Unsure And Need Advice

[ScottMedicRN]

I spent a whole year wanting to do travel nursing and doing extensive research. Now, as I'm ready to contact the recruiter I was referred to, I'm getting cold feet.

Here's my background: RN ADN, CCRN, over 1 year ICU exp at a pretty small hospital, $30/hr, 7+ yr exp as a Paramedic.

Some concerns about my length of experience as far as if I will be able to get a contract, but I'd find that out on my own. As far as acuity, my hospital has been boring lately, and most of the really critical patients are assigned based on favoritism. Still, despite feeling like a step down unit lately, I don't feel like I'd have problems managing drips on a sick patient, as I've done it before. I know how to use Swans. I don't have experience with CVVH, IABP, ECMO, open heart, etc, but I hear that most travel nurses aren't put in those situations anyway. I'd probably be at a smaller ICU anyway, as I hate big cities. Also, I work night shift so there are some things I may not have experience in based on that alone.

Other concerns based on horror stories I've heard. Contract cancellations. Just how rare are they? I know it happens, but if it happened enough it would make a big dent in income, possibly making it not worth the switch of jobs. Is it common that the travel RN floats first, or in a rotation list? When it's my turn at work, I don't complain, but I don't think I could handle being on a med surg floor regularly. I've heard people on here getting all sorts of vague complaints about them from staff, one even apparently got a complaint for "looking tired" and another had a more serious complaint to the board of nursing by someone who was allegedly out to get them.

Still, I've never met a travel nurse at my hospital that had much bad to say.

I'm hesitating between traveling or trying to find a job at a more intense ICU and eventually working towards being a Flight RN years later. I've always wanted to do that as I like critical patients, and in theory I would be happier with that job. But I feel like I'll probably never travel if I don't do it now while I'm young and single. Also, travel nursing was my plan to "scope out" potential areas to buy a house one day when I move out West, all while bulking up on the money to do so.

Maybe I'm worrying too much.

Any advice?

[NedRN]

Nice first post!

I like your thought of a more challenging job. You could use the experience before travel anyway and it will make you more competitive. You didn't mention your age, but if you want an anecdote, I entered nursing school in my thirties, did three years of staff, and have been traveling over twenty years. Not for everyone, and you haven't met those who "failed" (many of them just trying if for the wrong reasons, or to get it out of their system while young). But it is challenging, which is inviting to some and not for others. Sounds like you are in the former group. I have met mediocre travelers, but many more excellent clinicians. Sort of the nature of the thing, that those with more on the ball (who are not tied down by family and even some who are) are more likely to travel, and travel gives you exposure to many different patient populations and different practice methodologies. That automatically makes you stronger than most staff nurses with the same practice time.

IAPB is easy, ECMO you are guaranteed never to use, not sure about CVVH but suspect that would be rare in most ICUs. Open heart is a subspecialty, do it if you are interested. Not as many travel assignments so you won't have a big a location choice, but they are more likely to have top pay. Experience in any device or procedure is a resume enhancer, and even if a unit doesn't need that skill, the manager may still give you preference over other candidates. Most managers like having a resource nurse, or at least someone with greater depth of experience. The bill rate is the same for all nurses, so better candidates (or "fit") are always given priority.

For most travelers, cancelation is a rare thing, particularly if you understand your role in the broad scheme of things: you are a hired gun and have to perform at a high professional level without raising a fuss clinically or in personal interactions, much higher than is necessary as staff. But the real statistics are that one out of ten assignments industrywide fails to complete for all reasons (many of those didn't actually start but contracts were signed). Some agencies/recruiters have much higher rates than others. Most cancelations are preventable. What is needed is a good recruiter who isn't going to try to put you in a high paying assignment from hell, but rather ensure a good fit for both parties needs and skills. This is particularly important on your first assignment, and your first year as a traveler. Besides proper vetting of recruiters, you need to ask pertinent questions of both the agency about a particular unit, and the manager when you interview. Turn down assignments with red flags - behave rationally versus emotionally. Forget about that great beach job with a couple red flags.

I know many travelers who have made it twenty years without a cancelation (I'm not one of those). Cancelations are tough emotionally, but you can a least prepare financially so you won't care if you miss a month of work. I miss several months of work annually on purpose! You can also prepare for cancelations by having a Plan B, which usually entails working with more than one agency. One cancelation for any reason, and a single agency may decide you represent too much risk for them to continue working with them. Which will really make you mad! Again, cancelations causing horror stories you read about online are indeed rare, but it is good life planning to prepare for contingencies.

[ChrisMMS]

Recruiter here! I've tried to answer your questions to the best of my ability below.

1) One year of experience is the minimum amount of time that we require for our travelers some agencies will want you to have two, but it's going to vary. You're going to be able to find contracts and agencies willing to work with you with your experience. I'm not 100% sure on the second question, but from what my travelers have told me they are often placed where they need the most help. You generally are going to have to fill out a skills checklist so facilities will be aware of what you are capable of without putting anyone in danger.

2) Contract cancellations are fairly common with certain health systems and agencies because of how they work. HCA and Kaiser are a few health systems that some travelers try to stray away from because they have a propensity to cancel their contracts. In terms of agencies the only one I know of that has a lot of contract cancellations would be FastStaff. This agency specifically works on very high pay packages because a majority of their contracts are strike or crisis contracts so once those events end so do the contracts. Depending on the contract it is very common for travelers to float to other departments based on the census especially for smaller hospitals.

3) I don't think you're worrying too much about traveling, you'll want to make sure you have all your ducks in a row before you make the leap. There are a lot of things you need to scope out and answer for yourself to see if traveling is going to be the right for you. If you haven't taken a look into traveling yet I would start looking into how stipends work, double expenses, how to negotiate the best contract for yourself, etc.

[ScottMedicRN]

Thanks for the replies. I've heavily researched travel including talking to tax professionals. Its just weird that I had a change of heart just as I planned to start applying.

Though I have some worries about not having enough experience since my hospital has become a glorified step down unit lately, I still feel like I would probably be okay.

The other side is that I crave interesting critical patients, and I feel like travel nursing will not give me that often. I may not be able to handle being floated to tele or med surg often.

It sucks that sometimes in life opening one door means closing another. I doubt I'd do travel nursing after getting higher acuity experience when I'd be more likely to pursue flight nursing after that.

I may just see where the wind takes me. Either way I feel like I am not going to be learning much more at my current hospital and have to decide what's next very soon.

[guest769224]

You ought to consider taking a travel position in Northern California (Bay Area, Sacramento region), and upon completion of assignment, submit an application or request to be hired as staff. You'd really have to shine during your contract of course. But the hospitals in that area have the best working conditions for nurses in the world.

High pay, $80/hr + in some areas, especially Kaiser Permanente

California ratio laws, guaranteed breaks/relief

Progressive, advanced healthcare

Very strong, watchdog CNA union in place

And geologic wonders in nearly every direction to travel to.

That's a goal of mine...and a lot of travelers have started off as contracted in California and then switch to staff. It seems to be a good strategy. Just something to think about.

Also, I have been an ICU nurse for 2.5 years now, and considered traveling right at my 1 year mark. However I stayed staff, and at my 2 year mark I felt significantly more competent. You could go at 1 year, but your skills will be more solid if you were to wait.

Good luck

[ScottMedicRN]

I appreciate the idea, but California is not for me.

Also, I feel like my skills won't be going growing at my current hospital. I need higher acuity.

[Argo]

I dont find travel as something to grow your nursing experience on for critical patient care. It will grow you as a person with more diverse ability level, career wise. Travel for the life experiences more so than the career building experience.

OR is a little different since they will contract us to do transplant, CV and trauma specifically. Even at the easier contracts they will put experienced travellers in the more difficult rooms.

[ScottMedicRN]

Chris, could I have your contact information?

[ChrisMMS]

You may Scott I've sent it to you in a private message let me know if you got it.