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In 2001, the health care segment of the temporary staffing industry was an $8.5 billion industry in 2001, according to the trade publication Staffing Industry Report. That figure marked an 18 percent increase from $7.2 billion in 2000. Nurses account for more than 70 percent of the revenue generated in the temporary medical staffing business, according to the publication.

Gallant, a native of Calgary, Alberta in Canada, who is working at Yale-New Haven Hospital in Connecticut, started his travel nurse career "as a way to see states," he said. "It just kind of ballooned from that and I'm still going. I love nursing, and this way, you get to practice your profession, see the country, meet a variety of people and just enjoy life."

Because of their diverse experiences, travel nurses learn more skill sets, work with more physicians and are exposed to different protocols, said P.K. Scheerle, president of New Orleans-based American Nursing Services, a national per diem and travel nursing business. "So what you're getting is the cross-pollination of best practices and a more well-rounded practicing nurse."

Transience also produces a higher level of scrutiny than that of permanent staff RNs, according to travel nurse organizations. "They must go through all the same competency verifications and background checks, but they're doing it every 13 weeks," said Frank Shaffer, president of Cross Country's education and training division. "Their skills are checked more frequently than probably any hospital employee."

Cross Country requires nurses to have at least one year of experience in their specialty before they can be assigned to a travel post, he added.

Gallant said travel nurses face challenges in keeping up with nursing license nuances and practice standards in each state.

"They all have different renewal fees, dates and continuing education requirements," he said. "You should make sure you take care of it well in advance, even if you're thinking about going to another state."

Gallant has learned to adjust from job to job. "One of the reasons they take you on is you're supposed to be able to adapt quickly," he said. "You can't be rigid. And you really can't go into a new environment with a know-it-all attitude. You've got to realize when in Rome, do as the Romans do. Then you'll be fine."

From time to time, he does face resentment from full-time hospital staffers who are envious of his freedoms. "But you have to be able to let that roll off your back. You have to realize that most of the [permanent nurses] have been short-staffed, overworked and shuffled around," Gallant said.

Pricey personnel

Although hospitals are eager to have them, travel nurses cost hospitals more per position in part because of the learning curve they must undergo when they arrive at a new facility, Armstrong-Gay said.

Of the hospitals that use travel nurses, 76 percent are paying more money per capita for travel nurses than for their own staff, according to the American Hospital Association.
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We really see travel nursing as a short-term solution to a long-term problem," Armstrong-Gay said. "We would prefer to retain employees … but there are just not enough people in the pipeline going through [nursing] school."

With the nurse shortage estimated by the AHA at 126,000 positions, travel nurses provide health care entities one solution to the shortage plus the flexibility to address staff personnel changes when demand shifts, Shaffer said. They also give these facilities a pool of potential full-time job candidates, he added.

Many travel nurses recently have gravitated to permanent or longer-term assignments because of the economy "or because their [spouses] are out of work. As soon as the economy swings the other way, I think we will start to see that change," Scheerle said.

Free to roam

But many other travelers appear ready to stay unrestrained. Despite the uncertainties of the economy and aggressive recruitment and retention efforts by hospitals to capture them as full-timers, most travel nurses say they won't be leaving their transitory posts anytime soon, according to a recent survey issued by qShift Travel Nurses in Colorado Spring, Colo.

Listing adventure and travel as the primary appeals of their lifestyle, 91 percent of 79 travel nurses surveyed said they'll continue to be travelers for at least the rest of this year. Burnout, lack of advancement, unfavorable nurse-to-patient ratios and salary issues at hospitals were factors in their decision to forsake permanent posts.

"Nurses leave the institution because of inflexibility, pay and support issues," said Terry Whitlow, president of qShift. "They get fed up, but want to remain in the industry. So travel nursing becomes an ideal option."