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As we’ve seen over the past two years of the COVID-19 pandemic, nursing shortages can become incredibly problematic and dangerous if left for too long. But once shortages hit, what can the healthcare industry do? Who is the first point of call for healthcare providers having trouble locating staff?
Two words: travel nurses!
Travel nurses, AKA ‘TNs’, relocate for a set period of time in order to support healthcare practices – often hospitals – due to an unexpected lack of staff. Depending on their circumstances, TNs can be employed by hospitals or agencies and the duration of their placements depends on the needs of the employer (as well as the circumstances of the TN, of course).
The COVID-19 pandemic saw the true power of a travel nursing directory, especially given the many state-wide code browns throughout Australia.
Why does travel nursing exist?
The idea of traveling to new locations in order to provide much-needed care is nothing new: that’s been happening since the birth of nursing itself. However, the creation of the travel nursing industry occurred at a very specific moment in time.
In the 1970s, the U.S experienced a nursing shortage the likes of which had never before been seen (Carlson et al, 1992). In addition, the gay liberation movement was gaining traction: in 1978, the first Mardi Gras was held in New Orleans. This resulted in a spree of bashings that left many people – predominantly gay men – requiring medical assistance both in the streets and at the local police station (78ers, 2021). This one evening’s events mixed with the nation-wide nursing shortage prompted the beginning of what we now call ‘travel nursing’; nurses were brought into the city on short-term contracts to help manage the influx of patients across the city (Fastaff, 2014).
This idea carried through to the '90s when it was revolutionised by the advent of the widely-usable internet. The idea of a central directory for nurses willing to relocate for work was born. This way, hospitals could easily put a call out to travel nurses and receive applications from people who were prepared to relocate in order to fill positions (Carlson et al, 1992). The idea for directories quickly spread internationally, and travel nursing agencies quickly followed.
How does travel nursing work?
There are many factors at play here: how long does a travel nurse hold a position? Where do they live? Are they paid more than nurses who work long-term in the same place?
Position duration: TNs work on short-term contracts, and can usually hold a position for between 2-26 weeks in Australia. However, TNs can sometimes be requested to fill annual leave or long-service leave gaps, which can be longer (VU Online, 2020).
Living situation: Some TN agencies provide specific housing, while some TNs are given an allowance – either by the hospital or by their agency – that is intended for rent.
Compensation: Due to the immediacy of the employer’s needs, TNs are generally paid more than their long-term non-TN counterparts. During the COVID-19 pandemic in the U.S, wages for TNs reached up to double that of their non-travel nursing peers (Dixon-Luinenburg, 2022).
Looking at this, you might think it’s a young person’s game: this is not the case! Becoming a TN is a great opportunity for people who would like to retire from full-time work but still want a consistent income. Many people use TN opportunities as a way to move around, make new friends and see new parts of the country – all while serving the profession they love.
Are there any benefits of working as a travel nurse?
Absolutely! The TN industry doesn’t only benefit employers: becoming a TN can be a great long-term or short-term career choice.
Primarily, by working in various parts of the country or the world you will see medical presentations, conditions and diseases you’d never see otherwise. For example, when working somewhere like Weipa, QLD, you would likely see a lot more mining-related conditions – such as high-pressure injection injuries – than you’d otherwise see if you were working in Melbourne. Or on an even broader scale, if you relocated to work as a TN in Nigeria you’d likely see far more malaria than you would in Australia (World Health Organisation, 2022). Essentially, working as a TN – especially early in your career – broadens your skillset and experience, which is a massive benefit to any healthcare practitioner and their patients.
Additionally, the higher level of compensation and freedom to choose is a huge benefit of working as a TN. If you want to work fewer weeks of the year and are happy to move around a bit, why not work as a TN and make the same amount your non-TN peers would make in far less time? Or you could work the same amount as your non-TN peers and use the extra money to your advantage.
Another benefit – depending on your career ambitions – is the huge network of healthcare professionals you’re able to create. By having a strong web of connections across your home state, the country and even the world, you’re fortifying the future of your career. However, it’s important to note that when we say ‘creating a network’ we mean creating meaningful professional connections with individuals you’ve worked with or alongside, not just having a list of acquaintances you’ve met along the way.
However, these benefits do come at the cost of stability and long-term contracts, not to mention proximity to family and friends. Thank goodness for video calls!
How did the COVID-19 pandemic affect travel nursing worldwide?
We all know the havoc that COVID-19 wreaked on the Australian healthcare system, not to mention those worldwide. When it comes to TNs, however, the story is a little different.
Australian nurses were in massive demand, particularly in 2021 as the COVID-19 virus spread more rapidly as state governments tested strategies for reopening borders and returning to pre-pandemic lifestyles. In early 2022 Victoria was placed in a ‘Pandemic Code Brown’ in order to reprioritise resources towards fighting the COVID-19 surge. This was caused by both immense pressure placed on the functional-capacity of hospitals as well as the physical and emotional pressure placed on healthcare practitioners – many of whom understandably left the profession to protect their own health. As a result, ICU and EDU nurse Mary Colfer, an Irish national who has worked in TN capacity for many years, said that nurses could ‘literally grab a van and go town hopping' as a TN throughout the pandemic but particularly during peak shortages (VU Online, 2020).
It’s a similar story over in the U.S. According to Endowed Professor Tony Yang and Professor Diana Mason of George Washington University, the pandemic caused a nation-wide boom across the U.S regarding demand for TNs (Yang et al, 2022). The whole TN industry has been shaken up: one U.S hospital chain has expressed the need for an in-house travel nursing administrator. This would mean that instead of using an agency, the healthcare organisation would have its own list of vetted TNs who would be called on in cases of emergency or staff shortage. This could be due to reported price gouging performed by some travel nursing agencies who appeared to take advantage of the vulnerable pandemic situation.
Either way, the COVID-19 pandemic brought the strengths – and weaknesses – of the TN industry to light. Many people celebrated the work of TNs as a core reason for many communities making it through the pandemic. However, there are few who believe TNs are a band-aid solution to a larger issue, and the healthcare industry should be less reliant on them (Dixon-Luinenburg, 2022). Either way, TNs are becoming an integral part of the healthcare community.
How do I become a TN?
Firstly, you need to be registered with the Nursing and Midwifery Board of Australia. This applies to nurses who want to work as a TN inside Australia as well as those who would like to work internationally (Indeed Editorial Team, 2021).
Secondly, gain some work experience. While becoming a TN is a great opportunity for people early in their careers, it also comes with a lot of responsibility. The reason people are hired as TNs is because the employer cannot provide sufficient care to their patients without you: this means you’re going to have at least a portion of responsibility straight off the bat, so you need to understand the basics of nursing. In this sense, you should have about a year’s worth of professional experience before you start working as a TN (Indeed Editorial Team, 2021).
Finally, have a look at some agencies and directories, and see what requirements work for you. Keep in mind that some agencies may require different amounts of experience and different types of licenses.
Carlson, S.M; Cowart, M.E.; & Speake, D.L. 1992. ‘Causes of the Nursing Shortage: A critical review of the Theoretical and Empirical Literature.' Journal of Health and Human Resources Administration, vol. 15, no. 2. Accessed 14 April 2022 via https://www.jstor.org/stable/25780529