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Introduction   

The concept of travel nursing was first introduced around the 1970s. Over the years it has become very popular amongst nurses seeking travel opportunities and higher salaries. The purpose of this course is to discuss the history of travel nursing, how to become a travel nurse, and what to expect. It also reviews the pros and cons of being a travel nurse and handling culture changes. Last, it discusses tips for being a successful travel nurse. 

History of Travel Nursing 

This section discusses the history of travel nursing.  

The history of nursing dates back to the mid-19th century with the infamous Florence Nightingale, the founder of modern-day nursing. Florence was a volunteer who served during the Crimean War in 1854, caring for wounded soldiers in a Turkish military hospital. She discovered that many soldiers were dying due to the unsanitary conditions. Thus, she instituted clean sanitation practices, including clean water and fruits. She found that these interventions decreased the mortality rates within the hospital.  

These new and effective practices shed light on the need for trained nurses and thus, began the nursing profession. By 1860, Florence established the world’s first nursing school (4).  

The nursing industry expanded throughout the United States over the next several decades. It wasn’t until 1978, during Mardi Gras week in New Orleans, Louisiana, that the idea of travel nursing began to appear. That week in New Orleans, there were many patient injuries, and the local hospital was unable to support the patient influx with their nurse staff. The hospital was desperate for extra nursing staff, so they began to contact nurses throughout the country, offering temporary employment contracts.  

The travel nursing industry expanded more during the 1980s with the nationwide nursing shortage. During this time, many healthcare organizations discovered that offering travel nurses employment was a way to fill temporary gaps in nursing staff shortages. The world of travel nursing continued to expand and since then, there began to be as many travel nursing opportunities as staff nursing roles available.  

Since 2020, the effects of the COVID-19 pandemic have made travel nursing an even more lucrative career path. As staffing demands soared, many staff nurses left their permanent positions to pursue a career in travel nursing.  

There are many reasons why nurses report they decided to travel; citing reasons like flexible scheduling, ability to travel, higher compensation, and avoiding burnout (6).  

How to Become a Travel Nurse 

This section discusses the steps to become a travel nurse.  

A travel nurse is a nurse who works for an agency instead of directly for a hospital or healthcare system. They are contracted by the hospital through their agency to fill open and temporary nursing positions.  

Travel nurses have the same roles and responsibilities as staff nurses. They also work in the same settings as traditional nurses, like the intensive care unit, operating room, long-term care hospitals, and other healthcare facilities.  

Travel nurses can work locally, near their current residence, or outside of their home state. Some travel nurses choose to work internationally (2). 

The steps to becoming a travel nurse are similar to becoming a traditional registered nurse (RN). First, you must earn either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) from an accredited nursing institution. However, many healthcare organizations are starting to prefer BSN-prepared nurses over ADN-prepared nurses. So, it might be best to pursue a BSN over an ADN (2). 

Once you’ve earned your degree, like all other RNs, you must take and pass the National Council Licensure Examination for Registered Nurses, also called the NCLEX-RN. After passing the NCLEX-RN, you can apply for a state nursing license (2). Consider applying for a compact nursing license, as this allows you to practice across certain states without needing to obtain another nursing license. However, this depends on whether your state of residence participates in the enhanced nurse licensure compact agreement (9).  

Next, you need to find a permanent nursing position in an area or specialty you enjoy and gain experience. After you’ve gained some experience, you can start applying for travel nursing assignments in your specialty. Almost all travel nursing agencies require at least one to two years of experience in your specialty before being considered (2). For example, you need at least two years of experience working in a critical care setting to be considered for critical or intensive care positions. So, make sure your experience aligns with the positions you apply for.  

In addition, before applying to travel assignments, make sure you have either a state-specific nursing license for the state you plan to travel or a compact nursing license. You will absolutely need a nursing license before you can start an assignment. 

What to Expect 

This section discusses what to expect as a travel nurse, including details before and after accepting an assignment. 

After gaining experience in a nursing specialty, it’s time to apply for travel nursing assignments. You can reach out to several travel nursing agencies or browse job boards. When browsing for opportunities, make sure to look at the requirements and certifications. Many travel nursing agencies require certifications like basic life support (BLS) and advanced cardiac life support (ACLS). Some specialties require additional certifications like critical care registered nursing (CCRN) or cardiac surgery nursing (CSC) certifications (1).  

If you’re searching for assignments in a different state than the one you reside in, look at the state nursing licensure requirements. You may need to apply for a specific state license or get a compact license if your home state and the state you plan to travel to participate in the compact agreement (9). Having your license in hand will save you some time in the long run. 

After applying, you’ll speak with a travel nurse recruiter. If you applied for an assignment, they would discuss the details. The recruiter will also ask about your preferred location, background, availability, certifications, licenses, and other requirements.  

Determine Where you are Willing to Travel 

As travel nurse assignments follow the nursing shortages, you may find that an assignment is not available in your desired location. So, have several destinations in mind. You can also talk about salary requirements and any time off you need at this time. If you’ve been selected for an interview by a specific unit’s nurse manager, the recruiter will likely prepare you for the interview.  

Length of Assignments, Living Costs, and Assignment Expectations 

After you’ve aced your interview, your recruiter will notify you and discuss your travel nursing contract details. Details typically include salary, time off, the shift, stipends, and assignment dates and length. Usually, assignments last anywhere from six to 13 weeks.  

Travel nursing agencies usually provide stipends for housing, meals, and travel expenses. If you have any questions about your contract, feel free to discuss these with your recruiter before signing. After you’ve signed your contract, a person from the travel nursing agency’s credentialing department will contact you. This contact will ensure all your licensing, certifications, and other requirements are up to date.  

Additionally, you will need to research and book housing if you opted for the stipend and other travel arrangements. Again, your travel nurse recruiter can help guide you through the process. 

Once you start your assignment, plan for at least one orientation day to the healthcare facility and unit, including learning the charting system. After the required orientation, you are expected to take your own assignments and care for patients. As mentioned, travel nurses perform the same duties and responsibilities as staff nurses (2).  

During your travel assignment, your recruiter will be in contact and check in to make sure everything is going smoothly. To get paid as a travel nurse, usually, you will need to submit weekly timesheets to your agency.  

Sometimes healthcare organizations also require that you clock in and out through their time systems. If you work any overtime, make sure to get this approved by the nurse manager and your travel agency before submitting. Also, towards the end of your current assignment, your recruiter will help you start looking for your next travel assignment and location.  

Pros and Cons 

This section weighs the pros and cons of travel nursing. 

Since the start of the COVID-19 pandemic, travel nursing has become increasingly more popular. However, before deciding to travel, consider weighing the pros and cons. 

There are many pros to becoming a travel nurse. Many travel nurses cite the higher compensation and ability to travel as major pros. They also report that travel nursing experience made them stronger nurses and they have the freedom to avoid hospital politics and solely focus on patient care. Many nurses pursue a career in travel nursing for professional growth opportunities (6). Additionally, travel nurses have more flexibility in choosing their schedules and time off. They can build new friendships and avoid burnout because they continuously change assignments and locations (7). 

There are some cons and challenges of being a travel nurse. Some travel nurses say that having to frequently move is a major con. Before ending your current assignment, it’s best to have your next assignment lined up and it may mean moving to another state.  

Sometimes travel nurse agencies offer excellent benefits when compared to those offered to permanent staff nurses. Additionally, many travel nurses are not offered job promotions and might have trouble with long-term career planning. Some mention that their social lives take an impact, being away from family (5). Last, some travel nurses report animosity from staff nurses while on assignment (6).  

Handling Culture Changes 

This section reviews cultural changes and strategies to combat incivility and bullying. 

Travel nurses must have the skills to handle shifting cultures since they are frequently moving and orienting in new healthcare settings. Sometimes, travel nurses are subject to bullying and incivility from permanent staff nurses, which can add unnecessary stress (6).  

Incivility 

Workplace incivility is rudeness or lack of courtesy from other team members [8]. Some travel nurses may be subject to incivility since permanent staff nurses know they get paid more. They may be unwilling to train or help travel nurses with their patients. 

Bullying 

Oftentimes incivility is a risk factor for bullying, which is repeated, unfavorable treatment of a person (8). Some travel nurses perceive workplace bullying as receiving heavy workloads and patient assignments (6). 

There are many ways for travel nurses to combat incivility and bullying in the workplace. First, travel nurses should talk to the nurse manager about the behaviors of their fellow nurses. A research study has shown that most organizations encourage staff to report incivility and bullying behaviors. Management can help resolve conflict between nurses (3).  

Also, make sure to speak with your recruiter about the situation and have it documented. Travel nurses should also practice de-escalation techniques, like using a calming tone or reminding them that they are new. Practicing effective communication and self-awareness are important in preventing issues from arising (10). 

Succeeding as a Travel Nurse 

This section reviews strategies to being a successful travel nurse.  

Many travel nurses are successful in their careers and enjoy being a travel nurse. However, there are some key strategies to being a successful travel nurse. First, be flexible and adaptable to change. This can be with your location or even your patient assignment for the day. Oftentimes travel nurses are also floated to other units within the hospital.  

Next, stay organized and understand the requirements of your assignment. Make sure your licenses and certifications are up to date as well as any immunizations. This will save time when you begin the credentialing process.  

Research your desired location ahead of time. Look at the cost of living and compare it to what salary and stipends you may receive as a travel nurse. Sometimes the cost of living is high, cutting into your potential take-home pay.  

In addition, stay in contact with your recruiter, they are your advocate and can help you navigate your assignment and contract. Be open with your recruiter about vacations and expectations. They will also help you look for your next assignment and help if any issues arise while on your current contract.  

Sometimes being away from home, including family and friends, can be challenging. Make sure to stay in contact with them while traveling by regularly talking on the phone or even planning visits back home or traveling to your location. 

While working, practice a team-based approach by encouraging other nurses to collaborate in patient care (7). Communicate regularly with other nurses since this can promote collaboration and a positive work environment (11). Be eager to learn and practice new nursing skills, while gaining invaluable experience.  

Lastly, expect there to be some challenging days, which are normal. If you experience incivility or bullying, don’t be afraid to speak up and talk to your recruiter and nurse manager. They can help you take steps to resolve the behavior and any conflict.  

Conclusion

Many permanent staff nurses are now choosing travel nursing as a career path. Travel nurses have the opportunity to travel throughout the country while earning a higher salary and having greater flexibility. Nurses should weigh the pros and cons before becoming a travel nurse and understand strategies for being a successful travel nurse. As travel nurses frequently adapt to cultural changes, they should be aware of ways to prevent and resolve workplace incivility and bullying.  

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