NICU Travel Nursing

Mags4711, RN · Feb 18, 2007

Many of my close friends are travel nurses, and several travel NICU exclusively. The fact that you could travel NICU or PICU is very helpful. I see you have two years experience listed, may I ask how much of that is in a Level III (b or c) NICU? I know that in our IIIc NICU the manager will not consider hiring a travel nurse if he or she does not have at least 2 years in a Level III NICU. Though not all NICU's are like we are. One of my friends has landed in a couple of Level II's in her 7 years traveling. While it was nice for the first couple of weeks, she said she was bored to tears. Just a couple of points to think about.

One thing that all of my friends say who either do or did travel, is to be very wary of American Mobile. They are the biggest, but...

Gompers, BSN, RN · Feb 19, 2007

I've got friends that did NICU travel nursing. They went to Boston, Las Vegas, NYC, and all over California. The most jobs were in CA because of the safe staffing ratios - that said, they were kind of bored with those jobs as a result. They were used to being busy, and just having one vented baby was kind of slow for them. One did a Level II but hated it, so I'd stick with Level III or IV if I were you - since I know you like excitement!

As long as you have at least a year's experience - though some companies and hospitals want two or more with NICU - you shouldn't have trouble finding a position. It might not be in the city you want exactly when you want it, but you should have quite a few choices, especially if California interests you.

SteveNNP, MSN, NP · Feb 19, 2007

Good advice....

I have 2 years Level III experience... I can never keep track of the "a...b...c.." designations, but we do everything except cardiac surgery and ECMO. I'll have my RNC certification as soon as I take the test in a few months. Our neos have been great about teaching those of us who are studying for it, and quiz us while we round, write orders, transport, etc...They're as excited as we are about taking it! I have to admit that my number one concern about traveling is that I'll get a crap assignment, or constant feeder-grower assignments, which, don't get me wrong, I don't mind once in a while, but like gompers said, I need some excitement! (like the diaphragmatic hernia yesterday) I'm really considering finding a Level IV where I can train for ECMO and flight transport. I want to really stretch my legs as a staff RN before finishing my NNP.

Stephen

Mags4711, RN · Feb 19, 2007

Some places call it a Level IV, but I guess it's technically called a Level IIIc now (It is hard to keep those straight, isn't it?). Level IIIc does ECMO and Cardiac surgery. That's what we are.

I can't speak for other travel assignments, but in my institution travel nurses can take anything they feel comfortable with (jets, HFO, etc.), other than ECMO, cool cap/body cooling, and admits. We don't give them those assignments because it really isn't fair to make someone who didn't have an extended orientation in our unit do any of those things. But we've had travellers who have come in and had ECMO experience elsewhere that have volunteered and taken those babies (we also always have an ECMO tech at the bedside), and if they feel comfortable, they also can take admits. We just don't make them do it. Not many have come in with any cooling experince so that hasn't come up yet. No, we do not make then take feeder/growers. We have too many nurses who fight over those kids already :) Just as we have lots of nurses who scramble for the sickies :)

In polling my traveling friends, none of them has been trained for transport while on a travel assignment. Not to say that no place would, but orientation to transport is expensive and time consuming and I can understand why a unit would not spend that $ and time on a non-permanent nurse.

I think you'd do well to find someplace that you could do both ECMO and flight transport prior to starting your NNP, but I see your countdown to starting your program is 190 days. It might be a challenge to find a unit to go into, and immediately get trained for transport, let alone be trained when they'll know you are leaving so soon for school. I know they won't train you for transport in my unit until you've been with us for at least a year, possibly two.

Shouldn't be a problem to get trained to take the ECMO babes, though. Most places you don't run the ECMO circuit, a tech (RT or RN) does.

SteveNNP, MSN, NP · Feb 20, 2007

Thanks again for the advice.....

I am considering taking a 13 week travel assignment to Columbia-Pres Children's Hospital this summer, while living with my parents. (and pocketing the $1200 monthly housing allowance) OK! I'll give my parents some rent....it's the right thing to do...Since I am applying to Columbia University, this might give me a glimpse into the unit I may end up FT on. Apparently they are a Level IV, and take scads of transports. I spoke with the recruiter from CP, and she said they'd create a FT position in their NICU (none posted right now) for me b/c I have experience. That would mean I'd have to do nights again for a while, probably while in school FT. I don't know how that'd fly...... I may do the aforementioned 13 week assignment, then when the times comes for school, either take a FT position or take a PRN agency position with the same travel agency, (I would continue working at CP, just PRN agency) depending on my school schedule. CP does ECMO, Cardiac sx, cool-cap, and pretty much everything else. They'll also give me 10k for school each year..... AAUGH!!! SO MANY CHOICES!! Such is nursing.... while other people are just glad to have a job, I'm inundated with options.....

RainDreamer, BSN, RN · Feb 21, 2007

I would definitely find out which hospitals will let travelers with no ECMO/cardiac surgery experience learn and take those assignments at their hospital.

We're a level IIIc ..... we do ECMO, cardiacs, etc. None of our travelers take those kinds of kids though unless they have had previous experience with such. Like faith said, it's just not fair to ask them to take them because the orientation isn't all that involved for travelers.

I'd take a full time staff position in a level IIIc and learn all you can, getting as much as experience as possible.

Good luck!

mac23 · Feb 22, 2007

I did travel nursing before I took my first full time NNP job and I loved it. It just depends on where you want to go. I met some of my very best friends on the road, saw places I might not ever have seen (Alaska was simply amazing and Hawaii was paradise), did a lot of networking (which led me to my dream NNP job) and overall had A LOT of fun.

Of course each unit is vastly different so you have to keep that in mind first and foremost. Go with the flow and offer advice on how you did things at your old job but always remember you are not there to change that unit so be careful because you are likely to insult someone and make for a tough 13 weeks while you're there.

Make sure you ask a lot of questions on your interview about what you are expected to do. Deliveries? Taking sicker kids? Floating? Being called off (how often). etc. Get EVERYTHING in writing and I do mean EVERYTHING

I did actually take a job in Cali that allowed me to do transport but I had previous transport experience.

There are a lot of units in the travel world that will treat you just like staff and let you take whatever you feel comfortable handling. Some places I hated but had the time of my life when not at work so to me even though the job was crappy my days off were amazing.

Overall I think my travel experience made me a better person and a better NNP. I learned 1000 ways to skin a cat and am much more flexible and relaxed at work. I wouldn't trade my experiences for anything. Once my husband is done with his residency we're going to hit the road only this time I'll be a traveling NNP! If you have any other questions I'd be happy to help.

SteveNNP, MSN, NP · Feb 25, 2007

Hey, did you do your NNP degree online, or classroom-based?

I'm having a tough time deciding which to do.....

Any recommendations?

Also, what was your "dream job?" What is a normal day for you like?

I really feel the drive to get my NNP. The bits and pieces of patho and other stuff I squeeze out of our neos, combined with the stuff I'm studying for my RNC really motivates me to go for it..... Any suggestions for me as I head down this path?

Thanks for your help!

Stephen

Mags4711, RN · Feb 25, 2007

Stephen, I work with three newer NNP's who were nurses on our unit before (and during) NNP school. Two went the traditional route, one did online/distance. I do know that the one who went online/distance had a VERY hard time setting up clinicals anywhere around and was just about to go back to NY (we're in Ann Arbor, MI) and do clinical with the brick and mortar (B&M) version of the University she was doing her distance learning through. She looked everywhere around here (and we are an area with quite a few teaching hospitals around us) and as far as three hours drive away, and no one would take her on.

As I understand it, the biggest problem seemed to be that so many students from other B&M schools were in clinicals at each of these institutions already. She also had to find an NNP who would agree to act as her "clinical instructor" which is on top of their hospital duties, and the neo who is the unit director had to sign off on it as well. In the eleventh hour our facility was able to make it work and she did clinical with one of our NNP's.

mac23 · Feb 25, 2007

Well I did a little of both types of programs. I had a lot of family issues to contend with so I started online at MUSC, then went classroom at Duke, then finally finished my degree online through Rush.

The online route was a life saver for us due to my family issues. I enjoyed the flexibility it gave me (I have a kid and a husband) and I could work at my own pace. I guess it would depend on your learning style as well.

As for the clinicals the online route will allow you to do clinicals at any NICU in the country that will allow you to do it there. This is where the networking I was speaking of comes into play. While I was on the road I took an assignment at a facility that I loved from day one. While I was there I really tried extra hard to get to know the NNP's and figure out who i might learn the best from. I didn't let them know I was a student at first just so I could feel them out. About 8 weeks into my assigment I asked my first choice. Since she was the director of the NNP's her plate was already full but she did help me decide between two other's I thought would be a good fit for me and we worked it out. She was an awesome preceptor and was as eager to teach me as I was to learn.

But even before I did the traveling thing I was doing a lot of networking with the NNPs from past jobs and the one I was working in at the time. I got to know them the best that I could. Asked a lot of questions about how they've been treated as NNP's, how they were treated in their current job versus how they were treated if they worked somewhere else. Asked what they liked/didn't like about being an NNP etc.

My advice for you in no particular order

1. Go for it! It's a great career.

2. The learning curve is HUGE. There is a lot to learn and people will be relying on you to know your stuff. Take in as much as you can and never be afraid to say I don't know but try to think through it and offer what you do know and go from there. The attendings expect you to know your stuff; some are harder on you than others. Some respect your education.....some don't. Be confident in what you know and never let the learning process end.

3. Network, network, network! Join some professional associations if you haven't already and be active in them. Attend a conference or two. You'll meet a great deal of people and at the same time stay current in what is happening in the field.

4. Never ever forget where you came from (being a bedside nurse!) I've met alot of NNP's who have forgotten. I try to keep that in mind at all times.

I will write more later. Good luck in whichever route you decide.

suzanne4, RN · Feb 25, 2007

Thanks again for the advice.....
I am considering taking a 13 week travel assignment to Columbia-Pres Children's Hospital this summer, while living with my parents. (and pocketing the $1200 monthly housing allowance) OK! I'll give my parents some rent....it's the right thing to do...Since I am applying to Columbia University, this might give me a glimpse into the unit I may end up FT on. Apparently they are a Level IV, and take scads of transports. I spoke with the recruiter from CP, and she said they'd create a FT position in their NICU (none posted right now) for me b/c I have experience. That would mean I'd have to do nights again for a while, probably while in school FT. I don't know how that'd fly...... I may do the aforementioned 13 week assignment, then when the times comes for school, either take a FT position or take a PRN agency position with the same travel agency, (I would continue working at CP, just PRN agency) depending on my school schedule. CP does ECMO, Cardiac sx, cool-cap, and pretty much everything else. They'll also give me 10k for school each year..... AAUGH!!! SO MANY CHOICES!! Such is nursing.... while other people are just glad to have a job, I'm inundated with options.....

If you are actually moving there, then you do not qualify for the housing stipend free, it will be taxed. You have to have a different tax home for you to be able to get it.

If you are going to CP as a travel nurse, you are not going to be able to go there as their employee for some time, per the fine print in your contract with the agency that would be sending you there.

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And agree with the above poster, if you have never done cardiac, then you should not be given those kids. Dangerous for the two of you. The amount of drugs that you need to be very familiar with will be mind-boggling to you, and you really need to know them inside and out. It is way too much of a liability for you and the facility if you have never had any training in that area. Suggest you go there as a full-time employee and get the training, not what you want to do, especially for the reasons that you want to go there.

Best of luck to you. Remember when you first were starting in the NICU.

Tranport for NICU requires years of experience and usually a Ladder IV nurse if they have them in that facility.