Can You Switch Specialities as a Traveler?
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life You have finally made it. You hit the coveted two years working as a nurse and are able to start applying for your first travel job. Maybe, just maybe this will be the answer to the nagging burnout you are already starting to feel. After two years of hospital politics, difficult patient loads, and too much overtime you are ready to hit the road and see what other facilities have to offer. After two or three contracts it finally hits you–maybe it isn’t just your staff job that was the problem. Instead, you realize that your particular specialty just isn’t the right fit for your personality. Travel nursing may help with some of this internal stress, but ultimately your curiosity about your dream specialty is still there. There is just one problem. The only way to actually stop and start again in a new specialty is to hit pause on travel nursing for the time being. Hang up your travel shoes for a year or more and try to score a job in the new specialty. Which also entails giving up travel pay, extra time off, and the general adventure that travel nursing has to offer. This can be a devastating decision for many nurses to make. Inevitably it leads many to ask the question: do I really have to stop traveling to switch specialties or can I find a way to do it while traveling? The short answer to this question is: maybe. Many seasoned travelers will tell you there is absolutely no way to switch to a new specialty as a nurse without taking a permanent job for a minimum of one year before going back to a travel assignment. But every once in a while an opportunity may come along that proves them wrong. In certain situations, travelers will have the opportunity to be hired into an area they may be unfamiliar with. This usually happens when a facility is particularly desperate to get a traveler hired ASAP and leadership is willing to compromise by offering a little extra orientation time in exchange. Most commonly I have seen this happen between critical care and procedural areas. For example, ICU nurses who are familiar with vents and drips may encounter opportunities to cross-train to a procedural area like Interventional Radiology because management feels that people with those critical care skills will have an easier time learning the procedural side. I have also seen opportunities for critical care areas like ER and ICU offer extra training to nurses from the opposite specialty. Chances are the worst ER patients will be something an ICU nurse is familiar with, and an ER nurse has the training to manage most of the medications and interventions happening in an ICU, just in a slightly different setting. While these opportunities may come along every once in a while, they are not a guarantee that you would be competent enough to change specialties after a 13-week assignment. In many situations where they offer to less experienced travelers to a new specialty, the facility may only have time to train the new staff to take care of the less acute patients. By offloading even the “easier” patients this allows them to have more experienced staff free to take the more complicated patients. Because they can’t offer a full orientation period there may simply not be enough time to learn all you would need to to become a fully qualified traveler in that specialty. There may be ways to still use this to your advantage. If the opportunity arises to extend your contract, consider asking for a few extra orientation shifts during your extension so you can care for a bit more critical patients. You may also find that they will gradually increase the acuity of your patients as you gain confidence in your new area. In the event that you stay 6 or more months in a job willing to cross-train, you may gain enough experience to feel confident traveling in the new specialty. On the other hand, getting a taste of this new specialty could be a great tool to help you decide if it is really a good fit. Rather than committing to a full-time job and stopping travel altogether, getting the opportunity to try a new setting for three months could be helpful in at least eliminating that area from your list of potential future jobs if nothing else. This was my experience when I had the opportunity to cross-train to a case management position. It was in a dream location and had great pay, so I jumped on the opportunity to try something new. After thirteen weeks I was so thankful I had not committed to that type of position in a full-time job and was able to move along and be thankful for the chance to realize this before I felt stuck in a permanent job. Many people will refer to opportunities to learn a new specialty as a “unicorn” assignment–meaning the chance to snag them may be few and far between. If changing specialties is on your mind but quitting travel is not, I highly recommend discussing this with your recruiter so they know if a job like this comes across their desk you are the person to reach out to. As with anything in travel nursing, stay flexible and don’t be afraid to try something new if the little voice inside your head is saying it might be a good fit. After all, in the end, it is still only thirteen weeks. Alex McCoy currently works as a pediatric travel nurse. She has a passion for health and fitness, which led her to start Fit Travel Life in 2016. She travels with her husband, their cat, Autumn and their dog, Summer. She enjoys hiking, lifting weights, and trying the best local coffee and wine. << What I Would Change if I Could Reset My Travel Nursing Career
7 Travel Nurse Instagrams You Should Follow: Summer 2019 Edition
It’s time to round up some more awesome healthcare travelers’ Instagram accounts that will give you all the wanderlust and inspiration for your career and life. Know of a great travel nurse Instagramer that’s not on our list? Share them with us in the comments below. @we_the_wanderers This travel nurse team shares their love for hiking and their love for each other. Meg and Ty are truly #couplegoals. Check out their Instagram story highlights to see breathtaking views of Washington, Oregon, Arizona and New Mexico. We can’t wait to see where their travel nursing careers take them next. View this post on Instagram Views like this reminding us of why we love picking up and moving every three months 🙈✨ #gypsynurseadventures #travelnurse #travelrn #fulltimetravel #travelnursing #nursesofinstagram #adventurethatislife #earthcouples #upperleftusa #pnw #pnwonderland #travelblogger #wanderlust #travelcouple #hiking #hikingbangers #instapassport #goneoutdoors #pnwhiking #exploremore #hikingadventures #roamtheplanet #getoutside #optoutside #travelwithtnaa #explore #liveyouradventure #adventureenthusiasts #explorewashington A post shared by M e g & T y (@we.the.wanderers) on Jul 21, 2019 at 7:52am PDT @scrubsinasuitcase Scrubs in a Suitcase founder Leah G. has been documenting her travel nurse adventures on Instagram and her blog. A cardiac travel nurse, she shares a perfect mix of professional encouragement, #nurselife and traveling goals. She also hosts traveler meet ups from time to time. If you’re in the area definitely check them out! View this post on Instagram As a nurse we have a lot of tasks to complete. We continuously receive new orders while still having to complete to old ones. We have to make sure we pass our meds, draw the blood, chart our assessments, etc. — Sometimes I think we get so caught up in completing our tasks that we forget about the patient. We just see our list we need to get through. We don’t take the time to sit and talk with the patient when maybe that’s what they really need. — We get so stressed out with our “to-do’s” that we forget our “why.” Why did you become a nurse? Probably to care for people. To make a difference in someone’s life. To be that beacon of hope when there is none. — I expand more on this in my latest blog post “Patient’s Point of View” {link in bio}. And I challenge you to take a step back from your tasks and think about why you started nursing in the first place💉💊 • • • #patientspointofview #nurselife #travelnurse #travelnurselife #travelnurseadventures #gypsynurse #gypsynurseadventures #nurse #rnlife #rn #hospital #hospitallife #travelnurserepeat #nursesofinstagram A post shared by Leah Gnitka (@scrubsinasuitcase) on Jul 18, 2019 at 9:42am PDT @nurseswandering Another sweet travel nurse team, Kyle and Amanda travel the country with their RV and sweet pooch named Atlas. Currently on assignment in Southern California, they are living out their dreams in a home on wheels. Their Instagram page is fairly new but definitely worth the follow. View this post on Instagram Welcome to our Travel Nurse page! Join us as we post about the gypsy life we have created for ourselves in a 5th wheel trailer that we call home. First stop? Southern California. #rvliving #travelnurse #backpacking #california #nurselife #hiking #icunurse #nicunurse #gypsynurse #registerednurse #fulltimerv #jmt #johnmuirtrail #sierranevada #nurseswandering A post shared by K Y L E + A M A N D A (@nurseswandering) on Jun 12, 2019 at 9:21pm PDT @catchbrittifyoucan This pediatric ICU traveler will light up your Instagram feed with inspiration and joy. She shares her passion for nursing, volunteering and world travel. Especially love seeing her memories of volunteering with Mercy Ships helping care for children in West Africa. View this post on Instagram “Maybe it’s not about You” (When asked what I’d gained from my Mercy Ships time) It’s not. – humbly speaking Many of our patients were shunned, exiled, or forgotten. They lived shamed lives where they hid themselves and their deformities. Children ridiculed, women with no marital prospects, and men unable to provide. ‘Cursed’ as they call it. It’s about the lives transformed. Families restored. Futures Imagined. Smiles and laughter revitalized. Hope Discovered. It’s about them. A post shared by Britt (@catchbrittifyoucan) on Dec 14, 2018 at 4:50pm PST @thetravelnursefamily Curious what travel nursing with a family would look like? These Insta-stars can show you. Dad, Tim, is a travel nurse while his wife homeschools their son and runs The Travel Nurse Family blog. They share great tips for traveling as a family, staying healthy, homeschooling and exploring the country. View this post on Instagram Over the last few days we have driven 2/3 across the country and have been so impressed by all the landscapes and people. We love the USA. 🇺🇲 . . Happy 4th of July. 🎆 A post shared by The Travel Nurse Family (@thetravelnursefamily) on Jul 4, 2019 at 5:29pm PDT @nurse_alee Travel RN A. Lee has always had a desire to motivate and inspire other nurses on the same path, which she shared on her blog. Her Instagram does just that! You’ll find encouraging messages, helpful tips and stunning photos from her travels. If YouTube is more your channel, she also shares weekly travel nursing insights on her video blog. View this post on Instagram If there’s ONE thing Hawaii has taught me, it’s to take care of yourself first. As nurses, our job is demanding PERIODT and we are forever short staffed.. so if you’re picking up shift after shift without having that necessary day or two of self care? I’m telling you now that you deserve it and owe it to yourself to do so WITHOUT feeling guilty! ☝🏾 . . . . Tag someone below who needs to hear this and tell me some things you do for self care ✍🏾! A post shared by Nᴜʀsᴇ A. Lᴇᴇ (@nurse_alee) on Aug 7, 2019 at 9:56am PDT @watch__us__wander Another family is showing us that travel nursing across the country while raising your children is 100% possible. This Travel RN
The Real-Life Conversion of a Former Anti-Vaxxer (KHN)
John M. Glionna, Kaiser Health News Amid the contentious dispute over immunization requirements for children, Kelley Watson Snyder stands out: She has been both a recalcitrant skeptic and an ardent proponent of childhood vaccines. Snyder, a Monterey, Calif., mother of two, was a so-called anti-vaxxer for many years, adding her voice to those that rejected mandatory vaccinations for school-age children. She later realized she was wrong and in 2014 founded a pro-vaccination Facebook group called “Crunchy Front Range Pro-Vaxxers,” which she administers. It is an invitation-only site on which approximately 1,100 members exchange views and information. Snyder, 38, is also an advocate for pending California legislation, SB 276, which targets bogus medical exemptions that allow unvaccinated children to attend school. The number of medical exemptions issued by physicians has risen sharply in recent years. The Medical Board of California is investigating at least four doctors for issuing questionable exemptions for children. Meanwhile, some infectious diseases once thought under control are breaking out again because parents failed to have their children vaccinated. Between Jan. 1 and July 25, 1,164 new measles cases were reported across 30 states, the most since the disease was declared eliminated in 2000, according to the Centers for Disease Control and Prevention. California has seen 62 new measles cases this year. Kaiser Health News talked to Snyder about her transformation. Monterey, Calif., mother Kelley Watson Snyder, 38, poses with her two children, Jaylen, 9, and Kira, 5. Over time, she changed her opinion on vaccinations for her children, converting from an anti-vaxxer to an ardent proponent of vaccines who runs a pro-vaccination Facebook page. As a former opponent of mandatory childhood vaccines, can you describe the mindset? Anti-vaxxers have been around for a long time, but social media makes it easier to get into a loop. And once you’re there, it’s hard to see outside of it. Algorithms just show you more of what you’re already looking for. If you start searching anti-vaccination stories, that’s what starts popping up on your tagline. You start to think, “Oh, my God, there’s all these people and there’s so much of this going on.” But if you have a chance to peel back from that, you see that it’s actually a very small portion of the population who are really, really loud. The fear makes you angry and it makes you lash out. Once you get into that state, it’s easy to stay there. Describe a moment when you were in that state of mind. When my daughter was born, I refused the Vitamin K shot. I remember lying there with my daughter in my arms, and the nurses said, “Hey, we’re going to give her the vitamin K,” and I said, “No, we’re not doing that.” They made me sign a form that said I was going against the recommended medical care. At the time, the anti-vaxxer voices in my head said they were trying to coerce me into doing something dangerous for my child. They told me I was going to have to stay in the hospital longer for observation. I saw that as trying to force me to inject my child with this poison. What activities did you engage in as an anti-vaxxer? I joined some social media groups and would get together with some of those mothers who believed what I did. We used to call the pro-vaccination mothers “sheeple.” You’d ask them, “Have you thought about your stance? Have you even done any research?” Because when you’re in that anti-vax mindset, you spend all these hours on the internet, reading studies. I’ve come to realize that a Google search isn’t really research. Most times, you’re not reading an entire study, but only the abstract. What changed your mind on vaccinations? In the summer of 2014, I was in one particular anti-vaxxer Facebook group, and there was a debate going on about vaccines, and I started to notice that every time someone disagreed with them, the core members got belligerent, going straight to personal attacks. I also noticed that every single point they brought up had this immense conspiracy to go along with it. By that point, I’d started to think, “Do I really believe in all these conspiracies? Am I really that afraid, or can I go back and look at the evidence again?” By then, my daughter was 8 months old, and I just got over the fear I had as a first-time mom. I realized that my daughter was going to be OK. How do you think the vaccination fight will play out in California and nationally? I think California is setting a precedent for vaccine laws across the country. We’re making sure that medical exemptions for vaccines are not being bought, and that’s a very serious problem. Other states have seen the work we’ve done and they’re working on their own legislation. We’ve come to realize that unless we get more vocal about our pro-vaccine stance, the anti-vaccine voices just get louder and louder. I sometimes refer to anti-vaxxers as the drunk drivers of public health. They’re dangerous. What do you say today to the anti-vaxxers you once aligned with? I tell people that I understand their fears. I understand that parenting is very difficult, and all of us truly want the best for our children. I also know that the evidence is out there when people are willing to let their guards down. And I’m always happy to share real solid scientific evidence with people who want to do their critical thinking for themselves. I’m hoping people come around. I did. But we can’t force anybody. We just want to protect everyone else. Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.
Differences Between Being a Pediatric Staff Nurse vs a Pediatric Travel Nurse
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life In the course of my five years working as a nurse, all but thirteen weeks have been spent in pediatrics. Pediatric nursing is not for everyone, but I cannot imagine working with any other patient population. While there are some differences in travel versus perm positions that may apply to all specialties, I am going to focus on my favorite specialty this week. I have been fortunate enough to work in a variety of hospitals and units–from a 7-bed pediatric unit in a rural hospital to a children’s hospital system that boasts multiple campuses and level one trauma designation. All of these experiences have helped me learn more about the ins and outs of being a pediatric nurse, and the pros and cons of each setting. Here are my takeaways about working in pediatrics both as a staff nurse and a traveler. 1. Staff nurses have more opportunity to specialize Within pediatrics, there are a variety of specialties, similar to adult nursing. I have worked on hematology and oncology floors, liver and kidney transplant units, and floors that are a sort of “catch-all” of different specialties. Some hospitals are more restrictive about which types of patients travelers can take. For example, one facility did not allow travelers to administer chemotherapy. Another would not allow travelers to take fresh spinal fusions. Even if you are eager to learn the unit may not have time to adequately train you into a new area or may have policies restricting you from taking the higher acuity patients. While this can feel limiting, try not to take it to heart and remember you are still there to take the best care of your patients no matter the diagnosis or complexity. 2. Pediatric travelers may find inconsistency between policies One of the unique aspects of pediatrics is how precise some of our practices can be. Medication dosages and blood transfusion volumes are just two things that come to mind. Because we are so precise, there may be a variety of policies governing safety checks related to medications or other procedures. Even more confusing is that a lot of these policies will vary from facility to facility. The best practice I have found is to be respectful of the policies and procedures your particular facility uses. Unless you are concerned about the safety of the patient, it is best to comply with the rules of that particular organization. In the event that no policy exists, I use my best nursing judgment. This is a great example of why a solid background in your specialty is a necessity before you hit the road as a traveler. 3. Pediatric travelers may have to care for adult patients in some form or another While you should not expect to be the primary nurse for adult patients unless that was specified ahead of time, pediatric travelers may be asked to float to adult units to act as extra hands or as 1- on-1 sitter. If I know I interviewing for a pediatric job within an adult hospital, I make sure to ask if this will be a possibility in my interview. Each nurse may have a different level of comfort with this job requirement, so it is better to know the expectations ahead of time. 4. Full-time pediatric staff may have more opportunities to cross-train Before I started traveling I worked on a general pediatric unit. As I became more experienced I was offered opportunities to cross-train to both NICU and PICU. Eventually, they also offered to cross-train to postpartum and nursery. I enjoyed these opportunities to explore other specialties, especially in case I ever decided to switch my primary job. As a traveler, I have found most places are less likely to offer these opportunities. For one, if you are hired as a traveler, chances are the unit you are working on will be needing you the majority of the time. For another, most hospitals do not want to spare extra orientation days to an already short contract. Even if you are eager to help, these limitations may decrease your chances of working in areas outside of your specific hired unit. 5. While some of these differences are subtle, they are good things to consider when looking for a travel assignment I can’t say specifically whether these points are more pros or cons of staff versus travel jobs as a pediatric nurse. Each individual will have different opinions on what their preferred work setting or opportunities will be. Personally, I see all of the above as another set of considerations to weigh when deciding if travel nursing is the right career path for you. In addition, these points will help you decide if a specific job is the right fit. While pediatrics isn’t the highest paying or most talked-about travel specialty, it is still important for us peds travelers to know the caveats that come along with our unique specialty. Alex McCoy currently works as a pediatric travel nurse. She has a passion for health and fitness, which led her to start Fit Travel Life in 2016. She travels with her husband, their cat, Autumn and their dog, Summer. She enjoys hiking, lifting weights, and trying the best local coffee and wine. << What I Would Change if I Could Reset My Travel Nursing Career
Travel Nurse Spotlight: The Best of Both Worlds
In the Travel Nurse Spotlight series, HCT Today is highlighting travelers’ own unique stories and perspectives. Healthcare travelers don’t have to take assignments on the other side of the country to take advantage of all of the exciting benefits and career development opportunities that traveling offers. A registered nurse and mom of two, Sarah A., is able to enjoy the both of best worlds: travel nursing while staying close enough to home and family. A Southwest Illinois-native, Sarah started her nursing career at a local community hospital. Her primary specialty is Medical-Surgical, but she was able to do a little bit of everything and developed her skills in several areas. After five years as a staff RN, she wanted a change; she heard about travel nursing and decided to “give it a go.” “You can have the best of both worlds, traveling and experiencing new environments, and being close enough to home,” Sarah said. Raising two young daughters, she chooses travel assignments at facilities within a few hours away so she can spend time with family on her days off. In her first year of traveling, she worked with a smaller local healthcare staffing agency, but wanted to branch out for more opportunities. In 2018, she was referred to LiquidAgents Healthcare by a friend and says it’s been a successful experience ever since. Sarah enjoys meeting new people, being with other working moms and making new friends. “I could not choose a favorite travel assignment because they’ve all been nothing but amazing,” Sarah said. “At each facility, I’ve been surrounded and supported by amazing people. They welcomed me with open arms and brought me in as family.” Sarah’s biggest advice for travelers is to be open. Traveling puts you in new environments that may have a different way of doing things. Don’t go into an assignment looking to change the processes in place. Instead, take advantage of learning opportunities. “Even when there may be tough personalities to work with, show them that you’re there to be a part of their team and let them be the guide,” Sarah said. “As a traveler, you’re there to help them with the challenges they’ve been experiencing.” Sarah loves the learning curve that comes with travel nursing. In addition to MedSurg, she’s very interested in orthopedic and neurology nursing. While on assignment in Springfield, IL, she gained first-time experience at a Level 1 trauma center and teaching facility. For her upcoming assignment this fall, she’s excited to cross the Illinois state line to St. Louis, MO. “Southwestern Illinois is kind of a trauma desert,” Sarah explained. “Patients that need more critical care or specialized procedures are typically sent to St. Louis. My next assignment at SSM Health Saint Louis Hospital has been on my bucket-list. I’m excited that I’ll get to see and be a part of the next step of my patients’ journey.” “I’ve worked with Sarah for over a year,” said talent advisor Allie Harrell. “We both have trust in each other during this whole process, and that is exactly the kind of relationship you need in the travel nursing market. Whether we’re going over details for an assignment or just calling to check in and catch up, we’ve built a special bond that will last a lifetime. I can even tell you what the theme of her youngest daughter’s birthday party was.” When Sarah’s daughters are older, she would love to branch out more and try cross country traveling. But until then, she enjoys the flexibility of staying closer to home. In the Travel Nurse Spotlight series, HCT Today is highlighting travelers’ own unique stories and perspectives. Want to share your story? We’d love to hear from you.
Eight Things I Never Forget When Starting an Assignment
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life When I first became a travel nurse I spent hours searching for lists or ideas of what to pack for each assignment. Paring down a whole apartment or house worth of belongings can be very intimidating especially when you aren’t quite sure what to expect. After living on the road for three years I will say that learning how to pack for a travel nurse assignment takes a little bit of trial and error (and possibly a few boxes shipped home). What most of the internet packing lists don’t account for is other habits or routines that will help you make each new transition a little easier. I have found that having the perfect combination of creature comforts and good habits make moving across the country and settling into a new job every thirteen weeks much more seamless. Here is a list of my must-haves before starting each new assignment. 1. The right mindset This sounds a little cheesy but hear me out. Walking into each assignment brings a lot of unknowns, so I tend to take some time before my first day and think about what my goals are for that assignment. I list particular places I want to visit, financial goals, and any personal goals I want to focus on as well. 2. My favorite pillows I was one of those people who thought I could sleep anywhere…until I started switching beds every three months. While we simply do not have space to pack a mattress topper, I have found having a good quality pillow goes a long way. Not only that, but it makes our new place feel a little more like home. 3. Professional paperwork Most of my paperwork is stored on my phone via CamScanner, but I do keep a few hard copies of certain items on hand. I keep my nursing license copies, certifications, social security card, and a few extra vaccination records in a leather folder to stay organized. Every so often an assignment will ask for copies of licenses and certifications so it is nice to have these ready if needed. 4. Crockpot My husband and I downsized to one car on our Seattle assignment and were forced to scale way back on the items we brought along. My crockpot did not make the list which resulted in me purchasing a new one on Amazon a week after arriving. Since then I make packing my crockpot a priority because when I want to spend more time adventuring and less time cooking this kitchen tool is a must-have. 5. A list of local gyms Staying healthy on assignment is a huge priority for me. I have found that if I wait until I arrive at a new location to find a gym it takes much longer for me to get started at the said gym. Now I sit down as soon as I find an apartment and look for two to three gyms close by to check out as soon as I arrive. That way I have zero excuses to get my sweat on once I get there. 6. One nice outfit When I packed for my very first assignment I brought way too many clothes. I quickly learned that occasions to dress up are few and far between on the road, so it was unnecessary to bring much more than casual clothing. Now I keep my wardrobe very simple and have a staple black dress that can be dressed up or down if needed. 7. A quick overview of my first day A lot of the time first-day information is not provided until the very last minute. Because of this, it can be easy to feel a little flustered trying to get ready for your first day while also settling into a new apartment and city. Before heading to your new job, sit down and write or print out your first-day instructions so you can feel confident going into the first day. 8. My tablet As a very avid reader, I had some adjustments to make once I started traveling. While I much prefer physical copies of books I decided to switch to ebooks was much more practical for the sake of space. Before hitting the road I always make sure I have my tablet charged and a new book downloaded. After long days on the road winding down with a book before bed is a must. Travel nursing comes with the unexpected blessings of making you realize just how few physical belongings you need. As you go along you will find your own rhythm for cutting down your packing list and fitting your entire life into one car. Similarly, you will find certain habits and routines that make each transition a little bit easier. I truly believe having some constants in your life helps make life on the road easier amid the chaos. Alex McCoy currently works as a pediatric travel nurse. She has a passion for health and fitness, which led her to start Fit Travel Life in 2016. She travels with her husband, their cat, Autumn and their dog, Summer. She enjoys hiking, lifting weights, and trying the best local coffee and wine. << Stocking Up: 4 Ways to Cheaply Furnish Your Travel Nurse Short Term Rental
Travel Nurse Spotlight: Taking on New Adventures Across the Country
In the Travel Nurse Spotlight series, HCT Today is highlighting travelers’ own unique stories and perspectives. Working more than 40 hours a week with very little time for vacation or recreational activities, Renee B. and her husband, Gabe, were ready for a change. With 25 years of experience as a staff nurse, which includes 19 years in endoscopy, Renee looked into the healthcare traveler lifestyle and in 2018, her and her husband began a new exciting chapter in their lives. They were intrigued with the “tiny house, big living” phenomenon, which also happens to be a great, flexible housing option for travel nurses. In 2018, they “pulled the trigger, bought the RV, the truck, and started the downsize mission,” Renee said. And they were off! Renee started working with a few different travel nurse agencies and was happy to land her first travel RN assignment in Upstate New York. Renee shares what travel nursing has taught her so far. Renee’s Travel Nursing Tips Budgeting. As pay and cost of living varies from state to state, Renee recommends creating a weekly budget for each assignment so you know exactly what you can afford. Deal-breakers. Communicate any deal-breakers you have with your travel healthcare agency, whether it’s the type of shift, call duty, length of contract, location, etc. Recruiters. Renee highlights having and maintaining a good relationship with your recruiter. They are your main supporter and oftentimes become a friend. If you have unresolvable issues, ask for someone else. Networking. While travel nursing, you meet a lot of different people in various departments. Take advantage of those connections. You can gain tremendous insights about other units or hospitals by just asking others. Extending. Use extensions to your advantage. For example, Renee extended her first travel RN contract while she waited for her California license to process. She extended in California because she wanted to enjoy the beautiful weather before the summer heat. Patience vs. Perseverance. Traveling has so many moving parts and you’re constantly introduced to new things, experiences and people. Having a patient, open attitude always wins. “Remember to have fun, and know it’s only 13 weeks if you’re not having fun,” Renee added. “Personally, my stress level has decreased tremendously. I know that no matter what, the assignment is temporary, and I always put my best foot forward from the get-go.” Exploring Coast to Coast in a RV Florida-natives, Renee and Gabe love the traveler RV lifestyle and experiencing new cultures across the U.S. For every new location, she does thorough research for the best things to do and places to go, including The Food Channel’s Guy Fieri’s favorite places to eat. While on her first assignment in Albany, New York, they visited Lake George, Niagara Falls, Saratoga and of course, the Big Apple. “Traveling on the road has allowed us to see various treasures in the country’s landscape,” Renee said. “We’ve been able to live amongst the natives of each state and experience local cuisine, activities, history and climate. Every weekend and every day off is a potential getaway to explore historical landmarks and attractions.” Since traveling, Renee’s mindset has changed. She no longer prejudges a new area without seeing it for herself, which is how she has found many “diamonds in the rough” throughout her travels. Renee’s favorite travel RN assignment so far was in Bakersfield, California. “Not for the city but for its location,” she added. “We were able to do so much exploring in California including Winchester Mansion, Hearst Castle, San Francisco, Pismo Beach and Los Angeles.” Her and her husband also attended the popular TV game show, The Price is Right. Meeting new friends along the way and cultivating lasting relationships has also been a big part of traveling for Renee. Friendships lay the foundations for possible reassignments in the future or planning a fun visit to see each other. Currently, Renee is working in Dallas, Texas and is already booked for a new contract back in her home state of Florida at the end of the summer. Renee and Gabe eventually plan to move home in two years to spend more time with their grandchild and family, but for now they’re loving the flexibility and adventures of RV life across the country. In the Travel Nurse Spotlight series, HCT Today is highlighting travelers’ own unique stories and perspectives. Want to share your story? We’d love to hear from you.
How to Stay in Contact with Friends and Family as a Travel Nurse
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life When I first set off on my travel nursing adventure I could see the mixed emotions cross the faces of my loved ones. My mom had just gone through my brother moving out of state and I could tell the idea of having her children spread across the country made her a little sad. Meanwhile, a lot of my friends had experienced how people can drift apart as a result of college and grad school so they knew a move certainly changes the dynamic of relationships. In the end, I had to do the thing that was best for myself and my family. In my heart, I realized that if I did not explore travel nursing I would always spend my life with a nagging “what if” in the back of my mind. That being said I also valued my relationships with my family and close friends. I knew the balance between adventure and happiness would best be found by making time to keep in touch with all of my people back home a priority. By keeping this in mind from the get-go, I have found it easy to stay in touch and when I go home it hardly feels like I have been away. Here are some of my best tips for continuing your relationships as you move around the country. Utilize social media While I know some people are very anti-social media, I believe it is incredibly useful in keeping friends and family updated on your life. While I don’t use this as my number one form of communication, it makes everyone back home feel a little up to date with where I am and what I am doing even if we don’t talk super regularly. I particularly love sharing photos because I can also use this to catalog some of my adventures. I am probably one of the few people who actually still uses the album and caption feature on Facebook, simply because it’s an easy way to make notes about photos I post. My family especially loves seeing photos as well, so I try to do a photo dump every month or so. Make an effort to do more than text Texting can be great for quick updates or to say I love you or check-in, but the deeper personal interactions cannot be conveyed via text. In a day and age where we have so many ways to connect virtually, I see texting as the bottom of the totem pole when it comes to real communication. Instead, make a point to actually speak on the phone with the people you love back home. Better yet, use an app such as FaceTime, Zoom, or Marco Polo to video chat. This lets you read people’s voices and facial expressions and greatly cuts down on the feeling of distance between you and your loved ones. Schedule time to connect with the people you care about Each new location brings a whole host of new adventures to be had. Days off on travel nurse assignments can look very busy, so time seems to fly by. Before you know it you are four weeks in and all of your days off have been spent adventuring and you haven’t spoken to your best friend in over a month. Instead of relying on pockets of free time to connect with people back home, schedule a time to chat just like you would schedule lunch or coffee if you were home. I usually text my best friend every other week or so and get a rundown of her schedule so we can pick a day to talk. Usually, we are able to actually catch up and talk for an hour or so rather than just getting snippets of life updates here or there. Encourage people to come to visit. One of the ways I convinced people to get excited about me traveling was to remind them that each assignment meant a new place for them to come explore. Some members of my family rarely traveled before we started moving around, so it’s been cool to see how us traveling has inspired them to get outside of their comfort zone and see the country as well. Each of my apartments has been small but we always keep an air mattress and a few extra blankets on hand. Not only is it so fun to spend one on one time with the people who visit, but we love getting to show them how we live as travelers. Prioritize the people in your life who you want to keep in contact with This sounds a little harsh but the reality is you simply can’t keep up with every friend/coworker/family member/gym buddy from back home once you hit the road. Some people may be more likely to reach out to you, and you will find yourself realizing who is most important to keep up communication with as you go along. Luckily I was at an age where I had a pretty solid list of the people I knew were important for me to keep up with. Aside from family, I had about three friends who either made an effort to reach out regularly or who I knew would be there for me no matter the distance. When time at home or time to chat was cut short, I made a point to prioritize these people first. By having this list in my head, it made it easier to figure out who I needed to schedule time with whether that was at home or via video or phone on assignment. In the end, the little bit of extra effort is worth it Thankfully we live in a time when staying connected is so much easier than it was even ten years ago. Leaving my friends and family behind was such a hard decision, but between technology and visits home between assignments, I rarely feel like I am missing
Miracle Machine Makes Heroic Rescues — And Leaves Patients In Limbo (KHN)
Melissa Bailey, Kaiser Health News The latest miracle machine in modern medicine — whose use has skyrocketed in recent years — is saving people from the brink of death: adults whose lungs have been ravaged by the flu; a trucker who was trapped underwater in a crash; a man whose heart had stopped working for an astonishing seven hours. But for each adult saved by this machine — dubbed ECMO, for extracorporeal membrane oxygenation — another adult hooked up to the equipment dies in the hospital. For those patients, the intervention is a very expensive, labor-intensive and unsuccessful effort to cheat death. ECMO, the most aggressive form of life support available, pumps blood out of the body, oxygenates it and returns it to the body, keeping a person alive for days, weeks or months, even when their heart or lungs don’t work. The invention is creating “an entirely new paradigm,” said Dr. Kenneth Prager, director of clinical ethics at Columbia University Irving Medical Center. “You have a heart that’s not working, yet the patient is not dead.” Most commonly used for newborns, ECMO use has been growing dramatically among adults. In the United States, procedures tripled from 2008 to 2014, up to an estimated 6,890, according to the federal Agency for Healthcare Research and Quality. Experts caution that as ECMO becomes more available, it is also being used as a last-ditch attempt to buy more time for dying patients with poor chances of survival. ECMO is not designed to be a destination, but a bridge to somewhere — recovery, transplantation or an implanted heart device. But when patients are too sick to reach those goals, ECMO can become a “bridge to nowhere,” leaving the patient in limbo, possibly even awake and alert, but with no chance of survival outside the intensive care unit. Medical teams and families can be fiercely divided over when to pull the plug. ECMO is very expensive, mostly due to the labor involved: A person on ECMO cannot live outside the ICU and must be continuously monitored for complications, such as blood clots, bleeding, infection and loss of blood to the limbs. Median charges for ECMO in 2014 were $550,000, making it the 15th-most-costly procedure that year, according to the AHRQ. In one recent case, a teaching hospital charged $4.2 million for a 60-day ECMO stay for a 19-year-old man with acute respiratory distress syndrome who was comatose the entire time and did not survive, according to Dr. Merrit Quarum, CEO and founder of WellRithms, a cost-containment company. Quarum said a self-insured health plan is covering the bill. The number of U.S. hospitals offering ECMO has more than doubled from 108 in 2008 to 264 today, according to a registry run by the Extracorporeal Life Support Organization (ELSO), which tracks most but not all programs. “In the United States, the competition between hospitals is so intense that every hospital wants the ability to provide this level of care,” said Randy Bartilson, president of the ECMO Advantage consulting firm. But “as ECMO expands, there’s still a lot of places that still don’t fully understand what it can do and how to use it,” he said. Four patient stories highlight the promise — and complexities — of this game-changing technology. The Seven-Hour Code Dr. Jessica Zitter was working in the ICU in an Oakland, Calif., hospital one day when she got summoned for a code blue. A 60-year-old patient had arrived with a heart attack. His heart went into ventricular fibrillation, where it just wiggled like “a bag of worms,” she said. Hospital staff started pumping their palms on the man’s chest and put a tube in his throat to help him breathe. Every so often, they stood back and zapped his heart with an electric shock. It didn’t work. So, they strapped onto his chest a LUCAS machine, which automatically performs chest compressions like a jackhammer. The man’s oxygen levels were plummeting. At the same time, Zitter recalled, he kept moving, giving her the feeling there was a life to be saved. The medical team decided to go to the next level: ECMO. Everyone waited, with the jackhammering compressions still going, as an ECMO team scrambled to get there from another hospital across the city. Zitter watched in awe as the ECMO team from the University of California-San Francisco got to work. They stuck one huge tube in a femoral artery and one in a femoral vein. As they pumped his blood out, it was black from deoxygenation. But after it ran through the ECMO machine, she recalled, it transformed into a bright red. Once on ECMO, the patient didn’t need his heart, so it could sit idle and recover. Zitter watched as oxygen returned to his body and brain. He was whisked back to UCSF. Zitter, who has written about the overuse of modern technology to prolong death, wasn’t optimistic. The patient had coded, with people and machines ramming his failing heart, for an astonishing seven hours before ECMO arrived. But as she kept tabs on the patient, she was amazed to learn that he was able to recover and go home. The case was a “big shocker,” Zitter said. But it was “a crazy, crazy, crazy outlier case with a crazy, crazy, crazy outlier response,” she cautioned. “When these kinds of things happen, people tend to look at them and assume that they will have the same odds. The reality is that they won’t.” When patients receive ECPR (ECMO for cardiopulmonary resuscitation), only 29% make it out of the hospital alive, according to international statistics from ELSO. Survival rates are higher for people who use ECMO for only the lungs (59%) or only the heart (42%), according to ELSO. Saving ‘Santa’ A more common outcome for ECPR looks something like what Dr. Haider Warraich of Duke University Medical Center came across three or four years ago during his cardiology training. Warraich was called to the waiting area of a lung transplant clinic, where a
Navigating Travel Nurse Contract Extensions
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life Whether you go into travel healthcare planning to see the world or just trying to pay off debt, contract extensions can be a difficult piece to navigate. Once you get to an assignment all preconceived notions about the area, future plans, and whether or not you will stay can be upended once you get into the flow of things. Maybe you fall in love with the staff. Maybe you start dating someone locally. Maybe you realize you scored a great pay package and just can’t leave, even though you swore you’d only work your 13 weeks. Maybe you realize you just can’t fit all of your to-dos into your time off in the three months you are there. After working ten travel assignments in the last 3.5 years, I have been offered an extension on every single assignment. This is a powerful bit of knowledge because it is comforting to know that most of the time you want to stay you will have the opportunity. When you are working a short-staffed unit, there is a sort of snowball effect that makes it very difficult to rebuild nursing numbers. Once a unit loses a few nurses, it often takes months to actually get new staff on the unit between interviews and pre-employment screening. Then once the new hire hits the floor they usually have 6-12 weeks of orientation. Unit managers have to be aggressive and forward-thinking to make up for a few lost nurses, and often upper management is slow to respond to their cries for job postings. Thus, short-term needs are put out in the form of travel nurse postings. Once onboard, it is easy for management to just extend a good worker than to try and find another one to fill the gap for the few months needed to try and fill their permanent staff positions. I think every travel nurse acutely assesses the unit they are on for the first few weeks of an assignment thinking “What will I decide if they ask me to extend?” We mentally weigh the pros and cons and have to assess everything from our housing situation to family obligations that may fall within an extension timeframe. When my husband graduated and we began full-time travel we realized that we did not have the financial pressure that many others have when they leave home for contract work. Instead, we were tempted by one major factor: freedom. Freedom to take time off when we pleased, freedom to explore new places, and the bonus of the financial freedom that travel packages afforded us. This focus on freedom quickly laid out our blueprint for deciding if we stay or go when offered an extension. We ask ourselves these three questions: Did our current positions offer something in the way of expanding that freedom? For us, this could mean a well-paying job that would pay for additional time off afterward. It could also mean experience in a new specialty that could help us when we were looking for a future assignment. Would we feel hampered by our jobs rather than blessed by them in the next few months to a year? The beauty of travel healthcare is that you are not tied to a job you hate. We made it clear from the beginning that we would not extend anywhere that made us dread going to work each day. Sometimes the money factor started to lure us (re: me) in, but setting this guideline from the beginning helped us remember how important it was when deciding on extensions. Would we have the opportunity to save, travel, and smash financial goals if we stayed put? Some locations are great destinations but are lacking in the pay department. These assignments are fun but ultimately don’t allow us to have as much fun in our off time. Typically if the location is great but we are breaking even or just above, we make the decision to move on so we can save more for time off and other goals. Sometimes the answer is not clear cut and there are other ways to go about figuring out your next move. I have actually never taken a full extension. Instead, I request a partial extension of six weeks or so if I am on the fence. This can also be a good option if you aren’t in love with your assignment but you also don’t see any open jobs that are particularly appealing. The reality of being a traveling worker is that the next job is not guaranteed. But you are not obligated to stay in a job you hate either. If you are like me and choose this lifestyle for the freedom, there is no point in sacrificing that freedom by staying somewhere that is detrimental to your mental health. Figure out what is important to you, remember why you started, and take each contract extension as it comes. You never know which place will make you want to stay awhile and which one will have you running to the next assignment as fast as possible. Alex McCoy currently works as a pediatric travel nurse. She has a passion for health and fitness, which led her to start Fit Travel Life in 2016. She travels with her husband, their cat, Autumn and their dog, Summer. She enjoys hiking, lifting weights, and trying the best local coffee and wine. << 5 Ways to Make Sure You Always Land a Travel Healthcare Contract