American Mobile Nursing

After being off work for 5 weeks from traveling overseas I decided to go with American Mobile Nursing (AMN) for my travel nurse assignment to California. It was quite possibly the worst mistake I made from beginning to end.

I applied to be a travel nurse back in March and within a day I had several voice messages on my phone. One of them was from American Mobile. I gave my references to two travel companies: AMN and Cross Country Trav Corp. Cross Country was able to get both of my references right away, but AMN couldn't reach them. I did not give permission to call my place of employment, and when they couldn't get my references they went behind my back and contacted the hospital I worked at and asked to speak to the charge nurse there that day. I did not give permission to contact the hospital and seriously did not want them to do it! While I was out on my first travel nurse assignment they were asking for which hospital and floor I was working on. I didn't give out that information because I did not want them calling that hospital. If after reading this you should decide to still go with AMN, do not give them phone numbers or info because they may go behind your back to get references.

I decided to go with Cross Country Trav Corp my first time around, and my contract was renewed 3 times with that hospital in Texas. They liked me a lot, but unfortunately their hospital did away with travel nurses at the end of September. It was perfect timing for me since I wanted to go to Haiti and was ready to go to another travel nurse location. The day I left the United States I talked to the AMN recruiter in the airport that day. She wanted to set up an interview for my overlay the day I returned to the US. I am so so glad I didn't do the interview now. That interview was long and required great thinking skills. I was exhausted from travel and wouldn't have been able to think that day.

I was awaiting my California nursing license to process and didn't want to wait until November 15th to start working, but I did because AMN offered me a bonus so I agreed. The day before heading out on the road to my travel nurse assignment in California I asked the office manager if there was anything else I needed to do while I had computer access. She said we need a chicken pox titre and it has to be done by Monday. It was a Thursday, and luckily I was in small town Iowa and could get into the doctors office that day, but the minimum time they needed to get the results back for the titre was 3 days. So I literally did this last minute. If I wouldn't have asked I would have never known. AMN did not keep me well informed or help me through the process of being ready to start on time.

I then had traveled 2300 miles from home when on the Monday the office manager sent me an email saying I wouldn't be able to start until Dec 6th, because my California RN license wasn't processed yet and the requirement was that I have it 1 week before starting my new assignment. I did not know this. I was sitting in my hotel on a Tuesday night before receiving this email. Email is not the route to find out this vital last minute information when you are traveling on the road. I was 2300 miles from home and my computer had gone out of my car in the mountains and my convertible top was broken and needed fixing. I hadn't worked for 7 weeks, how was I to afford living in a hotel for 3 weeks? I contacted my recruiter the next day about this, and she worked out something with the hospital. Together we put in 3 phone calls to the California Board of Nursing, none of which were returned. I drove an extra 12 hours and 1000 miles to Sacramento to get them to process my license only to find out that they had processed it 2 days before. My time, mileage on my car, and gas money was a waste!!!!

AMN had told me that I would know where I was living 2 weeks before the start of my assignment. I still didn't know a week and a half before starting, and they told me it was probably because the housing dept was behind due to so many people starting at the same time. They didn't do it because I didn't have a CA RN license yet. After calling my recruiter to tell her my license had went through in the morning, she said the housing department would contact me in a few hours. It was 5 in the afternoon and still hadn't heard from them, so I called and left my recruiter a message. I found out where I was going to live an hour before arriving to LA. The lack of communication is poor. When I got to my apartment there was no microwave or vacuum cleaner. My recruiter told me to go out and buy a little microwave, "They're real cheap" and to ask the apt office if I could borrow a vacuum cleaner. First of all travelers are supposed to have all of this set up for them. They are supposed to have the best of the best housing. Cross Country always accomodated me in anyway that I needed. I didn't buy a microwave, I have no room in my car for one more thing when traveling and the office didn't have a vacuum I could borrow. Incase you haven't read my whole entire blog let me recap what my apt with Cross Country was like: fitness center, swimming pool, BBQ grills, clubhouse, business center, racquetball, basketball, tennis, and sand volleyball courts. My own garage, fireplace, 750sq ft apt, gated community, on the major lake in Dallas, vacuum cleaner for my car, walkin closet, food pantry with washer/dryer optional hookup, on site laundry in my building. Now let me tell you about the dump AMN gave me: pool (too cold to use this time of year), hot tub, 500 sq ft apt, laundry room a block away, gated community not locked during business hours, no way of letting guests in when locked, and a car port. No fitness center!!!! AMN should've been paying for my fitness pass. The other AMN travelers and I discussed our housing benefits. They were giving one RN $1950/mo housing stipend. 2 of the other travelers were living together and they were giving them $2200/month between the 2 of them. This isn't right! They should have both received $1950 each. I'm not sure what my housing benefit was but my apartment was a $1100/month to rent! They are not consistent with their benefits. They will jip you if they can!

As far as getting the travel nurse position...... AMN bought the exclusive travel nurse rights to Kaiser system in California. They got these exclusive rights by quoting Kaiser travel nurse pay way below the other companies. I had no idea how much I was getting paid until I signed my contract. I had no idea that nurses in California usually make around $60/hr until moving here! I'm use to $30/hr in Chicago, so when I found out my travel nurse wages I found out how much we have been taken advantage of. AMN is only paying $17.77/hr versus $60. Travel nurses are supposed to be making the dough! AMN has their own staff interviewing you then lets you know which hospitals are willing to take you. I signed the contract and realized, wait a minute, I didn't get to ask the patient/nurse ratio, if my night shifts would be able to be kept together, etc. They are quick to slide you in the door without you realizing it.

Then on my first day of my job my recruiter called me at 8:45 in the morning to ask how things were going. At that time I asked her what time I was to report for work that night. She tells me, aren't you supposed to be at orientation at 9:30? She forgot to send me the email giving me all the details. Once again email communication versus telephone communication.

Then after starting my assignment I get another email telling me that one of my assignment requirements is to take this LA Fire Class. The AMN website is so confusing that it's easy to miss the requirements. So once again it was dishing out more money for this cheap company. $45 for a LA Fire Class and $45 for a chicken pox titre! No reimbursement!

The final straw came when I reported to work the night after my LA Fire Class only to find out that I was taken off the schedule. Kaiser cancelled my contract which will be another post. AMN had once again another miscommunication, which I didn't find out about for 2 days. Had I known on time it would've been unnecessary to take that LA Fire Class and waste my money! I talked to the nurse liason who informed me that I should "Go back to Texas" or "Take a staff position" until I "gained more experience in basic nursing duties." They don't stand behind their nurses despite the fact that I had another contract inwhich there were never complaints, and I had staff nurse position in one of the best hospitals in the United States. They are so worried about making their money and not losing their contracts that they will do anything at YOUR expense.

Dealing with the Illinois, Texas, and California nursing boards.

First let me tell you that Illinois does not have a nursing board. Due to this fact everything takes wayyy longer there. This summer with only 6 weeks left to obtain a permanent license from Texas I found out that my license had not been verified from Illinois yet. Normally the verification process takes 4-6 weeks from Illinois. I called them, and they told me that it took at least 10-14 days to even get the info entered into their computers after receiving the verification form in the mail. Texas told me that once they received my verification it would take another 10 business days. If it took the maximum time then this could have taken 10 weeks, naturally I panicked, but here's what I did.........

I sent my verification form to Illinois by certified mail requiring a signature when they received it, inwhich the signature was scanned and sent to my email address. This way I had proof it was received, and who had received it incase I needed a contact person. I also sent a prepaid stamped and certified envelope for them to send my verification to Texas, so that I would know when Texas had received the mail from Illinois. Certified mail can always be looked up by a tracking number on the USPS website. It costs a $1 extra if you want the signature emailed to you. This process worked so fast! Forget the 10-14 days of entering it into the computer that they had told me on the phone. I sent it out on Monday, Illinois received it on Wed, and mailed it on Friday for Texas to receive it the following Monday. Within 3 weeks my license was verified to Texas.

Now let me address California......

If you have a conviction on your record of any kind. I don't care if it's a $300 speeding ticket have documentation sent from the court system. California does have a clause on doing an extended background check if you have a traffic ticket over $300. In my case I got caught with possession of alcohol 4 months before my 21st birthday while attending Iowa, the Big Ten party school. Once again make sure all stuff is sent certified!!!! They will send a letter that says it will take 4 weeks to process after receiving all documentation, but I talked to a lady that said it would be right away. Well after 10 days had passed it still hadn't been done. I made 2 phone calls and left a message, then my recruiter called and left a message as well. After 3 phone calls in 2 days they processed my license. Here's the catch. I drove 9 extra hours to show my face to the California Board and see what the hold up was to find out they had processed it 2 days before. I don't know how well it'd work, but maybe if you ever leave a message say something like "I will be driving 350 miles tomorrow to visit you if I don't hear back from you today!" You might save yourself a trip. Sometimes it requires showing your face to get them to move!

I had planned on my California licensure process going quickly and smoothly. I had called in advance and asked if I needed to send documentation regarding my possession of alcohol that happened 11 years ago and no longer applies to me since it's now legal for me to possess alcohol. The lady on the phone told me, "No, a simple explanation should be enough!" I found out 5 weeks later that they would need additional court documentation. So send it all up front. California is notorious for losing your application, so I asked for tips so this wouldn't be a problem. The lady told me that people often send all of their stuff separate, so it gets lost. So my advice is to send your application, check, fingerprints, and any necessary documentation all together and certified. While at the post office send your transcript form to your college. After doing that go home and do the online nursys verification from another state. Get it all done upfront and you will be issued a permanent instead of a temporary license. If you wait until last minute to complete the process I can guarantee you'll be frazzled! There are certain requirements for a temp, the transcript is not! You have 6 months after receiving the temp to get a perm license.

Fingerprints are also another issue. My recruiter sent me 2 California fingerprint cards that they had got extra from the board. You might check with your recruiter to see if they have any, because California may take awhile to send you some. Many people have had their fingerprints sent back for smudges, cards bent, etc. You can either go to a Livescan in California to have this done, which processes in 72 hours and no worries of your fingerprint card being denied. Since I was in Texas that was not a convenient option so I went to the local sheriff's office to have it done. I took 2 cards with me and was explicit in saying these have to be perfect with no smudges. Afterwards I slid them into an envelope, and the sheriff told me to let them dry for an hour before mailing them out. Voila! No return on my fingerprints. I still had a spare set of fingerprints incase they decided to deny the original set. If that would have been the case I wouldn't have had to wait until the next available fingerprinting day at the sheriff's office. I could have been to the post office with my spare set in 5 minutes had that been the case.

I hope this will help someone else with less stress than I've had in these licensure processes!

Long Beach

So I have finally arrived in California and residing 2 miles from the ocean in Long Beach. I had 5 long days of driving to get here. My first day of driving was from Iowa to Denver. I spent 3 days there with my nurse friends I met in Haiti. We went up to St Mary's Glacier. I had no idea that there were actually glaciers on the mainland. We went to Idaho Springs, Red Rocks park and ampitheater as well.

My next drive was from Colorado, across Utah, to Page, Arizona on the Utah/AZ border. If you have a GPS you may it programmed to show you the fastest route. The faster route might not be faster. I programmed my GPS to take me the shorter route, which was 70 miles shorter. 70 miles on an already long drive is an hour less of driving, and by

the end of the day you'll be thankful for that hour. I believe GPSs estimate that your highway driving time will be 55mph, most of the back highways

I drove had speeds limits of 65-70mph. In the end I honestly don't think the faster route was any faster, but I did save 70 miles worth of gas and saw some awesome scenic scenery I wouldn't have otherwise seen. All of my videos are posted on Youtube, just search "iahawkette" and all my public videos should pop up.

The next day I drove to the Grand Canyon 140 miles further south. For reference it is $25 to drive through and they prefer debit/credit cards as form of payment. There are probably 12-15 scenic places you can get out of your car and look out into the canyon. I probably spent 2 hours at the most getting out of my car and driving around and through the canyon, but you could easily

spend 4-5 hours there. I was on the south brim of the canyon. The north brim is only 10 miles away from the south brim, but by car is over 250 miles away. The north brim is 1000 ft higher, but is closed October-May due to snow.

I drove next to the Hoover Dam on the Nevada/AZ border. It had construction done in 2005, and I arrived after dark. However the dam is lit up at night, and I would have been scared to drive over that bridge if I would have known what I was driving over in advance.

I stayed at Circus Circus in Vegas that night. I got the room for around $33/night, which included the resort fee. Of all the hotels I stayed in last week it was the cheapest and nicest room. The hotel not only has a casino and restaurants, but an amusement park, massages, on the roof pool, etc. Parking in Vegas is also free and easy to find. The one thing I have never done before is wait in a long line to check into my hotel room.

I will explain the licensure process for California and Illinois later, but as of Wed my California license still wasn't issued. My company had contacted me by email on Monday night and I didn't get the message until Tuesday night telling me that because my license hadn't processed I couldn't begin my new job until Dec 6th. I was like, "Nooooo, I've already driven 2000 miles, haven't worked in 7 weeks, and can't afford to stay in a hotel for 3 weeks!" So Thursday I spent driving an extra 9 hours to go to the Board of Nursing in Sacramento.

Once again I drove the back roads. It was scary for awhile, because it was just me and God. I might have drove for atleast an hour before I saw another car or person in sight. The little remote mountain towns had gas over $4/gallon. The plan was to drive through Yosemite National Park, but all the roads were closed due to snow. I did drive through a couple other national forests and parks. One forest looked like it had been in a forest fire.

A couple years ago I went skiing for the first time. Afterwards I thought it would be fun to take a ski trip to Lake Tahoe thinking it was in Utah. Much to my surprise I found myself driving by Lake Tahoe on the California/Nevada border. If you have never driven into California before be prepared to stop at checkpoints as you enter in the state. No fruits/vegetables, firewood, or things made of ash are allowed into the state. Be prepared to pop your trunk.

I spent a night in Sacramento and drove Friday to Long Beach where I checked into my new apartment.

Postcards from LA

My next travel position will be in Los Angeles. The key to getting a job as a travel nurse in California before having your license is going through the American Mobile company. 90% of travel positions are within in the Kaiser healthcare system, and American Mobile owns it. There are tons of forms, tests, and tons of online tests and competencies for me to do. If you get a job within the Kaiser system then you have to show 2 TB tests that are taken within 365 days of each other, so hang onto records of all former tests.

Final thoughts on trip to Haiti.......

What astonished me the most is the level of commitment of the Haitians to themselves. After coming upon the accident our Haitian doctor insisted on going to the hospital with one of the unconscious men. He said, "This is my country!" as if us Americans shouldn't be responsible for their people. The following day one of the translators who was dropped off before the accident thanked me for helping the Haitian people. I don't think you'd hear this from an American to an international. I didn't choose the country I was born in, nor did the Haitians. I don't understand why God chose for me to be born in the wealthiest country in the world, but regardless we are all part of the human race. God says that whether Jew or Gentile, slave or free we will all be judged the same. I would never say "They aren't an American! They aren't an Iowan! They are a Cyclone so I won't help them!" I don't perceive it as a choice. There is only one choice in the matter, even when you don't like that choice! I was put in a position inwhich I didn't want to be present. I could have stayed in the car and did nothing, but God is that conscience that lies inside of me that would never allow me to do such a thing!

Leaving on the next jet plane out.....

I'm now in the Port Au Prince airport waiting for a 10:50 am flight out to Miami. Last night we took the helicopter from the JAX beach base to the Global Outreach base flying 800ft in the air over the terrain and ocean. The GO base is a half hour from the airport, JAX beach is 2 hours. My stomach could appreciate not having a 2.5 hour ride in the car over bump after bump; however, after this trip I have decided nondrowsy Dramamine has to be a staple item in my travels.

Yesterday was our last day at the clinic. It was quite an eventful day. An I&D was done to a man's infected hand. A toddler gashed it's head open, so right there out in the open the doctor sewed her up. If you have FB all of my pictures will be there. The Haitians bought us food for lunch, which was quite the change since our lunch everyday has only been PB&J sandwiches. Of course with me being gluten free I usually took some yogurt from the kitchen in the mornings, and ate it along with my almonds and Bumble Bee bars. While in Africa they cooked with peanut sauce a lot. I can't stomach or smell it in any foods. The Haitians have something they cook with too! I taste the flavor in everything, their hamburger, pasta, rice, etc. I didn't mind it until I got car sick on some of it.

When I was 11 years old, one of our horses rared up, and flipped over on my little 90lb body. I was taken to the ER, and I walked away with a seriously bruised groin from the saddle horn. The next day my dad made me get back on a horse again, so that I wouldn't be scared of riding horses. I felt the same way again on Thursday. Wednesday we didn't drive by the accident site, but on Thursday and Friday we did. Wednesday we didn't go too far down the highway from base. We actually drove on a dirt path that day, but Thursday we took a highway trip again. I was actually fearing the ride after that accident on Tuesday. When we drove past the accident site all of the flour bags and spaghetti bundles were picked up. The only thing left is one of the trucks and flour dust on the side of the road. We were told that once they pulled the flour truck back up on its wheels that another dead body was found. The driver in the other truck who they guys worked hard to get out also died. I got a picture of that truck yesterday. I also videotaped our drive home yesterday. Just when I was trying to capture how unsafe it is to drive here is when all of the sudden everyone is driving slowly and safely. I'm not sure you will really be able to see in the video what my eyes saw! I forgot to mention that sometimes you will come around a corner and right there will be a car stopped right there in the lane, stalled and broke down. No one helps to get them to the shoulder of the road.

On this trip I felt as if I was able to speak the French, but not understand when it was spoken to me. The last time overseas I could understand, but they couldn't understand me. I didn't feel like it was that stressful of a trip. We had all the luxuries of home........air conditioning, beds, American food, etc. The only thing I'm missing is my hot shower, and soaking my fingernails until all of the dirt is gone. Heather and Brittany, from Denver are on a different flight to Miami, but we all have a layover there until 5:00ish. So we may have time to meet up for lunch! I still don't have a new job offer for my next assignment. My recruiter has me in for Houston, Dallas, and Tucson. So I will fly back to Dallas today, get my car, and drive back to the Midwest tomorrow.

Haiti Accident! 4 casualties, Several More Injured!

How ironic that my blog last night was on traffic safety in Haiti, because our medical team stumbled upon our first accident today. We had finished our clinic today and was driving back to the base, a little later than usual, when our group was the first on the scene. We had 3 doctors in our Land Rover, 2 nurses (me and an ER nurse), the driver, the pastor, and a translator!

My first thoughts were I'm staying in the car while they check out the scene. I may be a nurse, but I don't do injuries with people fingle fangled every which way. I'm a tele nurse! I deal with heart attacks, strokes, and surgical wounds. People's hearts stop beating other ways that aren't caused by trauma! So there were 2 trucks on an incline, on a narrow road half covered by rocks from the mountain on the side of the road. One was a spaghetti truck, one was a flour truck! One truck was tipped on it's side, the other was standing straight up on its front nose! The first thing I saw was someone standing up covered head to toe with flour. The only thing I could see was their eyes! I'm thinking what is going on here! People are standing up on the side of the road covered in flour!

There was our team and then a few bystanders who were trying to dig the people out from beneath the 50-75lb flour bags, and 20-25lb bundles of spaghetti packages. There were 3 men in the spaghetti truck pinned in their seats, dangling over the metal frame at the waste, with another piece of metal over the top of them holding them in. They had blood all over their heads and coming from their mouths. There were fractures all over the place, and I saw the tibia/fibula broken completely through the skin at the ankle with the foot hanging on by skin. There was a couple people pinned under the flour truck! All too much for me. I was crying and freaking out, because I didn't know what to do! I knew I wasn't going to be helping the men trapped! I knew I couldn't deal with open fracture wounds, I'd faint! So I ran and got the dressing kits, IV kits, and water from our Land Rover. Then I put my 6 weeks of working out almost everyday to good use! I lifted package after package of a spaghetti mountain to look for people underneath. It was a 95 degree and exceedingly humid here in Haiti today. We already had sweat rolling off of us at the clinic. I just so happened to wear a t-shirt to clinic today, instead of a hot scrub top. My t-shirt was completely soaked, I was covered in flour, and tossing spaghetti bundles after being absolutely exhausted already from going to bed a tad later last night. I was shaking from the adrenaline rush, and continued to shake for awhile after we left. 1 Corinthians 10:13 I believe is "The Lord will never give you more than you are able to bear. For when you are tempted, he will provide a way out, so that you can rise up!"(Sorry NLW ladies that I didn't perfectly recite that one, since it was one of our memory verses!) Decapitation would have been more than what I could have handled. I was not made to be a paramedic nor an ER nurse. I have the vivid images in my head of the traumatic stuff. I've never seen bones through skin before, but I have seen blood being vomited. At the end of it all I saw 2 dead bodies, but what the Lord spared my eyes was seeing the decapitated people. That would have been more than I could have handled, and I know I would not be sleeping tonight if I saw that!

Samaritan's Purse has a safety activation system. Our doctor called the base to the head security officer, who then notified other NGOs, the ambulance, etc of the accident. She said that in past accidents no ambulances had come nor were the civilians willing to help take people to the hospital. Today civilians were driving by in their flatbed trucks hauling patients with fractures to the hospital for us! Ambulances came! There were other medical personnel arriving from other NGOs! The UN arrived! It was truly the Lord that so many people showed up to help! Several men were pulling and pulling on the metal that had the 3 men trapped in their truck, but were gaining no leverage when our driver came up with the idea of our jack. The jack is what got those men out of that truck. They were all conscious when we arrived to the scene, but do to losing blood and the heat they were unconscious when being hauled away. An IV was started on one and he was hauled away to the hospital, and arrived at the hospital still alive! One of the doctors said one had a trapped foot, and he was able to free the foot by pushing the seat back.

There were 100s of Haitians at the scene wailing and crying. They were standing in the way staring! Standing on the flour where people could have been under! We were told when arriving at the base that an accident would probably be an occurrence during our trip and that it was up to our own discretion if we stop. Riots can break out, even against those trying to help! I got worried for a moment when a few of the Haitians were fighting! Anything can trigger something larger! They were pulling back the sheets to take pictures of the deceased. It's crazy chaos!

As if this accident wasn't unbelievable enough as we drove home we drove by our usual gas station. The long gas truck that came in was leaking out the gas. The Haitians had their buckets and were collecting free gas. All the way down the road we saw person after person with bucket on their head carrying the gasoline home! As we continued to drive we saw people sitting on the edge of the highway that didn't have a shoulder in the pitch black dark! Safety around here is a concept that so many have no idea about. It's crazzzyyyyy!

http://www.youtube.com/watch?v=xYPQmDsctb0 The Accident Video