Jul 23, 2008

HEALTH MATTERS: Travelers reap benefits of nurse vacancy rate

By LJ Anderson / Daily News Columnist

In a high-demand field like nursing, traveling nurses or "travelers" reap the benefits of this demand by working wherever and whenever they want. With a national RN vacancy rate of over eight percent, according to a 2007 American Hospital Association survey, one of the ways in which hospitals fill the staffing gap is through the use of traveling nurses. It's an expensive option for the hospital, but for the traveler, short-term assignments and benefits, such as free housing, offer an attractive career option. These nurses need to adapt quickly in a new environment, but for many, it's well worth the adjustment.

Dialysis nurse Donna Shultz, RN, and her husband lived on a farm in New Hampshire for 25 years where they raised their four children. They relocated to Arizona, rented out their home, and now pursue the traveling nurse lifestyle. Shultz is currently on a six-month assignment at Lucile Packard Children's Hospital until October of 2008.
Q: Where, and in what clinical situations, have you worked as a traveling nurse?

A: Generally, I work in hospitals in which there is a dialysis unit where patients come for treatment. However, when the patient is too unstable, such as on telemetry or in the ICU or CCU, dialysis is done at the bedside - since the machine and water purifier are portable.

I have been in nursing for 16 years, and traveled for four of them. I have worked in several states, including
MaineGeneral Hospital, Dartmouth-Hitchcock Medical Center in New Hampshire, Banner-Good Samaritan in Arizona, Washington Hospital Center in Washington, D.C., and here at Lucile Packard Children's and at Stanford University Hospital. By far these two hospitals - Lucile Packard and Stanford - make it hard for travelers. Once you start working at one, you want to stay and stop traveling.

Q: What does it take to adapt quickly to a new clinical environment?

A: My philosophy is "When in Rome, do as the Romans." There is more than one way to do things, but as a traveler, it is important to follow the procedures of each facility. I focus on being safe, and dialysis is pretty much the same procedure wherever I go. Most places have a preceptor and a short orientation period, and I will typically use the preceptor as a go-to person after orientation is over. (As for the patients), I say to them, "I'm new to this facility, but I do this all over the country. I'm a traveler." That intrigues them, and helps them feel more comfortable and at ease.

Q: Have you had any negative experiences, and if so, why was that?

A: Yes. I have been expected to, and have worked 16-hour days without a break. I've worked with substandard equipment, and I've had to do extensive computer charting without any training on the computer program. In general, this was due to a severe lack of staff. I was hired onto a 100-bed outpatient dialysis unit and by the time I arrived, one of the two charge nurses had gone out on maternity leave, and the other one had quit. I was the charge nurse, didn't know the doctors and had to handle all the issues. You learn to get along, but those three months felt like an eternity.

Q: What are the benefits of being a traveling nurse?

A: I can travel all over the United States, and I am able to get assignments in cities that I choose for a minimum of three months. If there is a need and I like the facility, I can renew the contract for several more months. Because we live in each place an average of six months, we get to settle down and meet the people around us. You would never meet the number and diversity of people that we've met while living in a small town in New Hampshire. We live in a place long enough to get a flavor of it, and we're invested in the area. It's nice because when you feel homesick, you go visit your kids.

My travel company, Medical Express, provides the housing, rents the furniture, pays the electric bills, and I have retirement benefits and health insurance. My husband is retired and travels with me. I call him my "kept husband," and I'm his "sugar mama." He loves it. I like that I am not involved in the workplace politics. My theory is when I know enough to have an opinion, it is time to move on. Travel has enabled me to stay with dialysis but to have varied jobs. Typically, most travelers might do one assignment, or sporadically. Few people will actually go from one job to another, but it works for us, and I want to do this for another 10 years.

Q: What kind of situation would you not consider?

A: I would not consider a workplace which is unsafe, such as if the patient-to-nurse ratio is high, or if I have little to no resources.
I showed up at one clinic, and they pointed me to the supplies and said "good-bye." There was no orientation, but I learned quickly, and I made it. There are other places like Stanford where the orientation is long and involved. Through experience I have found it important to ask key questions on the first phone interview of the facility. If I'm having trouble, who can I call? I've learned what to ask in an interview.



LJ Anderson writes on health matters every Wednesday. She can be reached at lj.anderson@yahoo.com.