A number of readers have written us with questions about travel nursing. For answers to these questions, we turned to an expert in the field—Dr. Franklin Shaffer, EdD, RN, FAAN.

What are the main benefits of travel nursing?
Dr. Shaffer: Travel nursing offers adventure, freedom of choice, and flexibility. Travel nurses can choose their work location and hospital, and they get a chance to work in exotic locations at prestigious medical centers. This freedom of choice is important today, with more people citing quality of life as their top priority. To a large degree, travel nurses control their own schedules. Recent interviews found that many of them had more than 15 years of continuous experience as travelers and planned to continue traveling for some time to come.
Also, many travel nursing companies (or staffing firms, as they’re officially called) offer higher salaries and a rich array of benefits; some offer access to continuing and higher education as well as certification. One of the larger firms even created a corporate university and is an accredited provider of continuing education for nurses.

Do travel nurses get to choose the exact location of their work and their exact work schedule?
Dr. Shaffer: Travel nurses decide where they work and when they will begin working at a particular facility—depending, of course, on availability of positions and shifts. The beauty of being a traveler is that you can shop around until you get the position and location you want. Having this autonomy and control over your schedule is a leading reason why nurses decide to become travelers. As for the daily staffing schedule, much of the traveler’s assignment, including days off, is worked out before the nurse accepts the assignment. Special schedule requests also are agreed to in advance. Typically, special needs that arise are worked out on a mutual basis by the traveler and the nurse-manager at the facility.Do travel nursing companies offer typical benefits, such as health insurance and 401K plans?

Dr. Shaffer: Nearly all nurse staffing firms offer a full array of benefits, including health, life, and liability insurance; 401K plans; dental insurance; and preventive care. Also, the staffing firm pays the nurse’s licensure and housing costs. Frequently, these benefits are effective on the first day of employment.

What’s the typical educational background of a travel nurse?
Dr. Shaffer: Travel nurses are likely to have BSNs or higher degrees and are more likely to be certified. A recent survey by a large staffing firm showed that 60% of their nurses had BSNs; this is above the national average. So travel nurses and other nurses working in temporary positions are just as qualified—and in some cases more qualified—than permanent staff nurses. Also, patient outcomes in hospitals that use temporary nurses have been found to be positive.

Why would a hospital want to hire a travel nurse?
Dr. Shaffer: For hospitals, travel nurses offer more flexible staffing and options that can be customized to meet their unique staffing needs in a cost-effective manner. Many hospitals have discovered that well-planned use of staffing companies is the secret to retaining nurses and, in turn, promoting patient safety. Some hospitals even use travel nurses as a way to recruit core nurses. A “try it, you might like it” approach gives everyone a chance to assess the situation and determine if it’s a good cultural fit. Also, some hospitals use temporary nurses to relieve their regular staff so they can attend training sessions for new technology or other major initiatives. Most recently, some hospitals have begun using travelers with the proper experience and credentials as interim nurse-managers and recruiters.

How would I go about choosing a travel nursing company?
Dr. Shaffer: If the adventure factor is important to you, look closely at the number of jobs available and their locations when choosing a staffing firm. Usually, the larger the firm, the greater the selection of jobs and locations offered.

Is travel nursing the same thing as agency nursing?
Dr. Shaffer: No. Some people mistakenly lump all supplemental nurses—travelers and agency nurses—in the same category. But there’s a difference: Agency nurses are per diem nurses who practice locally and don’t travel. Typically, they fill in for a day or several days. They don’t necessarily have the same education or experience as traveling nurses. Travelers, on the other hand, are fixed-term, temporary nurses who usually work at the same hospital for 13 weeks and are scheduled at least 2 months in advance. Hospitals are likely to depend on travelers for more specific or strategic staffing needs, such as to provide continuity of care when covering for maternity leaves, vacations, or sick leaves.

As a travel nurse, how often would my job performance be evaluated?
Dr. Shaffer: Travel nurses are evaluated more often than the average permanent staff nurse. They receive yearly performance evaluations from their employers and more frequent evaluations from hospital-based nurse-managers for each assignment—typically at least four evaluations each year. Also, before each new assignment, nurse-managers and human resources personnel at the next hospital where travel nurses plan to work interview them and evaluate their work experience and records.Does the staffing firm offer the traveling nurse any support while on assignment?

Dr. Shaffer: Staffing firms employ many people who work on behalf of their travelers. For the traveler, the most important support person is the recruiter. The recruiter is always there for the traveler, acting as a career lifeline and helping the traveler get the positions he or she wants. These firms also employ registered nurses to serve as clinical liaisons and career coaches and help travelers to solve problems and deal with emergencies. Other dedicated support personnel at staffing firms include chief nursing officers, educators, and specialists in risk management, workers compensation, payroll, and credentialing.

What qualities should I look for—or look out for—in a travel nursing company?
Dr. Shaffer: Most travel nursing companies work hard to assure quality for their clients and good working conditions for their travelers. As in any industry, the quality of the goods and services provided varies from poor to outstanding. In 2003, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) created a certification program to help hospitals determine whether a staffing firm can provide competent staffing services. Since then, a number of staffing firms have been certified—and recertified—and many others are seeking certification. For a list of certified staffing firms, visit JCAHO’s website at www.jointcommission.org. And, of course, you can ask traveling nurses for their recommendations.

I’ve heard a few nurses say it’s mainly the poorly run hospitals with heavy workloads and high turnover that use travel nurses. Is this true?
Dr. Shaffer: Absolutely not. More than 80% of Magnet hospitals in the United States contract with staffing firms, including many leading medical centers. Magnet facilities use traveling nurses strategically—for instance, to cover for vacations and leaves of absence, to maintain morale by providing appropriate nurse-patient ratios, and to ensure constant delivery of high-quality and safe patient care. The vast majority of JCAHO-accredited hospitals contract with more than one staffing firm to help them meet fluctuations in demand.

Is the travel nursing industry likely to be around for a while?
Dr. Shaffer: Thanks to mandated staffing ratios and the desire of many nurses for freedom and flexibility, staffing firms are most likely here to stay.

Dr.  Franklin Shaffer, EdD, RN, FAAN, is Executive Vice President and Chief Nursing  Officer at Cross Country HealthCare, Inc.