Hi CT. Sorry for the long delay- been dealing with computer problems.
Why don't your CTICU travellers recover fresh hearts? If they are trained for it but your unit policy says they can't be assigned to fresh hearts, that's not the traveller's fault. Look at it from the other side- being hired for CTICU and when you get to the hospital, you're only allowed to take chronic patients the staff don't want. No fun and insulting, in a way. That is a management call- maybe your staff could lobby for a change.
Is your manager hiring nurses who don't have CTICU backgrounds? Again, not the traveller's fault, it was a management decision. At least they can take patients.
As for my background... I usually prefer SICU but I do Trauma ICU and can do CVICU in a pinch, although I would like more training than I have. I wouldn't take an assignment in a CVICU but I've taken fresh hearts in mixed ICUs when there just absolutely was no one else to do it and I had backup. MICU... I *can* do it, not my preference. I like Neuro and I hate Neuro... <grin> I usually prefer teaching/trauma centers, but I've worked at a few community hospitals that I enjoyed as well.
My patient assignment varies by hospital... I've never said "I'm a traveller so I don't take x y or Z patients." I have said "I am unfamiliar with that... is there someone who knows more about it ? I could watch and learn and be ready next time." That's safe practice- I would do the same if I were on staff. I've never asked for a lighter assignment. If anything, travellers either get even assignments or, frequently!, get dumped on. The "you're making more money so you get the GI Bleeding/TB isolation/psych history patient AND the DKA with Q 30min fingersticks" garbage happens a lot. One hospital would routinely give me the 3 sickest (and often farthest apart) patients while their staff nurses would have 1 each and be taking naps. One charge nurse who made the night schedule told us "staff aren't going to work holidays or weekends- that's what travellers are for." Nice, hmm? <g>
As for the money... Don't believe the magazine ads. <grin> My first couple contracts paid me less than my staff job did. The money and bonuses are getting better, but they are for staff RNs too. I make a bit more per hour than staff nurses at some places but there are always trade-offs. I don't get sick time or vacation time. If I miss a day, I get billed and many hospitals will refuse to pay a bonus based on that, even if I make the day up. Contracts that are supposedly binding can be ignored or cancelled at the hospital's whim, leaving the traveller stuck in terrible conditions or without a job. Our insurance isn't as good as staff's, shift and weekend diffs are extremely rare. The "free housing" is only free as long as you pay to maintain a residence at home and meet IRS guidelines for being away on business. So it's not free- it just prevents us from having to pay for 2 apartments. If there are any disputes, travellers can be fired with no HR or union representation to back us up. There are some hospitals that have no complaints with their travellers until days before the contract ends- then fire them to avoid paying a bonus.
There are lots of things about travelling that staff don't see. The big hourly rate that the hospital is billed for me covers my salary, benefits, and employer paid income/social security taxes on top of housing and the company's cut. The traveller isn't paid anywhere near the entire rate the hospital is charged. Staff RNs often don't realize that the cost of employer taxes and benefits can add 35-40% on to their salaries. That money isn't visible in your paycheck, but the bill rate for me has to cover it so it looks artificially high.
Don't get me wrong- travelling has been a great experience for me and I am so glad that I did it. There are ways to make money at it, same as staff nursing. But staff RNs often don't see the negatives. I think nurses everywhere are overworked and feeling stressed and often vent at any perceived imbalance. Travelling has been better than staff nursing for me for a while now- but it sounds like your staff might not know the big picture.
Argh- very long post, sorry. Just trying to imagine what might be happening from the travellers point of view. Can you expand on why your travellers don't recover hearts? Or why the assignments are uneven?