip planned while I am here, down the Oregon coast, barely into Cali to get my prints done for my licence....its way faster to get these done in state vs mailing in a hard card, so Crescent city it is in a week from now. Then, so far....the plan is to head back to Alberta for a week or two before making my way back across the border AGAIN to either the east or west coast.

They say you never know unless you try.... now I know... as crazy, unpredictable, and chaotic this lifestyle can be....it is 100 percent for me....I am challenged to be versatile, creative, and flexible on the daily....I get to meet new people, see new things, and be the captain of my own ship. I don't ever feel totally bored because even 9 weeks in, I am still learning daily. I have been reminded, away from the inevitible politics that come with being a full time staff nurse, that I absolutely love this career. Travel nursing has taken the focus off of the job, the tasks, the mundane..... and put it back on my love for my career, my patients....AND I am getting to travel!!! I havent dreaded going in to work once......So here's to a whole bunch of unknowns, staying open and positive, and embracing the adventure of whatever is coming next.

xoxo

Alana