Author Archive for Sarah Wengert

Hi, I'm Sarah Wengert, a creative content writer for the amazing Medical Solutions based in Omaha, Nebraska. While I'm not a Travel Nurse, I love to travel and I truly appreciate the hard, important work that nurses do. I'm very happy to represent a company that cares so much about its people. Thanks for reading!

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Congrats to February 2019’s Traveler of the Month and Rising Star!

Allison 1024x768 - Congrats to February 2019’s Traveler of the Month and Rising Star!
Congrats to the February 2019 Traveler of the Month, Allison H. (pictured), and also our Rising Star winner, Amanda M.!

Many thanks and congrats to the February 2019 Traveler of the Month, Allison H., and also our Rising Star winner, Amanda M.!

Traveler of the Month Allison is a Labor & Delivery RN, currently on assignment in Ashland, Wisconsin. She’s been in nursing for 10 years and traveling about a year and a half. Allison works with Career Consultant Jill Kent.

I’ve loved all of my locations but have especially liked Ashland,” says Allison. “Not only is the location ideal for all the outdoor activities I like to do, it is also close to family. I’ve made great friends with the staff and the unit is a nice mix of lower and higher acuity patients.”

Allison says she’s lucky to travel with her partner, Spencer, their Great Pyrenees, Willow, and her cat, Kitty Bon Bon. She also loves to eat and delights in trying new dishes.

The best thing about Travel Nursing is the knowledge that you can take an assignment anywhere,” says Allison.

Allison shared a few helpful Travel Nursing tips for aspiring Travelers:

  1. Be flexible! There is more than one right way to do the same task.
  2. Always ask questions. (Everyone knows that you don’t know where the clean utility is located!)
  3. Have open lines of communication with your recruiter. He/She is there to help and support you!

Thanks so much for your great advice and incredible dedication to great patient care, Allison!

Rising Star Amanda is an ICU RN. She’s been in nursing for 12 years and has been working as a Travel Nurse for two-plus years. Amanda is currently on assignment in Paducah, Kentucky, and works with Career Consultant Kayla Simpson.

Amanda Brunette - Congrats to February 2019’s Traveler of the Month and Rising Star!
Rising Star Amanda (pictured at right) and her fellow Medical Solutions Traveler Brenda explore sunny California!

Nursing is a second career for Amanda, who originally graduated with a business degree that left her unfulfilled. Her father, who was diagnosed with cancer while she was still in school, passed away less than a year after his diagnosis.

“The wonderful care we all received from his nurses never left me,” says Amanda. “So, four years after he died I got accepted in a local nursing program and I’ve never looked back. I often say it was the best decision I ever made.” 

After working as a staff nurse at the same hospital for 10 years, Amanda decided to try Travel Nursing.

“I really felt as though I was getting burned out,” she says. “Traveling was the second best decision I’ve made.”

Amanda says the staff at her current assignment “is wonderful and they make you feel at home.” But a couple other locations top her list of favorites. 

“My favorite location has been Los Angeles. There’s so much to do in Southern California and the weather is amazing,” she says. “But another place that surprised me was Missouri. I absolutely loved it; there’s just something about the Midwest. I worked in a town called Joplin. Most people know it due to a horrible tornado that came through and destroyed one of the hospitals there. But I’ll always remember it as one of the friendliest, most welcoming facilities. I’ve made lifelong friends with the staff there and still talk to them on a regular basis. I always feel as though I take a little piece of a place with me when I leave. However, I feel as though I left a large chunk of my heart there.”

Amanda Joshua Tree - Congrats to February 2019’s Traveler of the Month and Rising Star!
Amanda explored gorgeous Joshua Tree National Park while on assignment.

It’s just those kinds of important connections that Amanda really loves about Travel Nursing.

“The best part of travel nursing is not only the experience and thrill of a new place but also the connections you make,” she says. “I’ve made lifelong friends with staff and some patient families. If you do this just for the money then you are missing out on the best part.” 

Amanda shared some great advice for Travelers about what to look for in an assignment and maintaining a great relationship with your recruiter.

“I really feel as though new Travel Nurses mess up and leave traveling feeling unfulfilled when they only chase the money. I always tell nurses that are considering traveling to do their homework. Try to go places that are very Traveler friendly. Sometimes it’s not all about the money,” she says. “Also, maintain a strong partnership with your recruiter. Don’t approach it as though they work for you. They don’t. Your recruiter works with you. I think that’s why I’ve been lucky — my recruiter knows me well enough to know what facilities I will and won’t enjoy.”

Thank you, Amanda, for sharing your words of wisdom and for your incredible work!

Congratulations again to the Medical Solutions February 2019 Traveler of the Month and Rising Star! Allison and Amanda, we are so grateful to both of you for your commitment to patient care and Travel Nursing!

Could you be the next Medical Solutions Traveler of the Month or Rising Star? Travelers who receive a perfect hospital evaluation are eligible to win these monthly awards — with Rising Star going to newer Medical Solutions Travelers. Click here to learn more and to see if you could be the next winner of a $100 Visa or Amazon gift card as recognition for a job well done!

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Clinical Corner: Nurse Burnout and Stress Management

Stress Meditation 1 - Clinical Corner: Nurse Burnout and Stress Management
Recognize Stress Awareness Month by checking in on yourself and finding healthy ways to manage stress and avoid nurse burnout.

By Phil Niles, Clinical Nurse Manager, Medical Solutions

April is Stress Awareness Month, and that’s relevant highly here considering two of the biggest challenges nurses face are chronic stress and burnout. I can tell you from my own experience that unchecked stress leads to physical pain, lack of energy, bitterness, feelings of dread, and becoming mentally checked out of caring for patients. When you burn out, nursing can become a never-ending hamster wheel of dreading everything negative that could happen during your day. These “could happen” scenarios become expected, inevitable truths in your mind each day, even if they do not occur. Pretty bleak, right? 

Healthcare in general is often listed as one of the top most stressful jobs in the United States. A few of the reasons for this trend include workload caused by insufficient staffing and long shifts without breaks. One of the most dangerous effects of this are increased risk for patient harm. Stress makes you tired and confuses your thinking, leading to mistakes and breaks in standard of care.

So, what can be done? Shall we all throw our hands in the air, toss our stethoscopes in the nearest trash can, and go live the hobo life riding the rails? Sure, I exaggerate a bit, but I know a few of you are holding your hands high yelling “Amen!” Obviously, there are steps that need to be taken by health care organizations, which some have done, to decrease the demand on nurses and improve the overall work environment.  Additionally, instead of asking only “What are they doing to help me?” we should ask, “What can I do to help myself?” We need to focus on ourselves and practice mindful self-care. How do we care for ourselves?

STOP and take a deep breath.

It is very common to get caught up in all the things that need to be done and the lack of time to do it. Stopping and taking a deep breath helps clear the frustration that can cripple your ability to think clearly and prioritize care.  After three or four deep breaths ask yourself, “What needs done right now?” You are only one person and cannot be in three places at once, even though it feels like we are asked to do this all the time. Start with the first thing that needs to be done and prioritize from there. Pop your head into the other patient’s rooms and let them know you haven’t forgotten them. This will help your patients feel respected and validated instead of ignored. 

Be vocal and a clear communicator.

Let your Charge know what you have going on and what you can take on to help the team. The only way they know you are feeling overwhelmed is if you communicate. I’m sure many of you have been to assignments where you felt like you could not depend on anyone. Be the positive change of teamwork you want to see! Offer your help when you can and ask for help when you need it. Assuming everyone knows you are extremely busy is the cause of a lot of unnecessary frustration. 

Stay hydrated!

Most nurses are pushing their kidneys into early failure with poor hydration. Dehydration can cause fatigue, headaches, lack of energy, and slower thinking. I can hear it now … “I don’t have time to pee let alone drink any water!” Yes, you do! It is just not a part of your daily work habit — yet. Prioritize yourself for your own health, but also because, in the end, taking care of yourself makes you better able to care for your patients.     

Leave a bad work day at the door and do not assume it will be the same tomorrow.  Easier said than done, I know! It does take work to not let the “black cloud” of a bad day follow you home and shape your mood for the rest of the day and the next. Commit to making time for yourself. Nursing is a very engaged, social profession. Decompression in a quiet space is necessary to let your mind relax. Even if it’s just the drive back home while listening to a podcast, music, or nothing at all! Take an extra spin around the block if you’re coming home to an equally busy household, which many of us are. You’ll thank yourself for the extra five minutes. Your brain needs the downtime!

Take advantage of the resources available to you. 

As a Traveler you may feel alone with no one to call on for support. This is not true! You can always contact your recruiter and some travel companies, such as Medical Solutions, have in-house nurses, such as myself, available to talk with you and truly understand where you’re coming from. This is often an unknown resource to many Travelers. Just talking something out with another nurse does wonders to get it off your shoulders and help you breathe a little easier. 

Stress is a very real and damaging force if not dealt with through healthy channels.  Remember this Stress Awareness Month and all year-round that the only way to provide skilled, compassionate care for your patients is to care for yourself first.

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State Spotlight: Nevada

Vegas Selfie - State Spotlight: Nevada
Read on to learn why Nevada is a great place for your next Travel Nurse gig!

This month’s State Spotlight takes us to noble Nevada! The Silver State is known for its varied landscapes and scenery, intriguing attractions, the iconic sights, sounds, and shows of Las Vegas, and so much more. There are also tons of great Travel Nurse jobs in this cool state. Read on to learn more about why you should roll the dice and try Travel Nursing in Nevada!  

Travel Nursing in Nevada

Nevada Stamp - State Spotlight: Nevada

Nevada is a great place for a Travel Nursing assignment. In The Silver State you’ll have tons to do and see on your days off while also building your skills and resume on the job.

Nevada is home to about 55 hospitals — according to U.S. News & World Report’s 2018/2019 Best Hospitals list. That includes UMC of Southern Nevada in Las Vegas, MountainView Hospital in Las Vegas, Renown Regional Medical Center in Reno, Southern Hills Hospital & Medical Center in Las Vegas, and Sunrise Hospital & Medical Center in Las Vegas.   

U.S. News & World Report’s 2018 “Best States” ranked Nevada #34 overall, as well as #5 for infrastructure and #12 for economy. According to Livability.com, some of the best places to live in Nevada include Carson City, Sparks, Reno, Henderson, Elko, Paradise, Fallon, Boulder City, Summerlin South, and Spring Valley.

As for licensing, Nevada is not currently a walk-through state or a compact state, but it is a NURSYS state and nurses licensed in other U.S. states may apply for license by reciprocity. Click here for more, up to date info on licensing in Nevada.

Nevada Fast Facts

Hoover Dam - State Spotlight: Nevada
The Hoover Dam on the Black Canyon of the Colorado River between Arizona and Nevada is a sight to behold!


State Nickname: The Silver State

Capital: Carson City

Largest City: Las Vegas

National Parks: 4

State Parks: 27

National Historic and Natural Landmarks: 14

State Motto: “All for our country” 

State Flower: Sagebrush

State Tree: Bristlecone Pine

State Animal: Desert Bighorn Sheep

State Metal: Silver

State Gem: Virgin Valley Black Fire Opal

Nevada was the 36th state.

Charles Fey invented a slot machine called Liberty Bell in 1899, which served as the model for all future slots.    

In 1931, the Pair-O-Dice was the first casino opened on Highway 91, which would become the future Las Vegas Strip.

Bugsy Siegel’s Las Vegas casino was named The Flamingo after the long legs of Virginia Hill, a showgirl and Bugsy’s girlfriend.  

Nevada was the first state to ratify the 15th Amendment, giving black men the right to vote in March 1869.

Slot machines and video slot machines, required hard hats at construction sites, multi-state hydroelectric power, blue jeans, quickie divorces, the pistol offense in football, fingerprint convictions, and solar cells were all invented in or originated in Nevada!

Shrimp Cocktail - State Spotlight: Nevada
Approximately 60,000 pounds of shrimp are consumed each day in Las Vegas!

In 1859 the Comstock Lode — a discovery of lots of silver — triggered a silver rush to the state and sent the population soaring.

Nevada stands is one of seven U.S. states that do not collect individual income tax.

Nevada is the nation’s driest state, with less than 10 inches of rain annually.

Believe it or not, Reno, Nevada is actually further west than Los Angeles!

Oregon is the only state with an official state nut. The nut in question? The humble hazelnut!

Approximately 86 percent of Nevada land is owned by the federal government — including the famous Area 51. In terms of size, Nevada is the seventh-largest state. 

Construction of the Hoover Dam began in 1931 and upon completion in 1935 it was the largest dam in the world. It remained the world’s largest producer of hydroelectric power until 1948.

Elko, Nevada is home to an annual Cowboy Poetry Gathering.

Las Vegas has more hotel rooms than any other city in the world

More than 60,000 pounds of shrimp are consumed each day in Las Vegas!

Famous folks from or who’ve lived in Nevada include Jena Malone, Andre Agassi, Pat Nixon, Amy Purdy, Kurt Busch, Dawn Wells, Thomas Ian Nicholas, Sailor Jerry, Cosmo Baker, Bryce Harper, T.J. Lavin, Brandon Flowers, Jimmy Kimmel, Mark Twain, Robin Leach, Floyd Mayweather, Mike Tyson, Coolio, and Jenny Lewis.     

The Kangaroo Rat, which lives in Death Valley, can live its whole life without drinking a drop of liquid.

Each day in Las Vegas, approximately 150 couples get married.

The name Nevada comes from a Spanish word meaning “snow-capped.” Yes, most of the state is desert, but the Sierra Nevada Mountains near Reno and the Ruby Mountains near Elko have quite a bit of snow for about six months each year.

Highway 50 in Nevada is known as the “Loneliest Highway in America” for its scarcity of stops along the 287-mile stretch between Ely and Fernley.

In Nevada, camels were used as pack animals until about 1870.

The humanmade Lake Mead is the nation’s largest reservoir.

Native American tribes which inhabited Nevada included the Shoshoni, Northern and Southern Paiute, and Washo.

To Do & See in Nevada

Lake Tahoe - State Spotlight: Nevada
Gorgeous Lake Tahoe!

From the lights of Las Vegas to the serene scenery of the desert, The Silver State is a wonderful place for Travel Nurses to work, live, and play!The state offers diverse natural beauty including mountains, desert, forest, and lakes, as well as super unique tourist attractions, delicious dining, and stimulating culture — making Nevada a fabulous place to for your next Travel Nurse adventure. 

For city lovers, The Silver State’s largest cities include Las Vegas, Henderson, Reno, North Las Vegas, and Sparks. The state’s shining urban star is most certainly Vegas, where you can travel the world all in one city with facsimiles and likenesses of the Eiffel Tower, the canals of Venice, the great pyramids of Egypt, and other worldly locales. If you love neon and kitsch, you are sure to love Las Vegas! In addition to gambling, Vegas is also well known for having some pretty incredible theatrical and musical performances, so you’ll want to take in some shows for sure. Other things to see and do include Fremont Street, the Stratosphere, Siegfried and Roy’s Secret Garden, the Bellagio Fountains, the Mob Museum, the Neon Museum, SPEEDVEGAS, The Strip in general, and so much more.   

Fire State Park Nevada - State Spotlight: Nevada
Valley of Fire State Park, Nevada.

If you prefer solitude, you’ll love Highway 50 — dubbed the “Loneliest Highway in America.” Nevada also has some wonderful petite towns, including the state capital, Carson City, and Elko. Outside of the city, you’ll also want to explore the famous Hoover Dam, Red Rock Canyon National Conservation Area, Fire State Park, Lake Mead, Lake Tahoe, Sand Mountain Recreation Area, Lehman Caves under the Great Basin National Park, the Hickison Petroglyphs, the Ruby Mountains, Bootleg Canyon, and tons more in this beautiful state of mountains, lakes, and deserts.

Nevada’s food offerings are as diverse as its landscapes. From tiny roadside diners to fine dining foodie havens, Nevada offers a little bit of everything for folks to chew on. Shrimp cocktail is a huge favorite throughout the state, but especially in Vegas, where it’s reported that 60,000 pounds of shrimp are consumed each day! While on assignment in Nevada you can also enjoy iconic faves like onion rings, sushi, paella, Thai cuisine, prime rib, bone-in ribeye, steak and eggs, burgers, charcuterie, chateaubriand, tamales,  and, of course, buffets galore. Wash it all down with a Bloody Mary or Picon Punch and you’ll be living like a true Nevadan!

Ready for your adventure to noble Nevada?! Search jobs now to find your dream Travel Nurse job in Nevada! Or, search all jobs here.

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Share the Luck Referral Giveaway!

ShareThe Luck - Share the Luck Referral Giveaway!
Share the Luck and refer your friends to Medical Solutions by April 26, 2019, for a chance to win on of three TravCon prize packages valued at $1,500!

Medical Solutions already offers a great $500 referral bonus, but the wonder of a gorgeous, hopeful spring cutting in on a grizzly, old winter had us wanting to raise the stakes. In that spirit, we bring you the Share the Luck Referral Giveaway — your chance to win one of three trips (valued at $1,500 each!) to TravCon 2019 this September 8-11 in Las Vegas!  

Through April 26, 2019, for every validated new referral you submit to Medical Solutions you will receive one entry to win. Three winners will be randomly selected, and each prize package will include airfare, hotel accommodations, one TravCon conference pass, and some spending money to boot!

Remember, this is a chance to double your luck, because even if you win the Share the Luck Referral Giveaway, you are still able to collect Medical Solutions’ standard $500 referral bonus for any qualifying referrals. So, you could get lucky and win a prize and/or a bonus, your friend could get lucky with a fulfilling new gig with Medical Solutions, and we could get lucky and add some great new Travelers to our ranks. That’s a lot of good luck flying around! (Seems like our lucky day. Maybe we should all buy lottery tickets, too?)

Click here to learn more about this opportunity and to “Share the Luck” today by referring your friends for a chance to win!

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Congrats to January 2019’s Traveler of the Month and Rising Star!

rsz jacqueline - Congrats to January 2019’s Traveler of the Month and Rising Star!
Congratulations to our January 2019 Traveler of the Month winner, John S., and our Rising Star winner, Jacqueline B. (pictured)!

Many thanks and congrats to the January 2019 Traveler of the Month, John S., and also our Rising Star winner, Jacqueline B.!

Traveler of the Month John is an PCU RN, currently on assignment in Dalton, Georgia. John works withCareer Consultant Vince Odorisio.

“I have worked with John since October 2018 and he has been a great addition to the Medical Solutions team,” says Vince. “He puts in his work and completes all of his paperwork/compliance items on time. Great to work with!”

Vince also says he instantly felt a personal connection with John, due to John’s exceptional demeanor.

“After chatting the first time for only three-four minutes, John made me feel like we had been working together all year. He is very easy to talk to and, based on my own experiences, he is most likely very approachable at work with the staff, patients, and the patients’ family members.”

Vince also says John has a lot of great qualities that makes him a natural fit for nursing and traveling.

“I think John is a great RN because he goes with the flow,” says Vince. “Nothing gets under his skin — except maybe the ATL traffic! — and he has a passion for what he does. You can tell that he enjoys nursing and tries to be the best he can possibly be every shift.”

Thanks so much for all of your hard work and commitment to great patient care, John!

rsz 1jacqueline athena - Congrats to January 2019’s Traveler of the Month and Rising Star!
Rising star winner Jacqueline’s “adoring pooch” Athena is such a cutie!

Rising Star Jacqueline is an RN, BSNspecializing in PCU/IMU.She’s been in nursing for five-and-a-half years and has been working as a Travel Nurse for three years. Jacqueline is currently on assignment in Salem, Oregon and works with Career Consultant Mike McSorley.

Jacqueline doesn’t have a favorite location — but only because she thinks they’re all great!

“Honestly, every location has its own spark,” she says. “Your assignments are only what you make them.”

Jacqueline, who shared a pic of her “adoring pooch Athena,” says the ability to travel and see new places is her favorite part of Travel Nursing.

“[The best thing is] being able to see parts of the U.S. I wouldn’t normally get to see,” says Jacqueline. “I love small towns since I come from such a big congested city. I love to eat. I try to find that hole in the wall and get recommendations from the locals. Bacon is life.”

Jacqueline shared some amazing tips for new or prospective Travelers:

1. “Patient population is nationwide, you have to like what you do and embrace it with all its quirks.”

2. “Go with an open mind, body, and spirit. Find what makes each place unique; I always find local art in each location.”

3. “Get along with your coworkers and work as a team. It’s easier to be part of a group than struggle on your own island. OFFER to help whenever you can if you see someone drowning, you will get the same in return.”

Thank you, Jacqueline, for sharing your words of wisdom, incredible work, and dedication to quality patient care!

Congratulations again to the Medical Solutions January 2019 Traveler of the Month and Rising Star! John and Jacqueline, we are so grateful to each of you for your commitment to patient care and Travel Nursing!

Could you be the next Medical Solutions Traveler of the Month or Rising Star? Travelers who receive a perfect hospital evaluation are eligible to win these monthly awards — with Rising Star going to newer Medical Solutions Travelers. Click here to learn more and to see if you could be the next winner of a $100 Visa or Amazon gift card as recognition for a job well done!

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Clinical Corner: What the Dialysis?!

What The Dialysis - Clinical Corner: What the Dialysis?!
Clinical Corner demystifies dialysis!

By Phil Niles, Clinical Nurse Manager, Medical Solutions

As healthcare providers, many of you have cared for a patient that is dependent on dialysis. Yet, even you may have wondered, what the heck is dialysis? Well, let’s talk about that! A friendly dialysis RN shows up on their dialysis day, takes up your sink, clogs your room with machines, and, in the end, leaves you with a healthy smell of bleach lingering in the air. What happened? You know the basics of the process: The blood is “cleaned” and fluid is removed from the patient over three-four hours. The patient has an access such as a catheter, fistula, or graft that the dialysis RN accesses for the treatment. Patients commonly have three four-hour treatments per week. But, what else is going on during the treatment?

First, we start with water. A single dialysis treatment uses over 150 liters of water. Water from the faucet cannot be used because there are impurities, trace heavy metals, and chlorine in standard faucet water. This is all fine and dandy for us to drink, but during dialysis this water will come into contact with the patient’s blood, so it must be as pure as possible. One of the machines that a Dialysis RN brings into the room is a reverse osmosis machine or RO. This machine moves solutes from a concentration to a higher concentration producing high-concentrated water (waste water) and very low concentration water (RO water). The RO water is used for the treatment and delivered to the hemodialysis machine by a product hose. Tap water generally has total dissolved solutes level of 100-200 parts per million. Dialysis water is 10-15 parts per million — a much lower concentration. Before the water can be used the Dialysis RN must conduct a series of quality control tests to be sure the water is good to use. The main test is a chloramine test. Chloramine is a derivative of ammonia that’s used to treat drinking water. It cannot be in the product water because regular levels of chloramine would cause seizures and potentially death in your dialysis patients. After all the tests are complete, the water is considered good and the hemodialysis machine can now be set up.  

The dialysis machine is then put through its own tests and it is “strung.” Stringing the machine means installing the blood tubing and dialysis filter, and priming out all of the air in the system. During this process “acid” and “bicarb” are added to the water being delivered by the RO. Acid is acetic acid or vinegar with electrolytes added specific to the patient’s needs. The bicarb is just sodium bicarb. The machine mixes dialysate at a ratio of one part acid, two parts bicarb, to 40 parts water. The pH is blended to the pH of normal blood. Dialysis patients are usually in early metabolic acidosis before treatment. The dialysis treatment normalizes this, while also balancing electrolytes and removing excess body fluid. 

Once the machine is set up and has passed all quality control tests, the patient can be accessed and bled on to the dialysis tubing, which is called the circuit. Patient access is either an externalized catheter or internalized fistula or graft. The catheter is commonly surgically placed in the right or left jugular vein then tunneled under the skin four-six inches to where it comes out into two limbs, the arterial and venous access. The blood being accessed is venous blood. The arterial limb is called arterial only because it is moving away from the body. The “venous” limb returns cleaned blood back to the patient. A fistula is an access created by a passthrough or “fistula” between an artery and a vein that was not there before. This causes higher pressure arterial blood to flow through a lower pressure larger vein. Over time, usually two-three months, the vein enlarges due to the increased pressure and the walls of the vessel thicken. At this point the newly developed fistula vessel can be accessed by larger fistula needles. New fistulas are accessed by 16-17-gauge needles until the vessel becomes accustomed to the needlestick. Standard dialysis treatments are run with 15-14-gauge needles. Two needles are required — an arterial needle to pull blood to the dialysis machine and a venous needle to return the newly cleaned blood. Needles are placed at least an inch apart from each other to prevent recirculation, or recleaning of freshly cleaned blood. A graft access is a synthetic tube that is placed under the skin connecting a vein to an artery. The optimal access for a dialysis patient is a fistula. However, not all patients are candidates to receive one. 

The biggest rule to follow is to never allow the extremity with the fistula or graft to be occluded, including and especially taking blood pressures. All lab draws and blood pressures must be done on the non-fistula extremity. Occluding the vessels or the fistula itself can lead to it clotting off and potentially losing that access. Many long-term dialysis patients do not have many options for accesses, so it is so important to protect your dialysis patient’s access while in your care. This is their lifeline!

The dialysis process itself is a fairly simple one that works on two principles — a concentration gradient and a pressure gradient. Diffusion, as most of you are very aware, is the movement of solute from a high concentration to a lower concentration. This is the entire science of electrolyte balance in a dialysis treatment. Potassium is usually high in a dialysis patient needing treatment. The dialysate mixed by the machine has a specific potassium prescription based on a sliding scale. This prescription will bring the patient’s potassium to a normal level after dialysis. The dialysis treatment does this with all electrolytes. It is important to note that the dialysis treatment only balances electrolytes in the blood. Higher levels may exist in the tissue and as dialysis progresses these higher levels continue to shift to the blood stream throughout treatment. Lab values are not accurate until at least an hour after dialysis treatment. It is highly discouraged to order labs before this so that inaccurate results are not given. 

The other half of the dialysis treatment is fluid removal. This is accomplished by the dialysis machine exerting a specific negative pressure on the dialysis filter that causes fluid to move from the blood stream to the dialysate side of the filter and be disposed of. Generally speaking two-four liters of patient fluid is removed from the patient during a four-hour treatment. Fluid removal is the component of the dialysis treatment that can lead to episodes of low blood pressure in the patient. This occurs when fluid is being “pulled” faster than the patient’s vasculature can tolerate. The ability to tolerate fluid removal varies greatly from patient to patient. Blood pressure and other vitals are watched and recorded at least every 15 minutes during treatment. Fluid removal also requires work from the body to shift that fluid.  Patients are often very tired after treatment due to this. 

And there you have it! I hope this sheds a little light on the often-mysterious ways of dialysis and gives you more knowledge to better care for you patients. I also hope it makes you more aware of what your kidneys do for you! Uncontrolled diabetes and high blood pressure are the top causes of kidney failure. Love, protect, and care for your kidneys!

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State Spotlight: Texas

Texas Austin Water - State Spotlight: Texas
Texas is a great location for your next Travel Nurse gig!

This month’s State Spotlight takes us to tremendous Texas! The Lone Star State is known for its warm weather and varied landscape, exciting sports culture, thriving arts scene, incredible food, maverick attitude, and tons more. Read on to learn more about why you just might want to mess with Texas during your career in Travel Nursing!

Travel Nursing in Texas

Texas Stamp - State Spotlight: Texas
Texas has more hospitals than any other state in the nation — which means loads of gigs for Travelers!

They say everything’s bigger in Texas — and that includes the state’s abundance of Travel Nursing opportunities. Not only does The Lone Star State dependably have lots of Travel Nurse jobs at great facilities, Texas also offers plenty of exciting, bucket list level things to do and see on your days off.

Texas is home to about 600 hospitals — more than any other state in the nation — 23 of which meet high enough standards to be ranked among U.S. News & World Report’s 2018/2019 Best Hospitals list. That includes their #1-ranked Texas hospital, Houston Medical Center in Houston, which is nationally ranked in eight adult specialties, in addition to being ranked “High Performing” in two additional adult specialties and nine procedures/conditions. Rounding out the top five overall best hospitals in Texas are: UT Southwestern Medical Center in Dallas, Baylor University Medical Center in Dallas, Baylor St. Luke’s Medical Center in Houston, and Memorial Hermann-Texas Medical Center in Houston.   

U.S. News & World Report’s 2018 “Best States”ranked Texas #36 overall, as well as #8 for economy,#17 for fiscal stability, and #21 for infrastructure. Livability.com ranked Austin, Houston, San Antonio, Lubbock, College Station, Dallas, San Antonio, Denton, Plano, Garland, and Fort Worth among the best places to live in Texas.

As for licensing, Texas is not currently a walk-through state, but it is a compact state and a NURSYS state. Click here for more, up to date info on licensing in Texas.

Texas Fast Facts

Lone Star State - State Spotlight: Texas
Texas is dubbed The Lone Star State because of its flag.

State Nickname: The Lone Star State

Capital: Austin

Largest City: Houston

National Parks: 14

State Parks: 95

National Historic and Natural Landmarks: 67

State Motto: “Friendship”  

State Flower: Bluebonnet

State Tree: Pecan

State Mammal: Texas Longhorn

State Small Mammal: Armadillo

State Bird: Mockingbird

State Dish: Chili

State Fruit: Texas Red Grapefruit

State Sport: Rodeo

State Music: Western Swing

Texas was the 28th state.

After being an independent nation from 1836-1845, Texas became the only state ever to join the United States by treaty rather than territorial annexation.

Texas is the nation’s second-largest state, coming in behind Alaska.

In fact, The King Ranch in Texas is itself larger than the entire state of Rhode Island!

Austin, Texas has been dubbed the live music capitol of the world.  

The Dallas/Fort Worth airport is home to the world’s largest parking lot.

Alamo - State Spotlight: Texas
Remember the Alamo!

Handheld calculators, 3D printing, stadium nachos, integrated circuits, liquid paper, frozen margaritas, silicone breast implants, corndogs, ruby red grapefruits, Whole Foods, Dell computers, chili, Six Flags, 7-Eleven, fajitas, shopping centers, and Dr. Pepper were all invented in or originated in Texas!

Texas’ 624 miles of coastline run along the Gulf of Mexico.

Caddo Lake is the only natural lake in Texas.  

The Waco Bridge was the first suspension bridge built in the U.S.

On July 20, 1969, “Houston” was the first word spoken from the moon.

The Texas cattle population is estimated to be 16 million.

Amarillo, Texas is home to the world’s largest helium well.

Jalapeno pepper jelly originated in Lake Jackson, Texas. 

The world’s first rodeo was in Pecos, Texas on July 4, 1883. 

Famous folks from or who’ve lived in Texas include Chuck Norris, Beyonce, Matthew McConaughey, Robin Wright, Jamie Foxx, Patrick Swayze, Woody Harrelson, Ethan Hawke, Kelly Clarkson, Jessica Simpson, Carol Burnett, Jennifer Garner, Selena Gomez, Joan Crawford, Dwight D. Eisenhower, Lyndon B. Johnson, Larry Hagman, Buddy Holly, Janis Joplin, Tommy Lee Jones, Willie Nelson, Sandra Day O’Connor, Dan Rather, Rip Torn, George W. and H.W. Bush, Alvin Ailey, George Foreman, Kenny Rogers, Luke and Owen Wilson, Ciara, Roy Orbison, Steve Martin, Jim Parsons, and Mary Kay Ash.     

Honorary members of the Texas rangers law enforcement group include Chuck Norris, Will Rogers, and John Wayne.

Approximately 75% of the world’s Snickers bars are made in Waco, Texas at the Mars/M&M plant. 

Laredo, Texas is the world’s biggest inland port.

The famous saying “Don’t Mess With Texas” originated as part of a 1986 campaign to eliminate litter from Texas roadways.

San Antonio’s Bracken Cave is home to the world’s largest bat colony.

Rumor has it that Aurora, Texas is home to an alien grave, after a UFO crashed in the area in the 1800s.

To Do & See in Texas

San Antonio RW - State Spotlight: Texas
San Antonio, Texas is known for its beautiful riverwalk. And don’t forget The Alamo!

Texas is known for being big and distinct. Thoughts of The Lone Star State may conjure images of everything from prairies to ranches to beaches, from charming small towns to urban hubs. And the truth is, Texas contains all of these multitudes and more!

Texas’ capital of Austin is known for keepin’ it weird and for being hailed “the live music capital of the world.” Great music, abundant outdoor activities, killer breakfast tacos, and cool festivals like South By Southwest and Fun Fun Fun Fest are just a few reasons why U.S. News & World Report named Austin #1 on its list of Best Places to Live. Check out Austin’s Rainey Street District, South Congress Avenue, Lady Bird Lake, Barton Springs Pool, Mount Bonnell, and the famous Congress Bridge Bats.     

In Houston, Texas’ largest city, you’ll want to check out the Space Center Houston, Discovery Green, Museum of Natural Science, Buffalo Bayou, The Galleria, and tons more. There’s also lots to see in cities like San Antonio, Fort Worth, Dallas, El Paso, and other urban hotspots.

Sports fans will be right at home in the state that made “Friday Night Lights” a thing. Pro teams here include the Dallas Cowboys, Dallass Mavericks, Dallas Stars, Dallas Wings, FC Dallas, Houston Astros, Houston Dash, Houston Dynamo, Houston Rockets, Houston Texans, San Antonio Spurs, and Texas Rangers. But keep in mind that Texas is also packed with incredible collegiate and high school teams, and the state is also a hotbed for rodeo sports, golf, gymnastics, and motorsports.

Texas food - State Spotlight: Texas
Texas is known for delicious chili, barbecue, Tex Mex, burgers, Gulf shrimp and oysters, and other yummy eats!

When the chuckwagon comes a rollin’ ’round in Texas, taste buds are bound to be delighted. In addition to The Lone Star State’s famous barbecue, Texas is also known for iconic faves like chili, chicken fried steak, kolaches, funnel cake, burgers, breakfast tacos, pecan pie, Gulf shrimp and oysters, peaches, Blue Bell ice cream, Frito pie, fried okra, Texas caviar, Vietnamese, Mexican, and Tex Mex like fajitas and queso. Wash it all down with an ice-cold Dr Pepper, sweet tea, or frozen margarita and you’ll be living like a true Texan!

When it comes to outdoor adventure, be sure to explore Big Bend National Park, Padre Island National Seashore, Palo Duro Canyon, Del Rio/Lake Amistad, Hueco Tanks State Park, Santa Elena Canyon, Natural Bridge Caverns, Lake Travis, Fort Davis, and many more of Texas’ natural wonders.

Ready for your adventure to terrific Texas?! Search jobs now to find your dream Travel Nurse job in Texas! Or, search all jobs here.  

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Congrats to Medical Solutions’ 2018 Traveler of the Year and Rising Star of the Year!

Kelsey C TotM
Congrats to the Medical Solutions 2018 Traveler of the Year, Kelsey C. (pictured) and Rising Star of the Year, Nicole M.! Each of them won a $500 Amazon gift card.

A big thanks and mega congrats to Medical Solutions’ 2018 Traveler of the Year and Rising Star of the Year winners! We are honored to work with healthcare pros who go out every day and make us proud by providing superior patient care with a great attitude. Because we have such great Travelers, we look forward to these annual honors which recognize a couple of our best and brightest. Each month we recognize a Traveler of the Month and a Rising Star of the Month, and our two annual winners are chosen from the pool of monthly winners. Learn more about the Traveler of the Month program here.

Without further ado, here are the 2018 winners!

Traveler of the Year

Congrats to Kelsey C. for being named 2018 Traveler of the Year! Kelsey, an RN, BSN specializing in progressive care/step down, was Traveler of the Month for July 2018. She’s been traveling since January 2018 and works with Career Consultant Jon Laubert.

“The best part of Travel Nursing is the freedom to go wherever you want on an assignment,” says Kelsey. “It’s so fun traveling to different states, meeting new people, and having new experiences. You get to see the diversity of geography, lifestyle. and culture within our own country. I also get to learn new skills and different policies at each hospital, which helps to enhance my overall nursing knowledge.”

Kelsey won a $500 Amazon gift card and received flowers as her prize for winning Traveler of the Year. Thanks so much for everything you do, Kelsey!  

Rising Star of the Year

Congrats to Nicole M. for being named 2018 Rising Star of the Year! Nicole is an RN, BSN, CNOR who’s been in nursing for nearly nine years and traveling since early 2018. She was named Rising Star of the Month for July 2018 and works with Career Consultant Travis Pond.

Nicole, who loves to weightlift and read in her spare time, enjoys the independence that Travel Nursing affords her.

“[The best thing about Travel Nursing] is the lifestyle of freedom it provides,” she says.

Nicole won a $500 Amazon gift card and received lunch catered in to her unit as her prize for winning Rising Star of the Year. Thanks so much for everything you do, Nicole!  

Congratulations again to our winners and a big thank you to ALL of our incredible Travelers!

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Clinical Corner: Team Nursing and Delegation

Team - Clinical Corner: Team Nursing and Delegation
Team Nursing can be a great, collaborative experience for patients and healthcare workers — as long as you know how to navigate the process!

By Phil Niles, Clinical Nurse Manager, Medical Solutions

Many of you have encountered the concept of team nursing during your travel and/or nursing careers. If you have not encountered it, you might one day hear something like, “Your assignment will have you taking a 1:10 assignment.” Then you might say, “What???” and they might reply, “Don’t worry — it’s team nursing!” Even more confused at this point, you might ask, “Well, what is team nursing?” What a great question! Let’s start with some definitions.

Team nursing is pairing nurses of varying skill sets and experience levels to care for a larger group of patients. This team can consist of an experienced nurse and a new nurse, a RN and an LPN, or either of these two with the addition of a nurse aide. The team is intended to create a collaborative, supportive environment that will collectively meet patient needs and promote improved communication between team members.

Team nursing is not meant to be an authoritarian hierarchy with one person ordering everyone else around. In fact, many factors go into determining how the workload is divided. Team members collaborate at the beginning of the shift to divide tasks amongst each other according to skill, scope of practice, and familiarity with each patient. A common misconception of team nursing is thinking you’d have to control every detail of care for all patients assigned to you. It’s difficult to get out of the mindset of primary nursing (one nurse to a group of patients) and give up a little control and the idea that you need to do everything yourself. For Travelers working an assignment with team nursing for the first time, it can be a challenge at first to adjust. So, let’s address a few questions you may have about team nursing as a Traveler.

What can my team members legally do in their scope of practice?

This is probably the most commonly asked question and an important topic to address. Scope of practice of LPNs and nurse aides varies by state, so it’s important to study up on the Nurse Practice Act of the state you are traveling to ahead of time. Each state’s Board of Nursing website is a good resource for this. You can also reference the National Council of State Boards of Nursing (NCSBN) website. Click here and you’ll find they have a drop down box where you can select your state and to generate a link to its Nurse Practice Act. You can also ask the floor manager or even the team members themselves! It is important to remember that hospitals may not allow the same scope of practice that a state lists as acceptable, so never assume anything. Even after reviewing your state’s Nurse Practice Act, make sure to ask the manager about the hospital’s specific LPN and nurse aide scope of practice.

What if something goes wrong with a patient whom an LPN or aide on my team was assigned to?

What is your accountability when delegating tasks to others? Every member of the team is accountable for their own actions. For example, an LPN may be held accountable for negligent or improper care that resulted in patient harm. However, the RN may also be held accountable for improper delegation or not intervening in the negligent care if the RN had knowledge that the care was not to standards of care.  There is a balance to be struck between delegating care and assuring that care was carried out. The RN is in a supervisory role in team nursing when the other member of the team is a LPN or aide. No one in a supervisory role should ever assume when you hand off a task that it was completed without verifying this themselves. As the RN Traveler in a team nursing scenario, you will likely see the same patients throughout the day while doing separate tasks. Take this time to also verify that all care was delivered and appropriate. 

What if the other members of my team do not communicate with me?

Team nursing relies on clear, consistent communication between all team members, so never be afraid to ask questions. Often, drops in communication happen because the other person assumes you already know the information. For example, a good way to approach this type of situation would be to say, “I’m going to see Mrs. X next. Did you already change her dressing? Do you have time to change it with me now, so we can both assess it?” This is a collaborative approach with clear communication. The other person will not be threatened or feel ordered around and will likely make a plan with you. On the other hand, an approach I do not recommend is to say, “Hey! When are you going to change Mrs. X’s dressing? You need to talk to me!” As you can tell, this may spark a bit of defensiveness and potentially damage your working relationship. Still, there are those that once in a while do not respond well to coaching, so you can always go to your charge for support if you feel your team is not working well together or have a concern about a particular team member. 

I hope this gives you guidance and arms you with information if you ever work in a team nursing environment. I also hope you see it as an opportunity to meet your patients’ needs in a new way.

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Congrats to December 2018’s Traveler of the Month and Rising Star!

Many thanks and congrats to the December 2018 Traveler of the Month, Quincy H., and also our Rising Star winner, Ivy P.! 
Traveler of the Month Quincy is an RN specializing in critical care, currently on assignment in New Orleans, Louisiana.
Three cheers each for our latest Traveler of the Month winner, Quincy H., and Rising Star winner, Ivy P.!

Many thanks and congrats to the December 2018 Traveler of the Month, Quincy H., and also our Rising Star winner, Ivy P.!

Traveler of the Month Quincy is an RN specializing in critical care, currently on assignment in New Orleans, Louisiana. He’s been in nursing for seven years and traveling for about six years. Quincy works withCareer Consultant Michelle White.

“After my first travel assignment I discovered what I love the most about Travel Nursing, which is the ability to be the boss of myself,” says Quincy. “I’m able choose not only the city and state, but the hospital I want to work at. Travel Nurses are able to choose what time of the year they want to work. You also meet so many different people and expand your knowledge of various cultures.”

Quinn, who travels with his fiancé, says his most memorable travel assignment so far was in Santa Clara, California.  

“The staff was awesome, not to mention the perfect location near the Bay Area with beautiful scenery, beach, and mountains that have seasonal snow,” he says.

Quinn says his unique ability to adapt to any situation or circumstance has been very important to his success as a Travel Nurse. He also shared these great tips for other Travelers.

“A few tips from an experienced traveler to a beginner traveler: Have flexibility, be open-minded, kind, and don’t be afraid to speak up when something doesn’t feel right,” he advises.  

Thanks so much for your hard work and great advice, Quincy!

Rising Star Ivy is an ER RNcurrently on assignment in Ottumwa, Iowa. She’s been in nursing for three years and traveling since October 2018. Ivy with Career Consultant Bill Thomson.

Ivy is known for smiling often, which makes her a great fit in the sometimes-challenging field of healthcare because she keeps the level of optimism high! Ottumwa is her first Travel Nursing job and she says the best thing about traveling is keeping things fresh.

“[I enjoy] meeting new people, new environments and new challenges,” says Ivy.

Ivy offered the following advice to new and aspiring Travelers: “Be open-minded and unafraid to ask questions and express concerns.”

Thank you for all of your hard work and dedication to quality patient care, Ivy!

Congratulations again to the Medical Solutions December 2018 Traveler of the Month and Rising Star! Quincy and Ivy, we are so thankful to each of you for your dedication to patient care and Travel Nursing!

Could you be the next Medical Solutions Traveler of the Month or Rising Star? Travelers who receive a perfect hospital evaluation are eligible to win these monthly awards — with Rising Star going to newer Medical Solutions Travelers. Click here to learn more and to see if you could be the next winner of a $100 Visa or Amazon gift card as recognition for a job well done!