I know I’ve shared a lot about my other experiences I had in West Virginia, but the whole purpose of me going out there in the first place was because of work. So I figured I should tell you some about my hospital experience I had there.
Before working on the floor, there were some steps I had to take first. After I accepted my position in West Virginia, I had to apply for my West Virginia
nursing license in order to be eligible to work in this state. After I received my license, I had tests I had to pass on my first day of orientation. On that first day I had to pass a test on reading telemetry strips, performing medication calculations, and administering blood products. The next two days of orientation were filled with computer training on the hospital’s charting system and learning how to work their IV pumps. After the three days of orientation, I was on the floor for two days with a preceptor. The preceptor told me, “you already know how to be a nurse, I’m just supposed to show you how we do things here.” I was nervous at first of only having two days of orientation and then being sent off on my own, but surprising myself, halfway through my second shift with a preceptor I felt more than ready to be on my own. After that second night with my preceptor, I was sent on my own for the rest of my time that remained.
After that first day of computer training, I was feeling quite overwhelmed and wondering if I was even going to remember how to chart everything or where to find things on the computer. Their charting system is older than the one I was used to and also takes longer to chart on than I was used to. It definitely took a while to get the hang of and I would sometimes still have to ask where to chart something specific, but for the most part it is not as complicated as it seemed to be that day in orientation. It was encouraging that I was able to catch on to the charting system fairly quickly, as I do not know what other charting systems I will encounter in the future.
Back home I worked on a cardiac-stepdown unit. Given away by the name, most of the patients I took care of came in with heart problems: chest pain, heart failure, dysthymias, and needing stents or pacemakers placed. The unit I worked on in West Virginia was a medical-surgical/telemetry unit. Before coming to the unit I was told that the patient population was mostly cardiac and it sounded very similar to the unit I was working on previously. I definitely was in for a little bit of a surprise when I actually started working on the unit. The patient population was quite different than I was expecting. There was cardiac monitoring on the unit, but not everyone was monitored; and we actually seemed to have very few cardiac patients. With that being said, it was definitely more of a medical-surgical unit and not much cardiac. I was a little disappointed at first, but I ended up not minding because I just learned that much more and was exposed to that much more. The floor got about every kind of patient as it is almost like the “melting pot” of the hospital. I took care of patients who had seizures, altered mental statuses, post surgeries, broken bones, IV drug use, withdrawing from alcohol abuse, foot ulcers, infections, cancer, kidney failure, gall stones, respiratory failure, gastrointestinal bleeds, and amputations just to name a few. Like I said, the unit receives just about every kind of patient.
I definitely learned a lot working on that floor. I was was also able to utilize a lot more of my medical skills on that floor. Something I am sad to have learned so much about working there is the drug abuse that occurs in the area. West Virginia has a lot of really sick people; a lot of the patients that come in to the hospital do not take care of themselves, live in dirty conditions, and most devastatingly use drugs. The drug use problem is real and it is sad to see. West Virginia’s overdose death rate is higher than any of the other states. We got some sad cases coming into the hospital and it’s hard to see people who have turned their lives over to drugs. We had to watch certain patients and the visitors they had because some patients will have their friends bring them drugs in the hospital. This absolutely breaks my heart knowing that they are already sick and in the hospital and all they still want is drugs. That being said, we also got some exciting moments when people decided to turn their life around and planned to stop using drugs or to go to rehab because they really wanted to have a second chance at life. I had a patient who was on our unit for a month and at the end of the month he was really excited to be clean and happy that he had been sober for thirty days. He realizes how his life was so close to ending and he was given a second chance. His mother was telling me how when she had brought him into the hospital he was overall very sick because of everything the drugs had done to his body, and the nurses and doctors in the ER did not have much hope for him surviving. His mother immediately started a prayer chain and states that God did the rest.
There are some general differences between this hospital and the hospital I had worked at back home. The hospital in West Virginia had shared rooms which can definitely get awkward at times if the roommates do not like each other. For example, one time my patient clogged and flooded the toilet by accident (several times), and his roommate became furious by this. One of the hard things about having shared rooms is that you are not always the nurse for both of the patients in that room; sometimes you are the nurse for just one of the patients in the room. Sometimes, because you are a nurse, the roommate assumes you know everything about them and will ask you questions about what’s going on with them; for example, if they can eat certain foods, when they’re going home, if they can go out and smoke, and when their medications are coming. Unfortunately, I am unable to answer these questions as I don’t know the roommate’s situation.
One of the other differences that took a while to get used to, is that the patients were allowed to go out and smoke. They have to sign a waiver before going outside and sometimes doctors will absolutely not allow them to go outside. It is just sad to see some of the patients as they scream out in pain, but then as soon as they receive their pain pill they all of a sudden feel better and go right outside to smoke. Also, due to the IV drug use, certain patients can only go outside if accompanied by someone trusted by the hospital in fear that they now have really easy access to being able to get a drug inside of them since they have an IV in place. Letting my patients go outside and smoke was just something that made me nervous because I didn’t always know what they were really doing when they would go outside.
Another difference at that hospital is that they have LPNs (licensed practical nurses). When needed, the LPNs will take a patient load with the Charge nurse overlooking them, but usually the LPNs work as med nurses. They are in charge of passing patients’ medications and taking their blood sugars. Nights we have a LPN to be a med nurse is beyond helpful and makes the night go much smoother. Having someone else pass medications, gives the RN time to focus on the other cares and tasks that need to be completed.
There are some other differences I have encountered such as verifying specific medications with another nurse and not verifying other medications; running protocols differently; or knowing when or when not to call a doctor. I will not bore you with all the specific details though. Probably my favorite difference is that the nurses on the floor can stick their own IVs. At the hospital I worked at previously, we had an IV team and never put in our own IVs. So I am excited to be able to perfect that skill that I truly think is an important nursing skill to have.
My overall experience as a travel nurse in West Virginia was very good. I hear so many horror stories of travel nurses being hated by the hospitals they are working for and not being treated well. Everyone there was so nice to me. If I ever had a question, they were willing to answer it. If I needed help, others on my unit would help me. I felt like I had worked at that hospital for a lot longer than sixteen weeks because of how welcoming the team had been to me. I know not all the hospitals I work at will be this welcoming, helpful, and nice; but I am sure glad that my first experience traveling was as great as it had been. I can’t wait to see what else I will learn and experience at the other hospitals and states to follow.