Health Care Professional
Transcription
Health Care Professional
Table of Contents Acknowledgement Introduction: What is it worth to you? . . . . . . . . . . . . . . . Page 5 Chapter 1: The Essence of an Elite Traveler. . . . . . . . . . . . Page 7 Chapter 2: Travel Nursing as a Career. . . . . . . . . . . . . . . Page 10 Chapter 3: Emerging Travel Nursing Trends . . . . . . . . . . . . Page 16 Chapter 4: Your Money Mindset . . . . . . . . . . . . . . . . . . Page 22 Chapter 5: Do You Have What it Takes? . . . . . . . . . . . . . . Page 31 Chapter 6: The Power in Preparation. . . . . . . . . . . . . . . . Page 36 Chapter 7: The Fine Art of Recruiter Relations. . . . . . . . . . . Page 50 Chapter 8: Hot Spots for Travel Nursing. . . . . . . . . . . . . . Page 53 Chapter 9: Capitalizing on the Health Care Traveler’s Lifestyle . . Page 63 Chapter 10: Unforgettable Luxury Housing. . . . . . . . . . . . . Page 67 Chapter 11: What to Do with All That Cash you Stashed? . . . . . Page 74 Chapter 12: The Lucrative Business of Travel Nursing. . . . . . . Page 76 Appendix Appendix A: Travel Nursing Forums and Blog Sites. . . . . . . Page 80 Appendix B: Travel Nursing Magazines . . . . . . . . . . . . . Page 81 Appendix C: State Boards for Licensure and Endorsement. . . Page 82 Appendix D: Nurse Licensure Compact States . . . . . . . . . Page 83 Appendix E: States with No State Income Tax. . . . . . . . . . Page 89 Appendix F: The Agency Structure. . . . . . . . . . . . . . . . Page 90 Appendix G: Hospital Interview Guidelines . . . . . . . . . . . Page 94 The Elite Traveler: The Lucrative Business of Travel Nursing 2 Back to index... ACKNOWLEDGEMENT I dedicate this book to all the lives I have touched and all the lives that have touched me throughout my travel career and therefore contributing tremendously to this project. My most sincere gratitude to my mother for accompanying me for the countless 1,450 mile drives to and from South Florida on more occasions than we care to admit to although we said “never again!” after the first trip. Thank you for the soothing hot cup of Lemon Zinger tea when I needed a break while writing, what would later be, the beginning of the very first chapter of this book. I can’t thank you enough for your support and encouragement. I’d also like to thank my close friends and family in New York for all the joyous memories while on assignment in the city and for visiting South Florida when I needed my family most. A special thanks to the amazing travelers, all of whose cheeky humor, to the point of tears, has led to exceptional experiences and fantastic friendships along the way. To the Monsoon Internet Marketing Group who has shown an undying commitment to my success and how to go “from good to great” in this endeavor. You all have left such lasting impressions which I will forever cherish. The Elite Traveler: The Lucrative Business of Travel Nursing 3 Back to index... What Is it Worth to You? The Elite Traveler: The Lucrative Business of Travel Nursing 4 Back to index... Introduction: What Is it Worth to You? Are you ready to catapult your life and career into a world of endless vacations and a potential six-figure salary while challenging yourself with fantastic new experiences? Are you ready to be a part of the elite group of free-spirited nurses nationwide who are taking charge of their lives and nursing careers to conquer/ tackle their life goals and financial dreams? Well then, welcome to my world! The vibrant career of travel nursing affords you the opportunity to create the lifestyle you’ve always wanted, on your terms, while enjoying new, relaxing and captivating cities. With travel nursing, you don’t have to wait until you’re retirement eligible to vacation for three months in Europe. Rather than working at the same hospital throughout your entire career, with the same coworkers day in and day out, waiting years for a promotion or a new position to open up in another department, travel nursing offers a new and exciting assignment every three months. And, you’re in charge of selecting the assignments that are most appealing to you. Travel nursing provides an excellent opportunity to gain experience in a variety of specialties as each assignment adds depth and diversity to your resume. uu Do you enjoy expanding your inner circle of friends and acquaintances by meeting new and interesting people? uu Are you a traveler at heart? uu Do you thrive off of new adventures, sightseeing and learning about different areas of the United States and abroad? uu Does your perception of the cost of frequent traveling hold you back as you consider newfound experiences? uu Do you feel stuck in a position where your current pay is unlikely to allow you to live the lifestyle you deserve or allow you to save up a nest egg for a rainy day? If you answered yes to any of these questions, then traveling as a healthcare professional, may be right for you. Travel nursing provides an excellent opportunity to create an ever-widening and diverse group of friends from across the United States and around the world! You can enjoy learning from those you meet and work with and gain an appreciation for differing perspectives and ways of life. Developing new relationships of varying levels amongst new friends and co-workers can provide The Elite Traveler: The Lucrative Business of Travel Nursing 5 Back to index... an enriching dimension to your personal and professional life. Travel nursing not only provides the opportunity to see new cities, but to truly get to know the area and people who live there. You learn much more about an area, its unique features, culture, and people by living there and truly becoming a part of the community— even if for a limited time. You aren’t just a tourist rushing to see the sights in a couple of days. Instead, you will be immersed in the local community and culture, learning from your own experiences and from those with whom you live and work. You’ll never be able to travel throughout the United States more economically than you will as a travel nurse! Visit areas of the country you think you’d enjoy living in before pursuing a permanent position, take a mini vacation as an escape from the mundane, and be free to govern your career by making more money and working less. With considerably higher pay rates than those typically seen for traditional employment, travel nursing can provide the financial stability you need for both an enjoyable lifestyle and a bank account bursting at the seams. So what is it worth to you? More time to yourself and with your family, less stress, a hefty financial cushion to go along with those amazing vacation plans you’ve had in mind for quite some time now? Or, perhaps, professional growth? Now is the time to take advantage of your versatile career in healthcare and make it work for you. As a nurse, you give of yourself daily to care for your patients, why not give to yourself and experience the lucrative lifestyle/ business of travel nursing? The Elite Traveler will guide you through making the most of a career in travel nursing. Let me show you how! The Elite Traveler: The Lucrative Business of Travel Nursing 6 Back to index... Chapter 1: The Essence of an Elite Traveler Do you remember the day you decided to become a health care professional? Take a moment to recall that turning point in your life when becoming a member of the healthcare industry was a passion that burned within. There are many Elite travelers across our nation and across the world that share the same vision, the same personal responsibility to achieve a greater good for all mankind, to see the best in individuals of all creeds and cultures by providing non discriminatory care to those in need. It’s a personal virtue to succeed in the art of caring. It’s evident in all we do. The magnanimity of hearts The loftiness of minds Nurtures all things that grow It harmonizes and unites Through our eyes the intent of our souls ~ Paramahansa Yogananda When I Chose my Career Path I recall, at the tender age of 15, babysitting for my neighbor. She was a working mother with a one-year-old son Andrew and a newborn daughter Samantha, both as beautiful in my eyes as a clean crisp Fall day in New York. Bundles of joy who make you warm and cozy inside like being bundled up in a pea coat and scarf. As I routinely would, I eagerly awaited 7 a.m. for the children to wake. However, I noticed Samantha wasn’t resting as soundly as usual. She tossed and turned and simply wouldn’t settle. I laid her on my chest and sound asleep she fell. She was very warm to the touch so I undressed her, keeping her diaper on to avoid any potentially unfavorable accidents, and laid a blanket over top of us. Thinking she would now rest well, I attempted to put her down. No such luck. She, again, fussed and seemed uncomfortable. After about an hour I phoned her mother and suggested Samantha see a pediatrician. I was then, even at the young age of 15, able to pick up on the nonverbal cues even the tiniest of beings could relay in an effort to communicate. She was taken to a pediatrician that afternoon who diagnosed her with otitis media, an ear infection. That was the day I decided to become a pediatric healthcare professional. I’m sure you have a similar story, and I’m willing to bet that’s not all we have in common. The Elite Traveler: The Lucrative Business of Travel Nursing 7 Back to index... Qualities an Elite Traveler Should Possess The Essence of the Elite Traveler is more than going to work and clocking in and out—it’s compassion. It’s delivering a new life. It’s the feeling you get when you put on a hair bonnet, surgical mask and booties. It’s finding joy in scrubbing your hands for three minutes from your fingertips to your elbows, backing into the OR door and drying off with a sterile towel. The excitement that comes with donning the sterile gown as the scrub nurse affixes the ties in the back and you unfold the sterilized baby blanket. The exhilaration you feel with an umbilical cord clamp and sterile scissors in hand awaiting the bundle of joy who has failed to progress. Happy birthday! It’s taking the time to read a get well card sent to the unit for Helen, a patient with Sundowners Syndrome and dementia, recovering from a total hip replacement that is wheeled out into the hallway in her Geri Chair at night so the nurses can keep her company. The darkness for her is frightening. Her catalog of life experiences was truly amazing. It’s comforting the pre-operative patient as best you can prior to surgery; taking the results from the pre-operative labs to the surgeon, checking for allergies, making sure their personal belongings are with a family member who will be awaiting their safe recovery from anesthesia. Off to the OR we go. Cap, mask and snow shoes. Bovie patch, scratch, tip. Allis, Babcock, Crile, curved Criles and Kellies, DeBakey, Army Navy’s, Kocher’s, Deaver retractors and Mayo scissors. Can I have a 2.0 silk, please?! With the hopes her recovery will go fairly well…it’s time for a safe transfer to the stretcher post closure, ensuring the patient is comfortable and off to the Post Anesthesia Care Unit. The essence of the Elite traveler is serving as the definitive resource in your specialty. Remain up-to-date and knowledgeable of the changes that have come and gone to enhance patient care and provide modern medicine as it evolves. It’s important to participate in clinical trials and research developments to learn about new technologies and cutting edge treatments. Subscribe to a medical journal in your specialty. You can often find the latest issue of any given journal at your local library in the medical references or periodical section. Take the opportunity to read a few articles that may interest you and perhaps provide some insight into tailoring your patient care. Additionally, subscribing to your specialty-specific organization will show your dedication to your profession. The Elite Traveler: The Lucrative Business of Travel Nursing 8 Back to index... Keeping abreast of ongoing research studies will give you the opportunity to present options to your current facility and department to perhaps implement a new protocol when caring for your newly admitted patients. Always stay true to your inner voice as a patient advocate and do what’s right. Your virtuosity will not go unrecognized and you will be respected for a job well done. You’ll ensure excellent references and clinical evaluations by being a team player who also has the ability to work independently. Lastly, live by the 5 Tools for Travel Nursing Success: Diversify Your Funds: Increase your knowledge base to increase your marketability to ensure ongoing travel nursing opportunities and keep the cash flowing. Maintain a Lucrative Mindset: Change the way you view opportunity. In order to succeed in travel nursing, you will no longer think like a staff nurse with limited options; you must train yourself to think as a travel nurse on a more global scale. Keep Energized: Create a fitness regimen to include restorative sleep and a well-balanced energy-boosting diet for your long, 12-hour shifts. Power in Preparation: Set yourself up for success. Get organized! The Fine Art of Recruiter Relations: Manage your life and day-to-day communications with your recruiter. The Elite Traveler: The Lucrative Business of Travel Nursing 9 Back to index... Chapter 2: Travel Nursing as a Career The Nursing Shortage Nursing has evolved over the years both in terms of the practice of nursing and the career opportunities available to nursing professionals. With each nursing shortage and during times of war, nurses have continued to rise to the occasion. We now realize that many of the greatest advancements and achievements in nursing have been connected with war time and recession. Nursing has created so many opportunities for us to serve and care and to become the strong, independent leaders we are today. We must take an active role in the implementation of a strategic plan to overcome the future of our profession. According to the U.S. Department of Labor, Bureau of Labor Statistics, Registered Nurses constitute the largest healthcare occupation with 2.5 million jobs—59 percent of which are in hospitals. The Bureau also says the largest health care industry, hospitals, will grow slower than that of other industries due to the early discharge (< 24 hours) and more outpatient procedures. To the contrary, home health care, outpatient facilities and offices of physicians are expected to grow 34-39 percent. As baby boomers age, so does the nursing population—leading to a retirement boom slated to occur between 2011 and 2020. With the average age of the Registered Nurse population documented by the National Sample Survey of RN’s by the Federal Division of Nursing as being 46.8 years in 2004, 40 percent of Registered Nurses are well over 50 years old. This means younger people must enroll at the same rate annually in order to replace the expected number leaving the workforce. In an effort to unite the professionals that make use of healthcare products and pharmaceuticals along with the community that receives them, the Johnson & Johnson family of companies began their commitment to the healthcare community in 2002. With the increasing number of vacancies in The Elite Traveler: The Lucrative Business of Travel Nursing 10 Back to index... nursing, Johnson & Johnson championed a multi-year $50 million national initiative to, according to their website, “enhance the image of the nursing profession, recruit new nurses and new faculty, and help retain nurses currently in the profession.” They feature real nurses whose stories of compassion and heroism are poignantly defined within two comprehensive websites — www. discovernursing.com and www.campaignfornursing.com. As the Johnson & Johnson campaign states: “Today our nation faces the most profound shortage of nursing professionals in its history.” The current lack of professional nursing staff is here to stay with many professional bodies predicting an even more severe shortage to come. Take a look at these shocking statistics regarding the current state of the nursing shortage: uu According to a 2007 American Hospital Association report, U.S. hospitals need approximately 116,000 registered nurses to fill vacant positions nationwide. uu Based on findings of the Nursing Management Aging Workforce Survey, 55 percent of surveyed nurses reported their intention to retire between 2011 and 2020. uu The University of Pennsylvania Council on Physician and Nurse Supply, has determined that 30,000 additional nurses will need to graduate annually to meet the nation’s healthcare needs, which represents an increase of 30 percent over the current number of annual nurse graduates. uu According to the U.S. Bureau of Labor Statistics, nursing is the nation’s top profession in terms of projected job growth with more than one million new and replacement nurses needed by 2016. The shortage is not confined to the U.S. According to Associate Professor Amanda Kenny of La Trobe University, Australia, the main causes of the current and continuing shortage include “the exponential increase in the aging population, the burden of chronic disease and the significant workforce scarcity.” With the need for qualified staff on the rise, now is the ideal time to take advantage of this shortage and consider the option of travel nursing to meet the high demand for skilled professionals across the country. If you are seeking to either develop your career, or to change locations while greatly benefiting both professionally and financially, travel nursing is for you. How I Learned about Travel Nursing as a Career Six months after graduating, while on staff at the University of Rochester, I was pod mates with Heather taking care of six newborns for our 8-hour day shift. As the day went on we became more acclimated to one another and began talking about how long she had been nursing at the hospital. The Elite Traveler: The Lucrative Business of Travel Nursing 11 Back to index... Shortly thereafter, she mentioned how she had lived in upstate New York her entire life and was ready for a change. “Where are you looking to move?” I asked puzzled. At the time, I was perfectly happy in upstate New York, why would anyone want to leave such a peaceful and beautifully green city? Her response was one of uncertainty. She wanted to perhaps travel as a nurse to North Carolina where some of her close family members had moved in recent years, but was afraid to leave her immediate family behind. She was obviously torn between seniority of seven years at UR and giving in to experiencing the unknown. The following day, I was on my two-day stretch of “days” off and headed to the downtown library to do some research. I was determined to see what travel nursing was all about. Several months later, I began looking for a travel nursing assignment in South Florida. A close friend and neighbor had moved to Palm Beach the year prior and I missed her dearly. I figured I would find an assignment in South Florida for the summer, hang out with her and catch up on old times. And so began my travel nursing frenzy. I wasn’t for sure at the time but I could only imagine how different travel nursing was going to be from the staff job I had back in New York. Based on the contract I signed, there were no 8-hour days backed with 12-hour night shifts. No fighting icy roadways and slick bridges in the dead of Winter. No sir! There were no politics of seniority and no more settling for vacation dates I didn’t really want because some tenured nurse, who had been there 25 years, wanted to take that exact week to catch up on her Danielle Steel collection. Plus, there was my own health to think of. Within months of starting a full-time position in my dream specialty of Neonatal Intensive Care, I began experiencing tremendous stress from not sleeping and eating properly. I soon found myself at my primary care physician’s office complaining of headaches that didn’t seem to go away after countless milligrams of ibuprofen, eating, sleeping, hydrating beverage after hydrating beverage and they only continued to get worse. Soon I discovered that MSG, raspberries and an inconsistent work schedule left me with debilitating migraines. As a healthcare traveler, the mindset is entirely different. You learn to place value on what’s really important. My knowledge and expertise led the way for my reputation as a travel nurse, not the nurse who complained about not having a 1cc heparinized normal saline flush cosigned when trying to maintain the central venous catheter port patent as indicated on the MAR. What a headache. Travel nursing was the way to go. The Elite Traveler: The Lucrative Business of Travel Nursing 12 Back to index... The Response to the Nursing Shortage Why do hospitals utilize healthcare staffing agencies? With the costs of healthcare constantly increasing and hospital budgets not keeping up, hospital administrators have to make decisions about where their budget dollars will be most effective. As a result, they choose to let staffing agencies incur the costs of payroll, education, housing, travel, and benefits. So it may be that a nurse you see in a hospital for a few weeks, the one who acts like they’ve been there for years, is actually a seasoned travel nurse who has been assigned to the floor for a short-term assignment. Travel nursing began as a seasonal substitute due to the increase in population during the winter months in the Sunbelt states. As individuals escaped from the frigid winds and heavy snows of the Northern states, hospitals in those areas saw a steep incline in care. As the beds filled, the hospitals needed a plan to increase nursing staff. Hospitals began to hire nurses for temporary employment a few months out of the year until the seasonal citizens returned to their permanent residences back North. Recruiting nurses proved rather easy to do. Nurses who signed up for the jobs may be from the same northern areas and welcomed the break from the drudgery of snow and slush. The work was challenging, but the nurses became tourists on their days off. The trend soon caught on as a solution for nursing assistance across the country. As Travel Nurses Now states, “Countless travel nursing agencies have since emerged, making thousands of positions available to qualified nurses across the country.” Within the past decade, travel as a healthcare professional has been an increasingly popular option and has expanded rapidly for qualified nurses looking for career moves, financial security and the pleasures of a traveling lifestyle. Hospitals are finding that not only does outsourcing fill the gaps when they arise, but it also benefits them financially. David A. Manko, author of the article, “Hospital Outsourcing Continues To Expand” in Hospital Newspaper, explained that outsourcing is attracting more and more media attention as corporations across the country outsource an increasing number of jobs formerly held by permanent employees in an effort to cut costs. With the ability to hire staff only as needed, the travel nursing business befriends the finances of many major hospitals in the U.S. Today, the combination of filling vacancies and saving money continues to strongly attract numerous hospitals to the travel nursing market irrespective of the economic climate. The Elite Traveler: The Lucrative Business of Travel Nursing 13 Back to index... In his article, David A. Manko also confirmed that both hospitals and physicians are recognizing that outsourcing can be a win-win situation. Once hospitals regard outsourcing favorably and start experimenting with hiring medical staff on a temporary basis, they realize that it works very well for them, which encourages them not only to continue with it but also to depend on it more heavily. By 2006, many hospitals which were looking into employing other medical staff were realizing the benefits of outsourcing. With baby boomers reaching the age group which needs health care most and with people living longer due to advances in medical treatment, the travel nursing business can only be looking toward stronger growth as the need for more nursing staff continues to increase exponentially. Change in Career Path for Male Nurses An article published on July 17, 2007, illustrated a new trend in nursing. The article titled “Men Shift Career Focus to Travel Nursing,” revealed that roughly 13 percent of student nursing graduates are males. Nursing organizations and travel nursing employers around the country are attracting more men to the female-dominated nursing profession with innovative recruitment tactics and lucrative salary and benefits packages. Now that the recognition and encouragement to join the nursing profession has been openly offered to the male population, it is interesting to note that there has been a gradual increase in the number of men considering this career. The Department of Health and Human Services claims that the figure of male nurses has risen from 2.7 percent in 1980 to 6 percent in 2007. Even with this increase, there remains a large gap between the available qualified nursing staff and job vacancies. What Companies Offer There are currently more than 350 travel nursing companies across the U.S. assisting more than 25,000 registered nurse travelers. Each of these companies is on a continuous mission to recruit and retain high-quality, experienced nurses. Nurses are offered short-term employment positions at various in-need locations in exchange for a higher salary, bonuses, PTO programs, the same benefits as full-time permanent positions and a flexible schedule to help avoid a potential burnout. Some agencies even offer guaranteed pay programs where you still receive full pay even if a shift is cancelled. It’s important to understand how guaranteed pay for the hours contracted to work will help you, as housing costs, daily allowances and other incentives are based on full-time hours The Elite Traveler: The Lucrative Business of Travel Nursing 14 Back to index... worked per week. If hours are not complete due to low census or cancellation but your contract indicates guaranteed pay, taking the time off is OK. However, be sure to document your availability to work for each additional day of the pay period. Otherwise, if you do not have the leeway to take the time off, then be clear that you need to maintain full-time hours to fulfill your obligation to the travel nursing company. Completion bonuses are also offered and range from $500 up to $5,000 for assignments lasting 13 weeks. Travel or relocation allowances are frequently provided as an added feature. Other advantages of travel nursing include health and dental insurance, referral bonuses, tax benefits, 401k, as well as a basic vision plan, life and professional liability insurance. Also found amongst several company incentives are free quality housing, free continuing education, 24-hour support, credentialing assistance and tuition discounts. So the opportunity for you to create a new and improved career as a travel healthcare professional awaits you. Why not take the initiative now to contribute to the recovery of the nursing profession all awhile creating new and cultivating experiences. The Elite Traveler: The Lucrative Business of Travel Nursing 15 Back to index... Chapter 3: Emerging Travel Nursing Trends The Future of Travel Nursing The U.S. Bureau of Labor Statistics projects that jobs in the field of nursing will increase by at least 23 percent by 2016 and that the shortage of qualified nurses available to fill those positions will be even greater than it is today. In 2005, there was a shortage of 116,000 nurses. That number is expected to grow to 800,000 by 2020 leaving ample openings for experienced nurses who are willing to travel. With the new medical technologies that are being developed, the shortage is expected to grow even higher in specialty nursing practices. With more than 200 specialties available in a career field that has one of the most stable employment outlooks, you can imagine the effort needed to recuperate the expected loss. Yet, after all these years, hospitals have not yet figured out how to combat frequent demands of overtime, rotating shifts of nights and weekends and on-call hours. All these issues are contributing factors to stress, burnout and, ultimately, a high turnover rate. Employment of registered nurses by hospitals is slated to rely on foreign educated nurses as well as temporary employment to fill staffing needs. As the demand for nurses grows, temporary nurses will be needed more often, leading to a growth in the employment services industry. The American Hospital Association reports current vacancy rates in some hospitals as high as 19 percent for full-time Registered Nurses. So what are travel nursing companies doing to attract the attention of potential Registered Nurse candidates and keep their travelers on board? Let’s take a look. The Elite Traveler: The Lucrative Business of Travel Nursing 16 Back to index... Top 5 Recruitment and Retention Tactics for Travel Nurses With the looming shortage of nurses nationwide, it’s no wonder healthcare staffing agencies are finding it increasingly difficult to fill the overwhelming number of nursing positions currently available. Nurses who wished not to brave the storm during the downward turn of the U.S. economy over the last three years found themselves quickly foregoing the luxury of freedom, turning to safety and security. It’s expected by the year 2018 nearly 600,000 new RN positions will be created, therefore increasing the volume of the RN workforce by an astounding 22.2 percent according to the December 2009 Workforce analysis by the Bureau of Labor Statistics. In turn, every effort is being made by each and every travel nursing company throughout the U.S. and abroad to come up with innovative ways to retain their nurses. I guarantee their creativity will be a win for you. Respect and Open Communication The number one factor in recruitment and retention is respect and communication. Nurses want to know that their work is appreciated and, if they have a concern, they have someone they can count on to hear what they have to say. Nurses also need to know that they are important to their employer and that if they are giving their best they will get the best in return. Recruiters who understand the stress that comes along with a career in nursing and leave an open line of communication between themselves and the travel nurse they are representing stand to retain the most clients. If you feel like your recruiter is working with your best interests in mind and really listening to your needs, you will be more likely to stick with him or her for your next assignment. Allowing for Assignment Flexibility Flexibility is essential. Travel nursing offers you the ability to accept or reject assignments based on a number of factors, including rate of pay, geographic location, specific facility, and many more. It also offers you the ability to safeguard your professional license if you find that the facility is not living up to their end of the bargain. If a staffing agency is on the ball, they will take their employees’ concerns seriously as they have an obligation to ensure that an employee’s assignment is what was contracted and that the employee is being treated well. A good recruiter or travel nursing company will never pressure you into taking an assignment you don’t want or staying on assignment at a facility that doesn’t live up to your standards. The Elite Traveler: The Lucrative Business of Travel Nursing 17 Back to index... Competitive Compensation The third-highest determining factor in employee satisfaction amongst healthcare travelers is salary. Compensation for work done and work done well can mean the difference between a happy employee and one who could easily leave a job. Nursing has been a traditionally low-paying, time-intensive, and high-stress job—until recently. If you are an experienced nurse with a great employment history and the ability to prepare and adapt to most any situation, recruiters are going to want to keep you. Don’t sell yourself short in the negotiation process. Comprehensive Benefits Benefits are number four on the list of employee recruitment and retention tactics. Some agencies provide immediate access to healthcare and retirement benefits and compensation for housing and utilities. Some companies will also reimburse expenses for travel to and from an assignment. Because healthcare staffing agencies don’t want to lose great employees, once you have proven your value to the agency, you’ll be able to negotiate some additional or enhanced benefits. Complimentary Continuing Education Free education is the fifth tactic for recruiting and retention of travel nurses. Continuing education is a necessity in the field of nursing from licensure renewal to specialty-specific credentials. It can also be quite expensive if a nursing professional has to pay for it out of his or her own pocket. Expanding your knowledge base opens up more assignments for you in the future, as well as ensuring a top-notch pay rate for those assignments. This tactic is a win-win for both travel nurse and recruiter and has the potential to persuade a travel nurse to sign on or forge a long-term commitment with the agency. Travel Nursing as a Mainstay During Trying Economic Times America is in the middle of a financial crisis and, believe it or not, it is the perfect opportunity for nurses to meet healthcare needs across the country and to profit from travel nursing assignments. During tough economic times, stress takes its toll on everyone. There is an increase in poor nutrition; the population feels there is no longer money for fresh fruits and vegetables and focuses on less expensive and less nutritious food. Stress affects every part of the body and frequently results in increased smoking and alcohol consumption, which often leads to illnesses that require immediate medical attention as well as hospitalization. Concurrently, there is less money for entertainment and eating out; crime increases as does the number of pregnancies as more couples are spending more time at home. So during a financial crisis, unlike many other career The Elite Traveler: The Lucrative Business of Travel Nursing 18 Back to index... opportunities, the demand for nurses increases. While unfortunate for America, a nurse can take advantage of the opportunity gap and profit tremendously from the travel nursing industry. Get In, Get Out and Get Paid! “Get In, Get Out, and Get Paid” has long been my motto. Are you captivated by dollars or intrigued by cents? Travel nursing offers a lucrative world of opportunity coupled with the exuberant lifestyle of an Elite Traveler. The wave of travel nursing has changed significantly since the mid 1980’s. It is soon to become the emerging trend within the healthcare industry and the fast track way to earn the most money in the shortest period of time. I have worked eight months a year with four months to vacation as I chose with amazing salaries and reimbursements. Because of the current state of the economy, many facilities are unable to forecast far in advance and find themselves less willing to offer up a three-month assignment. However, they are willing to look at four-, six- and eight-week assignments. Oftentimes these assignments are extended, if not renewed, as they continue to bring additional travelers on board. Traditional travel nursing companies are now looking toward the future with this economic crisis at hand, offering rapid-response contracts to picket lines and strikes as well as guaranteed 48-60 hour work weeks with shorter contracts in tow. Per Diem rates for daily meals are also crucial. Working 60 hours a week, who has time to cook? Agencies such as Fastaff, Cross Country Trav Corp’s First 48 and CRU offer exponential hourly rates, guaranteed overtime and weekly pay. Any way you view it, ultimately, the money matters! So whether you are a new graduate or a seasoned staff nurse, pay close attention to the information provided and you will instantaneously see that your time is a huge proponent of your financial success. The idea is to condense the amount of time spent yet yield a much larger financial return. Staten Island Although I enjoyed each and every assignment, by far, one of my most rewarding assignments was in Staten Island. At the time, a close cousin was getting married in Long Island the weekend following the completion of my NICU assignment in Westchester, NY. I arrived promptly at 7am on the unit for orientation and met the Nurse Manager; a New Yorker through and through— hysterically funny and easy going. We discussed my shift availability and preferences and began creating a schedule. Something I hadn’t experienced in previous assignments: a Nurse Manager who understood that her nurses have lives. On this unit, everyone worked well together to not only accommodate the unit needs, but each other’s needs also. I simply mentioned that I had the wedding of a lifetime to attend that upcoming weekend and I’d like to have The Elite Traveler: The Lucrative Business of Travel Nursing 19 Back to index... the following Monday off to spend with my family. Without missing a beat she replied, “Sure, no problem, take as many days as you need.” I thought, wow! Who wouldn’t want to work for a manager like that? I couldn’t have asked for a better assignment. Not only was I close to family and lifelong friends, I could take the Staten Island Ferry or a twenty minute train ride from New Jersey for a quick trip to lower Manhattan and even hang out in Short Hills, NJ. But, who knew that working 48 hours a week would prove to be so lucrative. What’s one extra shift per week? At a base rate of $38/hr for 40 hours and time and a half at a rate of $57 for the remaining eight hours—you do the math. I was making $2,065 weekly. Don’t believe me? Take a look at one of my paychecks. On staff, it would have taken me 117 hours or three weeks to make the amount of money I made in 48 hours or one week on assignment as a travel nurse in Staten Island. How amazing is that?! Really and truly, for each week worked in Staten Island, I could have taken two weeks off from the staff position I had previously. So again, let’s do the math. For an eight-week assignment, I could take off 16 weeks or four months and spend the summer down under in Australia! To top it all off, the staff was great to work with, accommodating, always willing to help and a ton of fun no matter which shift I worked. Ultimately you are leveraging/maximizing your time to your financial gain, therefore freeing up even more time to capitalize on an additional short-term contract. In the end you will have earned twice as much money in two thirds the amount of time than a traditional travel assignment. If 60 hours per week The Elite Traveler: The Lucrative Business of Travel Nursing 20 Back to index... is a bit much, there are also 48-hour guaranteed assignments in which you are simply adding one extra shift per week. There are windfalls of profits to be made with travel nursing so choose to Get, in Get Out and Get Paid. Increase Your Marketability! The next trend that is ongoing but resurfaces during trialing economic times is the need for you as a travel nurse to broaden your horizons. This is what I call: Diversifying Your Funds, Elite Traveler Tool #1. If you prove you have the ability to care for a broader patient population, you’ll be more likely to get the position you want. Expand your options within your subspecialty to increase the number of ways in which you can add cash flow into your pocket. Secondary specialties offer you the opportunity to increase your marketability to travel nursing companies, affording you a wider array of travel opportunities. For example, I am a Neonatal Intensive Care Nurse by trade; however, to broaden my knowledge base, I went through orientation and gained a full-time staff position on a Postpartum, Mother/Baby unit. Caring for the newborn came rather easy; however, learning how to organize a postpartum check was priceless when asked to float to Mother/Baby while on assignment in Chicago, IL. Hospitals are not only looking for travelers with strong intrapersonal skills, but also travelers with strong clinical skill sets who are willing to float to a similar unit. This is key in alleviating potential contract constraints with unpredictable census fluctuations. You will find many facilities request, in their position summaries, the need for a traveler to fill a Pediatric ICU position who must also be able to float to the Cardiovascular ICU with a pediatric case. As healthcare professionals, we know how important credentials and certifications are in keeping current with national protocols and the delivery of up-to-date patient care. By doing so, you automatically set yourself apart from the rest. So, imagine wanting to travel to Colorado or Utah in the winter to learn how to ski for the very first time, and to your amazement there are two assignments: One in Salt Lake City, Utah on an Adult Hematology/Oncology unit and the second on a Pediatric Oncology floor in Denver, Colorado. Having a solid knowledge base to excel in either unit, which would you choose? By broadening your level of expertise, you now have the ability to choose where the fun begins! Take the time to invest in yourself. Use your knowledge to delve into endless possibilities and travel opportunities. Pave your own way throughout the travel nursing industry and multiply the number of available assignments at your fingertips. The Elite Traveler: The Lucrative Business of Travel Nursing 21 Back to index... Chapter 4: Your Money Mindset Determining Your Financial Future What Are Your Financial Goals? What are your fundamental views of money? “Money is the root of all evil.” Do you agree or disagree? Money allows you to forge a sense of self and help others along the way. Do you agree or disagree? Either way, the choice is yours. Either way you’re right. So let’s dive right in and take a look at your current salary. Are you really content with your current annual salary, coupled with mandatory overtime and on-call shifts? Are you managing to simply sustain your current lifestyle by paying the bills and perhaps saving a few hundred dollars for an emergency? Ask yourself: am I living or existing? Undeniably, there is a vast difference between the two. Ask yourself: what do I want to be worth? Do you want to be worth $75,000 in a year to two years? Don’t you think it’s about time you break out of the mundane and into an extraordinary life? You can and will by having and implementing a successful money mindset, Elite Traveler Tool #2. Your money mindset is a combination of your successes and failures to date, your underlying fears, as well as your earliest education in money management. In large part, your behaviors are established from modeling the behaviors and thoughts of those who surround you. Take a moment now to think about your overall view of money. What are your beliefs, thoughts and values when spending, earning and investing? What Does Money Mean to You? What purpose does money truly serve within your daily life? Is the thought of having an abundance of money a lingering concept or an attainable truth? Are you captivated by dollars or intrigued by cents? The significance of money ties into where those learned behaviors of your youth have led you today. Is money simply a means for exchange or does money have a more profound meaning in your life? To some, money signifies a level of freedom allowing you to express yourself freely and to truly live your best life. It enhances your personal sense of self and allows you to help others as well. There are varying reasons why having increased cash flow yielding disposable income ranks as a top priority to most; however, it is essential for you to determine why having additional income is meaningful to your life. The Elite Traveler: The Lucrative Business of Travel Nursing 22 Back to index... Despite where you currently find yourself, overall, your money mindset sets you apart from hypothesized goals to those in the forefront of attainable truths. The goal here is to improve your way of thinking and learn how to optimize your earning potential. Changing your mind to change your life is the key to financial success/freedom and I will show you how. 4 Steps to Reveal and Achieve Your Money Mindset First and foremost, the most important step to gaining financial freedom is to: Step 1) Acknowledge and raise your awareness of your current level of thinking when it comes to money. Raising awareness allows you to bring your unconscious behaviors to the forefront of your mind, resulting in a more deliberate state of action within your day-to-day life. You need to be comfortable and aware on a conscious level to what your ideas of success are to prevent yourself from unconsciously sabotaging your dreams. Take the following quiz to begin outlining and clarifying your financial goals: Which statement best describes your current financial situation? a) I am quite satisfied. b) I am moderately satisfied. c) I am not satisfied at all and unsure of what to do. d) My current financial situation is unacceptable, how do I achieve more? What are your financial dreams? a) Winning big in the lottery. b) Getting and keeping a good job with health benefits and ample vacation. c) Owning my own home despite the current condition of the housing market. d) Having a tremendous cushion in a savings account or other investments. Think of the last major financial decision you made, what were your feelings? a) Unsure of what I had just done, regretful. b) My mind was racing and my pulse was elevated. c) I didn’t ask enough questions and I skipped over all the details. d) I was confident and relaxed. If faced with a difficult decision, what do you do? The Elite Traveler: The Lucrative Business of Travel Nursing 23 Back to index... a) Brush it aside with the hopes it never returns. b) Complain to those closest to me. c) Delegate the task to someone else. d) Brainstorm to come up with an innovative solution. How much money would you like to make this year? a) $60,000 - $70,000 b) $70,001 - $80,000 c) $80,001 - $90,000 d) More than $90,000 Your score and how you rate: Total up your score: give yourself 1 point for each A, 2 points for each B, 3 points for each C and 4 points for every D. Find your score in the chart below to see how you rate. Number of Points 5 How You Rate You definitely have very limiting thought. This is ok; let me help you move from the scarcity mindset to the money mindset. 6-10 You’re on the right path, but could use a little more clarity of vision. 11-15 With a little fine tuning you are well on your way to reaching your full potential. 16-20 Congratulations! What you believe you will achieve. Explanation of the Questions 1. Which statement best describes your current financial status? How eager and determined you are to gain and achieve success hangs in the balance here. Successful people have successful mindsets, are more motivated to make life-changing strides and are significantly more apt to stick to those strides. Your thoughts must support your expectation; otherwise, limiting beliefs will hold you captive in mediocrity or prevent you from achieving your dreams of success. If you are satisfied with your current financial state, what will encourage you to set higher goals and desire to achieve more? The Elite Traveler: The Lucrative Business of Travel Nursing 24 Back to index... 2. What are your financial dreams? This question analyzes your ability to think above and beyond your usual scope of thought. Take the initiative when determining your financial future, why leave this decision to chance? Remember, W. Clement Stone said: “Whatever the mind can conceive it can achieve.” This is an important concept to take with you throughout the course of this book. You must be able to envision yourself on a much larger scale and deter yourself from a limited mindset. 3. Think of the last major financial decision you made, what were your feelings? Confidence is a keeper! It’s not to say that all decisions will turn out to be the best decision ever made, however, it is key to have faith and confidence in the choices you make. 4. If faced with a difficult decision, what do you do? Often difficult decisions come along with trying times. How well you handle adversity is a telling sign of your level of success. You must logically analyze the situation and be able to allow your instincts to guide you. With anything, the key to growth and development is the ability to reach higher. Being inquisitive and adventurous to see what else is available to you takes action and a steady drive for excellence. Your mindset is the determining factor to any outcome in finances and in life. 5. How much money would you like to make this year? Did you choose the amount slightly above what you are currently making today? Snap out of it and stop limiting yourself! There are a windfall of profits to be made in the travel nursing industry. You have the potential to make more than $100,000, why settle for less? Many have difficulty envisioning something so far from their current state. It’s important to remember to aim high and that there is nowhere else but up! Scarcity Programming vs. Abundance Thinking Is this particular mindset helping or hindering you from achieving your goals? Having taken the quiz, how did you do? Do you experience a limited view of money within your life? More often one is taught to hold on tight to earned income for “money doesn’t grow on trees.” This is an example of what’s called scarcity programming. The scarcity mentality holds that there is only a finite amount of wealth in the world and that when one person gains, others lose. Scarcity is limiting, (just the word alone is traumatic) yet safe. Most people value safety over potential opportunity or risk. So part of the challenge here is to override your fear and to recognize that playing it safe will only lead to a mundane, routine, status quo, ho hum (I could go on) life. Start thinking that you deserve a quarterly raise and that there is an ample amount of money The Elite Traveler: The Lucrative Business of Travel Nursing 25 Back to index... available to you as well as others, and then you can start attracting what you wish into your life therefore creating abundance. Whatever you can imagine yourself having will come to fruition. Create an environment for yourself with uplifting thoughts and motivational goals that are realistically attainable. Step 2) Clarify your existing beliefs truthfully! If you have a few limited beliefs about money, improving your income will not become a priority for you. You must be willing to challenge and reformulate your belief systems to gain a clear and concise attitude about money. This will, in turn, help you establish your desired level of growth. If you don’t believe you have the ability to make more money, naturally you will continually remain in your present state. So why not make a change to fuel your expectations? Determine what your genuine objectives are so they are in true alignment with your core values. Clarity is power. The power in clarity will help you move through the challenges you may face and give you direction. Determine what moves you. Nowadays, the difference between good or great and success or failure is motivation. Motivation is your “get up and go”; your personal reasons why you make the choices you do in life. We all have the opportunity to achieve our dreams, but how clear you are on how and why is really important. Did you intend on being at the point of considering travel nursing as a career right now? It could mean a better way of life, a means to give back to others in your community, help your family, increase or promote your own sense of self through brand new experiences. Your happiness lies within your ability to live consciously and make continuous positive strides towards success. Give yourself a reason to push through. Are you motivated by the best pay? Are you motivated to relocate to an area where you’ve always wanted to live? What are some of the things that you dream of having, being and doing that are supported by financial gain? A place you’ve always dreamed of visiting, a memory of a lifetime you wish to create, or perhaps that one thing you’ve always wanted to learn. The Elite Traveler: The Lucrative Business of Travel Nursing 26 Back to index... Fill in the blanks below to give you a clear vision on your dreams and goals. Where would you like to explore?_____________________________ Where do you want to live?__________________________________ How much money do you want to make?_______________________ What do you want to buy that you thought you would never be able to?_ ________________________________________________________ Why are these things significant for you? ______________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ Are these things worth the effort to become a travel nurse? Now that you’ve determined what it is that you want, let’s establish the short-term goals that will help you achieve your dreams. The Focus Funnel is a modern day take on motivation. It outlines the fundamentals of clear thought and precision of action in four key stages. The Focus Funnel The Elite Traveler: The Lucrative Business of Travel Nursing 27 Back to index... As we have previously concluded, your mindset is the biggest piece of the puzzle when trying to make changes to your career goals. Your ability to succeed highly depends on how careful and skillful you are at establishing and maintaining a lucrative mindset. How many times have we heard about a terminally ill patient, comatose on a ventilator that miraculously holds on for days while in the Intensive Care Unit just until that Aunt Susan who lives 1,500 miles away makes it to say goodbye? In most cases, while the hearing is the last to go, it was that determined mindset that enabled them to hold on long enough. Clarity of what you want to achieve validates your effort in setting achievable goals. Short-term goals provide conscious recognition to self fulfillment, in that you have successfully accomplished your desired outcome. Setting Personal and Professional Goals To become a successful travel nurse you need to set measurable goals. Begin by determining your long-term goal and setting a timeframe for accomplishing it. One rule of thumb to keep in mind is to make sure the goal is attainable within two years or less. Any timeframe longer than two years may prove a bit more difficult to outline clear and concise stepping stones to create your pathway to your desired outcome. Step 3) Set short-term goals. This step requires you to break your longterm goal down into smaller obtainable tasks. These short-term goals are created to provide encouragement and assurance along the road to achieving your desired outcome. Although fairly easy to set, it is equally important to set aside time and energy into creating these smaller stepping stones toward your ultimate goal. Short-term goals have to be simple in nature but significant enough to make some progress. Analyze your goals as a whole to ensure they are not in conflict with what you are truly trying to accomplish. Determine why these goals are important to you and what inspires you to achieve them. It’s like maintaining a post-surgical patient in the Cardiac ICU on respiratory support without the key piece of equipment to maintain the airway. Of course you have options, however I don’t know about you but I’d rather not have to Ambu bag the patient. The same applies here. In medicine, we’ve made tremendous strides not only out of necessity, but out of advancement, creativity and innovations. Knowing the reason why these stepping stones are significant will help you keep full grasp on the task at hand. Commit to your goals that have been set forth with enthusiasm. Give yourself specific timeframes to get the job done. Do not let false starts or adversity derail your pursuit. Believing in the outcome determines the outcome. The Elite Traveler: The Lucrative Business of Travel Nursing 28 Back to index... Once you have refined your written goals and created a plan of action, incorporate these tasks alongside your daily activities. Remind yourself of your goals and pursue your passion. Visualize your success. By concentrating your mental and physical energy on a single purpose, the positive energy that truly lies within will surface to promote your desired outcome. My Money Mindset I have come to determine that those with successful mindsets understand that imagination, inspiration, motivation and beliefs originate in our minds and that change in thoughts must take place here first. All in all, successful people have successful mindsets. Initially I didn’t have a money mindset when I began looking for travel nursing positions, nor when I accepted my first assignment and began working at Children’s Hospital. I understood that in taking my first assignment I would be making an additional $10 per hour than I had working a night shift with differential in my hometown in upstate New York; even more the reason to leave the snow behind and welcome the beach. After about a month of working in Miami and learning my way around, I realized I had the opportunity to put forth a more focused effort in exponentially decreasing my ongoing “good debt” incurred by student loans and car notes. It was then that I began developing the Focus Funnel. I created a rather simple, yet systematic, module proven to consistently achieve any underlying goal. I used the Focus Funnel to maintain an abundant mindset, gain clarity of what I deemed important, set the shortterm goals necessary to achieve my greater goal. As I became more involved as a healthcare traveler I realized there was an abundance of assignments with even higher pay rates and bonuses just waiting for me! I remember thinking “all I have to do is aim high.” Step 4) Optimize your earning potential; optimize your life experiences. Depending on your personal and financial goals, you may opt to travel with a more contemporary company as outlined in Chapter 2 with my Get in, Get Out and Get Paid motto. The important thing to take into consideration here is the hourly rate you need to optimize your earning potential and to therefore optimize you life experiences. Travel nursing can do that for you! Setting the Bar for Your Practice-Specific Expertise: I have experienced firsthand the lucrative business of travel nursing. What enticed me most was the option to choose when and where I wanted to travel, making very few compromises, and how much money I could make. As a travel nurse, I don’t have to wait for seniority to come around to hopefully get a 3 percent raise the following year. I became my own manager. I determine whether or not a specific assignment meets my standards based on compensation, location, income, bonuses available and if it’s the lifestyle I would like to lead The Elite Traveler: The Lucrative Business of Travel Nursing 29 Back to index... for the next three months—if not longer. Imagine thinking, “I will not work for less than $35/hr.” You have that option. Imagine how magnificent it is to give yourself a hefty raise once a quarter, simply by expanding your knowledge base across your specialty. So what determines an adequate salary for your current level of expertise in your specialty? Calculate your pay rate based on the information provided therefore allowing you to set the bar for what the minimum for which you are willing to work. How much you will need to earn per hour to cover the expenses of your current home? Include all utilities, mortgage or lease payment, insurances and upkeep. Include in this number the amount you will need to be able to put aside in savings and money to spend while you are at your assigned location. Use the following formula to figure your minimum hourly wage and yearly income: Yearly income = weeks per year X hours per week X hourly wage. If you want to have an annual income of $90,000, work 40 weeks a year, 60 hours a week, you would need to have a minimum hourly wage of $37.50. Some nurses plan to work 60 hours a week so they can meet their minimum yearly income and have 12 or more weeks off each year. How you will achieve this is entirely up to you, but with this number in mind you are already on your way to preparing to chose which company and which assignments will work best for you. You won’t waste your precious time negotiating mediocre contracts. The Elite Traveler: The Lucrative Business of Travel Nursing 30 Back to index... Chapter 5: Do You Have What it Takes? Throughout my travels I have come to determine some pretty important qualities a nurse should possess when deciding to embark on the magnificent journey of traveling as a healthcare professional. You may have already acquired some of these traits through life experiences or perhaps during your course as a healthcare professional; however, as a traveler, these traits make the difference between a pleasant and not so pleasant journey. Personal Preparation Assess your adaptability to a career in travel nursing with the following questions. uu Do you have strong clinical, organizational and interpersonal skills? uu Do you adapt well to changing environments? uu Do you have a curious sense of adventure? uu Do you thrive on the challenges of meeting new people, learning new protocols specific to each facility you are assigned? uu Can you easily adjust to different cultural experiences and customs that are not familiar to you? If you can identify yourself with the above questions, then you are definitely on your way to becoming an elite travel nurse. Autonomy First, let’s take a look at autonomy, which is the most important factor when determining if you are indeed ready to take on a career in travel nursing. By definition, autonomy refers to one’s ability to make an informed decision, with reference to patient care, based on fact. This means, acting immediately, without hesitation, once you have gathered and analyzed all the pertinent clinical information needed to make an informed clinical decision regarding the wellbeing of the patients under your care. Additionally, one’s moral and ethical responsibility for the actions taken in this self-governing or independent role is the foundation for outlining whether a healthcare provider can handle more autonomy and is also directly tied into the degree of strength a nurse’s skill set and analytical abilities possess. A successful nurse has a keen analytic quality along with an ability to equally weigh the facts given in order to make a sound clinical judgment. An Elite Traveler is able to take ownership of the quality of the work performed and gains more responsibility in the clinical decision-making process. So the question here is: are you capable of handling more autonomy with clinical decision making? Are you able to stand in front of the attending and/or fellow The Elite Traveler: The Lucrative Business of Travel Nursing 31 Back to index... and clearly and concisely state the basis of clinical decision making based on patient presentation and solid clinical findings? As in any case in healthcare, credibility is paramount. Taking your knowledge and putting it to good use towards both client wellbeing and professional growth will prove you are a strong nurse and a traveler worth keeping. Connect with New Co-Workers Finding ways to meet your new co-workers and connect with them will go a long way in making sure your assignment runs smoothly. From assignment to assignment you will notice that you will have to deal with a wide range of personalities; from the overly bubbly to the healthcare scrooge. All in all, you must possess the ability to easily adapt to new living and working environments without it taking a toll on your own personality and wellbeing. If you easily make new friends, that’s even better, because oftentimes co-workers are the best tour guides to show you the little-known, must-see places around the city or town where you’re working. Before long you will have a few new sightseeing companions in your fellow staff members and other travelers. Be sure to: uu Find the fine line between sharing your experience and bragging. You want to let your co-workers know you have experience in a tactful way to assure them of your clinical capability and establish trust amongst the group. uu Share a bit of yourself with your coworkers. Be careful not to divulge too much—just enough to be friendly and open the lines of communication. uu Keep your wage and benefits to yourself. Nothing can cause problems between co-workers faster than a difference in pay. If you are asked directly what you get paid, simply state, “I don’t discuss my pay with anyone.” uu Be careful with your comments of the culture and climate in the area you are assigned. Remember, your new co-workers permanently live in this area. Nothing is more insulting than a few ill-placed comments about the local culture. uu Stay out of workplace politics—at all costs! Always stand on neutral ground and do not take sides. As a traveler, you ultimately wish for your presence at any given assignment to be seamless. This effort to be seamless should be evident to your colleagues, indicating you can adapt to their culture, and also evident to the patients you are taking care of. Connecting with your co-workers is The Elite Traveler: The Lucrative Business of Travel Nursing 32 Back to index... important to work on so that the potential for you to be viewed as an outsider to your patients and perhaps portrayed as being incompetent based on lack of integration is kept to a minimum. Positive Energy and an Uplifting Spirit Although nursing does have its share of challenges, it is important to understand that positive energy and an uplifting spirit go a long way when providing excellent care to your patients and family members. This is also true when interacting with your newfound co-workers. Each day, you have the opportunity to make your day extraordinary. You have the power to make it positive or negative simply by how you view the situations that arise. Every person has days when situations arise that are less than desirable, time consuming and frustrating. It is how you deal with the ups and downs that make you a success. Looking at your co-workers with empathy will allow you to understand their situation in a positive light. As a traveler, you chose to pack up and move to a new location, new culture and new way of doing things. Coming in well rested, with a positive attitude and being mindful of the thoughts and concerns of the facility and its employees will allow you to offer empathy while maintaining professionalism and delivering high-quality care. Don’t forget, you are there to provide your new co-workers with a means of reprieve from the stress they have been experiencing during their time of shortage. Be Productive Adaptability equals productivity. The ability to adapt quickly to everchanging working conditions and unit requirements will show the hiring facility they have made the right choice in you. Each hospital has its own work culture and requirements for travel nursing jobs. Each state has its own work rules and certification requirements. You must have the ability to adapt quickly and easily to the various needs of a travel nursing assignment. This includes learning where to find the basics, i.e. the linen closet/cabinet, the Pyxis for medication dispensing, the crash cart and chart location, the pharmacy and central supply. (There’s nothing like needing the Haldol and not knowing where to find it!) A successful nurse delivers quality patient care while being flexible, approachable and at times a leader amongst the team. Having a proper work ethic is very important when beginning a career as a travel nurse. Do you typically go the extra mile or only do the bare minimum? If your work ethic is suffering now, who’s to say it will be any different while traveling as a nurse. Most importantly here, if your work ethic is in need of resuscitation or taking away from the level of quality patient care the facility strives for, your contract may be terminated. Your travel nurse agency may The Elite Traveler: The Lucrative Business of Travel Nursing 33 Back to index... not be able to continue providing you with assignments if contracts are being cancelled due to poor work ethic. Coping with Stress Where does stress come from in a nurse’s life or work environment? Perhaps an increased nurse-to-patient ratio, fear of the unknown, a less than favorable patient outcome or even personal matters. As fun-filled as travel nursing is, there is always a lingering element of stress. Stress amongst leaving behind a sense of comfort and predictability from your work week routine, the places you frequent to the friends you get together with after a long day at work. Your ability to cope with stress is very important to your success as a nurse and more specifically, a travel nurse. A successful travel nurse applies patience to pressure and learns successful approaches to stress management. Keep in mind that not only are you dealing with everyday stressors associated with life and death within healthcare, you are also faced with unfamiliar surroundings, new co-workers and ever-changing practices. All during which you must remain knowledgeably compliant at all times with established facility protocols. So it is important to find effective and healthy means to unwind and de-stress. Elite Traveler Tool #3. Create a fitness regimen to include restorative sleep and a well-balanced energy-boosting diet for your long 12-hour shifts. Indulge in the hobbies that bring you the most pleasure and joy. Try healthy stress-relieving activities until you are able to find the best activity that releases your stress. And never forget your daily routines while on assignment. A Love of Travel A travel nurse gets to see the country; however, travel nursing jobs are much more than a tourist trip. You will learn what it means to live somewhere, and discover the charms and rewards that most visitors miss. Different travel nursing jobs will have their own distinct personality, like the neighborhood in which you will be living. Some aspects will be great. Some will be challenging. A willingness to accept each in equal measure delivers the joys of travel without the frustration of not being in a permanent home. Determining why you’ve ultimately decided to travel as a healthcare professional, will thoroughly aid you in finding the perfect travel assignment that upholds your personal standards. If you’re physically and mentally ready to take on this challenging career, and you can quickly and easily adapt to new environments and protocols you will find it nothing but rewarding. Once you get into the swing of things, travel nursing will give you all the benefits of a permanent position with the flexibility of the self-employment theory. Add to that the fact that you are in charge of your career path and you couldn’t come up with a better career combination. You can use your skills and experience in The Elite Traveler: The Lucrative Business of Travel Nursing 34 Back to index... a rewarding career, while embarking on a non-stop travel adventure that pays you to visit your dream destinations for weeks and months at a time. Outside the clinical perspective, becoming a travel nurse takes much more dedication than one would typically imagine. Although you do have the option of bringing your four legged companion or your significant other, most travelers are going on this adventure alone. It is extremely important to know that, in order to take full advantage of your newfound residence, it will require you to step outside of your comfort zone and explore. Take day trips on your days off to explore what the location truly has to offer. Oftentimes, I waited to explore with other travelers or friends to go on these trips, I found myself doing less. Get out there and explore! While it may be a bit easier to explore in small rural areas, major cities offer a wealth of culture. Additionally, do not wait for the weather to dictate your willingness to venture out. There are plenty of alternatives when the weather does not permit. So, you ask, how did I know I had what it takes to be a traveler? How did I have the motivation to create this exciting lifestyle by taking care of sick, premature babies while seeing the sites in new and captivating cities while making a ton of money? I didn’t know exactly. I had completed school, got a job, but immediately the politics were overwhelming and I had “low man on the totem pole” syndrome. I always wanted to learn more, do more, achieve more and thankfully the Neonatal Nurse Practitioners and Neonatologists were always encouraging of my career as a Neonatal Intensive Care nurse and on board to teach. But I was eager to see how different areas of the country practiced my passion of neonatal medicine. Shortly thereafter I realized these characteristics were mainstays of a successful travel nurse. I put myself out there to experience a change that could only be for the better. Ultimately, my zest for adventure motivated me and steered me down the path of travel nursing. So if you have an uplifting spirit and can work productively and autonomously, connect with your coworkers in a way that shows you genuinely care about their unit, their wellbeing and you’re there to help, you’re half way there. Couple that with the ability to effectively manage unforeseen stress, and maintain a love for travel, then CONGRATULATIONS, you have what it takes to be an Elite Traveler. The Elite Traveler: The Lucrative Business of Travel Nursing 35 Back to index... Chapter 6: The Power in Preparation So you want to be an Elite Traveler and it’s evident that travel nursing sparks your curiosity. You have invested time in your current career but you have an urge to move on to something bigger, something better; better pay, better benefits, more exciting locations and adventure. The power in preparation outlines what I like to call: The 40% Advantage, Elite Traveler Tool #4. Prior to embarking on a fun-filled life of travel nursing, preparation in a number of key areas such as clinical education, personal preparation and organization, will give you the advantage needed to ensure success when obtaining travel nursing assignments. So where do you begin? Education and Experience Do you have enough experience to begin working as a travel nurse? Hospital representatives and staffing agencies look for healthcare professionals with a wide variety of experience within their given specialty. Begin building on your clinical expertise now. Strong skills checklists enable the interviewing facilities to see that your level of experience is exactly what’s needed in their unit. All travel nursing companies consider this portion of your application just as important as your active nursing license and certifications. Proficient and highly competent nurses are more likely to be selected simply for their knowhow. Prepare your career to exceed all expectations with the correct amount of clinical expertise. General Guidelines for Clinical Expertise: uu 8 Months: Dialysis uu 12-18 Months: ICU, OR, Ambulatory OR, PACU, PICU, Ambulatory PACU, NICU, PEDS, LD, Pedi ER, Home Health, Cardiac Cath Lab, CVICU, CVOR, BMT, Telemetry, ER uu 2 Years: Medical/Surgical, Endoscopy Lab, Psych, Rehab, Postpartum, Nurse Manager, Wound Care uu 3 Years: LPN Additional certifications such as Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS), increase your level of marketability, and in this competitive market, subsequent credentials are essential to your success. Skills Checklists There are a number of skills checklists in all of the major areas of nursing practice. These include: the Operating Room, Central Processing, Cath Lab, Emergency Room, Physical Therapy, Home Health, Postpartum, Pediatrics, The Elite Traveler: The Lucrative Business of Travel Nursing 36 Back to index... Labor & Delivery, Intensive Care/Critical Care, PACU, OR First Assist, and Psychiatric Skills Checklists, as well as checklists in Respiratory Therapy, Neonatal ICU, Telemetry/Step-down, Oncology, Sub Acute, and Med/Surg categories. The purpose of a skills checklist is to determine what specific clinical experiences you have had and which types of equipment and medical devices you have used during your overall course as a healthcare professional. These checklists are significant in that they provide the company, as well as the hiring facility, a collective summary of your abilities and competency in performing your specialty-specific functions. I recommend you go back through your educational materials and all of the job descriptions for positions you’ve held in the past. Write down every procedure and clinical responsibility you’ve ever had. The more skills you can prove, the more likely you are to be rewarded the job when in competition with another healthcare traveler. If you list a skill set, you must be prepared to demonstrate your skill, possibly in a clinical setting, probably in a knowledge-based test such as the PBDS testing system that many agencies use to ensure that their applicants have all the skills necessary to work for a particular medical unit. You can go over the skills checklist with your recruiter or complete the form online to expedite the process. What Is PBDS (Performance-Based Development System) Testing? Performance-based Development System (PBDS) is a series of standardized tests that evaluate the skill level of travel nurses and new hospital clinicians. The system was designed by Dr. Dorothy del Bueno to test the skills and learning needs of new RNs more than 20 years ago. It was later implemented at a number of hospitals across the country as a means of quality assurance. These exams are given in a variety of specialty areas to include both written and clinical evaluation of a nurse’s skill set. Many companies will confirm your assignment and send you on your merry way, left to the vices of this PBDS testing; no forward notice and no study materials. Administered online, usually upon day one of initial hospital orientation, you are required to successfully complete this testing or risk forfeiting your newlyaccepted assignment. I had already accepted my assignment, completed the paperwork and was on the road to my next destination 600 miles down and 850 miles to go when my recruiter called me and notified me of the mandatory PBDS test she neglected to mention several weeks prior when I applied for the position. I was speechless when she told me that if I didn’t pass, I would be forfeiting my assignment and would be left 1,500 miles away from home and paying the housing costs for the days leading up to the start of my assignment. Oh my gosh! This cannot be happening. I was in panic mode for the rest of the The Elite Traveler: The Lucrative Business of Travel Nursing 37 Back to index... drive that day and ultimately said, “Ok, how bad can it be?” My concern was that medicine varies widely across the country although often ending with the same results. Who’s to say that progressive medicine is incorrect or that non-teaching facilities lack the modern protocols necessary to care for their patients? I had no idea what to expect. Interestingly enough, the test was a lighter version of the NCLEX, a recap of nursing school in a nutshell. It covered everything from Geriatric care to Medical Surgical nursing with most of the questions concentrating on the wider specialty of Maternal Fetal medicine. So, make sure to ask your recruiter if the assignment you have agreed upon has any additional mandatory testing to be taken when you arrive on site. To make even more certain, ask the interviewer of the site you are interested in traveling to during your phone interview. Surviving with Little to No Orientation You’re ready for your first day: new location, new facility and new coworkers. Are you fully secure in your knowledge base to work independently of doctors orders and rely on your clinical judgment? Looking at the scope of a travel nurse’s responsibility, you will find autonomy is the most important trait for a travel nurse to possess; the ability to work independently and use clinical judgment to your discretion is paramount to your success during your travels. Understand that, oftentimes, there is little to no orientation. The facility that is employing you as a travel nurse often has the expectation that you are an expert who adapts easily to any environment and needs little—if any— orientation. Prepare yourself for this realistic expectation; however, do not hesitate to clearly state your level of discomfort if necessary to protect your patients as well as your nursing license. How you cope with constant changes The Elite Traveler: The Lucrative Business of Travel Nursing 38 Back to index... will determine the success of your assignment also. Your confidence in your abilities will shine through making you a valuable asset right from the start. Day One after a Week of Hospital Orientation I remember the first night shift at Children’s Hospital. Well rested and ready to go, I arrived at the unit promptly at 7:30pm to begin my first night shift as a traveler. I asked the day shift charge nurse to point me in the direction of the person who was to orient me for the evening. She explained they were short staffed that evening and I was assigned to two babies. The first was intubated on a ventilator I had never seen or heard of before, and as I was told “tried to die” on day shift. The second assignment: the unwanted colic-like long-term newborn who had already spent 40 days in the NICU with a tracheostomy, a trach collar and required frequent suctioning. “So,” she says with an eager smile, “Pam will be your resource.” I nearly freaked inside and naively said “when will I receive orientation?” The charge nurse chuckled and said if I were to have any questions to ask Pam. Pam was one of those eclectic nurses in her mid 40’s with short spiked hair and animal print scrubs. You could tell she was the no-holds-barred mother hen around the unit. Right off the bat she said, “You’re an experienced nurse right? You can take these two kids and let me know if you need anything.” (I thought, “Of course, while you roam the unit and chat the night away.”) “Not a problem really,” I said, “Just show me where the oxygen dial is on this Siemens ventilator, where I can find the ‘Manual Breath’ button, the button to silence the alarm and the digital measurements screen for the Rate, PIP (Peak Inspiratory Pressure) and PEEP (Positive End Expiratory Pressure). In the meantime, can you call the Respiratory Therapist to give me a detailed rundown on this machine while I assess the baby? I can find the Ambu bag and check the equipment.” “Sure,” she said. Pam turned out to be a riot, a really fun lady to work with; not big on babysitting which was great, but can someone show me where the supplies are?! Despite the fact that you are bringing assistance to these units, aiding in multi-disciplinary care for their patients for which they have long since been short staffed, you may be viewed as an outsider and many may not wish to become well acquainted. They are in need of your expertise, your knowledge and your ability to jump in to provide outstanding patient care; you are vital to the facility. Don’t be surprised when you are assigned the busiest and least desirable assignments or perhaps those that no one wants because the patient is on contact isolation precautions or the parents are extremely difficult. “Give it to the traveler”… (so we can sit and chat all night). Yes it happens—all the time! The Elite Traveler: The Lucrative Business of Travel Nursing 39 Back to index... Finding the Best Agency Finding the best agency to work with is also very important. Take your time and review the requirements and benefits each agency offers. Look carefully at housing, travel reimbursements, insurances, continuing education and assistance with state licensure. Time off policies and other benefits can make for an outstanding package. It is important to remember, you are a nurse in great demand, and you don’t have to go with the first agency you find. Take notes and compare the various agencies. Go with the agency that best suits your needs. There are several types of travel nursing companies: those on a global scale best suited to international travelers and assignments, those on a smaller scale catering to travelers and assignments on a regional or local level, and those which are specialty specific. For example, you may find during your research, a small or newly-founded company which mainly places specific specialties within the industry on a regional level, such as the Medical/Surgical units, the Operating Room and Same Day Surgery within the Mid West, while larger, more established companies focus on placing healthcare professionals within all specialties across the nation and internationally. As there are numerous agencies that vary in size and specialty, you may want to ask for references from current nurses the agency employs to gain a better understanding. Oftentimes, recruiters are eager to put you in contact with a traveler they employ to help answer any questions you may have regarding traveling or the agency itself. Overall, you are looking for an agency that will provide you with a great pay rate to travel to your most desirable location that will help you negotiate your needs and achieve your goals while on assignment with them. You are also looking for a travel nursing agency that will be flexible and accommodating during unforeseen circumstances. Assignment availability is also a huge factor in choosing an agency to work with and even more the reason to apply to at least three travel nursing companies that meet your outlined criteria, therefore giving you the opportunity to have ongoing travel assignments if you choose. Ultimately, the key to your success when choosing a travel nursing agency is to know what specific criteria you consider to be “showstoppers,” or things you are simply unwilling to compromise on. For example, are you willing to arrange for your own healthcare coverage to add a few dollars per hour to your hourly wage? Are you willing to forego private housing for your dream assignment and location? As a traveler, I’ve done exactly that. I have chosen to take my chances on having a roommate to ensure a profitable hourly rate and to live in an amazing city. On the other hand, I have met fellow travelers The Elite Traveler: The Lucrative Business of Travel Nursing 40 Back to index... who have no preference for their location. They simply want top pay and, in turn, treat each new location as a mini vacation and an opportunity to explore. So what’s important to you? The best salary, the prime location, comprehensive benefits and paid time off or private housing; take a moment to think about your key showstoppers and write them down. Once you have clearly identified your most important desires from a travel nursing company, begin your search online. Keeping these things in mind will help you narrow your list of potential agencies to work with. Initiating contact with a potential travel nursing agency is rather easy to do once you’ve done your research. The focus of your initial contact should be to gain a general overview of what the company has to offer. You’re also looking to sort out whether or not this particular company provides your key showstoppers, if not more. After your initial review of the company, if you would like to find out more, speak with a recruiter for the details and begin the application process. Also, make sure to add the company to your list of desirable companies. Most agencies will have you up and running in a minimum of two weeks after submitting your application. However, it is not unheard of for a travel nurse to begin the process and not take an assignment for several months. You have the ability to schedule your assignments as you need. Take your time and be selective. My First Travel Nursing Agency In taking my first assignment with Medical Express, I gradually realized what amazing benefits they offered. Aside from the extra $10 an hour over what I was making in New York, the company reimbursed me for my Florida license, and paid for travel mileage from New York to South Florida. Medical Express also allowed me to move in a week before my assignment started in order to give me some extra time to settle in. The best part was every three months, between contracts at the same facility in Miami, Medical Express flew me home to New York for two weeks and back to begin my second and then third contract at Children’s Hospital. It doesn’t get any better than being flown home to your family after your first assignment alone in a city three times the size of your hometown. Choosing a Destination Choosing a destination to travel to may not always be the easiest thing to do when the time comes; with so many opportunities and countless possibilities who’s to say which location will be best. So what do you want and where do you want to be? You can go surfing in the winter in Hawaii, The Elite Traveler: The Lucrative Business of Travel Nursing 41 Back to index... work at a prestigious medical center in the northeast in the fall, herd cattle in the Midwest in the spring if you want. From one assignment to the next you decide what is most important and at the top of your to-do list. Once you have decided to join the field of travel nursing, get a jumpstart on your licensure needs for areas you wish to travel. This will drastically decrease the amount of time spent preparing for the next assignment requiring an additional license. Write a list of cities and/or states you would like to travel to. Check the area’s website for licensure requirements. Twenty three states have formed an alliance for nursing licensure which allows you to practice in a participating state under the laws governed by your home state of licensure without obtaining an additional practice license. If your state of original licensure, the state in which you have taken the NCLEX exam, is not a part of the compact, you will need to take the necessary steps to apply for an additional license by endorsement. If you know you are truly interested in taking an assignment in a certain state, it is always best to begin the endorsement process well in advance of accepting an assignment. Also, take into consideration that background checks and finger printing are, for the most part, standard during the authorization process due to heightened security and may prolong your turnaround time to obtain licensure. Certain states, such as Florida, are well known for an elongated approval process, so begin early to avoid missing out on a dream assignment due to licensure delays. Keep in mind that temporary licenses may be issued in a timely fashion and are satisfactory to begin your assignment. On my first assignment I ran into delays while trying to obtain nursing licensure by endorsement from the state of Florida. My recruiter warned me of possible delays I may experience while trying to obtain licensure. Using my recruiter’s guidance, I applied two months in advance for my nursing license by endorsement and paid to have a temporary license issued. I accurately filled out the necessary paperwork in a timely manner and submitted the application with the hopes of a quick turnaround time. To my dismay, my recruiter was right. After four weeks and no word from the Board of Nursing, countless hours were spent each morning after my 11 pm – 7 am shift at my staff job, on hold, listening to elevator music, trying to get in touch with a live representative in the Licensure & Verifications department to no avail. Days and weeks had gone by and still no temporary license. I was worried that I would have to forfeit my already accepted and confirmed assignment in sunny Miami because there was still no license to practice. Before long, the time had come. I was scheduled to hit the road and make my way 1,550 miles to South Florida and, you guessed it, still no temporary license. Now down to the wire, I had no choice but to request to have the The Elite Traveler: The Lucrative Business of Travel Nursing 42 Back to index... start date postponed a week with the hopes that what the Board of Nursing had relayed to me was true. “It was in the mail.” I was discouraged. This was supposed to be an exciting time; this is my first travel assignment. What was I going to do if this didn’t work out? Now down in South Florida, I was fearful that the facility would cancel my contract after the unexpected delay, and that I would be responsible for paying housing costs for the week I was living in company housing and not working. But, there was a break in the clouds that scorching afternoon, shortly after the routine 2:15 South Florida spring rain. The temporary license arrived and I was finally able to kick off my first assignment in the exciting career of travel nursing. Many of the most desirable travel nursing assignments are not on the market for long. These prized positions are competitive and often have several, well qualified candidates with stellar profiles submitted for consideration. Make yourself more marketable, gain a leg up on the competition by having an active/current license in the desired state. The “50 Mile” Rule You will also need to decide if you are going to be traveling as a nurse locally or traveling more than 50 miles away from your home. There are a few facts you need to know before you make that final decision. Controversy and confusion tends to find its way to a traveling nurse when the “50 mile” rule is mentioned. Intense research on this rule has been done by many nurses and travel nursing agencies to clarify the rule. All in all, there is no real basis for the “50 mile” rule in the IRS code. Ultimately, the idea of tax-free reimbursements is contingent upon one’s need to sleep and rest while on assignment as the distance between the tax home is determined too far to commute. In other words, for your assignment to fall under this category, the distance between your home base and the contract facility must be viewed as non-commutable. If you live in an area in which the average commuter travels at least 50 miles to get to work, such as Los Angeles, you cannot be considered a travel nurse. If you travel 50 miles to your facility in an area in which the normal commute is 10 to 15 miles, you may be considered a travel nurse. Why the discrepancy? Hospitals will use the “50 mile rule” to resolve whether the employees are outside “their metropolitan area” to determine which employees will receive premium pay. Employers will use the “50 mile rule” as a screening tool to determine which employee is working away from home. One word of caution, always seek expert advice by consulting a tax advisor regarding eligibility for tax-free allowances or provisions. “Tax Home” City Your “Tax Home” city is the place in which you have legal and historical ties. These ties include driver’s license, voter registration, banking, car registration The Elite Traveler: The Lucrative Business of Travel Nursing 43 Back to index... and mail delivery. However, there is a catch: having these items may represent your permanent residence, not necessarily a tax home. A tax home is defined as the location in which a mortgage or rent payments are made. On the other hand, a permanent residence is defined as a location of which no exchanges of payments are made. If you live with a family member or a significant other in which no rent is paid, but you still receive local mail and are eligible to vote, etc., you have a permanent residence. Might you have additional questions regarding a “tax home” please consult a tax advisor to find out if you qualify. “Tax Free” Housing “Tax free” housing is what you receive if you have a tax home, work far enough from your tax home in which you would need sleep or rest to make it home after a shift and, in turn, your agency compensates you with free housing or a housing stipend. Another benefit to having an established tax home is that the amount of taxes deducted from your paycheck is significantly less. In this case, the dollar amount deducted will be based on taxes that are imposed by the city and state in which your primary dwelling is located. For example, if you have a primary tax home located in the state of California, all taxes placed on your gross income will be that of California regardless of the fact that your current assignment may be in Texas; a state with no income tax. If your current dwelling is company housing and changes with each travel assignment taken, the total dollar amount for housing paid by the Travel Nursing Agency will be placed into your paycheck as additional earning. You will then be taxed on that figure biweekly and the amount is then deducted. With all matters regarding taxes and the IRS, it is in your best interest to consult a tax advisor. Before choosing a tax advisor, be sure to ask if they have experience working with travel healthcare professionals to maximize your tax benefits. How to Anticipate Availability of Assignments When a healthcare professional decides to travel, one of the ways to judge where and when nurses or other traveling healthcare professionals will be needed is to pay close attention to geographic trends. The nurse-to-patient ratio at most hospitals has proven to be significantly lower than desired to achieve optimum wellness. This ratio can be adversely affected by seasonal increases in illness and accidents, as well as by aging populations, increases in birth rates, changes in demographics in a particular area, economic factors, The Elite Traveler: The Lucrative Business of Travel Nursing 44 Back to index... and many other environmental changes and challenges. Watch the news, read industry magazines and newsletters, talk with your recruiter. One example: the current economic problems seen in the U.S. Layoffs, downsizing and business closures have contributed to joblessness and highstress levels. The emergency rooms are dramatically impacted by people who are uninsured, self-paying clients have no insurance and no money for an office visit. The hospital ERs are pressed to the limit with people who would normally make an appointment with their primary care provider, because it’s the only way they can be seen by a doctor. This creates a huge gap in the nurse-to-patient ratio, requiring that agency nurses are hired in order to ensure patient safety. How to Create Assignments I was in my third week in the NICU while on assignment in Chicago, Illinois when Katrina hit the bayous of Louisiana. Within a couple weeks the facility I was working for at the time had already begun to rally mobilize groups of healthcare professionals and any volunteers to be vaccinated who wished to help Louisiana recover from the disastrous tragedy. Shortly after seeing the devastation on the news during morning break, I immediately contacted my recruiter to see what was being done on our end to further assist the relief efforts. Unfortunately, having been on assignment for only three weeks, I was unable to mobilize myself. Nurses were accepting three-week contracts for which they would be working seven days a week, 18 hours a day, making time and a half each day. You were only allowed one piece of luggage and you had to sleep in FEMA relief tents, but with such deplorable conditions none of that could compare to the life experiences of helping those in dire need. Although I was unable to help directly, three of our staff NICU RNs volunteered and departed shortly thereafter. I, on the other hand, was able to pick up at least one shift a week to help cover the staffing needs in their absence. As previously discussed, there are many times when nursing shortages increase due to various environmental and economic issues. When this occurs, if you are diligent, you may be able to create an assignment for yourself. How? Well, it’s really quite easy. When you see there may be a need, do as I did, contact your agency recruiter or account manager. Ask if there are any open assignments in the area where you see the need. If there is an area you would like to travel to, you can also start researching jobs at the hospitals, medical centers and other facilities in the area. When there are open positions that you are qualified for, you may also contact your recruiter or account manager to see if they have a relationship with that particular facility. If your agency already has a relationship with the facility, they may be able to turn the position into a The Elite Traveler: The Lucrative Business of Travel Nursing 45 Back to index... new contract. If they don’t have a relationship with the facility it will create an opportunity to develop both an ongoing relationship with the facility, as well as an assignment for the traveling healthcare provider. Negotiation Preparation Do you believe you are worth what you negotiate? As a trained and experienced professional, you are worth the wages, travel reimbursements, bonuses and luxurious housing you receive. Your services are in great demand and there are many facilities that are unable to perform at their desired level without the assistance of travel nurses nationwide. Go in Prepared You are knowledgeable; your skills are honed, so why not take that same professional approach to negotiating your contract? With solid information to back up your desired wages and compensation, you should be able to obtain a good portion if not all of what you desire on your travel assignment. If you don’t need particular benefits, such as company housing or health insurance—because you already have these items covered through other arrangements—be sure to convey this information to your recruiter. You will receive up to an extra $2 per hour for declined benefits and at least $700 per month for declined housing, all of which can be found on your contract agreement—so read every line. Read Every Line of Your Contract Aside from the details provided to you from Payroll regarding direct deposit and the specifics as to your exact housing locations, the majority of the binding details needed to get you on your way are found within the contract agreement. The fundamentals of each contract include the following: Greeting: The greeting is a welcome letter outlining who your contact liaisons will be during the course of your assignment. Your client accommodations associate, security deposit information, housing costs for missed shifts, tax home eligibility, group health insurance and its expiration date, any applicable bonus information, the number of hours the bonus is contingent upon and eligibility requirements allotted per pay schedule. The Contract: Contract and agency clauses are paramount when preparing for an assignment. All details and descriptions provided in your contract are your only protection and safeguard during the course of your assignment in the event something does not go according to plan. The Elite Traveler: The Lucrative Business of Travel Nursing 46 Back to index... To help you better understand your contract, I have outlined the key areas of the contracts you will come across no matter which company you chose. Routine Clauses are those that outline standard agency/company policies and procedure statements regarding non-wavering details, such the timeframe required to submit timesheets, confidentiality statements, signing of contracts prior to arrival on site, agency early termination clauses as they reserve the right to do so at any time throughout the course of your contract. The second aspect of your contract includes Wavering Clauses or rather details of assignment clauses as they change based on the specific assignment you chose. These clauses change based on your assignment specifics and vary from assignment to assignment. As an example, these include housing details, pay rate and bonuses, beginning and end dates for your current assignment, designated time off, scheduled shifts and shift differentials, floating requirements and guaranteed hours. It is vital you read these areas thoroughly and make sure they are accurate. Sample Contract: When reviewing your contract, DO NOT assume all the details verbally agreed upon are listed in the contract. A simple error could leave important details from the contract, leaving you in a bind. If anything is missing, any items written in a confusing manner or unclear, ask for clarification. This contract is The Elite Traveler: The Lucrative Business of Travel Nursing 47 Back to index... your confirmation that you will receive what you negotiated. Check out the penalty section regarding your potential inability to finish an assignment. Know what the conditions are and the cost of the penalty. Ask to include clauses in the contract for an option that offers a special leave agreement for an emergency without penalty. Long-term contracts are not the standard practices of travel nurse agencies, with the majority ranging from 13 to 26 weeks. You should only sign a contract for the length of your current assignment. When to Renew Approximately six weeks after the initiation of your original assignment, the decision has to be made if you are interested in renewing your contract. Although it seems rather early, this career is fast paced. No sooner than you arrive, you’re deciding if you’d like to stay on board once the contract is complete or venture off to experience a new-found travel adventure. The facility is also deciding if they’d like to renew your contract based on unit needs and traveler performance—all within the first six weeks. Be sure to review the assignment contract renewal/extension just as carefully as you would the original contract. Gain clarification if any area of the contract is unclear. Get organized! To me, this is the fun part. As you move from assignment to assignment, from the rural Midwest to the fast-paced metropolitan cities of the east coast, you have to find a way to keep up with all your stuff: licensure requirements from state to state, assignment contracts, Physician Exam forms and lab results. After about a year, I realized I had no idea where I had stashed my New York license information which, of course, was up for renewal. Was it hidden somewhere in a box I packed and shipped off to South Florida or was it still back in Upstate New York with all those Winter clothes that were no longer needed? So as organized as I am in my professional career, I really had no idea where the paperwork had gone. So I decided to get organized! A Helpful Tip Put together a three ring binder to include five durable hole-punched folders. The first folder is marked for company information, contact details for your recruiter and housing coordinator. The second folder should include all of your pertinent assignment research: state regulations, the facility, and the population you may serve; all will be a definite help if you are expected to dive right in. Complete the facility interview questionnaire to remind you of what was discussed when comparing assignments. The third folder should include your credentials, physical exam forms and any lab work that has been completed or may need to be completed before venturing off to your new assignment. At each assignment you will go through a thorough health screening process, which often includes reviewing your credentials such as the state nursing The Elite Traveler: The Lucrative Business of Travel Nursing 48 Back to index... license, CPR and advanced resuscitation certifications. Maintain a complete traveler profile with each assignment ensuring all paperwork is up to date and certifications are current. As you become an avid traveler, you will find yourself with multiple licenses all of which seemingly expire within one year of each other; you can store all of those in the fourth folder and leave the fifth folder to miscellaneous papers. While on assignment in Staten Island, I had the pleasure of caring for a lovely family who was always so thankful to each and every nurse who cared for their first-born child. The twin sibling was lost in utero, but every day the family showed how happy they were to have just the one son after trying so hard to start a family for so many years. With a little gaining and growing, and the resolution of Respiratory Distress Syndrome, the family was discharged. Shortly thereafter, we received a thank you letter from the family for our dedication to caring for their newborn. As healthcare professionals we take pride in giving unconditional quality care to our patients and never expect a thank you in return. I was simply happy for the success of their son’s stay in the NICU and went on to put a copy of that letter in my binder to carry with me on my travels as a reminder of a job well done. All in all, this binder will go along with you during your travels to help keep you organized and prepared. Remember: the power in preparation is tenfold when getting ready for a career in travel nursing. The legwork done upfront is key to your ongoing success as a traveler. The Elite Traveler: The Lucrative Business of Travel Nursing 49 Back to index... Chapter 7: The Fine Art of Recruiter Relations Although the first line of defense when embarking on a travel nursing career is deciding upon a company, additionally, establishing and maintaining a happy and healthy relationship with your recruiter is essential. Your best course of action is to be assertive. Come in prepared with your best and most assertive self. Build and nurture the foundation of this relationship, as it’s another integral piece of the puzzle, Elite Traveler Tool #5. So I will show you how to deal with recruiters who could potentially slash your bottom line profits in half. Interview Your Recruiter When you’ve decided upon an agency and completed the application process, you will then be assigned a recruiter. However, this does not mean you have to remain with that particular recruiter if you do not feel he or she is a good fit for you. I have found that interviewing recruiters up front and utilizing the following questions has proven key in determining the success of the relationship at hand. Immediately you will know if he or she has the qualities necessary to make your life as a travel nurse memorable or miserable. Prepare yourself with the following interview questions: uu Do you enjoy your position as a recruiter? uu What is the most challenging aspect of your position? uu What do you feel is the most important part of your relationship with a candidate? uu How long have you been a recruiter? uu Do you have nursing experience? If yes, have you been a traveling nurse? uu What do you feel is the most rewarding part of your position? uu How long do you expect to remain a recruiter? uu If you could change one aspect of your job, what would it be? uu How can I make our relationship work best for you? uu What do I need to tell you about me that will help you understand what I’m looking to achieve with this company? Secondly, review the verbal—and non-verbal if meeting the recruiter in person—answers provided by your recruiter. uu What was the reaction of the recruiter when asked to take part in an interview? The Elite Traveler: The Lucrative Business of Travel Nursing 50 Back to index... uu Did he/she answer the questions as if they were rehearsed or relaxed, encouraging and genuine? uu Did he/she listen when you spoke or seem preoccupied? How you find your recruiter’s responses, personality and gestures are equally important to the information he/she may provide or neglect to provide regarding the company you are looking to gain more information about. All in all, their response will also determine the quality of the relationship at hand. Only you can make that call and if you don’t find it to be a good match, ask for another recruiter. This is the person you will need to work closely with throughout the entire time you are with the agency. Ideally, you want to empower your recruiter to work for you, to work independently with your best interests at heart with the least amount of management from you. Clear guidance goes a long way. Building a Relationship Recruiters understand the value of a healthcare traveler’s expertise in the continuity of quality patient care. Your recruiter will work hard to assure that you are rewarded in return. The quality of your relationship plays a significant role in convincing your recruiter of your needs. Establish a relationship built on trust. Be honest and forthright about your strengths and areas where you may need improvement. Your recruiter can bring to the attention of the facility the areas where you shine and assist you in building your areas needing strength. Throughout my travels, I have had my fair share of stellar and not so stellar recruiters. By far, Jose Muñoz was the best recruiter I had ever had when I was looking to move on from South Florida. He was very attentive and thoughtful, always willing to help in any way possible and would make sure I received the company gift for Nurse’s Week. Come to find out, he was an Operating Room nurse and subsequently a traveler as well. When we spoke of what my needs were to accept a travel assignment he listened intently, jotted down key criteria as we spoke and understood that I worked the night shift and emailing me when a lucrative assignment became available was our best option for communicating. We had an amazing relationship. Quite frankly, I didn’t want to be bothered unless there was an assignment that fit my criteria. He understood and rolled out the red carpet. I never felt as though he was trying to get me to fill a position to pump up his commission. I found that most of the recruiters I dealt with only listen to portions of your conversation. No sooner do you take a breath, they are trying to ship you off to the nearest Walk Thru State’s Board of Nursing to hopefully make it through the picket lines in Missouri during the holiday season; rather than helping you land an assignment close to home for the holidays. The Elite Traveler: The Lucrative Business of Travel Nursing 51 Back to index... Seasoned recruiters typically manage between 50-100 active, working travelers at a time. As standard protocol for larger companies, there are greater incentives to ensure successful and ongoing travel nurse retention. Recruiters typically have a well-established base salary with the majority of their incentives coming from maintaining active travelers whether it be renewals, referrals, hard-to-place assignments or rapid response efforts. You will find recruiters make a valiant effort towards high incentive assignments or even find them in placement competition with one another. So keep in mind, they may have a profitable suggestion that you may not have considered. Take a careful and thoughtful approach to better establish and maintain your relationship between yourself and your recruiter. Communicate freely and frequently via email or by phone just to say “hello.” This will ensure a more honest and trustworthy level of communication enabling you to more easily bargain for the specific necessities to make each assignment special. I cannot stress enough how important it is that you and your recruiter are on the same page at all times on every aspect of your assignment. It is also important not to assume that he/she will have your best interests in mind. It is your responsibility to clearly convey your wants and wishes necessary for a fruitful assignment and relationship. Your relationship with your recruiter is vital to the success and profitability of your career. Look at it in an honest light and nurture this relationship. The Elite Traveler: The Lucrative Business of Travel Nursing 52 Back to index... Chapter 8: Hot Spots for Travel Nursing There are several ways to choose an assignment location. You may wish to travel for a special occasion in which the destination is predetermined simply to be with family or friends, or perhaps your location preference is based upon a city you have always dreamed of vacationing to, but haven’t had the opportunity to do so. Traveling as a healthcare professional is a joyous venture. It offers you the opportunity to learn new and alternative procedures, work with amazingly bright physicians, experience diverse work environments and provides exposure to a variety of challenges to build your professional portfolio. Amidst all this, traveling as a healthcare professional enables you to embark on a magnificent journey throughout the country in which your career is your reward. One of the biggest attractions to travel nursing for many is the hourly pay rate or salary offered by travel nursing agencies. Considerably higher than the typical pay rate for traditional employment, travel nursing can provide the financial stability you need both for an enjoyable lifestyle and in terms of saving for your financial future. There are a multitude of factors that influence the pay rates seen from assignment to assignment; however, location is key. Location ranks extremely high on the list when determining the level of a hospital’s desirability. Travel companies know and understand that a traveler will be more inclined to accept a position within a desirable location. Cost and probability of obtaining housing in exclusive neighborhoods is one of the biggest factors weighing in on a healthcare traveler’s earnings. Along with a location’s popularity, another consideration is the cost of living and quality of life. Pay scales often hinge on the allure of a facility’s locale. Traditionally, contracts in large metropolitan areas have been the highest paid compared to the outlying rural areas simply because the institution has allocated a larger budget for securing supplemental staff. However, recent trends have shown that facilities located on the outskirts of a major metropolitan area are becoming increasingly competitive. In the Northeast, the cost of living is indeed high in cities such as New York and Washington D.C.; traveling registered nurses typically earn a minimum of $35.00 per hour. This is comparable to areas of the west coast including major metropolitan areas in the state of California, as well as coastal areas in Washington and Alaska. At one point I looked into assignments in Hawaii and realized that I could have an amazing island lifestyle for $24 per hour at their military hospital located on the Big Island. Rural Midwest assignments tend to follow suit. For those who take assignments at facilities in the Midwestern and Central states, The Elite Traveler: The Lucrative Business of Travel Nursing 53 Back to index... the going rate falls between $28.00 and $31.00. If you’re interested in heading southeast for the winter, standard hourly rates begin at $28.00, depending on the company of choice. Your travel nursing agency can offer destination suggestions based upon demand, climate, working conditions and locations that most interest you. If you have a clear outline of your priorities, the agency can usually make suggestions and check their vacancies in the locations that most closely meet your needs and requirements. Although assignments fluctuate in availability, you can guarantee that the following are the top 13 hot spots for travel nurses to profit. NEW YORK CITY: New York City (NYC) is well known for its high population density. The population of New York metropolitan area is the largest in the nation, estimated at 18.8 million people and is spread over an area of 6,720 square miles. It is also one of the leading U.S. tourist destinations. Because of its large population, NYC has a great demand for nurses and there is still a shortage according to the New York State Nurses Association (NYSNA). NYC is an ideal location to consider for a travel nursing position, especially as nurses tend to work all hours. One of the great advantages of NYC is its 24hour public transportation system which is ideal for non drivers and those that do not want to hire a car or take their own with them. The New York subway runs 24 hours a day and both walking and cycling are popular methods of commuting. There are more than 12,000 yellow cabs and no shortage of cabs late at night. Furthermore, there are buses, ferries, and an aerial tramway. NYC has a humid subtropical climate. Summer temperatures often range from 75oF to 88oF but may creep higher on occasions, while winters offer temperatures often reaching below freezing, with snow being quite common. The rainfall in NYC is just less than 50 inches per year. Towards the end of the twentieth century, the crime rate in NYC was far worse that it is now, but this outdated reputation often deters people from visiting the city. However, the current crime statistics clearly show a downward trend, with NYC ranking the lowest among the 25 largest cities in the U.S. and a continually lowering homicide rate. There are five main boroughs in New York: Brooklyn, Manhattan, The Bronx, Queens and Staten Island. Some of the most popular tourist attractions include: the Statue of Liberty, the Empire State Building, Central Park, Times The Elite Traveler: The Lucrative Business of Travel Nursing 54 Back to index... Square, The Bronx Zoo and Ellis Island. NYC offers a great selection of U.S. and international cuisine and has many local specialties such as bagels, pizza and cheesecake. MIAMI: Miami’s tropical climate and coastal location attracts many tourists each year. Miami is a preferred destination for those seeking a warm climate. Summer highs of 85oF to 95oF are expected and often followed by a cooling storm or sea breeze in the afternoon, while the average temperature in the winter months rarely falls below 70oF. Demand for nurses is very good in Miami because it is a very popular retirement destination. According to the Nursing Consortium of South Florida there is still a severe shortage of nurses in the area. While there are not many tourist attractions in Miami, the beach and climate draw a lot of people towards the city for fun in the sun and water sports: boating, fishing, diving, jet skiing and parasailing. Furthermore, a lot of movies and TV shows, including many reality TV presentations are filmed in Miami; so why not increase your chances of getting your 15 minutes of fame! Miami is also a major hub for international travel with direct flights to the Caribbean and South America’s most desirable destinations. So, if you decide on venturing to Miami, take full advantage of this travel opportunity. CHICAGO: Chicago is another densely populated city, with more than three million residents. There are four main city segments: The Loop, also known as Downtown; the North, which encompasses the Gold Coast, Magnificent Mile, the Water Tower and Northwestern University; the Near South where you’ll find Soldier Field, the Shed Aquarium and the quiet, residential communities of the Prairie District; and the West Side, where you will find many of the outlying colleges and universities, the Ukrainian Village and suburbs west of the Dan Ryan. The climate is hot and sticky in the summer with temperatures range from 80°F to 88°F. The winters are considerably cold and below freezing with heavy snowfall coming off Lake Michigan and tremendous winds—so bundle up. The Elite Traveler: The Lucrative Business of Travel Nursing 55 Back to index... There is a definite shortage of nurses in Chicago and according to the Metropolitan Chicago Healthcare Council (MCHC), Illinois will have a shortage of 21,000 Registered Nurses by 2020. Chicago has many attractions including the classy Magnificent Mile shopping district, Grant Park, The Field Museum, Navy Pier, Lake Michigan, Sears Tower, and Buckingham Fountain. The city also offers a fantastic range of restaurants and local cuisine that includes deep-dish pizza, hot dogs, and the Italian beef sandwich. If you’re there in the summer, don’t miss the Taste of Chicago. In July, Chicago’s best line up for a week of amazing food, great musical entertainment and free concerts all along the lakefront’s Millennium Park. With famous stadiums like Wrigley Field and many professional and championship teams residing in the city, Chicago makes a great choice for sport enthusiasts. Transportation facilities in Chicago are excellent. The buses and trains, also called the “L,” operate as the main means of public transport in the city itself, while there are many bike lanes for cyclers. Chicago also has a clean environment for a city of its size and according to a June 2008 entry in the Chicago Sun-Times all city taxicabs will be using green energy by January 1, 2014. Of special interest to health professionals, is the fact that many medical associations are located in Chicago. The American Medical Association, American College of Surgeons and the American Hospital Association are among many medical organizations based in Chicago. A job in this city could therefore be the ideal location for further educational opportunities. HAWAII: Hawaii has top-notch health care systems and hospitals which go hand in hand with the wonderful weather and surroundings. With just two seasons, summer and winter, Hawaii enjoys average temperatures of 85˚F in the summer and 78˚F in winter. Nursing demand is evident in Hawaii among the estimated 1.2 million people living in Hawaii. In addition to the local residents, there are a large number of tourists who also need health care services while visiting. According to the Hawaii State Center for Nursing, the shortage of nurses is expected to get worse with shortage figures projected to double by 2020. Hawaii has much to offer including a wide range of recreational activities and facilities such as golfing, surfing, dining out and shopping, not to The Elite Traveler: The Lucrative Business of Travel Nursing 56 Back to index... mention the stunning and breathtaking views. A great variety of residential accommodations are available to traveling nurses including apartments in large residential complexes and quaint cottages in lush settings. Most of the housing options are typically centrally located near the assigned facility. Public transportation is usually available via the bus system. Nursing wages range from $26.00 to $31.00 per hour. Free housing and the beautiful locale make Hawaii a paradise destination for traveling nurses. U.S. VIRGIN ISLANDS: “Up-to-date facilities just as attractive as spectacular living conditions,” is how Schneider Regional Medical Center’s Chief Nursing Officer, Angela RennallsAtkinson describes the environment a traveling nurse will experience in the U.S. Virgin Islands. The USVI has a constant demand for nurses and is a great place to work on a temporary assignment with its tropical settings, perfect weather, crystal blue green water and beautiful islands. The cost of living is 33 percent more than most U.S. jurisdictions; however, the nursing demand has increased wages for nursing personnel, making this location a working paradise. Most agencies provide housing near the hospitals, significantly reducing the cost of living further more. Swimming, tennis, sailing, golf, horseback riding and hiking are just some of the outdoor activities one can enjoy in the USVI. Entertainment, dining and nightlife are also readily available as this is a popular tourist location. The islands offer good public transportation including ferries, safari taxis for the hills and other rougher terrain and, for the more adventurous, scooters. There is little variation in the weather throughout the year with temperatures ranging from 72˚F to 86˚F. The only weather concerns are the infrequent tremors from distant earthquakes and the occasional hurricane. But it is important to keep in mind that all in all, this is a pure example of island life. Challenge your creative healthcare abilities with working within the island culture: laidback and casual, all in due time. In addition, areas like these may not have the state-of-the-art equipment you may be accustomed to seeing in the more progressive healthcare systems seen on the mainland. Keep this in mind when you decide to travel. LAS VEGAS: “What happens in Vegas stays in Vegas,” may be the chosen slogan, but when it comes to the nursing shortage, the nursing need is filled by travel staff from all over the United States. Americantraveler.com says more than The Elite Traveler: The Lucrative Business of Travel Nursing 57 Back to index... 30 percent of the 23,000 nurses currently employed in Las Vegas have out-of-state addresses. Less than 10 percent of Las Vegas’ nursing workforce is under the age of 30 and even with major programs to increase the number of younger nurses—such as Adopt-a-student program, sign on bonuses, tuition reimbursements and scholarships—Las Vegas still needs to rely on traveling nurses to fill its needs, which is great news for you. In an interview with Jack Swinney, CEO of Integrated Nursing Alliance of Omaha Nebraska, the Las Vegas Business Press reported that Mr. Swinney, who provides traveling nurses to every private hospital in Las Vegas, has at any one time, between 500 and 1000 traveling nurses from his agency alone. Traveling nurses receive on average an additional $5 to $10 per hour and hospitals are paying for their housing as well. Traveling nurses have an excellent opportunity to cash in on the high demand, excellent pay and good benefits which make Las Vegas one of the very best destinations for traveling nurses. In addition to free housing and outstanding wages, Las Vegas also offers first-rate shopping facilities, shows, dining, spas and of course the magnificent casinos. Monorails, buses and taxis are available to travel about town. The weather ranges from a low of 34˚F and a high of 58˚F in the winter to 82˚F in May and 106˚F in August. BOSTON: Boston’s population of 589,141 is split between the big city, inner suburbs and outer suburbs. Boston has the distinction of being the largest city in New England, yet small compared to other major cities with the cost of living a bit lower than cities such as New York City, Los Angeles and San Francisco. Boston is a beautiful city that boasts about its historic presence, major professional sports teams, sailing, cross country skiing, Cape Cod, forest preserves, parks, skating rings and nightlife. Boston is also famous for its educational institutions and has 11 colleges and universities. The population of Boston is growing rapidly and as with any increase in population, there is an increase in healthcare needs. Boston offers great financial opportunities for all traveling nurses with salaries ranging from $58,000 to $88,000 per year. Boston has three and a half seasons with a full winter, a few weeks of incredible spring, the summer and the best season of all, autumn. So if you’re up for a cold weather visit with an occasional snowfall in April or perhaps a The Elite Traveler: The Lucrative Business of Travel Nursing 58 Back to index... sudden thunderstorm during the hot and muggy summer months, then Boston may just be the place for you. DISTRICT OF COLUMBIA: The District of Columbia is the hot bed of politics. Steeped in history and tradition from the Lincoln Memorial to the White House and the Washington monument, D.C. also boasts a variety of local and national parks. Working as a traveling nurse in D.C. not only provides busy shifts, but also real excitement after work. According to the U.S. Census Bureau, the population in 2007 was 588,292 people squeezing into 61.40 square miles that make up the District of Columbia. Salary ranges for a Registered Nurse in the District of Columbia begin on the low side at $65,000 to the high side of $102,000; the average wage is $87,000 per year. This makes traveling as a nurse in the District of Columbia very profitable. The District of Columbia enjoys four seasons: beautiful springs, colorful autumns, winters with 29˚F as a low and summers averaging highs in the low 90’s. The beautiful weather only adds to the benefits of working in the District of Columbia, not to mention the ability to take day trips to Harpers Ferry National Historical Park for white water rafting or perhaps Baltimore’s American Visionary Art Museum and National Aquarium. ALASKA: Amongst the bear viewing, fishing charters, shopping, tours and cruises is a need for travel nurses to provide care to the residents of Alaska. The vast size of unpopulated areas lends to the difficulty in reducing the shortage of nurses in Alaska. For those who love adventure and the great outdoors Alaska offers an exciting opportunity for either short-term or long-term assignments. In Alaska, even the larger cities have a small town feel to them and there are many excellent activities such as hiking, camping, and fishing in the wilderness. At the same time, Alaska offers the pleasure and entertainment of an exciting night life. With annual salaries for Registered Nurses averaging $66,000 per year, why not take the opportunity to discover why Eskimos build igloos? The Elite Traveler: The Lucrative Business of Travel Nursing 59 Back to index... DENVER: Healthinsurancecolorado.net has noted that there “are still a lot more jobs than qualified applicants” in the field of nursing. The population of Colorado continues to grow at projected rates. In 2008, Colorado’s population was estimated at 4.6 million. Coloradonursingcenter. org put out a report in 2004 that statewide Colorado had 32,370 nurses in the workforce. The projected numbers for 2014 is 47,120, which is an increase of 14,750 positions or 45.6 percent. Despite the income increases in nursing, the shortfall still continues. The Colorado Nurses Association reported that the median income in 2005 increased to $67,000. The need for additional nurses is evident in 25 of Colorado’s larger cities and incentives for nursing students, travel nurses, and nurses looking to retire have been extended to attract and retain nurses in all settings. Colorado has a wide variety of entertainment facilities and many outdoor activities including hiking, backpacking, skiing, snowboarding, and sightseeing. Colorado offers sporting events, theater, spectacular dining and an exciting nightlife. Choosing several assignments in Colorado can be an opportunity to explore the whole state, while earning a healthy income. SAN DIEGO: San Diego has many attractions including visiting the Aerospace museum, Frightmare on Market Street and the San Diego Zoo. It also has some incredible four star restaurants like The Bungalow, Nine-Ten, Whisknladle, Croce’s, and Candelas to name just a few. San Diego has such a wide variety of interesting sightseeing, theater, arts and nightlife that a traveling nurse may never run out of new experiences to try. The population of San Diego is just under three million according to the U.S. Census Bureau. A large number of the population are veterans from the Gulf wars and need long-term nursing care. Even without the increase in veteran population, San Diego is facing an acute nursing shortage and the figures of the next 16 to 18 years are even higher. According to the University of California, San Francisco, it is estimated that by 2030, 100,000 to 122,000 nurses will be needed in the San Diego area alone. The Elite Traveler: The Lucrative Business of Travel Nursing 60 Back to index... Currently the income range for nurses in San Diego is $62,000 to $73,000. As the shortfall increases, the median income is expected to continue to increase as well. Incentives are being offered to prospective nurses to encourage them to complete their schooling and remain in San Diego. Scholarships, tuition reimbursement and commitments with pre-agreed minimum salaries are just a small sample of the incentives offered. Travel nurses are also receiving housing paid for by the hospitals and agencies recruiting travel nurses. The weather, activities, income and benefits make San Diego an incredibly profitable opportunity for traveling nurses. LOS ANGELES: Nearly four million people claim residence in Los Angeles. It is the second largest city in the United States with many things to do day and night. Los Angeles offers movies, sports, aquariums, art galleries, museums, farmers markets, performing arts, racetracks, and tours. The nursing shortage is felt in great numbers in Los Angeles. Several travel nurse agencies only focus on Los Angeles as the need is so great. The low end of the pay scale is $50,000 per year, with the median at $67,000 and higher end at $78,000 per year. Agencies in Los Angeles also work with real estate agencies to line up apartments, homes and condominiums whose owners are more than happy to lease to healthcare professionals. This is a huge benefit considering how difficult it is to find temporary housing in a city of this size. There is great flexibility for travel nurses to work for an indefinite period of time in Los Angeles, while still moving about to several different facilities. DALLAS: Baylor University Medical Center in Dallas is number four on the top 100 hospitals to work for in the United States for 2009. Parkland Memorial Hospital ranks 51 out of 100 in the same list put together by Nursing Professionals as listed on nursingpromag.com. That’s just two of the countless reasons for choosing Dallas as a travel nurse location. Furthermore, the city has many attractions like the Dallas World Aquarium, a number of museums, art gardens, outdoor sculpture tour, Pioneer Plaza Cattle Drive, uptown and west village retail centers. There is also the Mary Kay Cosmetics company, Spanish art museums, and of course the well-known professional sports teams. There is a large variety of activities to fill up 13 weeks’ worth of after work hours. The Elite Traveler: The Lucrative Business of Travel Nursing 61 Back to index... Dining out is eclectic with unique tastes, thick steaks, high style or down home dining everywhere. Dallas has a population of 1.1 million according to the U.S. Census Bureau’s numbers. Dallas has 17 hospitals and medical centers, is the ninth largest city in the United States and the third largest city in Texas. There’s more great news for traveling nurses aiming to go to the Dallas area; nursing salaries begin at $49,000, with a median of $66,000 and some salaries as high as $77,000! Dallas is a city alive with culture, history and more activities than anyone can ever imagine. Along with the income that will be earned, Dallas is simply an exciting experience. As you can see there are several hot spots for travel nurses to profit both personally and financially. Make the decision that’s right for you and begin leading the lifestyle you’ve always wanted. The Elite Traveler: The Lucrative Business of Travel Nursing 62 Back to index... Chapter 9: Capitalizing on the Health Care Traveler’s Lifestyle What Does Your Ideal Lifestyle Exude? When you take the time to think about the daily activities that encompass your day-to-day life, what do you find yourself doing? Are you attending art shows or monster truck shows? Either way, it’s your life, your lifestyle: be an innovator in order to live your best life right now! Designing Your Personal Lifestyle The concept of lifestyle design is an emerging philosophy that seems foreign to most; however, it gives you creative control to live a more meaningful life every day by taking action and seizing the day. Your lifestyle consists of behaviors that make sense to you regarding social interactions, etiquette, entertainment and self expression. These behaviors and practices within your life are a combination of daily habits, conventional ways of doing things, and reasoned actions. Ideally, your lifestyle should reflect your individual values, attitudes and overall view of the world around you. Therefore, a lifestyle is a means of forging a sense of self to create a culture that resonates well with your personal identity. Stop wanting and start taking control of the steering wheel. Ask yourself if the actions you have put forth throughout the day today clearly represent you, what you deem meaningful, important and noteworthy, and if they point you in the direction of your intended success. It’s important to get to the root of your actions and determine if your actions are in line with how you truly want to live? What’s your ideal lifestyle? Write it down on that piece of paper you’ve been working on and let’s take a look. 4 Key Steps to Designing Your Ideal Lifestyle Define Your Lifestyle Goals Goals originate from your innermost dreams and desires. If you could do anything, be anywhere, and freely choose the people around you, what would your life entail? Take a minute to answer the following questions: uu Experiences: How would you invest your time? uu Places: Where would you live and play? The Elite Traveler: The Lucrative Business of Travel Nursing 63 Back to index... uu People: With whom would you like to invest more time? Which people are taking time away from the people and experiences that you truly enjoy? uu Things: What do you want to buy that you thought you couldn’t? The answers to these questions lie within you and will help you determine your lifestyle goals. However, only motivation and most importantly, persistence will help you achieve your goals and, in doing so, will prove life changing. So don’t spend your life in inner conflict; embrace what you hold so dear. Do you have goals that you wish to achieve that would mean providing a comfortable way of life for yourself? Some of your goals may be a new home, a new rewarding career such as travel nursing, to establish a business or personal relationship, or go on a vacation. Most often, your lifestyle goals coincide with your financial goals. Write down where your new home will be, what position you would like to hold and what aspects of you it would fulfill, what type of vacation is ideal for you and, how much money you would like to make. Take a moment to consider what you would do given no limitations. After creating your lifestyle design, with the end result in mind, establish short- and long-term goals that are achievable, clear and measurable. It’s significantly important to know why these goals are important to you and what inspires you to achieve them. Do not let fear of the unknown, false starts or other outside influences derail your pursuit of happiness. Hold steadfast to your vision and maintain your focus. Believing in the outcome determines your level of success. Once you have refined your written goals and created an action plan, find ways to incorporate your plan throughout the day. Concentrate your energy on a single purpose to support your desired outcome. Revisit your personal goals and visualize success. Make sure your goals are truly aligned with your personal desires, wants and needs and that they are in agreement with who you are and what identifies you. Eliminate Cast aside the actions, tasks and people in your life that deter you from your true goal. Eliminate the non-essentials. Oftentimes we inadvertently put more emphasis on tasks that aren’t necessarily part of our stepping stones to success. Making conscious choices takes sustained effort but there is a huge pay-off when you free your emotional energy and time currently being drawn away by unproductive events to focus on your heartfelt goals. Success comes from big goals and sustained action toward those goals each day. Many start with amazing ideas at hand, however, after encountering The Elite Traveler: The Lucrative Business of Travel Nursing 64 Back to index... a few false starts or a bump in the road, become distracted by competing faculties from daily life and are deterred from their main goal. It is important to dedicate at least two hours per day towards achieving your goals. No one should care more about your money and your success more than you do. Create a Plan to Best Suit Your Needs Once you have figured out exactly what you want out of life, it’s time to devise a plan to make it happen. Come to the realization that you are the sole creator of the life in which you live, understand that only you have the ability to change it. So if you find yourself desiring more, wanting more, then the only option is to be the change you wish to see in your life. The idea behind lifestyle design is to venture down the road less traveled, to break away from conformity…why accept what’s typical? Organize and arrange a lifestyle that affords you the opportunity to live more openly and to freely explore a greater sense of freedom and prosperity, to also create new and exciting experiences to obtain financial freedom. From personal experience, I have found that once you get started and build your momentum, you’ve got to run with it; otherwise you will find yourself exactly where you began, if not in the middle of nowhere, fast. Remember that making conscious choices takes sustained effort and the philosophy behind creating your personal lifestyle takes deliberate action. So GET TO WORK! Live Your Passion Let your creative energy flow. Be sure to set aside some time each day specifically for what’s important to you without interruption and enjoy what your travel assignment has to offer. How I Designed My Lifestyle with a Career in Travel Nursing? I enjoy learning all there is to know about the arts and culture; inspirational and educational, all of which a major metropolitan city has to offer. Cities such as Miami, New York, Chicago, Phoenix and San Diego offer diversity, deliciously eclectic foods and amazing architectural delights. Being able to enjoy these aspects of a city makes my career as a travel nurse most fulfilling. So, when looking for assignments, I began catering my travel to locations that offered what I enjoyed most. I found myself selecting cities close to a body of water, from the northern areas of the Hudson River near Sleepy Hollow, New York to Lake Michigan’s Grant Park in Chicago. Living in luxury housing by beautifully flowing rivers or the sounds of the Pacific Ocean is soothing and also part of the lifestyle I’ve created through travel nursing. I have also built in time off for a much deserved vacation and holidays to be with family and friends. I work hard throughout the year to give myself the The Elite Traveler: The Lucrative Business of Travel Nursing 65 Back to index... opportunity to take a few months off here and there. In doing so, I always let the Nurse Manager of the assignment I worked prior to the holidays know what my availability is shortly after the New Year. On several occasions, the managers take the initiative to contact my travel nursing company and request that I return. There’s nothing like having a contract waiting for you when you’re ready to hit the ground running. Today I live in a fantastic Miami condo that is the epitome of island-like resort living with a phenomenal Atlantic Ocean view, luscious landscaping, superb amenities and concierge service, on the Intracoastal Waterway; a waterway that allows easy access to watercraft travel. Who needs a car? A jet ski will do. On any given day, a leisurely stroll can easily turn into a nature walk. I often catch a school of cornet fish frolicking at dawn, a brown spotted stingray or a manatee trailing about. If that wasn’t all, I am surrounded by extraordinary international restaurants. With amazing summer-like weather year round, people from all over the world frequent Miami contributing to its vibrant energy and vivacious culture. Close to the Virgin Islands and Turks and Caicos, a quick getaway is always at my fingertips. Traveling is a joyous venture for whichever reason you chose to embark on this magnificent journey. Travel nursing offers the opportunity to learn new and alternative procedures and processes, work with amazingly bright, forward-thinking physicians across specialties, and gain exposure to diverse work environments all while creating a lifestyle made to order. Traveling as a healthcare professional is an important, life-changing decision that will give you the chance to break out of the mundane to create that new and exhilarating lifestyle you’ve dreamt of. The Elite Traveler: The Lucrative Business of Travel Nursing 66 Back to index... Chapter 10: Unforgettable Luxury Housing Safety and Cleanliness Are Important Consider the simple fact that travel nurse agencies recruit to secure and retain highly-skilled, knowledgeable and experienced nurses within their service. Company housing offers a safe haven, a place of refuge when long grueling shifts come to an end. Housing provided by the company is researched online and secured based upon proximity to contracted facilities in the area, price, fees and lease term negotiations. Valuable healthcare professionals in unsafe housing environments, is not an option. Nothing less than pristine conditions are acceptable. My Five-Day Stay at the Radisson Hotel Having been gone from home for eight months on my very first assignment in Miami, I decided I could do without working the Christmas holiday and returned to New York for the remainder of the year. After spending a fantastic new year at home, I hopped on the cheapest flight back to Ft. Lauderdale. This meant getting up at 4:30am to ensure I made the 6:30am flight because I was already scheduled to work on Monday night. So the flight went well and I made it just in time to unpack my things, spruce up my new housing and hopefully even get in a quick nap. I eagerly turned the key and opened the door to find there was no furniture. Great! Now approaching 5pm I began unloading a few boxes out of the back seat to free up some space for groceries. As I walked through the apartment, I noticed tiny black specks of what I thought was dirt coming from my shoes. Hmm, I thought to myself, have I really tracked in such minute debris? So I headed to the master bedroom to continue my inspection. Yet again, more black specks, but this time as I stared intently, what I thought to be specks of dirt, seemed to be moving. Immediately I headed to Wal-Mart and purchased a vacuum cleaner with a clear collection canister. I really need to know what the heck is going on here. In just a few minutes I managed to quickly vacuum both carpeted bedrooms and to my disbelief there were thousands of fleas leaping from dust ball to dust ball in a single bound. How disgusting! I called my company’s Emergency Hotline and explained the unacceptable matter at hand. I was then told to find a hotel for the evening and the company would reimburse me for the nights spent as long as the rate was less than $70 a night. What?! Oh NO. Do you know what a $70 dollar a night hotel room looks like in Miami and what neighborhood I would have to search to find such accommodations? I immediately said “You make reservations at the Radisson Hotel close to Children’s Hospital or else you can explain to the facility why they no longer have a traveler!” The Elite Traveler: The Lucrative Business of Travel Nursing 67 Back to index... The following morning I headed over to the leasing office of the rental property with the canister in hand. Come to find out, apparently the carpet was brand new. The previous tenants were pet owners prior to the Travel Nurse Company taking on a lease for this particular unit. With that in mind, you would think they may have utilized insecticide before hand as a precautionary measure. After five days at the Radisson Hotel, the maintenance department was finally able to bomb the place. Oh, and let’s not forget that yes, by then, the furniture had been delivered and now I’m expected to sleep on the bed that had been chemically treated with insect toxin. Great! I was given the go ahead to return to the apartment by my travel company’s housing coordinator, so off I went to check it out, just to give it one last fair shot. Upon turning the key it seemed like everything had ceased moving. A dead cockroach, greeted me at the door, you know the ones that are ridiculously huge and fly, yes those, on top of dead spiders, dead fleas and other varmints that I will purposely neglect to mention. And I was left to clean this up? No way! It was that day I decided on the housing subsidy and moved to the Flamingo South Beach. Let the fun begin! Types of Housing Available What You Need to Know about Paid Housing and Reimbursement Travel nursing agencies offer a variety of accommodation benefits. These benefits range from free, private company housing, typically a one bedroom with the essentials that is furnished, to a set reimbursement for housing and utility costs. In the majority of cases they will provide you with a housing specialist to set up and arrange your accommodations. If you are going to be living in company housing, you’ll want to know, up front, which utilities will be paid for by the company and which ones will be your personal responsibility. Do they pay for cable and internet or are these services available for a fee? Are you responsible for the electricity, gas and/or landline telephone service? Your company should provide you with documentation that lists these things. Housing criteria are included in your travel contract. Most agencies do their best to make their employees comfortable in their new surroundings. They understand that this is a must in order to build trust and loyalty in their employees. Consequently, you should always get your contract in writing and insist that the agency put your accommodations package in writing. Research your housing options to see pictures of the apartment or other facilities where you’ll be staying. You can also ask the agency to put you in touch with a couple of other travel nurses who have previously stayed The Elite Traveler: The Lucrative Business of Travel Nursing 68 Back to index... in their private housing. Ask questions. Find out if the housing is what the company says it is. Pictures are priceless and if it’s your first assignment with any given agency you want to be sure of your safety. Unit Inspection Whether you are going to be paying for your own housing or moving into company housing, when you first arrive you should receive a move-in inspection form to fill out. This form will go over all aspects of the accommodations from cleanliness to damages. If it is not offered to you, ask! Otherwise you will be held accountable for damages that may have occurred during a previous tenant’s stay. You will need to go from one room to the other checking walls for holes or marks, making sure lights and outlets work, the water is running, with no leaks or water damage, and if your housing includes furnishings, accounting for all the furniture is very important. If a lamp is missing when you arrive, you don’t want to be charged for it when you move out. If water damage is noticeable when you arrive and not reported, you may be held responsible for these damages as well. Always complete a move-in inspection. When you move out, the company or the landlord will expect the unit you’re living in to be in the same condition as when you arrived. Be sure to assess the unit as a whole or you may be faced with unforeseen charges and have any repairs or cleaning fees deducted from your pay. Keep a copy of the move-in inspection form and complete another inspection with the apartment or housing manager when you move out. You should do a walk-through with an appropriate person from the leasing office or the property manager and obtain a signed statement that no more than normal wear and tear has occurred during the course of your stay in the unit. Housing solutions can also be solved by looking at leasing private homes of residents who are interested in leasing to healthcare professionals. Craigslist. org is a great way to find amazing properties for rent. The owners of these properties choose to work with the travel nursing agencies as they will be assured of the agencies’ care of the property. Some travel nurse agencies have several properties with an apartment as part of a family home. The apartment usually includes a bedroom, living room, bathroom and kitchen. The nurse can be completely separate from the family in the home below. Usually the families are very welcoming to the traveling nurse and provide interaction, help with the feeling of isolation, and a sense of security. Pairing up with a Roommate Before the majority of the travel nursing companies became more competitive by offering free private housing, most housing accommodations The Elite Traveler: The Lucrative Business of Travel Nursing 69 Back to index... in major metropolitan areas came at a minimal cost of $350 a month. When I accepted my first assignment in the Bronx, New York, there was no way I was going to pay to live in the city when I could spend the housing cost attending Broadway shows and enjoying the New York City nightlife. I considered the option of having a roommate. In speaking with my recruiter I was made aware of the criteria I must adhere to in order to be considered for a roommate. She also mentioned that I could very well end up in a two bedroom, two bathroom unit without a roommate, so I took my chances. I was indeed paired with a lovely young lady, Jocelyn, from Tennessee. She worked 12 nights on the Peds Floor while I worked 12 days in the NICU. On our days off together, we met another traveler living downstairs and we were able to catch the train to midtown Manhattan and enjoy a day in the city. Jocelyn was by far the best roommate since college. We both enjoyed the arts, the exuberant culture of New York and loved being travel nurses. Monthly Stipends If you choose to go with a reimbursement plan or housing stipend for your accommodations, you’ll find that different companies have different compensation plans. The majority of them, though, use a standard reimbursement that is within the acceptable range to the highest allowed by the federal government as a daily housing expense for the area to which you are assigned. The allotted amount is divided by the total number of days within the month stipend is used to pay all housing and basic utility costs. The monthly stipend you receive for housing depends on many factors. The location of the assignment plays the largest part of the equation. Monthly stipend amounts range from $700-$2000 per month. Those numbers also include per diem meals and travel expenses. To obtain a daily rate, the easiest route to go is www.gsa.gov. Click on the state you are investigating and it will break the state down by city. This is a great resource if you choose to find your own housing. Housing stipends give you the best opportunity to maintain your personal lifestyle if you’re concerned about the housing that might be provided for you. My South Beach Stay So let’s talk about how you can get prime real estate for pennies a day. I did! After the company housing catastrophe, I decided to take the housing stipend and move to South Beach. I found an amazing, newly-built high-rise in the heart of Miami’s South Beach. With a view of the crystal blue green Intracoastal Waterway, the glowing hue of Downtown Miami at night, the port of Miami where the cruise ships departed and Star The Elite Traveler: The Lucrative Business of Travel Nursing 70 Back to index... Island due West, I had to live there. The amenities were outstanding! Two infinity pools on the North and South end of the property, three Jacuzzis, two beach volleyball courts, a tiki bar for afternoon cocktails, all served while you watched the beautiful water crafts and jet skiers glide by, a 10,000 square foot health and fitness center all amongst lavishly green landscaping. But, to enjoy these exclusive amenities, a resort pass was required and only attainable by being a resident of this prestigious property. While living in this fabulous gated community, I bumped into Dwayne Wade and several other Miami Heat players in the morning while on their way to basketball practice and actress Robin Givens just to name a few. The Video Music Awards came to town and the beach was swarming with talented musicians. Walking distance to Collins and a relaxing lunch on Ocean Drive— all for $200 a month! If you lived anywhere on South Beach, you needed to live here. And little did I know that as a resident of this amazing property I would find weekly invitations to the most trendy parties, art gallery openings, exclusive spa offers and Art Deco home décor discounts. Before long, I found working three days a week, strolling Lincoln Road in flip flops and beachwear, trying a new restaurant, stumbling upon a newly-found chic lounge was well worth taking the company’s housing stipend. Moving Into Your New Home Moving somewhere new is always a challenge. It is important to research an area thoroughly before applying for a travel position. Travel nursing blog websites can be helpful but you may want to call the area’s chamber of commerce or a travel agency so that they can give you even more information on things to do, places to go, population numbers and median age of residents. Your travel job shouldn’t take you away from things you enjoy, places you like to visit or groups you like to belong. As a matter of fact, getting out and meeting new people with the same interests is an opportunity many people only wish they have! Making Your Temporary Housing Feel Like Home You will probably be away from home for a minimum of three months and that can leave you wondering how you’re going to be comfortable in your new home in a foreign place. As a general rule, you’ll be assigned to housing that is private and furnished, but you won’t know, until you see it, just what your accommodations will look like and what kind of a neighborhood you’ll be in. You will certainly have some things that you’ll want to take with you in order to feel at home. Deciding what to take and what to leave behind will make all the difference in how comfortable you feel in your new place. The housing you are assigned will be completely furnished with everything from a washer and dryer, a microwave and dishwasher to, at times, dishes, The Elite Traveler: The Lucrative Business of Travel Nursing 71 Back to index... pots, pans and linens. However, you may want to carry along a favorite picture to hang on the wall, or perhaps photos of your family, and even a small pet if the housing allows for it. If you are a hobbyist, you may want to take along some of the tools and supplies of your craft so that you’re ready to relax on your very first day home from work. I enjoy painting and designing handmade journals for creative writing, so from assignment to assignment, I bring along my paint brushes and creative tools for these projects. Taking these things along with you can be more challenging if you fly to your destination although having your own car can also make getting around a little easier, if you’re assigned to a location that doesn’t have a great public transportation system. Make your new place your haven so you’ll be able to come home to relax and unwind. You will want to bring your top 10 list of favorite things that make you feel at home. uu Your favorite mug. uu A blanket or throw for your living room. uu A favorite comforter or quilt for your bed. uu That special pillow that guarantees a good night’s sleep uu Books to read, Kindle. uu iPad or personal computer uu Items for your hobbies. uu Photos of your family and friends. uu Your portable music collection. uu And your favorite foods. Over the years, I’ve managed to be quite creative with jazzing up the companyprovided housing. You can also find other ways to make your new place feel like home aside from painting an accent wall. I tend to bring the outdoors in with freshly cut aromatic flowers for a bit of color and my largely overgrown corrugated ivory plant. Add some personality by adding a decorative area rug or two, a slipcover to the couch and inexpensive window treatments. Traveling can be lonely at times. Choosing locations that challenge you and fit into your lifestyle design are all a part of your travel journey. A little imagination and creativity can go a long way, helping you make the best of any home away from home. The Elite Traveler: The Lucrative Business of Travel Nursing 72 Back to index... Chapter 11: What to Do with All That Cash You Stashed The additional income obtained through traveling opens up a world of financial opportunity. Depending on what your financial and personal goals are, you can chose to work for a more modern agency with diverse salary options to snag yourself a ton of cash. I did! Within the first six months of taking my very first travel assignment, I completely paid off my car loan and was on my way to being debt free! I took a few vacations from my working vacation, saved a little, splurged a little, invested quite a bit and contributed to my 401k while on assignment. Your options are endless. Pay off your student loans or any unwanted credit card debt. Save for a backpacking trip through Asia, Europe or even South America. Take a few assignments and save for a down payment on the home of your dreams. You can invest in the stock market, purchase government bonds for a rainy day or perhaps enjoy your favorite pastime of gambling at the Bellagio Resort and Casino in Las Vegas, Nevada. You could also decide to return to school to pursue an advanced clinical degree in healthcare. Whichever suites you best, I say go for it! The 1st Elite Purchase: I was on assignment in New York one summer shortly after the Fourth of July. I had been spending some time in the Bronx with Martin, a childhood friend, and decided we should take a leisurely drive to the Upper East Side of Manhattan; the Fall season’s newest IT bag was on display at Barney’s. As we headed down the West Side Highway, I was so anxious to see what people were up to on this gorgeous day. As many times as I have been to the city, I was always intrigued. The streets were bustling with eclecticism, movers and shakers on the go, financial analysts, the artistic and altruistic. What amazing energy; there’s something about pot hole ridden, extremely narrow one way streets swarming with yellow cabs and worldly pedestrians that seems so refreshing. Martin parked curbside, right in front of Barney’s main entrance. I stepped out onto the busy streets of Madison Avenue and 61st Street to be greeted by a towering hum of movement that jolted me with excitement. Wow! This is quintessential New York. I made my way to the couture section on the Main floor just behind and off to the left of the jewelry. Within five minutes, Balenciaga’s wild current Classic City Bag was mine to the sum of $1,500 USD. Michael, the sales associate, placed the purely soft vintage The Elite Traveler: The Lucrative Business of Travel Nursing 73 Back to index... lambskin handbag into its dust bag and then into the Barney’s very large black namesake carrier. I was so excited. “Thank you, Michael,” was soon followed by his “Please do enjoy that absolutely stunning bag, Hon” as I returned to the bustling streets of New York’s Upper East Side. Done. I thought to myself, this is the life. I ♥ New York! My first purchase was a classically elegant handbag. Imagine using the cash you stashed during your assignment to buy the home of your dreams! Lisamar, a fellow traveler, and I kept in touch after our assignment together in Miami. She had recently married and her and her husband decided they wanted to buy a home in the outskirts of Atlanta, Georgia. In taking note of the housing market at the time, Lisamar and her husband thought, what better way to take advantage of the opportunities as a healthcare traveler than to take an eight-week assignment in California to save up enough money to put a substantial down payment on the home of their dreams. Needless to say, two months and $30,000 dollars later, the lovely couple had the home they had always wanted in Douglasville, Georgia. The opportunities are endless with a career in travel nursing. Stir up your imagination and find new and innovative ways to allocate the cash you stash while on assignment as a travel nurse. The Elite Traveler: The Lucrative Business of Travel Nursing 74 Back to index... Chapter 12: The Lucrative Business of Travel Nursing Have what you want, when you want most of the time. You don’t have to wait until you’re retirement eligible to vacation for three months in Europe. Experience life, its energy and splendor with the comforts of a solidified position and income. Whatever your goals may be, travel nursing has the basis for providing you with all the tools needed to cater to who you are. It’s your life, it’s your lifestyle; seek to achieve your lifestyle goals and personal freedom will follow; limit yourself less! A Privileged Lifestyle Designed by You Your lifestyle consists of behaviors that exemplify you giving way to your means of social interaction, entertainment and self expression. Therefore, a lifestyle is a means of forging a sense of self to create a culture that wholeheartedly resonates with your personal identity. Determine the things in life that make you happy and create your own path. Stop wanting and start taking control of the steering wheel. Ask yourself if the actions you have put forth throughout the day-to-day clearly represent you, what you deem meaningful and successful. Are your actions in line with how you truly want to live? Travel nursing is a fantastic way to live an abundantly privileged lifestyle, full of vibrancy and enthusiasm. A happy nurse means better patient care. The happier you are the more valuable you are to the people around you. When you are passionate about the people and events in your life, you become a magnet for others living the same way and those desiring the same experiences. In effect, you can create an environment where those around you can’t help but to enjoy themselves. Organize your life around what truly brings you joy and happiness. By creatively designing your lifestyle, YOU determine what experiences will lead to your successful living by far encouraging others. The Luxury of Travel Travel nursing will give you the opportunity to do more, see more and learn more than you have ever imagined possible. All while helping others in need. Can there be a better career path? Nurses who desire to become travelers choose to leave their homes for areas in which they are unfamiliar. These nurses are just as dedicated to their profession as their local counterparts—with the additional dimension of moving to a new location, meeting new people, experiencing what each area The Elite Traveler: The Lucrative Business of Travel Nursing 75 Back to index... has to offer to its fullest. As a travel nurse, you have the opportunity to gain more than just a healthy bank account. You will gain experience in some of the best facilities throughout the United States. You will meet interesting patients, save lives, and you will be able to travel to some amazing destinations. An additional and equally important reason for considering a travel nursing career is the desire to visit friends and family in distant places without the financial burden. Travel nursing allows nurses to temporarily stay close to family or friends, whilst continuing to earn an income. In this way, experienced nurses can use travel nursing to catch up with long lost friends, attend social occasions such as weddings or reunions, and to spend time with relatives that live out of state. One more reason to become a traveling nurse is the sheer enjoyment of encountering fresh faces and new places on a regular basis. Some nurses find pleasure in regular travel without settling down in a specific location. Travel nursing allows a professional to travel throughout the United States while working. It is a great way to explore the country with minimal financial stress. It is refreshing to regularly start anew in a different location. This system offers a new experience, knowledge, and opportunity. There is no doubt that wages for travel nurses are generally much higher than those of a regular permanent position. Travel nursing offers an added incentive for those seeking to save money, obtain financial security and afford a better lifestyle. Financial Rewards for Your Practice-Specific Expertise Why are travel nurses compensated so well? You have been hired due to your phenomenal expertise with the added dimensions of moving to a new location to ease the stress on the local staff. Travel nursing offers top pay rates, completion bonuses, housing stipends and meal allowances. Licensure and travel reimbursements are also provided to help you achieve your financial goals. Imagine working 40 weeks a year and earning a salary of $100,000 or more! There is no doubt that wages for travel nurses are higher than those of your permanent staff counterparts. In addition, you determine whether or not a specific assignment meets your standard criteria based on compensation, housing location for amenities within the area, income as well as bonuses available. What moves you to achieve your financial dreams? Priceless Knowledge Traveling is a joyous venture for whichever reason you chose to embark on this magnificent journey. Travel nursing offers the opportunity to learn new and alternative procedures and processes, work with amazingly bright, forwardThe Elite Traveler: The Lucrative Business of Travel Nursing 76 Back to index... thinking physicians across specialties, and gain exposure to diverse work environments. By working at a teaching facility you have the opportunity to serve as the definitive resource in your specialty, remaining up-todate and knowledgeable as to the changes that have come and gone to enhance patient care and provide modern medicine as it evolves. Participate in clinical trials and research developments, subscribe to a medical journal or two in your specialty. You can find the latest issue of any given journal at your local library in the medical references or periodical section. Take the opportunity to read a few articles that may interest you and perhaps provide some insight as to how you may tailor your patient care. Keeping abreast of ongoing research studies will give you the opportunity to present options to your current facility and department to perhaps implement a new protocol when caring for your newly admitted patients. Free Will: The Ultimate Luxury As a traveler you have the option of determining your own schedule: when and where you would like to work and how long. The important factor to keep in mind in order to be successful is to enjoy the time that is allotted to you while on an assignment and know when to leave. Travel nursing will give you the ability to achieve your financial and lifestyle goals. The opportunity to do more, see more and learn more than you have ever imagined begins with your mindset, all while helping others in need. Can there be a better career path? Visualize Success The first step to success within the travel nursing industry is to establish a successful mindset of your ability as a traveler. As outlined in the focus funnel, your mindset is the foundation to all things great. Thinking that there are endless possibilities distinguishes that there are indeed a plethora of amazing goals just waiting to be achieved. Take a look at the lifestyle, personal and professional goals you have established throughout reading this book. With these goals in mind, make a consistent daily effort to tailor your routine, activities and experiences toward achieving your personal best. The Elite Traveler: The Lucrative Business of Travel Nursing 77 Back to index... Be confident in your capabilities. Remove all areas of doubt and uncertainty. Set the bar higher with each assignment to achieve greater financial and personal success. Look to outdo yourself and achieve more than you have previously. Visualize the potential of what a career in travel nursing will provide in your life and set sail! As a nurse, you give of yourself daily to care for your patients, why not give to yourself and experience the Lucrative Business of Travel Nursing. The Elite Traveler: The Lucrative Business of Travel Nursing 78 Back to index... APPENDIX A: Travel Nursing Forums and Blog Sites The information in this appendix is subjective in nature. www.healthcaretravelbook.com: a great source of information that is easy to read and navigate. The entries from the nurses are a great source of valuable information. It’s focus is positive and encouraging. www.nurses-forum.com: great source for learning about the profession of travel nurse as well as lively message boards. It is important to not only have a place to vent, but a place to share vital information. www.nurse.com: a nursing journal publication from Nurse.com, Inc. The information on this site is very informative. www.ultimatenurse.com: a great resource about the ins and outs of travel nursing. You’ll find great advice from experienced nurses. www.nurselounge.com: an easy to navigate site that shares a lot of information relevant to travel nurses. www.travelnursetoolbox.com: made for travelers by travelers. It addresses real experiences and what you can do to avoid common mistakes. The Elite Traveler: The Lucrative Business of Travel Nursing 79 Back to index... APPENDIX B: Travel Nursing Magazines: Keep Abreast of What’s Going On The selection of magazines in this appendix includes both online and print magazines. Online magazines listed in this section are free of charge. That is great news, while traveling you can be updated as needed. While researching print magazines, I came across several offers for the print magazines subscription for free. Search online even if you want print magazines for the free subscriptions. www.travelnursingmagazine.com: great information, free to join. www.healthcaretraveler.com: Modern Medicine Network has both print and online versions of their magazine. www.nurseweek.com: Nursing Spectrum offers both print and online versions of their magazine. www.nursing.advanceweb.com: an impressive site. The amount of information available at your fingertips is incredible. www.allnurses.com: an online magazine with great information for not only travel nursing, but nursing in general. RN Magazine can be purchased from www.magsdirect.com or www. subscriptionaddiction.com. American Journal of Nursing can be purchased through www.magsdirect.com or www.subscriptionaddiction.com. Nursing Made Incredibly Easy can be purchased on www.magsdirect.com or www.subscriptionaddiction.com. www.nursezone.com: an online magazine with great information for all nurses. The Elite Traveler: The Lucrative Business of Travel Nursing 80 Back to index... Appendix C: State Boards for Licensure and Endorsement State Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Address Connecticut Dept. of Public Health RN/LPN Licensure 410 Capitol Ave., MS #12 APP P.O. Box 340308 Hartford, CT 06134 Delaware Board of Nursing Cannon Building; Suite 203 861 Silver Lake Blvd. Dover, DE 19904 Department of Health Professional Licensing Administration Board of Nursing 717 14th Street, NW; Suite 600 Washington, DC 20005 Florida Board of Nursing 4052 Bald Cypress Way Tallahassee, FL 32399-‐3257 Phone 860-‐509-‐7624 Fax 860-‐509-‐8457 Website/Email www.state.ct.us/dph [email protected] 302-‐744-‐4500 302-‐739-‐2711 www.dpr.delaware.gov/boar ds/nursing Georgia Board of Nursing (mailing address) P.O. Box 13446 Macon, GA 31208 (physical address) 237 Coliseum Drive Macon, GA 31217-‐1640 Hawaii Board of Nursing DCC-‐PVL P.O. Box 3469 Honolulu, HI 96801 Idaho Board of Nursing th 280 North 8 Street; Suite 210 P.O. Box 83720 Boise, ID 83720-‐0061 Illinois Dept. of Professional Regulation James R. Thompson Center 100 W Randolph Street; Suite 9-‐300 Chicago, IL 60601 OR 320 West Washington St Springfield, IL 62786 [email protected] e.us 877-‐244-‐1689 202-‐727-‐8471 http://hpla.doh.dc.gov/hpla/ cwp/view,A,1195,Q,488526, hplaNav,%7C30661%7C,.asp [email protected] 850-‐488-‐0595 478-‐207-‐2440 877-588-0446 www.doh.state.fl.us/mqa/nu rsing MedicalQualityAssurance@d oh.state.fl.us www.sos.georgia.gov/plb/rn / 808-‐586-‐2695 808-‐586-‐2689 http://hawaii.gov/dcca/areas /pvl/boards/nursing/ [email protected] 208-‐334-‐3110 208-‐334-‐3262 www2.idaho.gov/ibn [email protected] 312-‐814-‐2715 OR 217-‐785-‐0800 312-‐814-‐3145 OR 217-‐782-‐3414 www.idfpr.com/dpr/WHO/n urs.asp The Elite Traveler: The Lucrative Business of Travel Nursing 81 Back to index... State Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Address Indiana Board of Nursing Professional Licensing Agency 402 W. Washington Street, Room W072 Indianapolis, Indiana 46204 Iowa Board of Nursing RiverPoint Business Park 400 S.W. 8th Street, Suite B Des Moines, IA 50309-‐4685 Kansas Board of Nursing Landon State Office Building 900 SW Jackson Street Suite 1051 Topeka, Kansas 66612-‐1230 Kentucky Board of Nursing 312 Whittington Pky., Suite 300 Louisville, KY 40222 Louisiana State Board of Nursing 17373 Perkins Road Baton Rouge, LA 70810 Maine State Board of Nursing 161 Capitol Street 158 State House Station Augusta, Maine , 04333-‐0158 Maryland Board of Nursing 4140 Patterson Avenue Baltimore, Maryland, 21215-‐ 2254 Massachusetts Board of Nursing 239 Causeway Street Boston, MA 02114 Michigan Board of Nursing Ottawa Towers North th 611 W Ottawa 4 Floor Lansing, MI 48933 Minnesota Board of Nursing 2829 University Ave SE Suite 200 Minneapolis, MN 55414 Phone 317-‐234-‐2043 Fax 317-‐233-‐4236 Website/Email www.in.gov/pla/nursing.htm [email protected] 515-‐281-‐3255 515-‐281-‐4825 www.state.ia.us/nursing/ [email protected] 785-‐296-‐4929 785-‐296-‐3929 www.ksbn.org/ 502-‐429-‐3300 OR 800-‐305-‐2042 502-‐429-‐3311 www.kbn.ky.gov/ 225-‐755-‐7500 225-‐755-‐7584 www.lsbn.state.la.us/ 207-‐287-‐1133 207-‐287-‐1149 www.maine.gov/boardofnur sing/ 410-‐585-‐1900 OR 888-‐202-‐9861 410-‐358-‐3530 www.mbon.org/main.php 617-‐727-‐9961 617-‐727-‐1630 www.state.ma.us/reg/board s/rn 517-‐373-‐9102 517-‐373-‐2179 612-‐617-‐2270 612-‐617-‐2190 Mississippi Board of Nursing 1935 Lakeland Drive, Suite B Jackson, MS 39216 Missouri Board of Nursing 3605 Missouri Boulevard P.O. Box 656 Jefferson City, MO 65102-‐ 0656 601-‐987-‐4188 601-‐364-‐2352 www.michigan.gov/mdch/0, 1607,7-‐132-‐ 27417_27529_27542-‐-‐-‐ ,00.html www.state.mn.us/portal/mn /jsp/home.do?agency=Nursi ngBoard [email protected] www.msbn.state.ms.us 573-‐751-‐0681 573-‐751-‐0075 The Elite Traveler: The Lucrative Business of Travel Nursing http://pr.mo.gov/nursing.asp [email protected] 82 Back to index... State Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Address Montana State Board of Nursing 111 N Jackson Helena, MT 59620 DHHS, Public Health, Nursing Licensure Nebraska State Office Building 301 Centennial Mall South; rd 3 floor P.O. Box 94986 Lincoln, NE 68509-‐4986 Nevada State Board of Nursing 1755 E Plumb LN: Suite 260 Reno, NV 89502 New Hampshire Board of Nursing 78 Regional Drive; Bldg. B P.O. Box 3898 Concord, NH 03302 New Jersey Board of Nursing th 124 Halsey Street, 6 Floor P.O. Box 45010 Newark, NJ 07101 New Mexico Board of Nursing 6301 Indian School Rd. NE Suite 710 Albuquerque, NM 87110 New York State Board for Nursing State Education Building nd 2 Floor Albany, NY 12234 North Carolina Board of Nursing 3724 National Drive Raleigh, NC 27602 North Dakota Board of Nursing Phone 406-‐444-‐2071 Fax 406-‐444-‐7759 Website/Email http://mt.gov/dli/bsd/licens e/bsd_boards/nur_board/bo ard_page.asp 402-‐471-‐2115 402-‐471-‐3577 www.hhs.state.ne.us/crl/crli ndex.htm [email protected] ov 775-‐688-‐2620 775-‐688-‐2628 www.nursingboard.state.nv. us/ 603-‐271-‐2323 603-‐271-‐6605 www.nh.gov/nursing/ 973-‐504-‐6586 973-‐648-‐3481 www.state.nj.us/lps/ca/medi cal/nursing.htm 505-‐841-‐8340 505-‐841-‐8347 www.bon.state.nm.us/ 518-‐474-‐3817 Ext. 120 518-‐474-‐3706 www.op.nysed.gov/nurse.ht m 919-‐782-‐3211 919-‐781-‐9461 www.ncbon.com/ 701-‐328-‐9777 701-‐328-‐9785 www.ndbon.org/ 614-‐466-‐3947 614-‐466-‐0388 www.nursing.ohio.gov 405-‐962-‐1800 405-‐962-‐1821 www.youroklahoma.com/nurs ing/ 919 S 7th Street; Suite 504 Bismarck, ND 58504 Ohio Oklahoma Ohio Board of Nursing 17 South High Street Suite 400 Columbus, OH 43215-‐ 7410 Oklahoma Board of Nursing 2915 N Classen Suite 524 Oklahoma City, OK 73106 The Elite Traveler: The Lucrative Business of Travel Nursing 83 Back to index... State Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Address Oregon State Board of Nursing 17938 SW Upper Boones Ferry Rd. Portland, Oregon 97224-‐7012 Pennsylvania State Board of Nursing P.O. Box 2649 Harrisburg, PA 17105-‐2649 Phone 971-‐673-‐0685 Fax 971-‐673-‐0684 Website/Email 717-‐783-‐7142 717-‐783-‐0822 www.dos.state.pa.us/bpoa/c wp/view.asp?a=1104&q=432 883 Rhode Island Board of Nursing 3 Capitol Hill; Room 105 Providence, RI 02908 South Carolina Board of Nursing Synergy Business Park; Kingstree Bldg 110 Centerview Dr., Suite 202 Columbia, S.C. 29210 (mailing address) P.O. Box 12367 Columbia, S.C. 29211-‐2367 South Dakota Board of Nursing 4305 Louise Avenue; Suite 201 Sioux Falls, SD 57106 Tennessee Board of Nursing 227 French Landing, Suite 300 Nashville, TN 37243 Texas Board of Nursing 333 Guadalupe #3-‐460 Austin, Texas 78701 Utah State Board of Nursing 160 East, 300 South Salt Lake City, UT 84111 Vermont State Board of Nursing National Life Building; N Floor 2 Montpelier, VT 05620-‐3402 Virgin Islands Board of Nurse Licensure PO Box 304247 Veterans Drive Station St. Thomas, VI 00803 Virginia Board of Nursing Perimeter Center 9960 Mayland Drive; Suite 300 Richmond, VA 23233-‐1463 401-‐222-‐5700 401-‐222-‐3352 [email protected] www.health.state.ri.us/hsr/pr ofessions/nurses.php 803-‐896-‐4550 803-‐896-‐4525 www.llr.state.sc.us/pol/nursin g/ 605-‐362-‐2760 605-‐362-‐2768 http://doh.sd.gov/boards/nur sing/ 615-‐532-‐5166 615-‐770-‐7441 http://health.state.tn.us/boar ds/nursing/ 512-‐305-‐7400 512-‐305-‐7401 www.bon.state.tx.us/ 801-‐530-‐6628 801-‐530-‐6511 www.dopl.utah.gov/licensing/ nursing.html# 802-‐828-‐2396 802-‐828-‐2484 www.vtprofessionals.org/opr1 /nurses/ 340-‐776-‐7397 340-‐777-‐4003 www.vibnl.org/ 804-‐367-‐4515 804-‐527-‐4455 www.dhp.virginia.gov/nursing / The Elite Traveler: The Lucrative Business of Travel Nursing www.osbn.state.or.us/ 84 Back to index... State Washington West Virginia West Virginia Wisconsin Wyoming Address Washington State Nursing Care Quality Assurance Commission (mailing address) P.O. Box 1099 Olympia WA 98507-‐1099 (physical address) 310 Israel Road Turnwater, WA 98501 West Virginia Board of Examiners for Registered Professional Nurses 101 Dee Drive, Suite 102 Charleston, WV 25311-‐1620 West Virginia State Board of Examiners for Licensed Practical Nurses 101 Dee Drive Charleston, WV 25311 Wisconsin Department of Regulation and Licensing 1400 E Washington Avenue P.O. Box 8935 Madison, WI 53708 Wyoming State Board of Nursing 1810 Pioneer Avenue Cheyenne, WY 82002 Phone 360-‐236-‐4700 Fax 360-‐236-‐4818 Website/Email https://fortress.wa.gov/doh/h pqa1/hps6/Nursing/default.ht m [email protected] 304-‐558-‐3596 OR 877-‐743-‐6877 304-‐558-‐3666 304-‐558-‐3572 304-‐558-‐4367 www.wvrnboard.com/ [email protected] www.lpnboard.state.wv.us/ [email protected] 608-‐266-‐2112 608-‐267-‐0644 http://drl.wi.gov/boards/nur/ 307-‐777-‐7601 307-‐777-‐3519 http://nursing.state.wy.us/ [email protected] The Elite Traveler: The Lucrative Business of Travel Nursing 85 Back to index... Appendix D: Nurse Licensure Compact (NLC) States (RN and LPN/LVN)* Participating State Arizona Arkansas Colorado Delaware Idaho Iowa Kentucky Maine Maryland Mississippi Missouri Nebraska New Hampshire New Mexico North Carolina North Dakota Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Wisconsin Implementation Date 07/1/2002 07/1/2000 10/1/2007 07/1/2000 07/1/2001 07/1/2000 06/1/2007 07/1/2001 07/1/1999 07/1/2001 06/1/2010 01/1/2001 01/1/2006 01/1/2004 07/1/2000 01/1/2004 07/1/2008 02/1/2006 01/1/2001 07/1/2003 01/1/2000 01/1/2000 01/1/2005 01/1/2000 * Table adapted from https://www.ncsbn.org/158.htm retrieved 10-19-2009. NCSBN list of participating states was last updated in June 2010. Contact your state board of nursing for specific information (see Appendix C). The Nurse Licensure Compact (NLC) is a mutual recognition agreement that allows nurses licensed in their state of residence to practice in other participating states in accordance with the participating state’s regulations. Participating states are required to establish legislation or regulations for mutual recognition, to enact rules for implementing the NLC, and to identify an NLC administrator. The National Council of State Boards of Nursing (NCSBN) and the Nurse Licensure Compact Administrators (NLCA) have adopted model legislation and rules for reference and guidance The Elite Traveler: The Lucrative Business of Travel Nursing 86 Back to index... Appendix E: States with No State Income Tax Seven states have no personal state income tax and two states tax only dividend and interest income. State Alaska Florida Nevada South Dakota Texas Washington Wyoming New Hampshire* Tennessee* State Department of Revenue Website www.revenue.state.ak.us/ http://dor.myflorida.com/dor/ http://tax.state.nv.us/ www.state.sd.us/drr2/Revenue.html www.window.state.tx.us/taxes/ http://dor.wa.gov/Content/Home/Default.aspx http://revenue.state.wy.us/ www.nh.gov/revenue/ www.state.tn.us/revenue/ *tax dividend and interest income For more information contact each state’s department of revenue and your tax professional. Additional information is also available at: www.irs.gov/efile/article/0,,id=130684,00.html www.govspot.com/know/incometax.htm www.taxadmin.org/fta/rate/ind_inc.html The Elite Traveler: The Lucrative Business of Travel Nursing 87 Back to index... Appendix F: The Agency Structure JCAHO Health care staffing agencies have been dealt an expensive hand with the new JCAHO requirements for certification. In order to place travel nurses into hospitals with JCAHO certification, they too must be certified. For larger agencies, the expense can be covered by the sheer volume of contracts they process. The smaller agencies may face financial hardships ensuring their agency meets the certification requirements. The purpose behind the requirements ultimately protects not only the hospitals and agencies, but the travel nurse. The travel nurse will be supported in their efforts to continually improve skills and knowledge in their specific specialty. This is a huge benefit as medical advances continue to improve the care for the patients and the quality of education of nurses fresh out of nursing school. As a travel nurse, you will be able to maintain and improve your skills to keep you in high demand. NATHO Another organization whose focus is to raise the standards of excellence in the travel nurse industry is National Association of Travel Healthcare Organization. NATHO is a non-profit organization of travel nurse agencies purposed to bring a higher and consistent level of quality, benefiting agencies, hospitals and travel nurses. NATHO provides access to information unique to travel healthcare: uu Insurance and risk management resources uu Public relations uu Shared marketing resources uu Federal and state legislative issues uu Ethics and arbitration guidelines uu Credentialing standards uu Standards of practice uu Industry benchmarking and stats uu Group purchasing The Elite Traveler: The Lucrative Business of Travel Nursing 88 Back to index... What makes NATHO unique? Their non-profit organization is managed by an independent third party allowing for the travel healthcare agencies to focus on their purpose. The NATHO connection The National Association of Travel Healthcare Organizations (NATHO) is a nonprofit association founded in 2008 to promote ethical business practices in the travel healthcare industry, setting the standard for conduct that is aligned among member agencies on behalf of travel healthcare candidates and clients. According to staffing industry professionals, NATHO’s overall role is to promote the travel-staffing industry. A staffing agency that is a NATHO member is held to a strict code of ethics developed specifically for the travel healthcare industry. The organization primarily serves in these capacities: uu Educate the healthcare industry on the benefits of travel healthcare staffing. uu Establish a set of service standards among travel healthcare companies. uu Share resources among member organizations. uu Offer a formal dispute resolution process through an arbitration committee. uu Aid all members in cultivating market growth. A recent NATHO initiative is collecting data on job orders and the number of travelers in the marketplace. This will help provide those companies that participate in the benchmarking with critical data concerning how they’re doing relative to other companies. This type of information was not previously available. Another NATHO initiative is an effort to find ways to educate hospital clients about the value that travelers bring to their organization. There is often a misconception on the true economic value a traveler brings to a facility as compared with the cost of a full-time nurse. The Application Process The application process to be a travel nurse is very simple; once you decide which agency to join forces with. You can call to request an application be sent to you. If you prefer, you can download a copy of the application, print it out, complete the application and mail or fax it to the agency. If you are computer savvy and want to move the process along quickly, you can apply online. The Elite Traveler: The Lucrative Business of Travel Nursing 89 Back to index... The application begins with your basic information: name, address, phone numbers and then requests licensure and certification information. You will be asked pointed questions; has your license or certification been investigated or suspended, and have you been convicted of a crime other than a minor traffic violation. You will also be asked if you have ever been named as a defendant in a professional liability action and for information about your employment history including times of unemployment. Skills Checklist You will need to complete skills checklists. Each specialty requires their own skills checklist: cath lab, critical care/ICU, dialysis nursing, emergency room, intermediate care/PCU/Stepdown/Telemetry, labor and delivery, medical/surgery, NICU, operating room, PACU, pediatric emergency room, pediatric unit, PICU, post-partum/nursery skills, psychiatric unit, urgent care/ clinic skills, wound/ostomy/continence. Assignment Selection The next step is to begin the assignment selection. You are able to make a desired assignment profile based on location, specialty, professional discipline, preferred shifts, and type of facility. It is crucial that you make your needs, wants and desires known. Travel Nursing Agency Roles After selecting your travel nurse agency, you may wonder who makes up the internal staff. Each person has a specified role within the agency set from JCAHO requirements for certification. Each person plays an integral part in the success of your travel nursing career. Recruiter The recruiter is your lifeline to the agency and to the facility in which you’ve selected. It is the recruiter’s responsibility to find prospective nurses to work with their agency. It is also their job to facilitate the hiring process of the nurses. The recruiter develops relationships with the nurses, the facilities and brings the best qualified nurses to the facility of their choosing. Clinical Liaison The clinical liaison is there to answer any questions you may have before and during your assignments with regards to clinical practice and facility related issues. The clinical liaison is a Registered Nurse, but may even be a Nurse Practitioner that will help you adapt to new facility procedures and protocols. This is a huge asset at the traveling nurse’s disposal. The Elite Traveler: The Lucrative Business of Travel Nursing 90 Back to index... Account Managers Account managers work with facilities across the country to develop relationships and provide nurses to work in their facilities. Their responsibility is to bring in the assignments travel nurses want to work. Payroll Payroll manages the travel nurse’s income, taxes, benefits and ensures paychecks are direct deposited or sent to you on time. Housing Coordinator The housing coordinator locates high quality, safe housing for travel nurses. They care for the leases, furnishing and other details necessary to make your stay in your chosen location all that you expect and more. Customer Care The Customer Care Line offers 24 hour clinical support and emergency assistance for travelers in need while on assignment or those who simply have questions. The Elite Traveler: The Lucrative Business of Travel Nursing 91 Back to index... APPENDIX G: Hospital Interview Guidelines When you choose a location, the process is not yet over. During the interview process, the facility is going to talk with you about the nature of the assignment all while gathering information to decide whether or not you are a good fit for the facility. This is your chance to find out if this is the assignment for you. By asking key questions, like the ones in the following form, you will find out if the management style and the flow of the unit will fit well with your personality and clinical expertise. The Elite Traveler: The Lucrative Business of Travel Nursing 92 Back to index... Health Care Professional INTERVIEW GUIDELINES UNIT 1. Number of beds Patient demographic 2. Nurse-to-patient ratio: Days Evenings Nights 3. Specialized Equipment used: 4. Type of electronic charting/documentation 5. Special procedure/medication system in use 6. Is a uniform required? Yes No Provided by: If scrubs are needed, is there a required color? 7. Patient Care Model Traveler Yes No Primary Nursing 8. Have travelers been used previously in your unit? Facility Color: Team Nursing Yes No If yes, how often? SCHEDULE 1. Available date to begin work Length of assignment 2. Shift to be worked: Single Shift: Rotating Shift: How will it rotate? 3. Split shifts policy: On a 12 hour shift, will traveler float elsewhere for 4 hours? 4. Weekend shifts policy? Yes No How Often? 5. Will travelers be in a charge nurse position at any time? 6. Is overtime available or mandatory? Yes Yes No No 7. Policy on requesting time off or schedule changes: 8. Policy on working holidays: 9. On Call policy, if required: FLOATING 1. Floating policy? Yes No How Often? 2. Will travelers float first or in rotation with permanent staff? 3. Will travelers float to similar units? Yes 4. Do travelers float to more than one unit per shift? No Which Units? Yes No 5. What is the length of orientation for units floated to? FIRST DAY/ORIENTATION 1. Orientation length: Hospital Unit 2. Where do I report to? At which time? 3. Who do I ask for? Should I wear a uniform? 4. Hospital/Unit Examinations: Is there a study guide available? 5. Is free parking available? Yes No Yes No If no, what is the cost? 6. Where can I find adequate parking? Notes: The Elite Traveler: The Lucrative Business of Travel Nursing 93 Appendix C: State Boards for Licensure and Endorsement State Alabama Alaska Arizona Arkansas California California Colorado Address Phone Fax Alabama Board of Nursing RSA Plaza, Suite 250 770 Washington Avenue Montgomery, AL 36130-3900 Alaska Board of Nursing Dept. of Commerce, Community & Economic Development Division of Corps., Business & Professional Licensing th 550 West 7 Ave.; Suite 1500 Anchorage, AK 99501 334-242-4060 OR 800-656-5318 334-242-4360 Website/Email 907-269-8161 907-269-8156 Arizona Board of Nursing 4747 North 7th Street, Suite 200 Phoenix, AZ 85014 Arkansas State Board of Nursing University Tower Building 1123 South University; Suite 800 Little Rock, AR 72204 602-889-5150 602-889-5155 www.azbn.gov 501-686-2700 501-686-2714 [email protected] www.arsbn.org California Board of Registered Nursing (mailing address) P.O. Box 944210 Sacramento, CA 94244-2100 (physical address) 1625 North Market Blvd; Suite N217 Sacramento, CA 95834-1924 California Board of Vocational Nursing 2535 Capitol Oaks Drive; Suite 205 Sacramento, CA 95833 916-322-3350 916-574-7697 www.rn.ca.gov Colorado Board of Nursing 1560 Broadway; Suite 670 Denver, CO 80202 303-894-2430 www.abn.state.al.us [email protected] www.nursing.alaska.gov [email protected] [email protected] 916-263-7800 916-263-7859 www.bvnpt.ca.gov [email protected] 303-894-2821 Elite Traveler: The Lucrative Business of Travel Nursing TheThe Elite Traveler www.dora.state.co.us/nursing Back to index... 67 67 State Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Address Connecticut Dept. of Public Health RN/LPN Licensure 410 Capitol Ave., MS #12 APP P.O. Box 340308 Hartford, CT 06134 Delaware Board of Nursing Cannon Building; Suite 203 861 Silver Lake Blvd. Dover, DE 19904 Department of Health Professional Licensing Administration Board of Nursing 717 14th Street, NW; Suite 600 Washington, DC 20005 Florida Board of Nursing 4052 Bald Cypress Way Tallahassee, FL 32399-3257 Georgia Board of Nursing (mailing address) P.O. Box 13446 Macon, GA 31208 (physical address) 237 Coliseum Drive Macon, GA 31217-1640 Hawaii Board of Nursing DCC-PVL P.O. Box 3469 Honolulu, HI 96801 Idaho Board of Nursing th 280 North 8 Street; Suite 210 P.O. Box 83720 Boise, ID 83720-0061 Phone Fax 860-509-7624 860-509-8457 Website/Email www.state.ct.us/dph [email protected] 302-744-4500 302-739-2711 www.dpr.delaware.gov/boards/nursing [email protected] 877-244-1689 202-727-8471 http://hpla.doh.dc.gov/hpla/cwp/view,A,1195, Q,488526,hplaNav,%7C30661%7C,.asp [email protected] 850-488-0595 www.doh.state.fl.us/mqa/nursing 478-207-2440 877-588-0446 808-586-2695 808-586-2689 208-334-3110 208-334-3262 Elite Traveler: The Lucrative Business of Travel Nursing TheThe Elite Traveler [email protected] www.sos.georgia.gov/plb/rn/ http://hawaii.gov/dcca/areas/pvl/boards/nursi ng/ [email protected] www2.idaho.gov/ibn [email protected] Back to index... 68 68 State Address Illinois Illinois Dept. of Professional Regulation James R. Thompson Center 100 W Randolph Street; Suite 9-300 Chicago, IL 60601 OR 320 West Washington St Springfield, IL 62786 Indiana Board of Nursing Professional Licensing Agency 402 W. Washington Street, Room W072 Indianapolis, Indiana 46204 Iowa Board of Nursing RiverPoint Business Park 400 S.W. 8th Street, Suite B Des Moines, IA 50309-4685 Kansas Board of Nursing Landon State Office Building 900 SW Jackson Street Suite 1051 Topeka, Kansas 66612-1230 Kentucky Board of Nursing 312 Whittington Pky., Suite 300 Louisville, KY 40222 Louisiana State Board of Nursing 17373 Perkins Road Baton Rouge, LA 70810 Maine State Board of Nursing 161 Capitol Street 158 State House Station Augusta, Maine , 04333-0158 Indiana Iowa Kansas Kentucky Louisiana Maine Phone Fax 312-814-2715 312-814-3145 OR OR 217-785-0800 217-782-3414 317-234-2043 317-233-4236 Website/Email www.idfpr.com/dpr/WHO/nurs.asp www.in.gov/pla/nursing.htm [email protected] 515-281-3255 515-281-4825 www.state.ia.us/nursing/ [email protected] 785-296-4929 785-296-3929 www.ksbn.org/ 502-429-3300 OR 800-305-2042 225-755-7500 502-429-3311 www.kbn.ky.gov/ 225-755-7584 www.lsbn.state.la.us/ 207-287-1133 207-287-1149 www.maine.gov/boardofnursing/ Elite Traveler: The Lucrative Business of Travel Nursing TheThe Elite Traveler Back to index... 69 69 State Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada Address Phone Fax Maryland Board of Nursing 4140 Patterson Avenue Baltimore, Maryland, 21215-2254 Massachusetts Board of Nursing 239 Causeway Street Boston, MA 02114 Michigan Board of Nursing Ottawa Towers North th 611 W Ottawa 4 Floor Lansing, MI 48933 Minnesota Board of Nursing 2829 University Ave SE Suite 200 Minneapolis, MN 55414 410-585-1900 OR 888-202-9861 617-727-9961 410-358-3530 Website/Email www.mbon.org/main.php 617-727-1630 www.state.ma.us/reg/boards/rn 517-373-9102 517-373-2179 www.michigan.gov/mdch/0,1607,7-13227417_27529_27542---,00.html 612-617-2270 612-617-2190 www.state.mn.us/portal/mn/jsp/home.do?age ncy=NursingBoard Mississippi Board of Nursing 1935 Lakeland Drive, Suite B Jackson, MS 39216 Missouri Board of Nursing 3605 Missouri Boulevard P.O. Box 656 Jefferson City, MO 65102-0656 Montana State Board of Nursing 111 N Jackson Helena, MT 59620 DHHS, Public Health, Nursing Licensure Nebraska State Office Building rd 301 Centennial Mall South;3 floor P.O. Box 94986 Lincoln, NE 68509-4986 Nevada State Board of Nursing 1755 E Plumb LN: Suite 260 Reno, NV 89502 601-987-4188 601-364-2352 [email protected] www.msbn.state.ms.us 573-751-0681 573-751-0075 http://pr.mo.gov/nursing.asp [email protected] 406-444-2071 406-444-7759 http://mt.gov/dli/bsd/license/bsd_boards/nur_ board/board_page.asp 402-471-2115 402-471-3577 www.hhs.state.ne.us/crl/crlindex.htm [email protected] 775-688-2620 775-688-2628 Elite Traveler: The Lucrative Business of Travel Nursing TheThe Elite Traveler www.nursingboard.state.nv.us/ Back to index... 70 70 State New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Address New Hampshire Board of Nursing 78 Regional Drive; Bldg. B P.O. Box 3898 Concord, NH 03302 New Jersey Board of Nursing th 124 Halsey Street, 6 Floor P.O. Box 45010 Newark, NJ 07101 New Mexico Board of Nursing 6301 Indian School Rd. NE Suite 710 Albuquerque, NM 87110 New York State Board for Nursing State Education Building nd 2 Floor Albany, NY 12234 North Carolina Board of Nursing 3724 National Drive Raleigh, NC 27602 North Dakota Board of Nursing th 919 S 7 Street; Suite 504 Bismarck, ND 58504 Ohio Board of Nursing 17 South High Street Suite 400 Columbus, OH 43215-7410 Oklahoma Board of Nursing 2915 N Classen Suite 524 Oklahoma City, OK 73106 Oregon State Board of Nursing 17938 SW Upper Boones Ferry Rd. Portland, Oregon 97224-7012 Phone Fax 603-271-2323 603-271-6605 www.nh.gov/nursing/ 973-504-6586 973-648-3481 www.state.nj.us/lps/ca/medical/nursing.htm 505-841-8340 505-841-8347 www.bon.state.nm.us/ 518-474-3817 Ext. 120 518-474-3706 www.op.nysed.gov/nurse.htm 919-782-3211 919-781-9461 www.ncbon.com/ 701-328-9777 701-328-9785 www.ndbon.org/ 614-466-3947 614-466-0388 www.nursing.ohio.gov 405-962-1800 405-962-1821 www.youroklahoma.com/nursing/ 971-673-0685 971-673-0684 www.osbn.state.or.us/ Elite Traveler: The Lucrative Business of Travel Nursing TheThe Elite Traveler Website/Email Back to index... 71 71 Phone Fax Pennsylvania State Pennsylvania State Board of Nursing P.O. Box 2649 Harrisburg, PA 17105-2649 717-783-7142 717-783-0822 Rhode Island Rhode Island Board of Nursing 3 Capitol Hill; Room 105 Providence, RI 02908 401-222-5700 401-222-3352 [email protected] www.health.state.ri.us/hsr/professions/nurse s.php South Carolina Board of Nursing Synergy Business Park; Kingstree Bldg 110 Centerview Dr., Suite 202 Columbia, S.C. 29210 (mailing address) P.O. Box 12367 Columbia, S.C. 29211-2367 South Dakota Board of Nursing 4305 Louise Avenue; Suite 201 Sioux Falls, SD 57106 803-896-4550 803-896-4525 www.llr.state.sc.us/pol/nursing/ 605-362-2760 605-362-2768 http://doh.sd.gov/boards/nursing/ Tennessee Board of Nursing 227 French Landing, Suite 300 Nashville, TN 37243 Texas Board of Nursing 333 Guadalupe #3-460 Austin, Texas 78701 Utah State Board of Nursing 160 East, 300 South Salt Lake City, UT 84111 Vermont State Board of Nursing National Life Building; N Floor 2 Montpelier, VT 05620-3402 615-532-5166 615-770-7441 http://health.state.tn.us/boards/nursing/ 512-305-7400 512-305-7401 www.bon.state.tx.us/ 801-530-6628 801-530-6511 www.dopl.utah.gov/licensing/nursing.html 802-828-2396 802-828-2484 www.vtprofessionals.org/opr1/nurses/ South Carolina South Dakota Tennessee Texas Utah Vermont Address Elite Traveler: The Lucrative Business of Travel Nursing TheThe Elite Traveler Website/Email www.dos.state.pa.us/bpoa/cwp/view.asp?a= 1104&q=432883 Back to index... 72 72 State Virgin Islands Virginia Washington West Virginia West Virginia Wisconsin Wyoming Address Phone Fax Website/Email Virgin Islands Board of Nurse Licensure PO Box 304247 Veterans Drive Station St. Thomas, VI 00803 Virginia Board of Nursing Perimeter Center 9960 Mayland Drive; Suite 300 Richmond, VA 23233-1463 Washington State Nursing Care Quality Assurance Commission (mailing address) P.O. Box 1099 Olympia WA 98507-1099 (physical address) 310 Israel Road Turnwater, WA 98501 West Virginia Board of Examiners for Registered Professional Nurses 101 Dee Drive, Suite 102 Charleston, WV 25311-1620 West Virginia State Board of Examiners for Licensed Practical Nurses 101 Dee Drive Charleston, WV 25311 Wisconsin Department of Regulation and Licensing 1400 E Washington Avenue P.O. Box 8935 Madison, WI 53708 340-776-7397 340-777-4003 www.vibnl.org/ 804-367-4515 804-527-4455 www.dhp.virginia.gov/nursing/ 360-236-4700 360-236-4818 https://fortress.wa.gov/doh/hpqa1/hps6/Nursi ng/default.htm 608-266-2112 608-267-0644 http://drl.wi.gov/boards/nur/ Wyoming State Board of Nursing 1810 Pioneer Avenue Cheyenne, WY 82002 307-777-7601 307-777-3519 http://nursing.state.wy.us/ [email protected] 304-558-3596 OR 877-743-6877 304-558-3666 304-558-3572 304-558-4367 www.wvrnboard.com/ [email protected] www.lpnboard.state.wv.us/ [email protected] Elite Traveler: The Lucrative Business of Travel Nursing TheThe Elite Traveler [email protected] Back to index... 73 73 APPENDIX G: Hospital Interview Guidelines When you choose a location, the process is not yet over. During the interview process, the facility is going to talk with you about the nature of the assignment all while gathering information to decide whether or not you are a good fit for the facility. This is your chance to find out if this is the assignment for you. By asking key questions you will find out if the management style and the flow of the unit will fit GUIDELINES well with your personality and INTERVIEW clinical expertise. Health Care Professional UNIT 1. Number of beds Patient demographic 2. Nurse-to-patient ratio: Days 3. Specialized Equipment used: 4. Type of electronic charting/documentation 5. Special procedure/medication system in use 6. Is a uniform required? Yes Evenings No Provided by: If scrubs are needed, is there a required color? 7. Patient Care Model 8. Have travelers been used previously in your unit? Nights Traveler Yes No Facility Color: Primary Nursing Team Nursing Yes No If yes, how often? SCHEDULE 1. Available date to begin work 2. Shift to be worked: Length of assignment Single Shift: Rotating Shift: How will it rotate? 3. Split shifts policy: On a 12 hour shift, will traveler float elsewhere for 4 hours? Elite Traveler: The Lucrative Business of Travel Nursing TheThe Elite Traveler Back to index... 79 79 4. Weekend shifts policy? Yes No 5. Will travelers be in a charge nurse position at any time? 6. Is overtime available or mandatory? 7. Policy on requesting time off or schedule changes: 8. Policy on working holidays: 9. On Call policy, if required: Yes How Often? Yes No No FLOATING 1. Floating policy? Yes No How Often? 2. Will travelers float first or in rotation with permanent staff? 3. Will travelers float to similar units? 4. Do travelers float to more than one unit per shift? 5. What is the length of orientation for units floated to? Yes No Which Units? Yes No FIRST DAY/ORIENTATION 1. Orientation length: Hospital Unit 2. Where do I report to? At which time? 3. Who do I ask for? Should I wear a uniform? 4. Hospital/Unit Examinations: Is there a study guide available? 5. Is free parking available? 6. Where can I find adequate parking? Yes No Yes No If no, what is the cost? Notes: Elite Traveler: The Lucrative Business of Travel Nursing TheThe Elite Traveler Back to index... 80 80