Much has been written about the nursing shortage, with the primary focus on the downside for RN’s working in the acute care setting. Where there is a downside, there is always an upside, and many nurses have found a way to use the shortage to their advantage: registry and travel nursing. Of course, it is not for everyone, but an increasing number of nurses are finding there are options that can accommodate their lifestyle and needs. They are choosing assignments anywhere from one day to 3 months, from local to long distance.
For many, the pay and flexibility are attractive, opening up opportunities and control over their lives they would not otherwise have. Obstacles such as the lack of benefits no longer exist, as many local agencies and most travel agencies now offer insurance and retirement investment plans.
The concern I hear most from RN’s is about the difficulty of adjusting to different working environments. The reality is that except for a few policies and differences in paperwork, all hospital units function pretty much the same. The issues of where to find supplies like stethoscopes (Read: a comprehensive guide to stethoscopes) and how to get the pharmacy to send you missing medications, are easily sorted out in a short time.
If agency nursing seems right for you, here are a few tips on making it work.
Choosing the Right Agency
Whether looking for a local or travel agency, interview them before they interview you. Call several agencies and compare their pay rates, the length of assignments, the hospitals they contract with, benefits, and accessibility of personnel to assist you. Their willingness to answer questions (or not) will tell you what you can expect if you have a problem. You want to work for an agency that is going to back you up in a difficult situation.
If it is a travel assignment, make sure the agency has contracts in the city you want to travel to. Don’t forget to inquire about housing accommodations, as there can be a vast difference in what is offered. Generally, you should not have to pay anything for housing, nor should you have to share. If you can provide your own housing (you have friends or family you can stay with), or your own health insurance, the agency should increase your hourly rate, or provide you with a housing allowance. The advantage of the housing allowance is that it is tax deductible. However, this is only true if the assignment is 50 miles or more from your primary residence.
It is not a hard and fast rule, but generally, smaller agencies will be more flexible than very large companies can afford to be.
If possible, talk to other nurses who work for the companies you are considering. Narrow it down to a couple of agencies, as the application process can be time consuming, especially for travel agencies. You will need copies of licenses, BCLS, ACLS and other certifications, a recent physical including PPD, Hepatitis vaccination or written decline, mumps/ measles/ rubella and varicella titres, and a recent tetanus vaccination. Most companies will require an application, skills checklist, proof of citizenship or right to work in the U.S. and personal references. Organize your materials and make copies for all the agencies where you plan to register. Of course, if you are going to another state, you will have to apply for a license in that state by reciprocity. Applications for most states can be downloaded and printed from their websites. Plan early, as the process can take from 2 to 6 weeks.
Choosing the Right Assignment
If working with a local registry, you need only commit for one shift. Try several hospitals and find the ones you prefer. Make your preferences clear to the agency, and remember that you are never obligated to take a shift you don’t want. It is best to establish a good relationship with the hospitals where you like working. Once you have worked several shifts for a particular hospital and they have been pleased with your work, the nursing office may ask for you.
When considering a travel assignment, you will have an opportunity to speak on the phone with the supervisor of the unit. Make a list of questions and don’t be afraid to get the answers you need. Be suspicious of a place that will not answer your questions. Remember, you are in charge and you always have a choice. Don’t rely on the information provided by the agency, they are in the business of placing nurses, and they don’t make money if you don’t work. Do some research about the facility on your own, and consider your personal preferences for a small or large facility, teaching or non-teaching, urban or rural. When you decide to take an assignment, make sure that everything you want is in writing in the contract before you sign it. If you take the assignment, and find that the facility misrepresented anything, you have the option of leaving, but this is a last resort. Do your homework before you accept the assignment.
Choosing the High Road
Once you have accepted an assignment, make it a pleasant and rewarding experience. Be professional and treat the nursing staff and the unit as if it was your permanent home. Be a team player. Don’t wait for the staff nurses to make the first overture. They have worked with all kinds of nurses and don’t know what to expect from you. They may have been burdened with nurses that were not experienced or didn’t pull their weight, making their jobs harder.
Let them know you are willing to work as part of the team and you will be pleasantly surprised at the results. By the way, bringing bagels on a Sunday morning doesn’t hurt. Once the staff sees that you are actually making their job easier they will welcome you with open arms. And, you may make some new friends as well. Remember that even though you are temporary, your reputation will follow you.
Per Diem and travel nursing can be wonderful experiences. There is something to be learned from each unit and each nurse you encounter. There are new friends to make, and new cities to explore. Very few professions allow the freedom to choose when and where you want to work. Maybe you will discover that you have the wanderlust, or maybe you will find a place you want to stay for a long time. You’ll never know if you don’t take the leap.