201-101413-gs0201You have searched all over and making every attempt to find the right company to assist you with your travel nursing career and now it’s time to find the best assignment.

A lot of nurses believe that the interview with the hospital is a time in which the unit manager asks a “million” questions to find out about you. This is really the most important time for nurses to find out what they are getting into.

The first thing that you need to know before choosing an assignment is what part of town the hospital is located in. If the hospital is down town, the crime rate is going to be a lot higher than out in the suburbs. Just be aware that the downtown ER is also known as “knife and gun clubs.” If you like trauma, go for it!

What type of unit are you going to be working and what types of units will you be expected to float to? This is probably the most important part of the interview. If you work Medical ICU, you need to know if you will be expected to float not only to other ICUs as in Surgical and Neuro or will you be expected to float to the ER or telemetry? I cannot stress enough how important it is to get this information, and have it put into your contract. You are expected to float, but no hospital should expect you to float to a unit that you are not comfortable or competent in. No company will have a future if they force their nurses to work on floors that put the nurses license in danger.

What is the nurse to patient ratio? To this date, only California has mandated nurse to patient ratios, but that doesn’t mean that you have to take 10 patients because you are working in Texas or Tennessee. An experienced travel nurse should know how many patients they can handle safely. For telemetry floor, you can give good care if you only have four or five patients, but you just find yourself running around like a chicken with its head cut off once you get up to six and seven patients. In the intensive care units, two patients should be your limit!

What kind of support do you have on the floor? I’ve been on floors in which there are 30 patients and it’s you and three LPNs. That means that the LPNs are taking 10 patients a piece and you are running around doing IV pushes all night. This is very different than having 30 patients with 3 LPNS and 3 RNs. The amount of nursing assistants can also make a big difference.

What types of support services are available? Larger hospitals have respiratory therapy on the unit full time while other hospitals may have one for all the floors. In a rural hospital or critical access hospital, YOU will be the respiratory therapist.

What types or colors of uniforms are needed? Hospitals now are trending towards having all the nursing staff wear one color. In Mississippi I was required to wear all white uniforms, but in Arizona I was required to have a navy blue uniform.

What type of medication dispensing system is being used? The larger hospitals will have a Pyxis of Accudose system, while the smaller hospitals are still using the old fashioned medication carts. In all the VA and HCA hospitals, you will be required to scan all your medications before they can be given to the patient.

You also need to know what is expected of you for orientation. One of the top things that you need to look for in a travel company is one that is aware of all these tests, including the PBDS (performance based diagnostic system.). Orientation may also including a medication test, the BKAT (basic knowledge assessment test), and an EKG test if relevant.

It is of most importance that all these items that you have spoken to the nurse manager about be included in your contract to protect you. “As discussed in the interview, Nurse will agree to float to other areas of competency which includes rehab, telemetry, step down, ER, and psychiatric units. Nurse agrees to float to the Intensive Care Unit, to take care of patients without arterial line or on a vent. Nurse will NOT be assigned to OB, LDRP, Oncology or Dialysis floors. Related to patient safety, the facility agrees not to assign more than 6 patients at one time.”

By interviewing the hospital and putting it in writing, you not only protect yourself and your license, but you are assuring that your patients get the best care that you can give.