When Bill Stevens RT(R) thought about a career in health care, he craved something that offered challenges in a fast-paced environment. "I realized I liked the hospital setting but not being saddled with one patient all day," he notes. "I liked the aspect of having variety." After considering his options, Stevens determined radiology offered everything he wanted and he set off on his career.
After working for a couple years as a full-time radiologic technologist (RT), Stevens began to feel a bit stifled. It's not that he was dissatisfied with his career; quite the contrary, he enjoyed the tests he was tackling. It's just that he was ready for a change.
Of course, Stevens could have chosen to switch careers. The skills he'd developed as an RT would have certainly made him a valued employee in numerous fields, but Stevens didn't want to leave health care or switch to a different area. He instead opted for a change of environment, or rather, many changes of environment. Stevens packed his bags and hit the road as a traveling health care professional. "I thought this was the perfect time for me," he states.
For more than 25 years whenever hospitals or outpatient facilities experience a sudden spike in patient population or change in staffing patterns, administrators often turn to supplemental staff to fill in temporarily. The two options that top their list are per diem and travelers.
Per diem literally means "by the day," according to Webster's New Collegiate Dictionary. These are professionals who specialize in fulfilling immediate, unexpected needs that arise for whatever reason. Per diem workers can be called in that day to work in the lab, radiology or wherever the need may be and on any shift. However, there usually isn't a contract that defines the specifics of employment, such as length of assignment. At the end of the day, you could be asked to come back for another few days, or be told the managers made arrangements for a staff member to cover the shift.
Although there's uncertainty involved with a per diem career, the lifestyle does appeal to a select group. "They are getting enough work to keep busy," says Aaron Nichols, an allied health recruiter for PPR Travel, based in Jacksonville Beach, Fla. "Hospitals like it because if the need drops, they just don't call the tech in any more."
Additionally, these allied health specialists tend to build very broad backgrounds. Because nothing is routine about their day-to-day responsibilities, they're able to pack their resumes with a variety of experiences; each challenge adds to their marketability.
On the other hand, travelers are more of a long-term choice. Travel assignments last a minimum 13 weeks, with the mobile practitioner scheduled to a specific shift. This use of supplemental staff is usually tapped when facilities predict an upsurge in census, such as the flu season or when a staff member will be out for an extended period, like maternity or disability leave.
Over the years, hospitals have come to routinely rely on travelers, and most have actually budgeted in funds for this type of staffing. For example, hospitals in the South know they will need additional staff during the winter, which makes it a popular region for mobile therapists and techs. When the population grows significantly with "Snow Birds"-the community of retired individuals who make their home in the warm-weather states-facilities in Florida and Arizona must boost their staffs in order to accommodate the increased need for health care providers of all kinds. "The highest demand is usually in the first part of the year," notes Nichols "That's when the aging population is there and there tends to be a lot of patients who need physical rehabilitation.
"We especially see a spike for respiratory therapists during the flu season," he continues. "Last winter, that was particularly true in the Western mountainsand Southwest regions with the outbreak of the flu. Obviously, that created a huge demand."
Mobile nurses continue to command the highest usage among travelers, but allied health professionals also have been able to establish mobile careers. The specialties that are in demand vary not only seasonally and regionally, but also cyclically. During the late 1980s, traveling physical therapists (PTs) and occupational therapists (OTs) were working virtually nonstop; they had unlimited assignments lined up and waiting. Then the Balanced Budget Act and Medicare reimbursement policy changes redefined how therapists and facilities were paid and, as a result, the need for mobile therapists dropped off dramatically.
The late 1990s saw greater calls for surgical technicians, radiologic technologists and nuclear medicine technologists. During that same time, there was a lot of attention given to the developing nursing shortage, however, several allied health specialties were also undergoing radical changes. According to the U.S. Bureau of Labor Statistics (BLS), those practice areas were-and continue to be-fields slated "to grow faster than average." Like nursing, the enrollment in education programs for these specialties was not in step with the number of vacant jobs. Facilities started scrambling to find enough qualified staff in order to meet patient needs, and more frequently they were calling in travelers.
During the last year or so, it seems as if the travel marketplace is switching gears once again with the majority of contracts swinging back to physical therapists. "There is a huge need right now for savvy therapists who can efficiently understand a facility's billing procedure and clinical protocol. Those are some of the things they get with a seasoned PT traveler," asserts Nichols.
Meanwhile, there's been a slowdown for a few of the other allied health specialties. "There are a number of factors ticking away at what used to be a robust revenue-generating business for RTs," states Nichols.
Indeed, radiology departments, in particular, still suffer from numerous vacancies, but hospitals began to back off from using travelers. Instead, administrators focused more on retaining current staff as well as recruiting techs to their facilities on a permanent basis. In fact, it's not unusual for managers to persuade talented travelers into signing on full-time after their travel contracts with the facility expire. Stevens has been approached at both of his assignments since becoming a traveler for Cross Country TravCorps. He says, "I've thought about going permanent, but I like not having a long-term obligation. You're there as long as you want to be."
Still, the current employment environment has prompted Stevens to accept extensions; both times he was willing to sign on for another 13 weeks or longer. "Jobs are harder to come by than a few years ago. It's not because of a lack of needs, it's just that hospitals are not using as many travelers," he explains.
Whether or not a facility opts to contract with supplemental staff comes down to finances versus personnel requirements. Regardless, the mobile career choice is often a beneficial one for allied health professionals on many fronts.
Fiscally, traveling can be a windfall. More times than not, supplemental staff earn more per hour than their permanent counterparts. Additionally, health care travel companies usually pay for practitioners' housing while on assignment, including utilities. Therefore, contract therapists or techs aren't responsible for paying rent or some living expenses while working away from home.
Other financial perks are the benefits packages most agencies offer their travelers. Early in the health care travel industry, the opportunity to have one working vacation after another that would take you to far off locales was enough to entice individuals to sign up. However, as the need for travelers increased along with the number of supplemental staffing companies, competition for these providers soared and many agencies started offering benefits.
In the past, only the full-time hospital personnel had health insurance, profit sharing, sick days and other benefits. Therefore, if mobile practitioners were sick and missed work, there wasn't any compensation coming their way for those missed shifts. Today, thanks to market competition, travelers receive similar benefits to their full-time colleagues, including 401(k) retirement programs, health insurance and travel costs. There are also numerous incentive packages, such as sign-on or completion bonuses, referral bonuses, and some companies even offer vacation and sick days.
Along with all the job perks, however, travelers must also make compromises. Perhaps the most common is where they're willing to work. Sometimes the job openings available are in cities you'd rather not visit. Or, in order to work in a city you love, you'll have to work in a long-term care facility because that's the only opportunity available.
Often times it just comes down to the personal and professional goals you set for yourself. "There are two distinct kinds of travelers," Nichols explains. "They either use geography or clinical setting as the most important assignment criteria.
"If a traveler only wants to work in outpatient clinics, then he or she isn't going to choose a long-term care assignment in Dallas just because it's Dallas," Nichols adds. "Then there is the traveler who's more concerned with geography and the clinical setting doesn't matter."
Stevens usually fits into the latter of the two categories. "The equipment and procedures are pretty much the same wherever you go, but it's what's outside of work that keeps you happy," he says. "If I can't do what I like outside of work, then I'm not happy. I like lakes, warm weather, camping and outdoor activities." After all, a travel career is a lot like a working vacation. When you're not on duty, you can explore the area at your leisure. "What better way to see the country?" asks Stevens.
When it comes to assignments, however, recruiters advise travelers to be flexible. Indeed, "flexibility" is probably the one word that can sum up what it takes to have a successful mobile career. Whether it's applied to assignment location or clinical environment, or adjusting to different protocols and coworkers, travelers are a group that is able to quickly adjust to any situation.
For example, Nichols says more and more calls are coming from rural communities, so therapists and techs who are willing to experience small-towns without all the cultural allure of a metropolitan area, would probably do well. Or, travelers who are willing to move from the hospital setting to outpatient or long-term care facilities will fit in well. "If you keep an open mind, then you'll be amazed at the experiences you'll encounter," he advises.
Once on the job, flexibility is still essential. Remember, supplemental staff are hired because there's an immediate need for additional personnel. Therefore, administrators and managers need travelers to be up to par as quickly as possible. There isn't the six-week orientation program that's commonly offered to long-term new hires. In fact, it's more like a few days, and in some cases, a few hours of orientation. Facilities expect travelers to be skilled enough to step in and be working at full speed right away.
"If you want to travel, then you have to be confident in [your skills]. You have to be able to make yourself get through any situation, which can be a little intimidating at first," notes Stevens. He adds that having a willingness to learn while on the job is also crucial. "It's important to watch other people. You never quit learning, especially when you work with different people. You might see something done differently, or you may be able to make suggestions."
Indeed, mobile professionals are often able to expand their skills sets by observing how procedures are conducted throughout the country. They're able to glean the best of their experiences. That can also be said about their cultural experiences. Going to various regions allows travelers to come in contact with diverse patient and peer populations. >From sunny southern Florida to rural Oklahoma neighborhoods or remote Native Alaskan villages, therapists and techs encounter a wide spectrum of people. And they learn how various cultural beliefs impact health care delivery and compliance.
Throughout the years, there have been numerous studies and anecdotal research that confirms patients feel more confident and comfortable with providers with whom they can identify. As a minority traveler, your presence can aid the facility in caring for its minority patients, whether that's by sharing a cultural understanding, speaking another language or simply making a person feel more at ease. "I pretty much get along with anybody," confirms Stevens.
The other critical component to having a successful mobile career, is maintaining licenses, registries and continuing education units. "If you have a specialty that requires belonging to a national registry, then do that as quickly as you can. That makes you much more marketable and in demand," says Nichols.
Hospitals and other medical facilities choose supplemental staff much like they do permanent employees-just on fast forward. They rely on the documentation travel companies supply them, which typically includes resume, skills and equipment checklist, criminal background checks, and drug and medical screenings.
Although travel recruiters will assist practitioners with licensure application and renewal processes, it's up to individuals to keep everything current. Additionally, not all states require nuclear medical technologists, for example, to be licensed. If you're going to accept a job in a state that does, then schedule in the time it takes for an application to be processed.
Within just a few weeks of deciding to join Cross Country TravCorps, Stevens was packing his bags and getting ready to leave for his first assignment. Although he was a bit nervous-after all, he was leaving behind his home-Stevens was also excited about the possibilities that lay before him. "I think it's one of the best things you can do."