Travel Nurses Need To Be Prepared for Anything

Growing up in Nashville, Makaya Carter, BSN, RN, CCRN-CSC, always wanted to work in the medical field. She began her college career studying to be a physician but eventually chose nursing because of the one-on-one impact she could have with patients.

After working as an ICU staff nurse in her hometown, she had the urge five years ago to see more, thanks to a familiar TV show. “I watched a lot of ‘Grey’s Anatomy,’ and I thought, ‘How awesome would it be to travel and see the world and go to Seattle, maybe meet a McDreamy,’” she joked, citing the popular Seattle-based show’s fictional surgeon.

She researched how to become a travel nurse, reached out to other travelers she met as a staff nurse, and has now spent the past five years working various assignments on the East and West coasts.

“For me, it was more about the adventure, the experience, the opportunity,” said Carter, who currently works as a cardiothoracic ICU nurse in Seattle.

Besides appealing to nurses with a taste for adventure, becoming a travel nurse has plenty of benefits, most notably the recent pay increase sparked by the COVID-19 pandemic and staff shortages around the country. But being a travel nurse is not a walk in the park. Travel nurses, according to Carter, must be able to work hard, adapt quickly, be willing to learn, ask questions, and prepare to uproot themselves as often as every 13 weeks.

Challenges for Travelers

Having a good grasp of your personal finances is a must for travel nurses.

“One of the biggest things that new travel nurses are sometimes naïve about is the financial implications of being a travel nurse,” said Emma Pointer, a former travel nurse who now works as operations manager for Trusted Health, an organization that matches nurses with travel jobs. Pointer recommends that nurses have a savings nest egg before traveling. “At any point, this job could be cancelled. A start date could be pushed back. So be financially stable before you take that leap.”

Insurance and taxes also are potential issues. Carter said she prefers the convenience of getting insurance through her agency and noted that a tax adviser can be a big help. Her career began in Tennessee, which has no state income tax. When she arrived in other states, paying state taxes was an adjustment.

“Pay attention to your paycheck stubs,” she said. “Make sure you have all [documents] together when you file your taxes. It’s really important. If you need help, your company offers resources on its website on tax information and the type of insurance they provide.”

Updating Onboarding

In a 2019 study published in the Journal of Nursing Administration, researchers from Arizona’s Banner Health identified more streamlined, organized onboarding as an area of needed improvement.

The researchers surveyed 306 travel nurses across the country. The nurses said onboarding and competency assessment checklists should be specific to the unit and healthcare facility where they are working. In addition, information such as unit patient ratios, an onboarding schedule 7-14 days before an assignment, and access/login IDs on the first day of work are critical.

Carter encouraged travelers to ask how to obtain information regarding hospital policies, protocols, and procedures to review.

“For example, you may come from one hospital [which is] titrating a medication or doing a dressing change a certain way but learn it can be completely different at another hospital,” she said. “You may have more or less autonomy depending on the hospital, so it’s important to ask questions to protect your license and for patient safety.”

For nurses with a compact license traveling to a non-compact state, Carter stressed the importance of completing continuing education requirements in that state to maintain licensure “because some states, like California, require it for license renewal.”

Perhaps the most important advice is simple.

“Read your contract,” Carter said. “Read it all the way through. Know what you’re signing before you sign. You may be an ICU nurse that has to float to an acute care floor. Some people are refusing to do that, but per your contract, it says you may float. As a traveler, you have the opportunity to ask questions when you interview with the unit manager about floating, scheduling, patient ratios, etc. Never take an assignment you’re not comfortable with.”

Traits of a Traveler

Travel nurses constantly have to adjust in a new role and then move on, making an adventurous spirit and flexibility paramount.

Those traits will help travel nurses fit well wherever they go. “There can be some instability as a contracted employee,” Pointer said. “So definitely know what you’re getting into, be very well researched, be able to go with the flow and adjust where needed.”

Carter said her upbringing helped her successfully network at various stops and make plenty of new friends.

“Being from the South, we’re huggers and ‘bless your heart’ kind of people,” she joked. “When you are a travel nurse, you have to be adaptable and flexible. Have a positive attitude, a strong sense of teamwork, and a strong work ethic.”

Carter said traveling helped grow her confidence on a personal and professional level, so much so that current and former colleagues were among those who wrote recommendation letters for her recent acceptance to graduate school.

“As a traveler, you have to be comfortable with change,” she said. “Be open to learn because that is the only way you will evolve as a traveler.”