Going Places
Drawn to the lifestyle for its adventure and flexibility, travel nurses find satisfaction in their mobile careers

By Steve McLinden
September 5, 2003


Since 1995, Brian Gallant has needed little else but his Nissan Pathfinder, his RN license and a need for discovery. The 38-year-old surgical registered nurse has served in Seattle, nurtured in New Haven, toiled in Texas and filled four different bills in Florida.

Gallant has called Massachusetts his home, as well as Joplin, Mo., all in the duration of 25 contract assignments with a national travel nurse placement firm that's fittingly called Cross Country Healthcare Inc.

Gallant, a licensed RN in 13 states, is one of about 20,000 similarly nomadic nurses nationwide who take assignments of about 13 weeks before moving on to another post or even opting to re-up for the same gig, if the situation is right.

"A lot of travelers do what we call 'traveling bare,' which means they basically just take their clothes, a microwave and a set of sheets," he said. "I have these huge Rubbermaid bins I take with me, and I tell myself, if it can't fit in there, it can't come along."

On the road again

Travel nursing has been a fast-growing career option for RNs who want the dream of traveling the country or the world. Many are finding they can work indefinitely as temps, as sure of their next assignment as a hospital staff nurse is of a regular paycheck.

Travel nurses even may find additional experience and sources for training and continuing education that weren't available in a permanent position-all while providing a godsend for hospitals that desperately need qualified nurses to fill critical staff shortages.

Many nurses "will travel with us and then take a few months off and take a vacation," said Brian Lee, marketing director for San Diego-based Access Nurses. "They know there will be a demand when they return and that they can be placed anywhere in the States within a few weeks."

Urszula Bednarska, RN, has been on the road since 1992, although she's taken numerous jobs around her home state of New Jersey to be near family and friends. Bednarska, a 35-year-old RN working in Pompano Beach, Fla., has ventured to travel nurse jobs in Hawaii, Chicago, Sacramento, Calif., Los Angeles and Virginia, among others. She also has used lengthy breaks between those jobs to vacation in Australia, Egypt, Greece and Europe.

"In just 13 weeks, you really don't get a chance to know the hospital and the people yet," said Bednarska, who likes to stay six months in a given post. "They'll say, 'So, you're leaving us already.' And you think, well, it was just too quick … But you are a gypsy in this job. And that's one of the drawbacks. But it's also one of the positives."

Gallant, Bednarska and other travel nurses receive free housing benefits, sizable travel allowances and enjoy 401(k) plans and other benefits comparable to full-time hospital posts, with the exception of sick pay. Even in a soft economy, and with at least one firm reporting slightly lower wage offerings from hospitals, many observers see travel nursing as a solid choice for restless nurses whose services remain in peak demand.

About half of American hospitals use travel nurses, said Jennifer Armstrong-Gay, a spokeswoman for the American Hospital Association.

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."

It will become an easier choice to make as more states sign on with the multistate RN and LVN/PN Nurse Licensure Compact from the National Council of State Boards of Nursing. Launched in 2000, the compact will include 19 states next year that will recognize nurse licenses from other compact member states.

Whitlow said hospitals have been pressuring travel nurse firms to lower the cost of services, and some agencies are responding by reducing wages. Those conditions are likely to create a more competitive agency environment, he said. His agency started to see a slight flattening in demand and pricing last year, he added.

Although hospitals lure nurses to permanent posts with large signing bonuses and escalating salaries, travel nurse and temporary agencies are countering by offering more corporate-style benefits and other inducements to candidates.

Based in Arlington, Texas, Nursefinders, although primarily a per diem firm, offered travel nurse applicants a chance to win a Mini Cooper earlier this year by signing on to work a 12-week contract in California.

Skip Lowe, the company's national recruiting director, said Nursefinders has expanded its travel nurse business to meet demand.

Lowe said hospitals are "throwing nurses a lot of money and incentives for shock value" to lure more full-timers, but hospital politics and less-than-desirable staff-to-patient ratios seem to keep nurses in temporary positions.

Return of retirees

The incentives sometimes are drawing more than the unattached 20-something nurse. Gallant said lately he has noticed many retired nurses coming back to the profession to serve two or three travel stints, sometimes with their spouses in tow.

RN Network of Boca Raton, Fla., now attracts many nurses in their late 30s and early 40s "who are more comfortable in travel nursing than they were in full-time nursing," said Steve Saley, the company's marketing director. "They have gotten their seasoning ... and now they want explore new lands and meet interesting people."

Bednarska, a native of Poland who earned her nursing degree from William Paterson University in Wayne, N. J., initially worked at a permanent post in Hackensack for two years. She met a traveler who inspired her to hit the road, which has brought her to a liver transplant unit in Chicago, a heart transplant observation at UCLA and other experiences she might not have attained in a permanent position.

"It has opened my eyes," she said.

She plans to settle down into a permanent position eventually, but it's not that time yet. "I will do it, but without any regrets. I will be more at peace, knowing I have traveled where I wanted to travel and seen what I wanted to see."

Contact Steve McLinden at smscribe@hotmail.com