Hawaii, Indiana, Washington Introduce Nursing Licensure Compact Legislation In 2019
Exactly a year and one month ago, the National Council of State Boards of Nursing (NCSBN) enacted the enhanced Nursing Licensure Compact—referred to as the NLC—with the goal of streamlining the compact license requirements and adding an extra layer of security by requiring federal background checks for all applicants. A total of 31 states have joined the NLC since January 19, 2018, including Kansas and Louisiana, which both passed legislation to join last year and are expected to fully implement their NLC programs by July 1. They weren’t the only states interested in joining the NLC last year. Illinois, Michigan, New York, Vermont, Massachusetts, Rhode Island and New Jersey all had pending legislation last year to join the NLC. Of those states, only New Jersey, Massachusetts, Indiana and Michigan still have legislation pending. Three new states—Hawaii, Indiana and Washington—have all introduced some form of legislation related to the NLC earlier this year that could result in three new compact states. While it’s unlikely that these states will implement NLC programs this year, we’ve provided a breakdown of the issues surrounding each piece of legislation, and if they will realistically pass muster with their state governments. Breakdown of potential new nursing compact license states Hawaii What legislation is in the works? Hawaii does not have a bill to actually join the NLC, but on January 24, House Rep. Ichiyama Takumi introduced a bill that would establish a study to identify potential issues that could arise if the state joins the NLC. How much progress has it made so far? As of February 16, the bill has been recommended for approval almost unanimously by every House committee assigned to review it, including the Consumer Protection and Commerce, Health and Intrastate Commerce committees. The bill is scheduled for a final review with the Finance committee on February 21. Why is this a big deal? While it’s not technically legislation to join the NLC, it’s still big news that Hawaii lawmakers are considering joining in the first place. If the results of the study are favorable and NLC legislation is introduced, Hawaii could become the first non-continental state to join the compact. Hawaii is already an incredibly popular destination state for travel nurses, but it could be even more popular if its made accessible for compact license holders. It could incentivize native Hawaii nurses to travel as well since they would gain more than 30 additional states to practice in if NLC legislation is approved. What are the chances it will actually pass? Very high. Almost every committee assigned to review it has recommended it for approval and are moving it quickly through the House, so there is a solid chance the bill could pass through the House by the end of February. Indiana What legislation is in the works? House Bill 1344, introduced on January 14 by Republican Rep. Edward Clere, would allow for Indiana to join the Nursing Licensure Compact. How much progress has it made so far? The NLC legislation passed unanimously in the Indiana House on January 31 and is making its way through various committees in the state Senate as Senate Bill 436. Why is this a big deal? If Indiana passes legislation to join the NLC, not only would compact license travelers have access to a new state, but it would allow for Indiana nurses to practice across the Indiana-Kentucky state line in Louisville—an issue that is frequently brought up by compact license advocates when addressing gaps in nursing service. It would also allow for nurses without a single-state license but who have a compact license to possibly start jobs quicker, as it can currently take several weeks to obtain a permanent nursing license in Indiana. What are the chances it will actually pass? Very high. This is the second time Rep. Ed Clere has introduced NLC legislation after his first attempt in 2018 with House Bill 1317, which urged legislators to conduct a study into the impact of joining the compact, among several other provisions. The bill went into a legislative study over last summer to address any concerns, and since then has gained significant momentum and support among lawmakers, according to a Komoko Tribune report. The current NLC bill also has the support of several healthcare associations and interest groups, including Baptist Health Floyd, One Southern Indiana, the Indiana Hospital Association and the Coalition of Advanced Practice Nurses of Indiana, according to the Indiana Chamber. Washington What legislation is in the works? Washington House Bill 1882 and Senate Bill 5460 were both introduced this year and would allow Washington to join the NLC. How much progress has it made so far? Both bills have moved to committee for further discussion and debate. The Senate Health & Long Term Care Committee public hearing on February 1 can be found here. Why is this a big deal? If implemented, Washington would be the first state on the West coast to join the NLC. It would also allow for Washington nurses to practice across the Washington-Idaho state line, as Idaho is already a part of the NLC. What are the chances it will actually pass? Mixed. Some members of the business and military sector in Washington, as well as the NCSBN, support the state joining the NLC, according to several testimonies given on February 1 during a Senate Health and Long Term Care Committee hearing. “We have, as a state, already passed the Physical Therapy Licensure Compact and the [Interstate] Medical Licensure Compact, and we’ve done so because we know the compacts are effective,” Sen. Annette Cleveland, a sponsor for the bill, said during the hearing. “31 other states…already have nurse licensure compacts, others are also considering joining, and I want to ensure our state is also having that conversation.” The Washington State Nurses Association (WSNA) opposes the bill, according to a Senate committee testimony by Melissa Johnson, a spokesperson for the WSNA. Some of the concerns of the WSNA include a lack of need for the compact with the state board’s
Tall Man, Tall Van: Nate Hemann Shares His Experience Travel Nursing While Living The Van Life
Like many travel healthcare professionals, nurse Nate Hemann wanted to pursue traveling to experience new sights, meet new people and gain experience working across the country. Before starting his journey, Hemann decided to make his first major commitment to the travel life in an unconventional way—by converting a freshly purchased 2018 Ford Transit into his permanent home away from home. Hemann started documenting his experience building and living in his van on August 2, 2018, through his Instagram account, @thetallmanvan. From his posts, Hemann shares messages of positivity, his enthusiasm for nature and all the highs and lows of living in a van while working as a travel nurse. I spoke with Hemann to find out more about his nursing career, how he converted his ride and why he decided to tackle the #VanLife. Editor’s Note: Photos in this story pulled from the @thetallmanvan account were used with permission. Some of the answers below were edited for clarity. Q: How did you get involved in the nursing profession? I decided I was going to go to school for nursing in about the 10th grade. I honestly don’t remember a single moment that sparked it. I did, however, grow up right next to the Mayo Clinic, and with both of my parents working there, as well as nearly every other adult in my life growing up, it’s really no surprise that I ended up with a career in the medical field. I have also always loved people and science, and to me, nursing is the best fit for me with my strengths in both of those areas. Q: What made you want to pursue the travel nursing route? Travel nursing was not something I had ever thought about until holiday break during my senior year of nursing school. I went on a study abroad trip with 20 some other nursing students to the Philippines to learn about and dive into the culture and nursing practices there. This single trip set me on the travel path that I am on now, both in my career and in my personal life. I made it a financial goal of mine after graduating college to always be able to say “yes” to travel when asked by anyone around me, and so far, I’m surpassing my goal of traveling whenever possible far more than I ever imagined I would. Q: Being that you’ve just started your travel career, what has the experience been like so far? Although I technically began my travel nurse career the beginning of October 2018, I feel that it really started in July of 2017. After working one year as a staff nurse in Duluth, Minnesota, I packed up my car and drove to Seattle to be a part of the amazing team and culture of Harborview Medical Center. After a year at Harborview, and meeting all of the countless, amazing travel nurses there, I knew that I had to be one as well. View this post on Instagram A post shared by Nate Hemann (@thetallmanvan) on Feb 6, 2019 at 6:59am PST The experience so far has been supportive and educational, as well as beautiful considering I have gotten to be in Northern California and Central Oregon for my first two contracts. I feel fortunate to have gone to two hospitals so far with an overall good attitude toward travel nurses because I know that that is not always the case. Q: What have you learned? Any unexpected challenges? I have learned that I love to float, which as a traveler is something you have to learn to like, or you certainly won’t have a good experience. I love the challenge of a new unit and a new patient demographic outside of my specialty. I will say that I am not learning as much nursing-wise as I would like to, and that’s why I will seek out more trauma and teaching hospitals, like Harborview. For now, I am trying to keep up to date outside of work. However, I am learning so much about myself being in these smaller cities and hospitals. It is giving me more financial freedom and time to explore the great outdoors with my van and any friends I meet along the way. As far as nursing goes, the main challenge I have found is that staff nurses tend to be resistant to change, and as the new nurse on the unit all the time, that can make me feel isolated. I have picked up skills and knowledge in various ways and places, and some nurses I work with only know nursing from the college in the same community that they work in—and perhaps have lived in that very community their entire life. As someone who constantly wants to learn and understand the world from other perspectives, it frustrates me to work with complacent and inflexible individuals. Q: Where have you visited so far? Considering that, what’s your most favorite moment from the places you have visited? My two contracts so far have been in Eureka, California and Eugene, Oregon. I have visited countless places outside of these two locations since I drove from Minnesota to get here, and in between contracts, I took two-and-a-half weeks off to ski in Wyoming and Utah. Top of my list since starting travel nursing would be as follows in no particular order: Grand Teton National Park, Lassen Volcanic National Park, Redwoods National Park, and the Southern Oregon coast. View this post on Instagram A post shared by Nate Hemann (@thetallmanvan) on Oct 19, 2018 at 11:24am PDT I’m not typically a man of favorites—usually a top three or five kind of guy—but there was an instance during this travel nurse journey that I felt absolute bliss. I hiked down a steep and wooded part of the Southern Oregon coast, made my way to rocky outcrops, and it was all just after a big storm system had rolled through. The waves crashing against the coast were absolutely massive. I
Travel Jobs: ‘Hot’ February 2019 Market Means More Location Variety, Fewer Premium Pay Options
As the last month of the busy winter season marches on, one of the main concerns circling around the travel healthcare community in recent weeks is the high amount of low-paying contracts advertised by recruiters or posted by agencies. While there is a kernel of truth in those concerns, recruiters and agency sales representatives say that the answer is not so simple. The travel nurse market is hot on both sides of the fence—healthcare facilities across the country have plenty of urgent needs, and lots of potential candidates are available and looking for work, said Oren Lavi, a director of client advisory for LiquidAgents Healthcare. “The market is hotter than it has been in the last 24 months. The time to jump in is now,” said Oren Lavi, a director of client advisory for LiquidAgents Healthcare. “More jobs means more variety. Hospitals are not going to list premium pay packages unless they see the nurse pool drying up. For now, the candidate pool is consistent so they have no reason to raise rates.” Some exceptions to this trend include northeastern states like Pennslyvania and New Hampshire, and Midwest states like Wisconsin, Illinois and Michigan. Similar to our January predictions, cold weather is keeping seasonal travelers away, which mean travelers are more likely to find premium pay packages—$1,800 and up per week before taxes—in these areas. Additionally, most of the northern and Midwest states where bill rates have remained consistently high over the winter also saw a spike in traveler job applications in January, according to StaffDNA job board data. Travel Healthcare Job Market for February 2019 Here’s a quick breakdown of the states and travel healthcare job specialties that are most-in-demand now and are expected to stay popular in February, according to data provided by industry sales and recruiting representatives. Arkansas RN: Medical-surgical, telemetry, step-down/PCU Illinois RN: Medical-surgical, telemetry, ER, labor and delivery Indiana RN: Medical-surgical, telemetry. Much higher needs compared to January, close to 100 open positions as of February 8. Job submittals around Indianapolis close within 24 hours. Kentucky RN: Medical-surgical, telemetry, step-down/PCU Missouri RN: Medical-surgical, telemetry, ER (On the lower end, but needs are increasing). All core specialties in demand in St. Louis. Allied: X-ray/radiology techs New Hampshire RN: Medical-surgical, telemetry. Bill rates much higher than average. Surgical Tech: OR Oklahoma RN: Medical-surgical, telemetry. Job needs are filling very quickly. Pennsylvania RN: ICU, OR, medical-surgical, telemetry Texas RN: Medical-surgical, telemetry, step-down/PCU January 2019 Top Markets Editor’s note: This list is created by analyzing the number of travelers applying for jobs in these individual states and Washington D.C. This data is not necessarily a historical indicator of job volume. Application data comes from the StaffDNA jobs database. Florida Texas California South Carolina Georgia Pennsylvania Tennessee Arizona Michigan North Carolina Indiana Arkansas Kentucky Missouri New Mexico Oklahoma Virginia West Virginia Iowa Nevada Oregon Wisconsin Idaho Maine Colorado Alaska Hawaii Illinois Ohio Washington Alabama Louisiana Massachusetts Connecticut Kansas Mississippi Maryland Minnesota New Hampshire New Jersey Utah Vermont Wyoming Washington D.C. Deleware Montana North Dakota Nebraska New York Rhode Island South Dakota
New ‘Healthcare Travelers Take Omaha’ Conference Set For Early April
Travel healthcare professionals have said pursuing a travel career can be a lonely experience. Travelers are spread all across the country, which can make it difficult to connect with their colleagues outside of social media. So when the idea for a new travel healthcare conference came about during TravCon 2018, it wasn’t out of a desire to create a competing conference, but instead to provide another event where travelers can network and connect, travel nurse Thomas Piper said. “We wanted to provide people another option to supplement TravCon,” Piper said. “Not everyone can make it to Vegas every year in September, so this conference is another place where travelers can connect.” Piper is helping organize the new conference Healthcare Travelers Take Omaha, which is set to take place from 8 a.m. to 5 p.m. on April 5-6 at the Holiday Inn Omaha Downtown-Airport in Omaha, Nebraska. Tickets cost $50, which covers the cost of food provided during the conference, Piper said. Only 150 tickets will be sold and the number of travel company exhibitors for the event is capped at 30, Piper said. So far, around 20 percent of the tickets have been sold, but Piper said he expects that number to increase as travelers settle into their first contracts of the year and plan time off. As of Wednesday, 21 of the 30 exhibitor slots have been filled, according to the conference website. Piper’s traveler Facebook group Scrub Squad 1978 along with Gypsy Soul Travel Nurses and Adventures In RV Travel Nursing are the official hosts for the event, according to their website. Along with a keynote speaker, recruiter panel and CEO panel discussion, the conference plans to offer several learning sessions with industry professionals and special group events, including a charity golf tournament benefiting autism research, a 5K fun run/walk and a meet-and-greet mixer. The learning sessions will cover topics like traveler taxes, fitness on the road, breaking a contract, RV travel and housing, according to their website. Small setting, good conversation Part of the reason why Healthcare Travelers Take Omaha is only accepting a small number of travelers and exhibitors is out of necessity, Piper said. Planning for the conference began in April, so with only six months to pull the event together, venue options were fairly limited. Organizers also wanted to keep the cost of entry as low as possible for both attendees and exhibitors, which is why Omaha was selected for the first year of the conference, Piper said. “Omaha is a central hub for travel nursing companies,” Piper said. “It’s also centrally located, so it’s very inexpensive for travelers to access who may be on the edges of the country.” More than a dozen travel healthcare staffing companies call Omaha home, including Aureus Medical Group, Atlas Medstaff and Fusion Medical Staffing, all of which are exhibitors for the event. The conference won’t be held in Omaha every year, however. Another reason why organizers wanted a different conference was a chance to meet up with travelers in new places, Piper said. Organizers are already looking ahead to next year’s conference in Orlando where they plan to offer more tickets for travelers and space for exhibitors. “We’re travelers—we like to travel the country and don’t want to go to the same city every year,” Piper said. “TravCon is great and a lot of fun. I plan on going to it every year. But it can be expensive to visit Vegas every year if you’re working on the East Coast or want to bring your family along.” Another reason why organizers wanted a smaller setting was to offer more time for travelers and companies to network with each other, Piper said. “We’ve set a lot of time aside for people to have actual conversations with agencies and recruiters,” Piper said. “It’s definitely going to be a more intimate setting for networking and forming relationships.” Piper was encouraged by how quickly Healthcare Travelers Take Omaha has come together and hopes this conference will provide another great option for travelers to connect with each other, he said. “Talking after TravCon last year, we weren’t sure we would be able to throw it all together within six months, but it’s coming along nicely,” Piper said.
Travel Healthcare As A Pair: Getting Creative When The Market is Tricky
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life My husband Keaton and I are lucky enough that we both have careers that allow us to travel as a pair. I am a registered nurse and he is a physical therapist, so we are both able to work 13-week contracts throughout the country. We have been doing this for about 18 months and have managed to find contracts together about half of the time we have traveled. Even if you don’t have a spouse who can travel, many people choose to travel with a friend who is also a travel nurse. Not only does this help with loneliness on the road, but it cuts back on the cost of living and some of the work that has to be done when you move to each assignment. If you travel as a pair it can be a little trickier to find jobs that work for both of you at the same time in the same area. In the past 18 months, we have gotten a little creative, but we have managed to make it work and have some great ideas for anyone else looking to travel as a pair. Look for jobs in larger metropolitan areas. While some rural assignments offer big money based on location, the job concentration will be much lower. We have had much better luck if one person takes a job in a big city and then the second person works on finding something in that area. Plus, jobs are more likely to pop up for later start dates throughout the duration of the first person’s contract (more on that later). Be willing to have a longer commute. Many large metropolitan cities come with the price of heavier traffic. Keaton and I have each had to commute up to 1 hour each way to find contracts in a similar area. Whether it is heavy traffic or long distance, commute time could very well be an issue you have come up when trying to find jobs in the same location. Have a plan for if one person’s contract falls through. We always pick our housing based on one person’s income. Because contract cancellations are an unfortunate part of working as a traveler, we want to know we can survive even if one of us gets cut from a job. Similarly, if you travel with a friend, make sure and have a plan or a good chunk of savings in case you lose your job while on location. Look for start dates no more than 3-4 weeks out. A few times one of us has jumped on a great-paying contract early only to find the market drying up for the other person. The travel market is so hard to predict, so you may not be able to guarantee jobs for both individuals if you look too far in advance. For example, the Phoenix market was great back in the fall, but by the time we got here in the winter, physical therapy jobs for my husband had dried up and he has had to get a little creative with finding work. Which brings me to my next point… Don’t be afraid to think outside the box for jobs. Even if you can’t find a contract, that doesn’t mean there aren’t facilities in need nearby. I was able to sign up for per diem flu shot clinics in Georgia, and my husband found a per diem agency locally in Phoenix. Many hospitals choose to use local agencies first, so you may have luck reaching out to them directly once you are in town. Some places will even hire you directly knowing you’re short term because ultimately it saves them more money than hiring a traveler through a company. While traveling with a friend or spouse may take a little more leg work, it sure is nice when you get hit with a little bit of homesickness or loneliness. Knowing you have a roommate or companion to lean on is always a great source of comfort when dealing with the stress of changing jobs and adjusting to a new floor. Be sure to be open and honest with your recruiter about your goals are if you are traveling as a pair. It is even more beneficial if you share a recruiter, but for many companies that won’t be possible if you are different professions or specialties. Also, keep in mind my previous advice about working with more than one company, as it will be especially helpful if you need to try and match specific locations with your travel partner. 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. Alex enjoys hiking, lifting weights, and trying the best local coffee and wine.
5 Things They Don’t Tell You About Travel Nursing
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life Now that the new year is officially in full swing there are a lot of people evaluating their life. Where do I want to be in five years? Am I working in a career that I love? What if now is the best time to take that leap I have been considering for a while? If you have been considering working in travel nursing for any amount of time I want to preface by saying I highly recommend this career path. My experience as a whole has been positive and to anyone considering travel nursing, I would say go for it. However, as with any positive thing, there are the inevitable negative aspects that come along with it. Getting into the travel nursing world can be daunting, and being unprepared is the worst thing you can do if you want to enjoy your work as a traveler. I feel that being upfront and honest about some of the common struggles travelers face is the best way for new travelers to be prepared to manage these stressors as they come along. Here are the top five downsides to traveling that I feel all travel nursing newbies should be prepared for: 1. There is a lot of behind the scenes work to get started in travel nursing. Before you can even submit to jobs, you must have references and an updated resume ready to go. In addition, you have to have licenses on hand, locations in mind and have a baseline idea of housing costs before you actually apply. Once you have secured a position, there is usually at least a few hours of credentialing and paperwork to complete. This includes visiting a walk-in clinic for drug screens, updated labs and submitting proof of all prior vaccinations and licenses. 2. There will be upfront expenses before you get your first travel nursing paycheck. Most travel nursing contracts include a form of travel reimbursement—on the first check, that is. This means if you move in the Sunday before a Monday start day, you will not actually receive your first housing stipend or travel money until about 12 days later. Some costs to consider at the start of each assignment include first month’s rent, pet deposits, and travel expenses on the way there. I have had to pay close to $3,000 before actually starting work, so planning ahead for this is key. 3. Each state has different renewal requirements you have to monitor. To make yourself more valuable as a travel nurse you will want more than one state license. If your home is in a compact state this is great, but a lot of the destination states are not part of the compact (Hawaii and Alaska in particular). After the leg work of getting the license is complete, you then have to maintain said license. Each state has different guidelines and fees for renewals and you will have to check the individual boards to make sure you stay on top of these. 4. Loneliness is a real problem in travel nursing. A more obvious downside to travel nursing is lack of in-person connections in each area you live. You may make friends on assignment but there is always an awkward period at the beginning where you don’t necessarily have people to hang out with outside of work. While there are many ways to combat this loneliness, it is also helpful to be aware of it so you can meet it head-on. This is a normal feeling and it is okay to be lonely, but have some plans in place to deal with these emotions. Call a friend, go to a workout class, or just go for a walk if you are feeling especially down about a lack of personal interactions. 5. If you decide to switch companies, all of that hard work has to be done a second time. Working with multiple companies is almost inevitable in travel nursing, but that doesn’t mean it is easy to coordinate. Each time you decide to submit for a contract with a company you haven’t worked with, you will have to re-submit your resumes, references and paperwork. The best way to handle this is to get organized at the start. Keep a folder of all your personal identification, license copies, and vaccination records. In the event that you have a company pay for a vaccine, TB test or physical, always request copies of these records in case you work with a different company for your next contract. By keeping your files up to date you can simply send all of your paperwork over in a matter of a few clicks each time you need to establish a contract with a new company. This can all be a bit of a downer, but I would not change my choice to work in travel nursing for anything. The people I have met and the experiences that came as a result of this career are without a doubt worth all of the extra work and planning. By being prepared and knowing what to expect you can have a more positive experience as a traveler and minimize the anxiety that comes along with this career. Expect the unexpected, plan for bumps in the road, and just be thankful when you don’t have to make use of those plans when everything goes smoothly. 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. Alex enjoys hiking, lifting weights, and trying the best local coffee and wine.
Healthcare Is Where The Jobs Are. But What Kind Of Jobs? (KHN)
By Rachel Bluth, Kaiser Health News More Americans are now employed in healthcare than in any other industry. The Bureau of Labor Statistics, which tallies job creation, says that for most of this year the health sector outpaced the retail industry. Only government, on all levels, employs more people. One of the consistent features of the BLS reports is that healthcare has reliably added thousands of jobs to the economy each month. November was no different. The healthcare industry created 32,000 jobs, adding to the 328,000 healthcare positions created since early 2017. But what kinds of jobs? Were they highly paid doctors and hospital executives or were they positions on the other end of the pay scale, such as nursing home aides and the people who enter data for billing in hospitals and clinics? It’s hard to know for sure, because the BLS monthly data measure industries not occupations and what information it does have on occupations is overly broad. For instance, it says hospitals accounted for about 13,000 jobs in November. Another 19,000 jobs were for “ambulatory” care, which is a broad term for services delivered outside of hospital systems, like in clinics and private doctors’ offices. But another set of BLS data offers additional insights. Every two years, BLS puts out a wonky set of numbers called “industry-occupation matrices,” which more finely slices job categories and predicts which will grow or shrink over the next 10 years. The most recent, from 2016, still provides a pretty accurate snapshot, according to Joanne Spetz, a professor at the University of California-San Francisco’s Institute for Health Policy Studies. Registered nurses are the fastest-growing occupation. They account for more than 25 percent of jobs in hospitals. If that share remained the same last month, 3,289 of the new hospital jobs added in November went to RNs. [protected-iframe id=”afd374bef04176b4120013d3f73733ab-7618883-99279322″ info=”//datawrapper.dwcdn.net/XoirU/5/” width=”100%” height=”500″ frameborder=”0″ scrolling=”no”] It’s likely that many of the hospital jobs went to medical assistants, who currently make up only 1.5 percent of the industry. Medical assistants are usually the people taking your vitals and helping the doctor take notes. The BLS expects about a 16 percent increase in these jobs in the next decade. “There will be a fair amount of growth in physician and surgeon employment in the next decade, but so many more medical assistants than physicians,” Spetz said. The national median pay of a registered nurse is $70,000 a year, according to more BLS data. For medical assistants, it is $32,480. Doctors’ median pay is more than $200,000. Far more of those medical assistants found work outside the hospital in the ambulatory sector: almost 1,300. There is also a good chance that in these ambulatory settings many of the newly created jobs were filled by non-medical staff. As of 2016, fewer than 30 percent of staff in ambulatory settings were workers whom Spetz calls “paper pushers.” If the trend held up, around 5,700 of the hires in November, or 30 percent of ambulatory jobs, fall into these categories. These jobs can pay as much as medical assistants. The BLS says the median income of “medical record and health information technicians” is about $39,000 a year. BLS is predicting around a 20 percent increase in “information and record clerks” and another 22 percent increase in “secretaries and administrative assistants.” But the idea that hospitals and doctors’ offices are hiring only lower-paid support staff might be overblown. The BLS figures “healthcare practitioners and technical occupations” still make up more than 37 percent of the ambulatory industry, and “health diagnosing and treating practitioners” are almost 23 percent. So nearly 70 percent of ambulatory hires last month were probably physicians or other skilled professionals like registered nurses, licensed practical nurses, social workers and personal care aides. “What we have seen over the past couple years is with the job growth in health it is not dominated by back office,” said Ani Turner, an economist who focuses on health sector labor trends with Altarum, a nonprofit health research and consulting organization. Another thing hiding in the numbers? A dissipating distinction between ambulatory and hospital care. Traditionally, hospital jobs were pretty straightforward; they referred to the doctors, nurses and support staff who worked in hospitals. But as business models shift, more care is given outside of hospital walls, something not reflected in employment numbers that split health into two distinct categories. Employees who staff the clinics, surgery centers, labs and imaging centers run by hospitals are counted as hospital staff, Turner said, though they work in outpatient settings. So those 13,000 new hospital jobs the BLS cited last month may not reflect real-world trends about where hiring happens. “Whether in physicians’ offices, free-standing clinics or hospital outpatient clinics, you’ll see it as the two separate settings, but the same trend,” Turner said. This story originally appeared on Kaiser Health News. 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.
Virginia Medicaid Expansion Enrollment Exceeds Projections
State officials had estimated 300,000 newly eligible Virginians would sign up for Medicaid coverage in the first 18 months of expansion, which takes effect on Jan. 1, but that estimate has increased based on the current pace of enrollment. As of Thursday morning, 140,643 adults now eligible for coverage under the expansion have enrolled in Medicaid, said Christina Nuckols, a media relations manager with the Virginia Department of Medical Assistance Service. State officials updated their estimate to 375,000 total enrollments by July 2020. That’s still 25,000 short of the 400,000 estimated Virginians who fall within the coverage requirements. Under the Affordable Care Act, states that expand Medicaid allow coverage for people with incomes up to 138 percent of the federal poverty level, which is $16,750 a year for a disabled person or able-bodied adult and $28,700 for a family of three. Virginia residents, find out eligibility requirements and how to enroll in Medicaid here >> A combination of automatic enrollments and streamlined enrollment processes for residents the state already knew were eligible—like those who receive Supplemental Nutrition Assistance Program benefits—are some of the reasons why the pace of signups have exceeded expectations, according to a Washington Post report. As part of the expansion, the federal government is expected to cover 90 percent of the cost of the program, to the tune of $2 billion annually. Virginia will foot its portion of the expansion costs through two new hospital taxes, which are expected to raise $590 million in two years, $248 million of which will be used to boost the reibursment rate for acute care facilities that treat Medicaid patients. The impact on travel healthcare in Virginia Even with less than one month until thousands of new potential low-income patients gain insurance coverage, Virginia hospitals are more worried about handling current needs than worrying about future patient loads, said Imran Chaudry, a senior client advisor for LiquidAgents Healthcare. “In the Richmond area, I can tell you from the feedback I’ve gotten that every hospital is still slammed,” Chaudry said. “I’ve tried talking to all of my…clients about the Medicaid expansion, but nobody is talking about that because they are so wrapped up in their day-to-day.” Job orders for travelers in the state have increased significantly since the start of November, Chaundry said, from around 100 positions to almost 200 open positions as of Dec. 5. Most of the market growth has occurred in the northeast and eastern portions of the state, around the greater Richmond region, Chaundry said. View current Virginia travel healthcare openings on StaffDNA >> Bon Secours Health System, the largest healthcare provider in the Richmond region, merged with Cincinnati-based Mercy Health in September. The merger is expected to boost services for Bon Secours in three markets including the Hampton Roads Health system near the state’s coast, according to a Modern Healthcare report. Both the Richmond region and the Hampton Roads region serve large populations of low-income residents, which could result in a wave of demand for travelers once newly covered Medicaid patients gain coverage in January. Studies have shown that low-income populations prefer using hospital emergency departments instead of primary care doctors for their around-the-clock availability and ease of use.
Missouri Travel Nurse Needs Remain High In Wake Of Slow Flu Season
Missouri travel nurse needs have remained at a significantly high number throughout November and the first week of December, according to current market data. More than 140 travel nurse needs are active in the state, most of which are newer positions located in or around the St. Louis region, said Jennifer Pomietlo, a director of client advisory for LiquidAgents Healthcare. That includes cities like St. Charles, Chesterfield and Columbia. The most-needed specialties include medical-surgical, telemetry, ICU, step-down and OR nurses, with limited openings for other non-core or surgical specialties, Pomietlo said. Allied healthcare travel positions are also fairly limited, but certified surgical tech and rad tech opportunities are available. Contact Allie Evans with LiquidAgents Healthcare for more information about Missouri travel nurse jobs >> Flu is the main driver for hiring in the state, Pomietlo said. Normally, Missouri hospitals will aggressively hire in early fall because the state is one of a handful that typically see high levels of flu activity starting in November, according to Centers for Disease Control and Prevention records. This year’s flu season is off to a slower start for the state, with “minimal” influenza-like illness activity and sporadic spread, according to CDC data. A total of one death and 1,384 laboratory-positive influenza cases have been reported as of Nov. 24 to the Missouri Department of Health and Senior Services (DHSS). More than 300 cases were reported from the eastern region of the state, where St. Louis is located. Missouri hospitals are hiring in December in anticipation of a delayed surge in flu patient census in January and February, Pomietlo said. “They get hit hard by the flu in St. Louis, and it also hangs around longer in Missouri than in other places,” Pomietlo said. In the record-breaking 2017-18 flu season, Missouri reported 133,957 laboratory-confirmed cases of flu and more than 2,000 pneumonia and influenza-associated deaths, according to a DHSS press release. Other things travelers should know about Missouri Missouri is one of the 31 states that are part of the enhanced Nursing Licensure Compact, meaning nurses who have a compact license can work in the state without paying additional licensing fees. Travelers who don’t have a compact license can get a single state license at a low cost. The state board charges $55 for a license by endorsement or $45 by examination. Missouri is also a walk-through state, so nurses can get a temporary license within a day. You can find more Missouri licensing information on the state nursing board website.
6 Unique Nurse Jobs & Specialties With Travel Potential
One of the many perks of being a travel nurse is the frequent exposure to new environments and experiences. Sometimes that can also mean trying out unique nurse jobs or specialties that aren’t always on the hospital floor. If you’re looking to take your nursing career to new places, check out these six unique nurse jobs and specialties with travel potential that you may never have heard of before. Cruise Ship Nurse On an ocean cruise in the Bahamas, work is probably the last thing on your mind. But even on the open water, cruise ships need healthcare professionals to treat vacationers and crew members in the case of any emergencies, accidents or illnesses. In 2018 so far, the CDC reported nine vessels had illness outbreaks including norovirus and E. coli. Accidents are also very common onboard. Cruise ship nurses serve as first-responders on the ship for all medical issues, treat a wide-scope of patients and manage transportation of people to larger facilities if necessary. To provide proper care, ships such as Princess Cruises, have well-equipped medical centers that include critical care areas, X-ray units, lab facilities and a pharmacy. Cruise ship nurses get to see the world all while providing excellent care and enhancing their nursing skills. Similar to travel nursing, most cruise ship companies require nurses to have at least two years of experience, preferably in an acute-care or emergency setting. Potential cruise ship nurses are also required to earn a certification in Advanced Cardiac Life Support (ACLS). Average Annual Pay: $82,883 Theme Park Nurse Just like cruise ships, vacation theme parks like Six Flags and Disneyland need healthcare professionals onsite in case of emergencies. While typically there are not doctors in place, it’s the theme park nurses who assist guests and staff with various immediate medical needs and manage a large flow of patients. Having diverse experience in emergency room care or fast-paced urgent care clinics is highly recommended. This year, Disney World & Resorts launched a large primary care center on the grounds specifically to care for more than 40,000 employees and their families. Disney has current nurse openings at its parks in Florida, California and France. If you’re looking for a fun yet challenging workplace, theme park nursing could be one of the most unique and happiest places to be. Average Annual Pay: Varies By Location Certified Nurse-Midwife Are you passionate about caring for mothers and babies? Experienced in labor and delivery? A certified nurse midwife handles patient care and safety through the entire process – pregnancy, labor and postpartum. At-home midwife births are becoming more and more common, and the American College of Nurse-Midwives has seen an increased demand for midwives. Midwifery offers a variety of settings including private practices, universities, military hospitals, birth centers, large facilities or through an in-home agency. There are also great travel programs for midwives with nonprofit organizations and the World Health Organization. WHO specifically launched a strategic initiative to help strengthen midwife nursing around the world, focusing on poverty and disease-stricken communities. Becoming a travel nurse-midwife brings care to people who need it most. Average Annual Pay: $107,460 Forensic Nurse If you’re a fan of the long-time TV show “Law & Order: Special Victims Unit”, you may be familiar with this healthcare specialty. Forensic nurses treat patients who were victims of trauma, violence or abuse. Playing a role in both nursing and the judicial system, forensic nurses need to be knowledgeable of the legal system while providing the best care to those in vulnerable or dire positions. The International Association of Forensic Nurses offers a variety of travel opportunities—for example, a pediatric forensic nurse from Colorado participated on an 8-week assignment in Swaziland, Africa to provide care for children and rape victims. The caseload of forensic nurses can be emotionally draining and even disturbing at times, but they provide an important service for those who are suffering from the impact of violent incidents. Average Annual Pay: $50,000-60,000 Nurse Educator Looking for an exciting opportunity to give back to the next generation of nurses? Consider becoming a Travel Nurse Educator. Also known as clinical educators, these positions are crucial for teaching hospitals and universities to help future nurses or recent grads develop the skills they need. While working in either a classroom or a clinical setting, Nurse Educators design, evaluate, update and implement top nursing curriculums, and act as mentors. To become a Certified Nurse Educator, you must have a BSN, RN, Master’s/Doctorate Degree and pass the National League of Nursing exam. These effective nursing leaders must be driven, highly knowledgeable and attentive for their students to succeed. Average Annual Pay: $73,265 Public Health Nurse Public health nurses work outside of the hospital and focus on the health of people in their community. They evaluate health trends, issues and laws, and propose strategies to help keep the population healthy. Public health nursing can vary state to state and is expected to grow by 19 percent, according to the Nurse Journal. Working with a health agency or a government health department, public health nurses educate people about important preventative healthcare, treat patients in public health clinics, work with youth programs and community centers, and help with training. Tasks can include providing screening tests and immunizations, collecting data from disease outbreaks, responding to natural disasters and community-wide emergencies, assisting patients and families in psychosocial health, and so much more. Every day can be different as a public health nurse. Average Annual Pay: $56,700