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Professional Insights

Creating Harmony Between Travel Nurses and Staff Nurses

Start with communication, showing support for both

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By Heather Stringer
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Christopher-Colombo,-RN.webp
Christopher Colombo, RN
Tammy-Jones,-RN.webp
Tammy Jones, RN
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Felicia SadlER, RN
Sarah-K.webp
Sarah k. Wells, RN
W
hen leaders at NYU Langone Hospital-Brooklyn started hiring travel nurses during the pandemic, staff nurses felt a range of emotions.
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“For the most part, we were relieved that the cavalry had arrived to provide back-up, but there was also some resentment about the significant pay difference between staff nurses and travelers,” said Christopher Colombo, RN, an ICU nurse who had worked in the hospital for 10 years.
Travel nurses were earning two or three times the rate of staff nurses, yet the range of experience of the travelers varied. Colombo was impressed with one seasoned ICU travel nurse who was so knowledgeable that he became a mentor to Colombo, but others were ill-prepared to work with large numbers of high-acuity patients.
Colombo remembers one travel nurse who criticized staff when they stopped attempting to resuscitate a patient with COVID-19 after 20 minutes of performing CPR. “It may have seemed like we didn’t care, but we’d been treating patients like this for three months,” he said. “We needed to gear up for the next patient.”
While travel nurses can provide vital support when units are short-handed, challenging dynamics may exist when staff nurses work alongside new travel RNs who will only be on a unit for a limited time. The travelers are expected to quickly learn new departmental policies and procedures while acclimating to their new environment.
Locating equipment and asking questions in a unit that is already short-staffed can lead to tense interactions, said Felicia Sadler, MJ, BSN, RN, CPHQ, Vice President of Quality for Relias, who has experience as both an ICU nurse and travel nurse. “There may also be pre-existing dynamics in the unit that the travel nurse is unaware of,” she said. “Some units are very welcoming, while others may see them as a threat to a cohesive team.”
Although the risk of relational fallout seems high in these situations — especially during a pandemic — there are strategies to improve the odds that the interactions will be satisfying to both travel and staff nurses.

Providing Support for Travel Nurses

“It begins with leadership sending the right message to their teams about why they are hiring travelers,” said Sadler. “It’s important to explain that patient safety is the top priority, and that additional help is needed to provide support for the staff.” The travelers can help the team avoid overtime, burnout, and stress, she said.
Sadler also recommends having ancillary support staff, such as patient care technicians or certified nursing assistants, available to answer questions about the location of supplies or equipment or other basic information. Nurse managers can also make themselves available to help travelers who may be feeling overwhelmed as they adjust to a new unit, Sadler said.
A year ago, Colombo realized he needed a change after two difficult years of treating COVID patients, and he started working as a travel nurse locally in New York. Although he was not required to take weekend shifts, he had opted to work every other weekend and holidays during travel assignments to “drive home the point that I want to be a part of the team,” he said. Caring for patients on Saturdays and Sundays with weekend staff nurses has given him an opportunity to build relationships with these employees.

Avoiding Shortcuts in Hiring Process

Nursing leaders can also facilitate positive relationships between staff and agency nurses by carefully screening prospective travelers. Sarah Wells, MSN, RN, CEN, CNL, who works as a per diem nurse in radiology and emergency departments, recommends hiring travel nurses with a minimum of two years’ experience.
Hospitals lowered the number to one year during surges in the pandemic, “But some facilities were taking people with less than a year in a particular specialty, which was challenging in high-acuity settings,” Wells said.
Wells encourages managers to include interviews in the hiring process for travelers — a screening tool that was sometimes omitted during the pandemic when hospitals were desperate to fill vacancies. Managers can ask travel applicants to provide details about their experience and answer clinical scenario questions. “Travel agency applicants may look the same on paper, but an interview can reveal important differences in experience,” she said.
Interviews can also help travelers determine if a job is good fit. Wells recommends that interviewees “ask about the specific patient population, the number of travelers on the unit, and whether you will be floating to other units.”
“It begins with leadership sending the right message to their teams about why they are hiring travelers. It’s important to explain that patient safety is the top priority, and that additional help is needed to provide support for the staff.”
— Felicia Sadler, MJ, BSN, RN, CPHQ
At University of Arkansas for Medical Sciences (UAMS), hiring managers explain to prospective travelers during the contract negotiation that they will be given a shift schedule that meets the needs of the department — rather than selecting their own schedule, said Tammy Jones, PhD, RN, NE-BC, Chief Perioperative Services Officer and Associate Chief Nursing Officer at UAMS. Travelers are also expected to take call and may work holidays.
To facilitate camaraderie, Jones includes travel nurses in department recognition programs and invites them to participate in committees related to their experience. “We don’t view them as temporary staff to fill a hole, but as nurses who have skills that can be utilized to help the entire team and our patients,” she said.
In Jones’ department, one-fifth of nurses are travelers and many extend their 13-week contracts to continue working in the unit. Three have converted to full-time staff nursing roles in the past year, and it is not uncommon for staff nurses to throw a going-away party for travelers who leave after several contract extensions.
“It’s important to take extra effort to help travel nurses integrate into the team,” she said. “This has facilitated harmony among the staff, better morale, and higher job satisfaction, which ultimately benefits the patients.”
ABOUT THE AUTHOR
Heather Stringer is a freelance writer based in San Jose, Calif. She has more than 20 years of writing experience and her work has appeared in publications such as Scientific American, CURE, and Cancer Today.