Best specialty for travel?

schnookimz · Dec 2, 2014

A year in the OR probably isn't enough. Most ORs have orientation that is 6 months to a year.

NedRN · Dec 2, 2014

What is your concern about the ICU? Even crappy hospitals usually take acuity ratios seriously. The larger issue for ICU travelers is being floated to med-surf.

OR does have a long orientation time initially and it typically takes longer than any other specialty to orient and then to acquire a level of efficiency and comfort at a new hospital.

While you can certainly get slammed in a case, they can't give you extra patients like medsurg. Day shifts only is a huge plus although call is part of the job.

If you choose OR, there is no way you can travel with less than two years experience.

PacoUSA, BSN, RN · Dec 2, 2014

I worked 2 years as a med/surg/tele nurse and got my first travel assignment on a cardiac tele floor. Way different experience. I get 5 patients still but I don't feel like I'm drowning like in my last unit as a staff nurse. Also, I've learned how to manage patients on cardiac drips such as milrinone, dopamine, cardizem, etc. whereas I only had exposure to heparin as a staff nurse. If you are looking to expand your experience beyond med/surg, try adding telemetry to your skills and look for assignments that are willing to teach you some new things. I don't want to be a tele nurse forever and would ideally want to work in ED later on, but for now I'm happy to stay in it just to benefit from the travel experiences.

Nessybean · Dec 2, 2014

So is MedSurg travel not as bad as I'm imagining? We don't have tele on my unit.

guest769224 · Dec 2, 2014

If you choose OR, there is no way you can travel with less than two years experience.

Why is this exclusive to the OR vs. other specialties?

PacoUSA, BSN, RN · Dec 2, 2014

So is MedSurg travel not as bad as I'm imagining? We don't have tele on my unit.

Honestly, it depends on the unit you are ultimately assigned to. I was a staff nurse on a notoriously heavy med/surg/tele unit, where 5 patients was usually way too much, oftentimes there were 4 totals in the group and too too many tasks to complete, along with the problem of some CNAs disappearing when you needed them the most and then magically reappearing once you completed the task you needed to delegate.

I was floated on my current assignment away from cardiac tele to a similar unit from which I was staff and I was kind of terrified on what to expect, especially when nurses warned me that I was being floated to the worst unit in the hospital. Turned out not to be as bad as they told me, it was similar to my best day at my staff job.

If I were you, I would try to get tele certified at your expense if you have to, so this way you are more marketable as a traveler and maybe you can get med/surg/tele assignments.

NedRN · Dec 2, 2014

Why is this exclusive to the OR vs. other specialties?

Well, a nurse can go traveling with no experience if a hospital is willing to take them. Realistically, you need experience. Some specialties take longer than others. Bedside positions including medsurg, tele, ICU among others have the basic supplies needed nearby. The OR requires circulators to be able to put their hands on literally 10,000 different supplies that are spread out over a large area inside of seconds. This is just a minimal example to show some of the complexities of working in an OR new to you, you have to learn not only where those supplies are, but the preferences of many surgeons. Adding to the complexity of OR work is that it is made up of many specialties or services including general (major and minor), ortho (minor, trauma, and totals), neuro (minor, spine cranies, and trauma), plastics (cosmetic and reconstruction), OB (hysterectomies, C-sections), vascular, open heart and the list goes on. Surgeries can be incredibly complex, open or with minimally invasive scopes, microscopes, argon beam cautery, robotics, and a wide range of equipment and positioning supplies.

Not only do you need to learn much of this during your initial staff orientation (mine was 9 months rotating through all these services scrubbing and circulating in a large teaching hospital), but you have to learn very different ways of doing surgeries at each subsequent hospital. After my nine months of orientation I was in no way a proficient OR nurse. I believe I was proficient after two years as a generalist, but stayed another year to nail down open heart.

I hope that gives you some idea that a really solid background is needed in the OR before you are expected to hit the ground running at a new hospital, likely in services you may not be really strong in. For myself personally, I learn faster when I'm just thrown in, but many ORs insist on a two week or even longer orientation for travelers.

The skills of an OR nurse tend to be more technical where other specialties are more clinical. Different skill set and clinical specialties are more self sufficient than the team work we rely on in the OR. I wrote this rather quickly and hope I haven't offended anyone.

jlshort06 · Dec 21, 2014

I think this is the sort of thread I'm looking for. I'm a tele RN and I'm ready to start looking at agencies. I'm hoping to take an assignment sometime in May or June at the latest. I was wondering about the nurse:patient ratios as well. Where I'm at, it is what I would consider high at 1:5/6 on daylight and 1:6/7 on nights and some of those patients are pretty high acuity. How much control would I have in negotiating a ratio or do I have that power at all?

jlshort06 · Dec 21, 2014

Didn't realize that particular formation of symbols and letters made an emoticon. As most can guess, that should be nurse : patient ratio

NedRN · Dec 21, 2014

No, you can't negotiate ratios with a hospital. All you can do is interview and discover what ratios they have and say yes or no. The exception of course would be California with state law mandated staffing ratio laws. Other exceptions are the many hospitals with union contracts that specify ratios. Places to prioritize looking for such hospitals include all the west coast states, and all the New England states. Mid-Atlantic would be next, and just write off the South completely!

sweetgurly25 · Dec 23, 2014

I agree with the south, ratio laws not matter and you can get 6-7 on ms/tele. The best thing to do is ask these questions during the interview process. Make sure you get what everyone's role is. I did research for almost 6months before I started traveling.