The In’s and Out’s of Travel Nursing

By Susan Frances Bonner, author of Opening A Registered Nurses Eyes; A life Altering Journey Across North America

What’s a Travel Nurse? This is a question that I have gotten from numerous patients as I traveled the entire North American Continent, as a Travel Nurse.

So, with that said, I will give you a brief definition of what a Travel Nurse is; from travelnursejobs,org. “Due to a nursing labor shortage and nurse specialization in the early 80s, the travel nurse was born. A travel nurse is a nursing professional who works with a staffing company and typically works at a hospital or healthcare facility in a temporary assignment that is usually 13 or 26 weeks. Travel nursing started as a means for these facilities to fill scheduling shortages resulting from census increases, maternity leaves and vacations.”

I became a Travel Nurse due to the nursing shortage that occurred in North Florida in 1998. The only job I could get was as a Travel Nurse because I lived in a rural area and there were only two hospitals, very few Doctor’s offices and one Home Health Agency outside of said hospitals. I did work for the one Home Health Agency in my area, but was laid off because of the hospitals. (That story will be for another article in the future.)

Travel Nursing, in my humble opinion is the most unique form of Nursing in the field. For starters, you have to have the mind set of becoming an independent contractor. Now, most Nurses know what it means to be independent or we could not do our jobs. But most of us work for either a hospital or other organization. We are given a schedule, shift time and know what departments that we will work in.

When you are a Travel Nurse however, you more than likely will have to be flexible when it comes to all of the above. See, hospitals hire Travel Nurse’s to fill shortages and most shortages occur during evening and night shifts, weekends and holidays. They also usually occur on a floor or department which is very busy and less desirable to work on. And not every hospital will have slots open that cater to your area of expertise. I found this out the hard way. All of these factors have to be carefully considered before you even look for an agency.

Next consideration is choosing an agency. And there are many out there to choose from, which believe it or not is a good thing for you. More agencies mean more competition in the hiring arena, which means that you are more likely to get an assignment that you really want and fits your needs. This is the most important part of becoming a Travel Nurse and by far the most critical. As I alluded to in the previous paragraph, Nurses are not used to being independent contractors. This is where that roll comes into play and it is a hard one to master, at least it was for me.

Make sure you contact more than one agency at a time, while looking for an assignment. I made the mistake of jumping in with both feet with just one agency my first time out. I picked the first agency I found in one of my nursing magazines and ran with them. As I chronicle in my novel; Opening a Registered Nurse’s Eyes, I only learned more about contracts and agencies when I met another Travel Nurse during my first assignment. I call her my “Travel Nurse Guru”.

She taught me that I could solicit more than one agency at a time and I could do so even while working on my current assignment. Pretty cool, huh? It’s just a perk that comes along with being an independent contractor. I didn’t know that at the time, so I ended up taking an assignment with an agency that was very small, did not have many contacts and I got gypped out of a chance to bargain for higher pay and a better place to live. During my first assignment we lived next door to drug dealers.

Once you find an agency that fits your needs; (and please make sure you find one that does), you must be vigilant when you are constructing the contract. I have had so many horrible assignments because I did not cover all of my bases during the contract phase of Travel Nursing.

You have complete control over your contract with an agency. Do not let any agent or agency tell you other wise. Even though they cover you with medical malpractice insurance, pay for your housing, travel expenses and give you a bonus, your professional license is yours. You own it, and you must protect it. You and only you can dictate what you will do as a Nurse. So keep that utmost in your mind when drafting your contract.

I cannot emphasize how important the contract phase is to becoming a happy successful Travel Nurse. It covers your shift, your department, your salary, your living expenses, your living accommodations, your travel expenses and terms of employment, not only with the agency, but what the facility can, and cannot do to you. Be meticulous in this process.

My second assignment was a nightmare because I was not explicit in its wording. See, I since I had graduated nursing school, I had always worked weekends, twelve hour night shifts. So, as a Travel Nurse, I wanted to continue that trend. I found that I was more marketable that way. But when I went to my second assignment, I was told by the assistant nursing supervisor, “I am paying a lot of money for you and I will schedule you when ever and where ever I choose or need you. You are mine for the thirteen weeks you’re working here.” And she had that attitude because I did not stipulate, 7pm-7am weekends, ONLY! One word caused a lot of headaches for me. Don’t let it happen to you.

When you are a Travel Nurse, you visit many places, you see many different types of medical care, and you make a difference. Believe me; I have changed many a floor as a Travel Nurse by bringing my unique perspective to any given hospital.

During my last assignment I had renewed a couple of times because this particular hospital was near the home I owned in Florida. The hospital was in a hiring freeze and many of the Travel Nurse’s did not renew, so we were critically short of nurses. My patient care load went from six to seven patients, up to ten to twelve patients. Very sick patients as well. One night I had a very heavy load and was told I would be getting two more admissions, something I knew I could not handle and would be putting my patients’ well-being in jeopardy. I told the charge nurse I would not take any more patients for the reasons I have stated above. I also explained that if I did take on more patients, I could not safely give my patients proper care due to the acuity of my current load. She told me that she would have to call the hospital supervisor if I refused these patients. I told her to go ahead and that I wanted to talk to her as well about what was going on, on this floor.

The house supervisor called just then and informed the charge nurses that our “census” was going to stay the same for the shift. We would not be getting any admissions that night because we were short staffed. I found out later, that the house supervisor was diverting any new admits to less crowded floors that night. According to existing hospital policy, if a floor was short staffed the supervisor was to be notified and other arrangements had to be made. The key concept here was the notification of the supervisory staff. Would I have done that if I was a regular employee of this hospital? Probably not, but since my contract was with my agency and the hospital was a secondary note, I had the freedom to do the right thing by my patients and the other nurses without fear of being reprimanded. So, keep that in mind when you hit the road.

In conclusion, Travel Nursing is an exciting and challenging form of our Nursing Profession. One for the “not faint of heart”. But one worth exploring if the timing is right and one is up to the adventure. And it is an adventure.

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