Getting paid to travel and help people? What could be better than that? Travel nursing is an alluring career option with its flexible schedule, high pay, and other benefits. But is travel nursing the best decision for your career long-term?
Like every job, travel nursing has pros and cons, and there’s a lot to consider before deciding. I recently had the chance to discuss this topic with Jerome Alacre, Director of Nursing (DON) at Vista Manor Nursing Center, a Generations Healthcare facility in San Jose, CA. Before becoming a DON, Alacre worked as a travel nurse from 2013 to 2016, traveling to 13 states. Throughout his career journey, Alacre learned three important lessons that are helpful to anyone debating whether to become a travel nurse or dedicate themselves to a singular facility:
1. You Have Less Support
As a travel nurse, you make big adjustments every time you move to a new facility. With new systems, people, policies, and procedures, there’s much to figure out with each move!
Because he was only in each facility for a short time as a travel nurse, Alacre felt less support in this role than he did staying with a facility long-term. Additionally, he thought that long-term employees were given higher priority while he was often left with more complicated tasks or transferred between units more frequently.
On the other hand, when Alacre became a nurse dedicated to a single SNF, he saw a huge change in how he was treated. “Because they knew me better,” he say, “upper management was better able to understand my needs and help me progress in my career. Even though the recent pandemic was a challenge, I still felt support from all who surrounded me at Generations Healthcare.”
2. More Difficulty Focusing on the Future
Travel nursing is an excellent option for those who are younger, more active, want experience, and want to see other parts of the country. However, because travel nurses are always on the go and never know where they will end up next, travel nursing can make it difficult to plan and focus on future career goals.
“In the long run, I didn’t see the position as a permanent job,” Alacre says. “As I got older, I decided it was better to settle down in one location and focus on my plans and goals. So once I settled down at one SNF, I finally had time to sit down, focus on my future, and set goals.”
3. Great Opportunity to Gain Experience
As a travel nurse, you get to meet many different people and learn a lot from different facilities around the country. With that in mind, Alacre is grateful for his time in this position. “My experience as a travel nurse has enabled me to perform better in my current role as a DON,” he says. “Because of my exposure to many different patients and hospitals around the US, I have an easier time understanding and managing patients.” In addition, Alacre’s experience and broad clinical skills allow him to be a strong support for the whole facility.
Generations Healthcare strives to recognize and appreciate the contributions of every staff member. Alacre says, “Generations has been very vocal and appreciative of my clinical experience. In 2019, I was the winner of Generations’ Presidential Award due to the tremendous decrease in readmissions to the hospital that Vista Manor saw in relation to my clinical skills and experience developed from travel nursing.”
Travel nursing has its perks. Depending on where you are in your career journey, it could be a great option to gain some valuable experience before settling down at one facility. Alacre is very grateful for his time as a travel nurse and has no regrets about his career.
If you are in a position where you want to travel and gain experience, consider travel nursing. If you prefer to have more support and focus on your future, consider choosing a facility where you can settle down. To see examples of the benefits available for staff nurses in skilled nursing facilities, visit lifegen.net/career.
For the last two years, hospitals have been reliant on travel nurses, with the demand for travel nurses skyrocketing. However, turnover has recently begun to increase, and hospitals and health systems are facing a turning point in addressing the staffing shortage crisis.
Minority Nurse chatted with Beth Brooks, Ph.D., RN, FACHE, and Clinical Advisor to Vivian Health, about how travel nursing is changing the nursing workforce and what hospitals can do to reconfigure the work environment to optimize the existing workforce.
Beth A. Brooks, Ph.D., RN, FACHE, and Clinical Advisor to Vivian Health
How is travel nursing changing the nursing workforce?
There have been travel nurses in the 30 years I’ve been a nurse. Of course, there have always been nurses who have chosen a full-time travel career path because they either wanted to travel the country or wanted the challenge of building robust clinical skills in a particular specialty. But for the most part, these travel nurses primarily filled temporary vacancies during past nursing shortages or labor strikes.
There are currently 4.4 million RNs in the U.S. nursing workforce. Between 2020 and 2021, the Bureau of Labor Statistics reported a 55% increase in travel nursing (from 43,160 to 66,790 RNs), representing 2.34% of the RN profession. Because travel nurses were all over the country working for different health systems during COVID, they are in a unique position to speak to how prepared (or unprepared) employers are to support nurses in their careers and mental health. As travel RNs consider permanent work, they are looking for employers to prioritize their mental health and well-being and provide flexibility, autonomy, career progression opportunities, and higher compensation to feel supported and respected.
Hospitals and health systems face a turning point in addressing the staffing shortage crisis. So what can we do to bring nurses back to nursing?
The industry has been facing many challenges. Recent research reveals that 600,000 Boomer RNs are expected to retire by 2030. The latest American Nurses Foundation (ANF) Workplace Pulse survey revealed that nearly half (49%) of direct patient care nurses intend to leave their position, 19% intend on leaving in the next six months.
That said, there’s some good news: 18-29-year olds remain interested in nursing careers. The National Nurse Work Environment study by the American Association of Critical-Care Nurses indicated that 75% would recommend nursing as a career, and interest in nursing school remains high. Rebuilding the workforce with these nurses is crucial, but the need to reconfigure the nursing workforce is equally important. This means adjusting how hospitals address staff churn and changing the care delivery model to ensure nurses are working at the top of their licenses. In addition, increasing the focus on mental health and well-being support, improving compensation, and reducing the complexity gap as more veteran nurses leave the profession and are replaced by newer, less experienced RNs.
Another interesting trend we’re watching is the new careers available to nurses. ANF’s Workplace survey indicates that 18% of RNs intend to find a nursing position outside the hospital setting, showing a growing interest in career pathing among nurses to build their career so it’s tailored to their specific lifestyle and interests.
During the pandemic, travel nurses tripled their pay by moving from job to job. But many see the short-lived boom as a temporary fix for a long-term decline in the nursing profession. So, do you think the travel nurse gold rush is over?
Travel nursing is not for everyone. It is its specialty, like pediatrics, critical care, peri-operative, medical/surgical nursing, or nursing leadership. Every nurse chooses a specialty area to focus on at some point in their career. Travel nurses feel that a higher salary compensates them for ever-changing patient assignments and adapting quickly to new organizations, making travel nursing their specialty. Some generational cohorts, such as millennials, are also drawn to travel nursing, but typically for a finite period.
Nurses attracted to travel nursing for the first time did so because early in the pandemic, they wanted to assist in regional COVID “hot spots.” Certainly, the salaries were a big draw. Still, these new travel nurses enjoyed control over their schedules, more autonomy, and flexibility, but whether these factors outweigh what they gave up – being part of a team, knowing the system, and professional development opportunities – remains to be seen.
We don’t know how many RNs will return to permanent roles or choose travel nursing as their specialty.
What has been the impact of travel nurses treating COVID patients for two traumatic years?
The pandemic has impacted every nurse – research studies of stress, fatigue, anxiety, moral distress, burnout, and some post-traumatic stress disorder reveal these findings. And let’s not forget that most of the 100,000 RNs who left the workforce during the pandemic were 49 years old or younger – not retirement age, as many assumed. What has been interesting is looking at the years of experience of travel nurses data: RNs who decided to travel for the first time during the pandemic report slightly higher stress, fatigue, and burnout levels than experienced travel RNs.
Do travel nurses feel like they answered the call and raced to help COVID patients, and now they’re being cut? Are the cuts attributed to federal and state funding drying up or something else?
During the early phases of the pandemic, permanent staff nurses were less tolerant of the initial drastic nurse staffing cuts when elective procedures were canceled. Then, during COVID surges, it was all hands on deck. This was hugely unsatisfying and may have fueled the interest in travel nursing (in addition to high salaries).
Nurses understand that when patient census decreases, there is less need for RNs, so their unit assignment or work schedule may change. This is true of permanent RN and travel RN staff. A lower patient census for RNs on travel contracts has led to a flurry of travel contract re-negotiations with hospitals. Negotiations to either end a contract early happened because patient census has decreased, or, where travel RN agencies benefited from federal and state funding by drastically increasing their billing rates, hospitals have been re-negotiating contract rates.
What can hospitals do to reconfigure the work environment to optimize the existing nursing workforce?
There are two areas to highlight: The first one is toxic cultures. Bullying, incivility, and violence perpetrated by patients and families towards nurses and hospital staff occurred at alarming rates. In acute care settings, 65% of RNs reported bullying or incivility, and 40% of RNs experienced violence. Nurses must have safer and more secure workplaces to provide the best care.
The second is to use more sophisticated math for nurse staffing and scheduling. Some savvy hospitals now view nurse staffing and scheduling as a logistics problem. Using a logistics management approach enables hospitals to use the science of operations research and more powerful math like linear programming. Predictive modeling is used to deploy the right number of staff with the right skills, at the right location, at the right time, with the appropriate patient assignment, and factor in the lowest cost with the best patient outcomes. This complex problem requires big data and sophisticated math, which is different from how nurse staffing and scheduling is typically done today. Nursing staff budgets are based on the “flaw of averages,” using rudimentary math to base nurse staffing on the census at midnight (Average Daily Census) and Nursing Care Hours per Patient Day (HPPD). This inevitably leads to some shifts being overstaffed (a nurse is sent home or floated to another unit) and some understaffed (not enough nurses during the day when the patient census is higher than at midnight). It is very dissatisfying for nurses.
Nurses are looking for scheduling flexibility and control. Health systems should consider creating different scheduling options like 8- or 10-hour shifts. Since nurses are familiar with gig economy-type jobs or travel nurse positions, they should also consider implementing these or similar options, which will be particularly attractive within large, geographically dispersed health systems.
Please discuss Vivian Health’s State of the Healthcare Workforce Survey findings. For example, why are nurses willing to trade the higher pay of travel nursing for a stable job with a strong employer?
Travel nurses learned to enjoy the sense of control and greater flexibility they had over their schedule while traveling during the pandemic. As a result, some want to continue traveling to see the country or build a robust clinical skill set. In addition, the pandemic created numerous work-at-home options. Those nurses with a partner who can “work from home” may choose to remain a travel nurse to continue enjoying greater control and autonomy regarding where and when they work.
It is becoming clear that while some first-time travel nurses want to return to permanent positions, they are demanding healthier work environments, flexible schedules, a sense of control, better staffing, more autonomy, and more significant compensation. Vivian Health’s recent survey asked travel nurses about their future career plans. Fifty-five percent were seeking a permanent position with a median salary of $65 per hour and being part of a team.
Why are nurses willing to trade the higher pay of travel nursing for a stable job with a strong employer?
Travel nurses learned to enjoy the sense of control and greater flexibility they had over their schedule while traveling during the pandemic. As a result, some want to continue traveling to see the country or build a robust clinical skill set. In addition, the pandemic created numerous work-at-home options, so those nurses with a partner who can “work from home” may choose to remain a travel nurse to continue enjoying greater control and autonomy as to where and when they work.
It is becoming clear that while some first-time travel nurses want to return to permanent positions, they demand healthier work environments, flexible schedules, a sense of control, better staffing, more autonomy, and greater compensation. Vivian Health’s recent survey asked travel nurses about their future career plans. Fifty-five percent were seeking a permanent position with a median salary of $65 per hour to be part of a team.
What about global nursing? What is the value of an American nursing degree internationally? What role do travel nurses play abroad?
First, there is a global nursing shortage. While we usually see nurses from abroad coming to the U.S. to work, many U.S. RNs travel abroad to work. There are a few interesting differences: First, travel contracts are for 1-2 years, not 13 weeks. Second, RNs traveling overseas need a U.S. Passport, an active, unencumbered RN license from a U.S. state, vaccines, and perhaps a work visa. Third, a language proficiency exam and board certification in a nursing specialty may be required. Finally, RNs who want to travel overseas must check each country’s regulations since they differ.
And yes, the value of an American BSN degree is significant. Unlike the U.S., where the minimum requirement for nursing is an AS degree, the BSN degree is the minimum requirement to be licensed in European countries.
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Life isn’t perfect. You may love working as a travel nurse or health care professional, but chances are good that you’ll eventually run into issues. Whether it’s an unexpected situation at home, the agency you work for, or even difficulties with the hospital, you’ll want to know the best way to handle the problem. Here are a few things you can do to resolve problems and get back to work.
1. Be open about personal issues.
Unfortunately, deaths and illnesses can’t be planned. While you may be a private person, open and clear communication is imperative. If you experience an issue that requires your immediate attention, such as a death, serious family illness, or even your own illness, let your company know ASAP. This will allow them time to develop a plan to help you work through the situation. Next, let the hospital know what is happening. To protect yourself and the agency from any contract cancellation penalty, it’s a good idea to keep documentation such as doctor’s notes, obituary, etc. Be sure to do your best to make the transition to the next nurse as seamless as possible.
2. Don’t allow yourself to be bullied.
This applies to the company you work for. For example, if you experience a problem with the agency, such as not getting paid correctly or being put in unsafe housing, stand up for yourself. Immediately make the company aware of the problem, provide documentation (if needed), and give them time to fix it. If the issue isn’t resolved in a timely manner, check with PAN Travelers (Professional Association of Nurse Travelers) for assistance. They act as advocates and can offer legal advice, if needed.
3. Be ready to adapt.
As a travel nurse or health care professional, you must be adaptable. For example, if you have an issue with a hospital’s policies and procedures, be aware that you’ll be the one expected to change. Keep in mind that hospitals may have good reasons for doing things a certain way, which may differ from other facilities. The exception is if you are asked to do something unsafe or ethical. Hopefully, this never happens, but if it does immediately talk to your employment agency. Be very specific with your complaints and allow your recruiter to work with the hospital to remedy the issue. This may or may not work. If you still aren’t satisfied, speak with your company’s chief nursing officer or clinical liaison for advice on how they would handle the situation.
4. Proceed with caution.
Unfortunately, you’re not always going to get along with your coworkers, especially those who are leery of travel nurses. If you find yourself in a hostile work environment, whether it’s with one person or an entire group, take the time to decide the best approach for dealing with the situation. You may find that you simply have to ignore the situation and go on with your work. If it’s unbearable, talk with the unit manager. If there is still no change in the situation, take the issue to your company. They may have dealt with similar issues in the past and may have ideas for how to “fix” things. Even if things don’t change, remember it’s only 13 weeks, and then you’ll never have to see those people again. Always be a professional.
DeeQuiency M. Donerson is studying in nursing school, but unlike some students, he already knows what he wants to be after he becomes an RN: a travel nurse. Since May 2010, Donerson has been working as a Certified Surgical Technician with Trustaff, and he likes what he does so much that he now wants to take on more and become a nurse.
“Every contract is 13-week assignments. I am almost always offered an extension because of my knowledge of surgical procedures. The longest contract I have done was nine months in Miami, Florida, which was a great experience,” says Donerson. “I wanted to become a traveler to gain as much experience as possible of surgical procedures, doctors’ preferences, instrumentation, and sterile supplies.”
Before 2007, Donerson wasn’t in the health care field at all. In fact, he worked as manual laborer making minimum wage. At the time, he even had to live out of his car. He decided that he wanted to attend surgical technology school, but when he had to fill out the application and include his address, Donerson wrote in his license plate number. Luckily for him, college staff realized that he was homeless and arranged for him to live in a dorm for the rest of that school year.
When a Trustaff representative spoke to college students about becoming a traveling health care worker, Donerson was interested. After graduating and getting a year of experience, Donerson became a travel CST. His first assignment was in the Virgin Islands. After that, he traveled the country, working in Louisiana, California, North Dakota, and in several cities in Florida.
Donerson says that he loves working with his recruiter, Danny Laurence. “He basically knows exactly what I’m thinking before each contract and after,” says Donerson. He also recommends that nurses thinking of becoming travel nurses be on a first-name basis with their recruiters. “Not having a great recruiter will more than likely end in disaster for a contract,” he says.
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