Farmington, NM San Juan Regional Hospital Travel Review
Nursing Background:
3+ years ER, 2+ years MS
Fiancé and I have been travel nursing for 9 months
San Juan Regional Hospital
San Juan is a level 2 trauma center with a 22 bed ER seeing around 150-200 pts per day. It’s the main hospital overseeing the Navajo reservation nearby. If not in triage, you are assigned 5 rooms, really 4 patients and a drunk tank pt (if there is one) with 1 of the rooms being a critical care room. If in triage, you send everyone you see to the waiting room and if a room becomes avaliable, that nurse will take them back (acuity based of course)….if there are no rooms, you watch them constantly eyeing you and asking about wait times. Occasionally one falls on the ground and you have to call charge to let them back. This place uses Cerner EHR and being this busy, it kinda reminds me of being in an HCA in Texas, staffing is still a hit or miss. Sometimes there are 6 - 7 nurses for a whole shift and other times I’ve been on shift with me, a new grad, and the charge nurse. There are techs, but you def gotta be comfortable managing sick pt’s all alone, start to finish. The patients are 90% adults and 10% peds. While the peds pts are super cute, the adults not so much. You will see mostly Navajo or white patients, surprisingly very few Spanish speaking patients. There are quite a few regulars and since Farmington doesn’t have a drunk tank for jail, the ED has a room dedicated for it. The techs really own this area and update vitals/ let them leave if they can walk (which is good since they are usually tucked away in a whole different section of the ED). Most of the patients you will see will have some alcohol related issue, diabetes, abdominal pain, or chest pain with quite a lack of health care literacy and even abuse of the hospital system. Didn’t see many codes, but do get quite a few intubations (intentional overdoses usually).
ER
Pros:
- Self scheduling done in 4 week blocks, often got the schedule we asked for.
- Friendly staff in the ER 60% of the ER was other travelers). ED Doc were easy to interact with :)
- Chillest day shifters I’ve worked with, giving report was easy af.
- Leave by 7:10-7:15 consistency.
- Only send 1 pink top/ blood checked by computer, no need for 2nd nurse check.
- Don’t feel too rushed to complete tasks or take new pts (for the most part).
- Pedi pts were chill and cute (docs didn’t needlessly order blood/ caths for urine on these pts).
- Docs give pain meds pretty regularly, which helps with the call lights.
Cons:
- Adult pts (a lot of people using the ER as a primary care or to not be on the street). lots of alcohol and drugs abuse.
- Lack of community culture between nurses (probably from so many travelers).
- HCA type busy/ low staffing with up to 6:1 ratios, I’ve seen the charge take on 10 pts.
- Lack of lunch aka downing it at the nurses station.
- CT/MRI are 1 mile away from the ER and the floors are far too.
- RNs responsible for changing pt’s out of clothes for MRI. When busy some of the techs will bring people fully clothed to MRI and YOU get in trouble….aka MRI lazy.
- 2nd nurse scan to give magnesium.
- On call pharmacy at night/ no neurology in house.
Fiancés Experience on MS
She had notoriously unfriendly staff interactions on floors a few times, in fact one nurse was training someone and told the trainee how not to nurse using my fiancé as an example. Most interactions were good, but there may have been some bad ones due to the fact that most of the floor nurses were staff and she was a traveler. Furthermore, she often times would get off shift at 0800 or after due to the time it took to give report to the next nurse as well as extended day shift huddles. Though it was busy, she was able to find time to take a lunch, but some nights she had sections with very confused patients. A few times, she was floated to the cards unit.
Farmington the town:
First impressions of this 45K population town feels like a drive through on the way to a bigger and better city. There is very little greenery and a lot of dirt. The buildings are 1 story, look run down, and all have flat roofs. There are quite a few chain restaurants in the area along the main road. Along the river, if the wind blows right, a water treatment center gives that nice sewage smell. This all gives off a lower income/ undesirable look. That being said, it does have its quirks.
- Animas river runs through it with a gravel trail (running, white water activities, fishing)
- Off roading and mountain biking trails nearby
- Mexican food slaps here
However, the best feature of this town is the location. Farmington is centrally located to some of the best outdoor recreational spots on the continent! We spent more time outside of this town than in it. Here are the areas we went to in 13 weeks, all between 1 - 6 hours of driving.
Phoenix, AZ
Sedona, AZ
Flagstaff, AZ
Page, AZ
Chaco Canyon, NM
Albuquerque, NM
Santa Fe, NM
Moab, UT
Durango, CO
4 corners of the US (CO, AZ, UT, NM)
Zion National Park
Grand Canyon National Park
Arches and Canyonlands National Parks
Overall, I like to call this the hiking contract cause we hiked a lot and saw many spectacular sites on our days off :) I ended up losing 13 lbs and all the weight I had gained eating food in Washington. Would we come back to work at this hospital? Hell no! But did we enjoy our days off more than any other place we have worked at? Hell yeah. It’s a trade off and we feel it was worth the value.