See More with Travel Nursing: Getaway to Jackson Hole, Wyoming

One of the great things about travel nursing is the flexibility that comes along with it, specifically in terms of scheduling. Each facility is different when it comes to how they produce work schedules (e.g. self-scheduling, repeating two-week schedules, filling in the gaps based on need), but once you know how they operate, you can use these to your advantage to make the most of your adventures. In addition, you can also use techniques specific to travelers in order to plan trips and getaways, including negotiating time-off during your contract when submitting for a position or planning trips before start dates/after end dates. I feel like this is much more superior than the alternative of rarely getting all of your vacation time approved while working as permanent staff or having to put in 30 years in order to have seniority and get the time-off you request. Recently, I was able to use these strategies and the power of trading shifts with coworkers to make it home for my sister’s wedding AND take the trip of a lifetime the following week!

Below, I’d like to share my experiences that I had in Jackson Hole, Wyoming, which would not have been possible if it weren’t for the flexibility that travel nursing allows me.

Backstory

A good friend from college, Shane, moved out to Jackson from Boston after college to pursue his love of skiing and the outdoors. He had been telling me to visit since he moved there over two years ago. I wanted to, but I just could never get the time off when I worked as permanent staff. Besides getting the time off, another obstacle is the relatively expensive airfare into Jackson due to only having a small airport and high demand to fly in. Until recently, I never knew my schedule in far enough advance to buy a ticket for a reasonable price due to the restrictions of staffing and scheduling. However, at my current assignment, they use a two-week rotating schedule, so I’m able to better plan out my time as opposed to waiting until just a few weeks out when the prices for airfare get jacked up. With that, I was able to book my flight and head out for a five-day adventure.

Day 1

After taking my flight from San Francisco to Denver and then connecting to Jackson, I was finally able to see what I had been missing for all these years (after I woke up from my nap of course). I could already begin to see the natural beauty of this place from the window of the airplane. It was unlike any other place that I have seen. The mountain range just erupts from the flat plains seemingly without warning. This first impression left me wanting to explore even more.

Upon arrival, Shane’s cousin, Aidan, who happened to also be visiting as well, picked me up from the airport around noon. Shane was stuck at work until later that evening, so it was just the out-of-towners for the afternoon. We dropped my stuff off at Shane’s place and then proceeded to hit the road. Aidan had flown in the night before, so he also had the morning to check out the town. While there, he got to chatting with some locals who gave recommendations of some key places to see. With this in mind, we set out.

To be honest, I don’t think we had as much of as a gameplan as we thought, but sometimes that makes the experience even better. To start, it was just us in the truck, admiring the incredible views as we drove along. Neither of us had ever seen such a beautiful place before. This was evident by our eyes being glued out the window and lots of pointing and “wows.” Much of the land was flat and untouched with grand mountain ranges in the distance. It took a little bit to gather ourselves and come to terms with the fact that we were there and not browsing a Natural Geographic magazine.

I’ll be sharing some pictures and videos from the trip. You can click on them to enlarge the album. Just keep in mind that these were all shot from my refurbished iPhone 5 from 2013, and that I desperately need an upgrade. Santa, I hope you’re reading this!

 

The first stop was Gros Ventre Road (pronounced “GROW-SHON”). From here, we just drove until we found a place to park and then explored the area, doing our best to remember the way we came. We did this for a few hours. As far as I’m concerned, we might as well have been on a different planet because I had never seen such a breathtaking place before in my life. 

We might have gotten a little lost. I’m not sure. However, to our fortune, we stumbled upon a cool spot with an abandoned cabin overlooking the mountains. All I could think was how great it must have been to wake up to that view every day.

 

Not too far from this spot were these other abandoned cabins. Actually, maybe they all weren’t abandoned and we were just trespassing because as we were leaving, some guys were riding up and turned down the path. Who knows? Maybe just some more adventurers.

On our way to find the main road, we found a Mormon ghost town. Apparently, it was a pretty sizeable community back in the day, but now there’s only have a few buildings (i.e. barns, homes) left standing. All of which were boarded up and locked so we couldn’t go inside. Pretty cool to see and read about on the placards, nonetheless. (There are tours that can take you around on a bus to see these communities for $100+ but obviously, you don’t need to spend the money to explore the land on your own)

After a good bit of driving, we found our way back to the main road. I mean, there are worse places to get lost. And if you don’t really know where you’re headed, are you even lost? Anyways, we headed toward Grand Teton National Park. It was starting to get late, and the sun was beginning to set, so we knew we had to make moves to squeeze in as much daylight as possible. We decided to explore String Lake and Jenny Lake. We even did a short hike (maybe a mile or so) through the forest and watched the sunset behind the mountains.

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Jackson’s Antler Arches in Town Square at Sunset

The sun had just about gone down and we were trying to avoid finding our way back at night, so we head back to town to meet up with Shane for drinks. Aidan’s friend from college, Shayna, also met up with us. Shane and Shayna (both locals) seemed pretty impressed with how much we got to see that afternoon. We caught up for a little bit, then shipped it back to Shane’s for dinner where we had an antelope steak waiting for us. I had never had game meat before. Most likely due to not having the opportunity to try it, but also because I’ve heard from people that they don’t care for game meats. I was willing to try it because “when in Wyoming…”, and I’m glad I did! Very tasty! Shortly after dinner, we began to wind down because we had to be up pretty early for a sunrise hike.

Day 2

I’ll be honest, I wasn’t looking forward to getting up so early after having just explored all day following two airplane rides and a few days in a row at work prior to that, BUT the excitement of getting out there in the wilderness made it a little more bearable (no pun intended). This trip was also multi-purpose since it was elk hunting season, so Shane brought his gear so that he could show us the process and effort that goes into it all. I had never been hunting before so this was a first for me, and I was interested in the culture surrounding it. As I was learning, I was very pleased to find that there are very strict controls and laws in place for conversation purposes.

As we made our way up the hills/mountains (not really sure where one stops and the other begins), you could definitely feel the change in the altitude. The air was thinner and oxygen was harder to come by. It probably also didn’t help that we were lugging big packs and I was breaking in brand new hiking boots. For a large part of the climb up, it was dark so we navigated by headlamps. Just as the sun began to peak over the horizon, we luckily had made it to somewhat of a clearing to see the sunrise. That was a pretty cool scene to see so we sat there for a little bit (I used this as a moment to question why I let myself skip my cardio at the gym and catch my breath).

The rest of the hike was also very scenic. We also found TONS of signs of elk, but no elk. We must have just been missing them by a few minutes the whole time. I was okay with not having seen any because it was still a different experience than I was used to and it was great to get out there and start our day. For me, it was a successful trip.

We managed to make our way back to the car and set off on home. We showered up and relaxed the rest of the afternoon after grabbing some lunch. That night, Shane’s house had hosted a dinner party. It was a great way to meet a bunch of people and try new foods again. This time, we had duck, which I’ve had before (prepared differently), and goose, which was surprisingly very similar to a beef steak. I also met a guy who rode his motorcycle through North and South America and much of Europe for the past year, which seemed like an awesome experience. Nothing much more to this day. Just some drinks and good food.

Day 3

This was Yellowstone Day. I was super excited for this one. I had heard great things about this place, and I knew they all can’t be wrong. It was about an hour and a half ride from Jackson to the south entrance, which wasn’t bad at all. When we got there, it wasn’t too crowded, which was pleasant. Apparently, during the summer months, the park gets swamped by countless tourists and the experience can be overwhelming and frustrating, according to Shane. We were lucky due to the timing of our trip being in late October. It’s considered the off-season for this area which is fine by me!

We saw a good amount of wildlife on the ride in, including this “little” buffalo below:

We walked around the hot springs as we would come upon them. There were quite a few. We didn’t go to “Old Faithful” because the timing was off. We had just missed it. But that didn’t stop us from checking out all the other springs that Yellowstone had to offer!

Since it was pretty cold out, it was hard to get pictures of some of the geysers due to the steam. It felt really good to be in the steam though. Just like walking out of a hot shower. (Just don’t go diving in because you’ll melt)

On our way out, we decided to leave through the west entrance so that we pass through new scenery (i.e. Idaho and Montana). However, there was some construction going on so we had some time to kill until they’d let cars through. We decided to explore until the path was clear. We ended up taking what I think is a cool picture after a long fought battle with some rocks to prop up my phone and the self-timer.

Yellowstone National Park
Left to Right: Shane, Aidan, Tom

We were finally able to pass and began to make our way home, but not before stumbling upon of elk and some more buffalo on the way out.

 

 

On our way home, we passed through Montana and Idaho – both very beautiful as well. The skies seem endless. I don’t necessarily like going on car rides, but when you have those views, it’s really hard to complain. The ride home was somewhere in the neighborhood of two to two and a half hours. All things considered, I think we made pretty good time. Once we got to town, we went out for dinner and drinks. We each got and different meat and shared it because we couldn’t decide on one (and because Aidan ordered the last elk steak). We ended up having buffalo, elk, and fried chicken (super exotic, I know). After dinner, we hit the downtown for a fun Friday night to cap off a pretty well-rounded day.

Day 4

It was all aboard the struggle bus to start the day. We might have had a little bit too much fun the night before, but it wasn’t before too long that we were back on our feet again. Sadly, Aidan was set to fly out so we got an early breakfast, said our goodbyes, and explored the town. The town was on the busier side, especially for an offseason. I guess it was your typical town square with quite a few souvenir shops, jewelers, and restaurants. I ended up finding a hat that I really liked to remind me of the trip.

After our outing, we hit up the hot springs. These ones were safe to go in, unlike the ones in Yellowstone. They were located right on the side of the river bank. The pools were encircled by rocks in order to keep the warm water in and the colder river water out (I hope I’m explaining this well enough. I don’t have a picture because I left my phone in the car). It was so relaxing, and just what we needed after a pretty eventful couple of days. The warm water in the pools would migrate throughout the pools so it was a constant shuffle in order to balance the temperature; you would be warm but not to the point where it’d feel like you were “boiling in a pot of macaroni” (how I described it that day). I ended up taking a dip in the cold river just outside our pool, and that sure woke me up. A lot colder than I thought it’d be, but glad to say I did it.

Night Sky
Photo by Shawn Paone @shawnpaone & shawnpaone.com

From the hot springs, we drove back home, showered off the sulfur smell from the springs, and got ready for a concert/Halloween costume party downtown. The night was great, the band was super talented, and we had a nice time. When we got home and started towards the door, I looked up at the night sky. I guess I hadn’t taken much notice of it since I had been there. At first, it looked like any other clear night that I’ve seen before. However, I began to stare a little longer. As my eyes began to adjust to the darkness, the sky lit up! There were so many stars. More stars than I knew that we could see from Earth. Having only lived in metropolitan areas before, I guess the light pollution has always drowned out their brilliance. Luckily for me, in this moment, that was no longer an issue. Never before have I felt so insignificant. Maybe that’s not the right word. I’m not sure how else to describe it though. I found myself gazing upwards in awe until my neck got sore, but eventually, I found my way inside and into bed.

Day 5

The dreaded flight back to reality…but not before a five-hour layover in Denver. I did manage to get my one last peek at the scenery as I got on the plane though as my going away present (I thought I was recording longer but I guess I didn’t hit the recording button). I really don’t think I could ever get used to this view. I know I’ll be back soon!

Conclusion

Lots of great experiences from this trip: five new foods (antelope, duck, goose, buffalo, elk), three states (Wyoming, Montana, Idaho), two national parks (Grand Tetons, Yellowstone), hunting, hot springs, catching up with old friends and meeting new ones too! Thanks to the flexibility of travel nursing, I was able to make this memorable trip happen. I’m not done exploring this place yet though! I’m already working on filing my license for endorsement in Wyoming – just in case something pops up at the little hospital in town!

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How to Be the New Guy

One of the major reasons people never dive into the world of travel nursing is because they’re comfortable. They have been at their hospital for longer than they care to admit, and on their unit longer than they can bear. However, they never leave because they are not at the bottom of the totem pole. They know people throughout the hospital. They know the protocols, the codes for all the doors, where things are kept, phone numbers for the other departments, and where the most secluded bathroom is in case you ever manage to sneak away to take care of business. Being comfortable is not a bad thing, but it can be dangerous. Not dangerous in the sense that you should worry about your life, career, or family. Dangerous in the sense that it doesn’t allow us to grow and push past the limits that we set for ourselves. No growth comes from your comfort zone. The saying goes, “If you’re the smartest person in the room, you’re in the wrong room.” I feel that this can be applied to our desire to venture out once we’ve nearly reached our full potential in a facility or location in which we live. There’s so much world to see, and you can’t see it if you’re afraid to take the leap and go. Further, would you rather be a big fish in a small pond or a small fish in a big pond? I challenge you to be that small fish and tackle the world! If the only thing that is stopping you from taking the leap is the uncertainty of a new job, then I will unveil my secrets to becoming a professional “new guy.”

Be Approachable

Make a conscious effort to be approachable. This is your first step to gaining allies in your new job. People sometimes feel intimidated about new people coming into their circle, just as you are uncomfortable taking your step into it. Try your best to ease their reservations. You have to be proactive and put forth the effort if it’s going to work starting day one. In your first moments on the unit, take the time to introduce yourself. Your goal should be to be a stranger for as little time as possible. Do this by smiling, using humor, and trying to learn names. This might seem straightforward, but a smile is your first impression. Before you get a chance to say anything, people will pass their judgment on on you. They will see how you are dressed, how your hair is styled, peek at your ID badge (trying to be sneaky), and see your smile. It is the ultimate icebreaker and will signal to the other person that you’re there to help, whether it be a patient, family member, or colleague. Your smile has the ability to set the tone for the entire interaction, so it’s silly not to take advantage of that.  Take the time to look up at people and smile while walking through the hallways. When going about your day, remember that the nurses you work with are people too. Everyone likes a good laugh, so don’t be too shy to try to connect with others in this way if that’s something you’re comfortable with. Also remember that you work with others, not just nurses. Try to connect with others as well, including nursing assistants, secretaries, therapists, pharmacy techs, housekeepers, dieticians, etc. Everyone is important in allowing you an easy transition. In your first couple shifts, do your best to learn names. If you’re like me, it won’t be a breeze. It’s like being a teacher on day one with a classroom full of students. They have one name to learn, you have thirty. There are little tricks to help learn names, but if all else fails, you can always go with nicknames. I know I’m guilty of an occasional “my friend” or “lovely.” Be sure go out of your way to put people at ease and you’ll be surprised at how much more enjoyable your experience will be.

Show Gratitude

People like to be appreciated. This is a pretty universal thing and shouldn’t come as a surprise to anyone. What is surprising, however, is how rarely we sometimes hear these comments of encouragement. Be the catalyst in creating that culture wherever you work. People will be more likely to help you in the future because they know that you are appreciative and it validifies their efforts. When someone does a good job, let them know. When someone helps you, thank them for it. When someone is working hard, let them know it is not going unnoticed. The lessons that your parents and kindergarten teachers taught you should not be forgotten in the workplace. “Please” and “Thank You” go a long way. You also don’t need to be shy with thanking others. There are no limits are how often you can do so. Be generous with your thanks. Frequently, I find myself thanking people multiple times during the shift. It doesn’t cut it to do it only as you’re clocking out. Do it in the moment or immediately after the fact. If I let it go a while without showing gratitude throughout the shift, I find that “thank you so much for your help so far” is my go-to and seems to work pretty well.

Ask once

Do your very best to do as much as you can on your own. Strive to be self-sufficient, but don’t be afraid to ask for help. When first taking a tour of the unit, it can be information overload, but try to mentally bookmark the essentials (i.e. code cart, med rooms, supply closets, bathrooms). Some hospitals will give you a checklist at orientation and allow you to tour the units in a self-guided manner. Other places will entrust their staff to point out these areas during your first shifts. Either way, it’s important to be aware of your surroundings because it becomes much less stressful when you need to do your job on the floor. It’s okay not to know where anything is, how they chart something, or what doctors need to be called after hours. It’s reasonable that you’d have these questions because you’re new! No one can expect you to know everything on day one. I can guarantee that you won’t know how to do everything on your last day either. That’s okay too. In the event that you have a question, be sure to only ask about that thing once – at least to that person. Show them that you are not wasting their time by walking you through everything, just to have you forget it all. You don’t want to be known as the one who is always running around like a chicken with their head cut off, always looking frantic. If they show you all of the codes to the doors, be sure to jot them down, even if you never use that paper again. It comes across in a way that you are taking the matter seriously. That way, when you have a question in the future, they know that their assistance won’t be a wasted effort.

Prove Your Worth

You know a lot. You’re an excellent nurse. Your résumé says it all. You have a lot to bring to the table. You know this. Your recruiter knows this. The manager who signed you on knows this. The people you used to work with know this. Now it’s time for your new colleagues to know it too. And now that we’ve shaken off the nerves of being in a new place, it’s time to hit the ground running. Bring your past experiences and allow them to shape your current environment. Bring your work ethic, your expertise, and your know-how. One of the great benefits of traveling is being able to see how different places solve similar problems. The tools that you use may be different as you change locations, but nursing is nursing wherever you go. The way you take care of patients doesn’t change; what changes are the tools at your disposal. You are not a new nurse, you’re just a nurse who is new to this location. You’ll be surprised at how much you’ll teach your new coworkers while on assignment. I promise that you’ll get so much pride in being able to show how great and skilled you are. Do your best to be an asset to those around you. Good at starting IVs? Be sure your coworkers know that so you can help with that “hard stick.” Helped solve a similar problem your facility is currently facing? Offer suggestions on how to improve outcomes. Have pride in who you are, where you came from, and what you’ve learned and bring that all to the table whenever you start an assignment.

Be a Team Player

Every place is different, and so is their work culture, but I can almost guarantee that no matter how nice, charming, and skillful you are, you’ll start somewhere on the “outside.” Sometimes (not always), people will be less willing to offer a helping hand to the new guy or gal. After all, they don’t know you nor do they know that you’re the hard worker that you are. They’re looking out for themselves and don’t want to be taken advantage of which is understandable. This is where you have to prove them wrong. You have to show them all the things that you’re bringing to the table and how you’re an asset to the team there. You need to embrace the team player attitude even if you haven’t quite yet received any benefits from it just yet. You need to try to sense when someone is struggling or ask periodically if there’s something that you can do to help. You need to speak up when you need help because people cannot read your mind. When you’re overwhelmed, don’t be sassy or rude. Take it on the chin and grind it out. Be sure to ask for help in a respectful manner. You need to erase any me versus them mentality. The only way we survive is together. If someone is drowning while you are sitting at the nurses’ station scrolling through your Instagram, trust me – it goes noticed. If a new patient comes to the floor, follow them in and offer to transfer the patient over to the new bed and get vital signs. Sometimes just checking in on someone or answering a call bell is enough to take some pressure off someone. Anything helps. If you’re caught up with your responsibilities (and sometimes when you’re not), just make sure to make yourself available. It’ll go a long way in showing your commitment to the team’s success and ease of transition to the unit.

Do Your Due Diligence

Remember that these are all new colleagues, and not all of these tips can be sunshine and rainbows. You don’t necessarily know their work ethics and how thorough they are. Be sure to cover yourself and maintain patient safety by checking active orders, equipment in use, medications, IV access and drug compatibility, bed alarms, etc. You no longer have the liberty of taking someone’s word for it. When you’re just starting, you don’t know who the super nurses are – the ones you’d let take care of your mom – and who the slackers and airheads are yet. Be sure to be vigilant in bedside report. Be attentive and observant, writing down your report as you normally would, but also ensure you’re double-checking the chart for accuracy. Just remember to be respectful and that no one likes that annoying nurse who asks a million questions in bedside report that have no relevance to what we’re doing for the patient. If you always keep this in mind, you’ll be able to keep two things: 1) patients safe and 2) your nursing license in good standing.

Travel Nursing: What’s That About?

“Oh, you’re a travel nurse? What’s that?”

That is typically how people or my patients respond when I first mention I’m a traveling nurse. At least once, I experience the following exchange with one of my patients while on assignment:

“So how long have you worked at XYZ Hospital?”

“To be honest, only a few weeks. I’ve been a nurse much longer than that – don’t worry. I’m actually a traveling nurse, so I’ll only be here a few months. You’re in great hands though because the people here are wonderful.”

From there, it sparks people’s interest. Some claim that they could tell that I “wasn’t from around here” or “[they] couldn’t tell because you blend right in” or “[they] knew it because of your accent” or “Wait, but, you don’t even have a New Jersey accent” or a combination of the above. Eventually, the conversation moves away from me and moves towards what travel nursing entails. Below is typically how I would explain it, with further details.

What is Travel Nursing?

I usually tell them that travel nursing is like the “band-aid” of nurse staffing issues. When a hospital has a problem with fully staffing a unit or units, they often utilize contract workers for temporary positions until they can resolve the shortage. Per Diem (or in-house, as needed) positions won’t entirely be sufficient because many times they aren’t required to work as much as the hospital might need in their particular situation. They also can’t force staff to work overtime to meet their needs. Travelers offer that little time-out to alleviate the pressure. We are nurses that bounce from place to place in order to meet the needs of the facilities and the communities they serve for a period of time.

When Do Facilities Need Travel Nurses?

Most times, there’s no crisis on the horizon. When someone retires or transfers, they have to fill that position of the retiree. If they have trouble doing so, and the unit was already tight, they might go ahead and get some help in the meantime until a qualified candidate comes along. When they find that qualified candidate (full-time), it takes some time to train him/her (up to 6 months). During this orientation period, you generally tie up two nurses, the nurse doing the training and the trainee. Orientation periods for traveling nurses are usually much briefer, and in my experience, last no more than one week. As a result, a traveling nurse carries a smaller opportunity cost than a full-time candidate, resulting in a more reasonable “quick fix” in tight staffing situations.

Other times, these facilities have good staffing, but there has been a sudden rise in a number of patients staying at the hospital. This is most common in the winter months due to the flu and the colder weather making those with respiratory issues more susceptible to becoming sick. These contracts can be a little longer due to the patient surplus, rather than staffing inadequacies. For example, if they hire a full-time candidate for a temporary problem, then the hospital could be wasting time and resources because, at this point, the hospital will be overstaffed once the winter is over.

How Does a Nurse Find the Right Facility?

That’s a great question. The facility has identified that they require a number of nurses to meet their needs. Now they need to find those nurses. This is where staffing agencies come in.

Staffing agencies work as middlemen for both the facility and the nurse. They put nurses who are in need of jobs in front of hospitals in need of nurses. They are very important in this whole process. These agencies do a lot of behind the scenes work. They maintain relationships with facilities and their staffing personnel, ensure credentials are up to date, manage payroll, find viable positions, help with housing (if needed), and many more things. Sometimes, facilities have exclusive relationships with companies called vendors. If the vendors are unable to adequately staff the needs with their own nurses, they will open up the contract to other companies in order to fill the need. The relationships of all the parties in the process are shown below:

Capture 1.PNG

I recommend you find an agency and recruiter you are comfortable with and that meshes well with your values and personality.  It’s not uncommon to work with more than one agency at a time while you’re looking for a job, however. Sometimes the agency you’ve worked with doesn’t have access to the contract that you really want. In those cases, it’s important to have eyes out there looking for potential jobs for you. That’s not to say there’s no loyalty, but this is your livelihood. Some recruiters will try to make you feel bad for working for someone else on a contract, but that’s all the more reason to leave. Nothing in these work relationships should ever be driven by personal reasons. As long as you are transparent with all parties involved and professional, then there should be no reason to worry. Remember: YOU are your greatest asset.

How Does Pay Work?

Remember back to when we discussed that the facilities reach out to these agencies and vendors? They also name what they’re willing to pay in regards to specialty, experience, and availability. When the agencies receive these pay rates, they reach out to their nurses and let them know what these facilities are offering in exchange for their care. If it’s a good fit, then the contract is drafted and signed. When thinking about contracts, it’s important to remember that the Facility/Agency contract and Agency/Nurse contract are different entities. When it comes to pay, the facility pays the agency, then the agency pays the traveler, following a similar pattern to the relationship pictured earlier. However, since these agencies offer their services, there’s obviously a portion that is deducted as a service fee. Some companies structure it in a way that is a percentage of the total contract and others set it up as a flat fee for a contract, regardless the size of the total package.

Some new travelers tend to get upset about these cuts, stating things like “But I’m the one who is making them their money. I’m the one on the unit. I’m the nurse. I should get all of it.” In reality, that’s just being greedy, and without the help of these agencies, we wouldn’t have jobs. Also, think back to the services they provide. They offer a service and deliver their service. As far as I’m concerned, what’s fair is fair. I understand that there are profits that the company must make and goals to meet. As long as I take home my fair share, it’s more than fine with me. I understand that there are many people involved long before I ever step foot in the hospital. Just to name a few, there are recruiters, managers, compliance coordinators, salespersons, and things like rent and utilities. It’s very important to understand that it’s very much a mutual relationship where we both benefit.

From the bit that gets taken out by the agency (and possibly vendor), the rest is for the nurse (and government in taxes). The goal is to have the least amount of taxable income possible so that you can take home as much as possible and pay the least taxes as legally possible. There are a lot of tax implications (and I am not a CPA), but the basic rule of thumb is that you need to have duplicated expenses of living at home and on the road in order to receive tax-free stipends (please see TravelTax.com for more).

To better illustrate, please see the image below:

pie chart

Please keep in mind that this is a VERY rough estimate and that there are many variables, including contract specifics, the business model of agency, presence of vendor, qualification of tax-free stipends, etc.  I promise to go in more depth on the breakdown of pay in later posts.

Key Points

  • Travel Nurses aid in the management of staffing issues in temporary positions
  • The Nurse/Agency relationship is important when landing a contract
  • Facility pays the agency who in turn pays the traveler

Why Do I Travel?

Behind everything we do there is a why that gets us out of bed in the morning and fuels our passions. This why gives us our destination, but it is our responsibility to create the path to get there. Many times, like in a coloring book maze, it is easier to start at the endpoint and work backward to until we reach the starting point. The why gives us our mission, but it does not name for us the tasks. It defines what we truly want (spending more time with family, traveling the world, etc.). It allows us to refocus on the things we do and ensure they align with the goals we set and, eventually, meet. Our why will change many times throughout our lives as we also grow and change. In our pursuit of achieving these things we have set out to do, it also might be beneficial to have sub-goals along the way so that we do not become discouraged by failure.

Imagine, for example, you and your friend want to run a marathon. On your first day of training, you decide to run 26 miles. On your friend’s first day of training, she decides to run 5 miles, then eventually move up to 10 miles, 15 miles, and so on. Who do you think will likely be more successful? It will likely be your friend because they set smaller, more realistic goals in order to reach their overall goal of running the 26 miles. There are countless models for success when training for marathons. Many of which people have created, tweaked and adapted to their personal preferences. Much like this, I saw a life in travel nursing as a model that I could use to my advantage.

For me, my overarching why is to be the very best form of myself possible. As a result, I identified areas of my life which are important and needed to be improved upon. Self-worth is the sense of value as a person. For me, my profession in nursing is how I contribute to society in terms of my job, but I am also very fortunate because I have the opportunity to impact others on more levels than just showing up and punching my time-card. I have a responsibility to do more than that. Maybe it’s this pressure that I place upon myself and one that no one else expects of me, but nonetheless, this pressure is still present because I feel if I have not made someone else’s situation better, then I have made it worse by not improving it. Therefore, my nursing practice was something that I wished to enhance. I also understand that you are your most important asset. Without your health, you have nothing. So, my personal health – physical, emotional, mental – became a focus for my betterment. In much the same way that I needed personal health, I knew that financial health is important to provide for myself and loved ones. Lastly, I wanted a broader appreciation for various cultures, climates, thoughts, people, and places in order to better understand others and their viewpoints. In all, these aspects of my life have funneled into my goal of being the best I can be and helped me make my decision to become a travel nurse.

Nursing Practice

I got my start in nursing as a pediatric home care nurse. Everything was 1:1, mostly neurological issues (i.e. cerebral palsy, seizure disorders), and I loved it. The pay wasn’t great, but the kids were. They made going into work enjoyable and that helped me fall in love with nursing. They were all full of life and it was my pleasure to help them thrive the best they could. I spent my first six months as a nurse in this setting, focusing on my nursing skills – medication administration, g-tube care, airway management, etc. After I got the hang of things, I felt it was time to move into a new space in order to challenge myself. I eventually landed in a telemetry unit of a community hospital.

On telemetry, I was faced with a new set of challenges. I now had to learn to manage multiple patients with a whole new set of diagnoses. I needed to hone in on facility protocols and procedures to provide more safety to my patients and uniformity throughout the hospital. I needed to learn how to work as a part of a team, the art of delegation, and to coordinate with physicians, therapists, dietitians, social workers, case managers, and discharge planners. Through this opportunity, I was excited to learn as much as I could. The more I could learn, the better. I attended classes related to caring for our patient population. I pursued national certifications as soon as I could in order to better my practice. However, after awhile, it felt as though I was stalling out in my progression. I loved the people I worked with and the patients I was taking care of, but, in a sense, I wasn’t feeling fulfilled. Not to say that I was peaking or anything, but I knew that I was reaching the ceiling as far as possibilities were concerned unless I wanted to transfer. But, that also wasn’t what I wanted. It’s not that I wanted higher acuity patients or more of a management or quality-based role. I wanted patients of similar acuity with new and different problems. I knew that as painful as it was for me to do and leave my work family, I needed to leave the community hospital setting and branch out into new areas to acquire new experience. After speaking with multiple colleagues who had worked as travelers or were currently on assignment and doing hours and hours of research, I knew that the benefits would be worth the risk.

Now, as a traveler, I’m able to take my experience and apply it to new settings. I soon learned that nursing is nursing no matter where you go. Whether you’re floating to a new unit or it’s your first day in a new facility, your nursing care remains top-tier despite having different tools and systems at your disposal. I became even more confident in my skills and assessments. My clinical judgment became even more important, especially when I hadn’t quite committed protocol to memory or gotten the hang of a new charting system. I realized that ultimately you are your most significant asset and important tool. All of your new patient interactions build upon ones you’ve had previously. In a way, the patients you take care of today extend their thanks to those who allowed you to care for them yesterday as they’ve enabled you to care for them better. I, for one, am truly grateful for these experiences.

On day one of traveling, I found out that I would be caring for patients on telemetry, but on a neuro unit. To be honest, this startled me a bit as it was not something I was expecting. However, I knew that this new patient population would help improve my practice because I was expanding my knowledge base. On this unit, I took care of patients with hemorrhagic strokes, neurological and spinal surgeries, craniotomies, halos, and more. All of which I would have never really seen at my home community hospital. At other facilities, I’ve taken care of VATS patients, those with specific cancers, and some post-trauma. Again, had I not traveled, I may not have had the opportunity to care for these patients and increase my level of comfort.

Financial Position

A driving force of many things leads straight to the wallet or pocketbook. As many of you reading this, in order to fund my nursing school, I had to take out loans. (Granted, I probably didn’t have to accrue as much debt as I did by going to an out-of-state private university, but that’s another story for another day.) Of course, as a teenager with no credit, my family had to help as cosigners, but I was determined to tackle the balance on my own. With more than $120,000 in the hole after my college career, I knew my journey had just begun.

As stated previously, I started in home care and worked as much as I could. Many times working multiple shifts, six to seven days per week. No matter how much I worked, it didn’t seem to help bring that massive number down. I continued to live like a poor college student and budget meticulously. As I earned more money, I dumped it all into my loans.

When I got the hospital position, I continued to work both jobs as much as possible. The increased pay rate at the hospital helped, but I knew there was still room to grow. Luckily, the facility had a way to increase your pay rate through national certifications and clinical ladder progression. I saw this as a way to increase my pay, improve care for my patients, and elevate the organization. It was a win-win-win. However, after speaking with a few travelers at my facility and doing some research, I knew that travel nursing would be that extra boost needed to jumpstart my future.

Travel nursing has many financial benefits, including high pay rates and tax advantages. Of course, “high pay” is relative to the area and the level of need for the facility, but if you can live economically and budget, you will typically come out ahead. High pay paired with the tax-free stipends for housing and meals, leads you to keep more of the money you make. (I will go into this further on future blogs). As a personal example, after my first year traveling, close to 50% more money hit my bank account after taxes while working close to half the amount that I had been per week while taking off nearly a month entirely. Of course, there are additional expenses required when traveling, but if you maintain your tax-free eligibility and do your research into the area, you almost always come out ahead.

Well-Being

Too much of something, even if it’s good, is typically not so good. Just think of peanut butter. There’s that fine line between “OMG this is amazing” and “My stomach is killing me, I’ve had too much.” As mentioned earlier, I had been working a lot. I believe 27 days in a row and 70-80 hour weeks was when I realized that I needed a change. I was 25 years old and was burning myself out. I was a machine. Wake up, workout, go to work, try to have a social life, sleep, repeat. It got to the point where even in my dreams, I was at work. The more I worked, the more money I made, but it ultimately didn’t seem worth it. I was drained all the time, struggled to be with friends and family, and when payday came, more and more money was coming out of my checks for taxes. There was a positive correlation between work put in and money out, sure. But overall, it just didn’t seem worth it. It was also obvious that I was ignoring my health. I couldn’t cut corners at work so I would cut corners at home. I stopped working out as much, stopped preparing food to bring to work and instead grabbed something from the cafeteria or fast food place.

When I started traveling, I stopped working as much. My first contract was for 36 hours a week, and the facility didn’t really like to pay for overtime, so that was it. No more, no less. At first, I didn’t know what to do with all my free time, but I soon learned how to use my time productively in other ways rather than working. I got back to the gym, meal prepping, playing basketball. Hell, it was southern California in the summer – there was plenty to do. I noticed my stress levels drastically decreasing and was able to think much more clearly when I wasn’t constantly on the clock. As an added bonus, in California, the mandatory ratios for patients to nurses was significantly lower than what I was accustomed to in New Jersey. I now had 3 to 4 patient at a time whereas I used to have up to 7. There are also scheduled breaks which I could have only dreamed of. When drafting a contract, you can put your required time off so you can go on that vacation you scheduled, and if you’re feeling a little lazy, you can take a break between assignments. This all just made work more pleasant which definitely impacted my life in a positive way. With the combination of working less often and more desirable work conditions, I was able to make some much-needed tweaks to my work-life balance and get my health back in order.

Cultural Experience

Everyone back home is just like me. If I had to guess, I’d say 98% of my town is at least one of the following: Irish, Italian, Roman Catholic, white, or Republican. And, I might be lowballing that number too. I value people’s differences. When everyone and everything is the same, it’s boring. I love to learn about people and new places. I got my first real taste of differences in people when I went away to college. Again, much of the physical make-up was the same having gone to school in the North East, but at least people were from different places. I found myself fascinated with everyone’s hometowns, what crazy words or phrases they’d say, or their accents. Like seriously, who calls a water fountain a “bubbler”? Also listening to a kid from Boston go on and on about how Tom Brady is one of the most important people to ever walk the planet followed quickly by a New Yorker who thinks otherwise was quite entertaining. Although this was all great, I knew I wanted more exposure to the world and to explore away from my comfortable little corner of it.

I’ve spent the last year working in Los Angeles, and it was a shock from the start – I still can’t tell if I’m impatient or everyone is just slow. In all seriousness, being immersed in this city, which is basically a bunch of mini-cities that grew in together, has been wonderful. I’ve gotten to learn about many cultures, enjoy their food, and stare blankly and nod when they speak to me in their language. Korean BBQ  – they supply the food and skillet, and you cook it. Taco trucks on the street with everything in Spanish. My barber is an Armenian guy who speaks some English but not enough to have a real conversation and I know absolutely no Armenian. We don’t really speak except for exchanging hellos and me saying “number two on the sides, trim the top,” followed by our good-byes. However, I value these conversations because as I sit in the barbershop and get my hair cut, I’m able to absorb a little of their culture even though I don’t understand what they’re saying. I’ve also been able to practice some of my Spanish, which is something I’ve always wanted to do for myself but also for the comfort of my patients. I still follow my little script, “Hola. Me llamo Tomás. Soy enfermero. Yo hablo español un pequito,” but I’m able to actually communicate a bit more which is always nice.

Key Points

  • Travel nursing allows me to improve my nursing practice, world exposure, and financial and personal health.
  • You can expand your nursing experience in different settings using previously acquired skills.
  • Less money out in taxes means more money for you thanks to tax-free housing and meal stipends for those that qualify.
  • Take that vacation without having to worry if your PTO will be approved.
  • Explore new places and be immersed in their culture while on assignment.