The upcoming flu season has the potential to be one of the most important and potentially deadliest in recent history because of the ongoing COVID-19 pandemic.
With COVID case numbers on the rise across the country, preparing for this winter is even more important than ever. There is an ever-increasing need to reduce the spread of respiratory illnesses and a push for vaccination. It’s interesting to note that most healthcare systems are not currently accepting flu vaccine waivers and are requiring all employees to receive a flu vaccine.
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While impossible to determine how severe the flu season will be, coupled with the ongoing pandemic, travel nursing could very likely be affected again. During the first wave of the pandemic, hospitals stopped all elective surgeries and saw a decrease in inpatient hospitalizations. Travel nursing was more or less halted since March.
Thousands of travel nurses across the country were laid off and contracts were canceled. COVID-19 hotspots brought in crisis travel nurses for temporary assignments while staff nurses throughout the country were without work.
It’s impossible to determine exactly how COVID and the flu season will continue to affect travel nursing but it is safe to say travel nurses will continue to adapt to the ever-changing environment. With so many unknowns, it is essential that travel nurses secure assignments as soon as possible. It is harder for a hospital to cancel a contract once it has started than to cancel a contract that hasn’t started yet.
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Hospitals have learned from the first COVID surge the resources needed to survive another wave of COVID. Healthcare systems are taking into account flu season as well to determine the needs of the different units. Anticipated needs are currently driving the openings for travel nurses and they will fill quickly. Travel nurses can expect to see shorter length contracts, for 6 or 8 weeks, versus the traditional 13-week contracts. Furthermore, hospitals are currently less likely to extend contracts early as needs are constantly changing. Travel nurses are not only filling the void to cover the influx of sick patients but also to fill gaps in staffing when permanent staff are out sick or on quarantine.
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In order for travel nurses to continue to find assignments, it is important more than ever to prevent getting sick or spreading germs to others. These recommendations are more important than ever due to COVID-19 and the upcoming flu season. The CDC recommends nurses and their patients:
The aftermath of this pandemic and flu season will only continue to highlight the need for nurses and the predicted shortage. The American Association of Colleges of Nursing predicts that there will be a need for 203,700 new nurses each year through 2026. This figure was determined before the pandemic and the stress COVID and the flu season are taking on healthcare providers. Travel nurses will continue to fill these needs.
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Kylee Nelson is a Neonatal Intensive Care Unit (NICU) travel nurse, avid explorer, who “aims to prevent nurse burnout by traveling.” She has traveled the world in search of adventure but also to recharge before the next nursing assignment. As COVID-19 has halted all international travel, Kylee has begun exploring parts of the United States and documenting her journeys on her Instagram, @passportsandpreemies.
Kylee’s website Passports and Preemies documents her adventures while navigating the complex world of travel nursing.
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Kathleen Gaines (KG): Can you give us some background on your Nursing Education? Where did you receive your degree? How long have you been a nurse?
Kylee Nelson (KN): I attended college at Clemson University where I studied biology. At the time, I didn’t know that I wanted to be a nurse and thought that I would go to PA (physician assistant) school. Once I became a senior, I still wasn’t sold on PA school so I started applying to nursing programs. After graduating from Clemson with a degree in Biological Sciences, I ended up attending Emory University in Atlanta where I joined the accelerated nursing program earning my BSN.
KG: Why Travel Nursing? What aspects of travel nursing appealed to you?
KN: When I first started out as a nurse, I would immediately look up to the other nurses on my floor who had been there 30+ years and know that in my heart that wouldn’t be me. As a new grad on the unit, I was already experiencing burn out from lack of leadership and understaffed shifts. I realized that by being a travel nurse I could create the life I wanted to live by having large gaps in employment, allowing me to travel, see the world, and come back to the bedside refreshed and ready to work again.
The other thing that appealed to me was the unknown. As a thorough, type A nurse, I wanted to be more challenged in this area. The thought of showing up to a new unit, not knowing anyone thrilled me. To this day the ability to take as much time off work as I want and the thrill of the unknown is still what draws me to travel nursing!
KG: Have you ever had trouble finding a position in the Neonatal Intensive Care Unit (NICU)?
KN: As a new grad, I had a lot of trouble finding work in the NICU. I knew that that was the only unit I wanted to work on and was open to living anywhere. I applied to hundreds of jobs all across the United States but it seemed that nobody was hiring new grads at the time. Luckily I happened to meet a faculty member at Emory who used to work in a NICU in Overland Park, Kansas. She passed my information along; I was interviewed, and landed the job! As a new grad who wants to work in the NICU, I would say never give up on applying and be open to working anywhere!
Now that I am a travel nurse working in the NICU I haven’t had much trouble until COVID. While I wasn’t always getting the exact assignment I wanted, I never had trouble finding work. Currently, I’ve been unemployed for 10-weeks, and just recently landed my next job in San Francisco.
KG: Did you work during the COVID-19 pandemic?
KN: I did work during the COVID-19 pandemic. I was working in the NICU in Seattle, however, my contract (along with all other travelers) got cut short; we were all terminated at the same time. I originally had planned to take 6-weeks off of work for the summer but have now been unemployed for 10-weeks due to the lack of NICU jobs.
KG: Have the opportunities for travel nursing changed since COVID-19?
KN: Travel nurses saw a drastic decline in jobs once COVID hit. Aside from “critical contracts” in hot states, it seemed that all other units across the states saw a decline in the need. Now that it’s been a few months since COVID has hit, jobs are slowly beginning to open again, however not at the pay rate that they once were. I would attribute this to hospitals blowing their budgets on COVID contracts and on OR closures during COVID.
As a travel nurse, it’s imperative to understand how your pay package works and to work with a company that you trust. I also believe that transparency in this industry is so important. When I first became a travel nurse I was making $200/week less than every other travel nurse on the floor. And that was without taking out any benefits. I learned that by talking with one another about what our pay packages are, we hold the power to change the industry.
Most recently I’ve been upset by the pay offered by hospitals since COVID-19 struck. In places such as San Francisco, nurses can make upwards of $2,500. I recently saw a contract come through where a hospital was offering such a low bill rate that the take-home pay would have only been $1,700. That saddened me because I know better, but a new travel nurse probably wouldn’t. That is why it’s so important to know the industry standard! I recommend keeping all pay packages sent your way (even if they aren’t relevant) so that you can reference them at any time. I currently have 30+ pay packages sitting in a folder in my email that recruiters have sent me over the past 3 years. It’s also important to know your worth. If you choose to take that contract for $1,700 you’re telling that hospital that it is okay to reduce travel nurse pay and we all suffer. If they can’t fill the position, they will be forced to offer more money.
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KG: Why is it important for travel nurses to fight for better pay that was available pre-COVID?
KN: If we don’t start standing up for ourselves and demanding better pay (pre-COVID pay), this industry may never recover. One of the main reasons a lot of nurses become travel nurses is because it is lucrative. By accepting low paying contracts, we’re telling the hospital, “Okay, I am worth less now than I was last year even though my skills and experience has only improved.”
KG: Are you worried that the money for travel nurses isn’t ever going to be as good due to the money spent during COVID or the money that was lost due to lack of patients?
KN: I think that with everything in life things ebb and flow. For that reason, I’m not too worried about it. For the next year or so I do expect contracts to be lower than usual. But eventually, I believe this industry will pick up again and the money will come back with it.
KG: Do you think that crisis contracts have hurt the future of the travel nursing industry?
KN: I do think that in light of what has been happening this year, crisis contracts given out have hurt the industry. But I also think it was necessary. In this instance, I don’t know how many nurses would’ve run straight into the fire without proper compensation. I think that there are scenarios (such as strikes and emergencies) where it is absolutely necessary to pay more than usual. So while it does hurt the future of this industry overall, I don’t think that it is permanently damaged.
KG: How many countries have you traveled to? And which is your favorite?
KN: I’ve been to 34 different countries! My favorite European destination is definitely Slovenia. You hardly ever hear anyone say, “I’m planning to visit Slovenia”, and truthfully I don’t know why not! The country is incredibly beautiful, not over-crowded, and affordable! If you haven’t heard of Slovenia, Google, “Lake Bled” to see what I mean.
In Asia, my favorite destination was Myanmar. It was a country that I hadn’t heard much about and didn’t know what to expect. It really got me out of my comfort zone and showed me what felt like an entirely different world.
KG: How can travel nurses recharge after physically, mentally, and emotionally challenging contracts?
KN: My favorite way to recharge after a challenging contract is by traveling. By getting away from the bedside and experiencing new things and meeting new people I feel the best. That way when I come back to the bedside I’m relaxed and am in the mental space to give it my all.
However, I realize that what works for me doesn’t work for everyone. I always recommend exploring what makes you happiest. Is it reading? Cooking? Time with friends? Figure out what you love and do that thing.
KG: What advice do you have for future travel nurses?
KN: My biggest advice for future travel nurses would be to go into travel nursing with an open mind. In this industry, contracts can fall through and things can go wrong, but if you have a positive attitude about it, you can learn to roll with the punches. Oh, and don’t burn any bridges! You’ll learn that this industry is actually quite small.
KG: How can nursing students prepare to become a travel nurse before even passing the NCLEX?
KN: If you’re in nursing school with the aspiration to become a travel nurse I would recommend figuring out what you like to do as soon as possible so that you don’t waste time figuring it out once you’re a new grad. I say this because you typically need 2-years of experience before becoming a travel nurse. If you start working in the NICU and don’t like it, and then you switch to L&D, that doesn’t count as two years of experience. You have to work for two years on one unit in order to begin travel nursing. I would also start reading as many articles as you can get your hands on to best prepare yourself for when it’s time to become a travel nurse!,/p>
KG: What’s next for you?
KN: Next, I am headed to San Francisco for my 11th contract! It’s a destination I’ve been trying to get to since I became a travel nurse three years ago. Once my contract ends in November I hope to take the holidays off and then (hopefully) do some traveling through Southeast Asia to avoid winter.
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Crisis contracts can be very lucrative for travel nurses but they come with tradeoffs. Crisis contracts are often the first to be canceled and working conditions can be less than ideal with long hours and complex patient needs.
COVID-19 has changed travel nursing for the foreseeable future. More short term crisis contracts are becoming available due to the ongoing pandemic.
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Crisis travel nursing contracts are offered when a hospital or specific geographical location are determined to be in a time of crisis. The reason for the crisis may vary. Crisis contracts have most recently been offered during natural disasters such as Hurricane Katrina and Hurricane Irma and medical disasters such as the Ebola crisis in Texas and the COVID-19 pandemic.
A crisis nursing contract is often more lucrative than regular travel nursing contracts because they are extremely time-sensitive. Generally speaking, the location or hospital needs nurses immediately and can not afford to wait for them to finish other contracts. For this reason, they will offer a higher salary to garner attention and interest. This also means that only nurses with the ability to pick up and leave immediately will be able to accept contracts.
Ultimately, the salary will depend on the location, hospital’s budget, what agencies are able to negotiate with the hospital or healthcare system, and the level of nursing care needed. For example, ICU nurses will earn a higher wage than a medical-surgical nurse based on skill level. Crisis contracts are highly lucrative because nurses are often working in high-risk conditions which are sometimes less than ideal.
Because crisis contracts differ from regular nursing contracts it is essential that nurses read the contract in its entirety including cancel clauses. Most contracts will not offer any type of reimbursement if the contract is canceled prior to the start date.
Crisis contracts will outline crisis pay which may include:
Extra compensation may be given in a crisis contract due to the unpredictable nature of the crisis and risk involved of working during a pandemic or natural disaster.
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Crisis contracts are usually shorter than typical travel contracts and generally will last for anywhere between 2 to 6 weeks. However, after the crisis contract is complete the hospital may have additional travel nursing needs or the crisis contract may be renewed. Employing crisis nurses for short periods of time at higher wages is more cost-effective than hiring for longer periods of time. Most contracts will require hospitals to pay a certain fee to the nurse if the contract is canceled once it has begun.
While a crisis contract might sound like an excellent idea during a pandemic or natural disaster, they are EXTREMELY risky. Because the hospital or location needs nurses quickly, they often overhire because they are aware that not everyone hired will complete the requirements prior to the start date. But, if there are too many nurses then the contracts can be cancelled. This often happens.
There are no financial costs for the hospital associated with canceling a crisis contract prior to a start date except for a few nominal costs/fees. For that reason, hospitals often will work with multiple agencies in order to secure the appropriate number of nurses. Furthermore, during a crisis, the patient census can change day to day. It’s possible that by the time additional staff arrive, the patient census will not require it.
During the ongoing COVID-19 pandemic, hundreds of crisis travel nurse contracts were canceled the day before in major hotspots such as New York City, parts of California and Texas. Nurses were left absorbing the costs of flights, hotels, rental cars, and potentially short term housing. This money is not refunded by the agency or hospital system. Unfortunately, because the contracts were cancelled the day before – this left hundreds of nurses without jobs. In the meantime, other regular travel nursing positions were filled.
When determining if a crisis travel nurse contract is right for you, consider the cancellation risk. It is much higher than typical contracts and will often not happen until the day before as seen during COVID-19. Accepting a crisis contract may not leave many other contracts available if you are canceled. Sometimes more money isn’t worth the risk of job security.
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The novel coronavirus has forever changed travel nursing and COVID-19 predictions for the coming fall suggest a continued impact on travel nurses.
Hundreds of travel nursing contracts were canceled without much notice leaving nurses across the country scrambling to find their next contract. Crisis nursing positions in Seattle and New York City were filled with lightning speed. As the number of COVID-19 cases continues to rise in parts of America, medical experts are predicting a hard-hitting second wave in the Fall of 2020.
The Centers for Disease Control and Prevention (CDC) predicts a second wave may, in fact, be more deadly than the first because it most likely will coincide with the start of flu season.
Unfortunately, it may be difficult to differentiate between a first wave and a second wave as the number of cases is reaching an all-time high in over 30 states. Technically, a wave requires a peak in infections followed by a substantial reduction. A new rise and peak would signal the start of another wave. Some will have a very clear first and second wave, such as New York while others will not have the differentiation. Without a vaccine or cure for coronavirus, a second wave is inevitable.
As healthcare organizations across the country continue to ramp up and resume elective procedures, travel nurses are finding an increase in opportunities, especially, in larger cities. Despite the increase in available positions, travel nurses must continue to be flexible and ready to go in a moment’s notice.
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The second wave of COVID-19 could potentially see similar closings as the first, including suspension of elective surgeries and a decrease in hospitalizations, particularly in children. During the first wave, hospitals rushed to hire hundreds of travel nurses expecting an influx of coronavirus patients. Unfortunately, most hospitals saw a decrease in patients; therefore, an abundance of extra nurses. Nurses working in the OR and PACU were left jobless and scrambling to make ends meet and had to file for unemployment.
The first wave led to the early retirement of Baby Boomers and those with pre-existing conditions. The U.S. Bureau of Labor Statistics has projected a nursing shortage with a career outlook growth of over 12%. The retirement of these nurses has only increased the shortage. The American Association of Colleges of Nursing has predicted that there will be a need for 203,700 new RNs each year through 2026, and those numbers will be much higher in the aftermath of this pandemic. Furthermore, it has led to many leaving the bedside to pursue other opportunities in nursing including telehealth nursing. Travel nurses help fill the void left by those staff nurses leaving.
With an all but certain second wave of COVID-19, travel nurses should be prepared to potentially change the way they view travel nursing. Most travel nurses are used to taking high paying positions in highly desirable locations in order to travel locally on off days. Unfortunately, that has not been the case lately due to the ongoing pandemic.
Travel nurses might need to consider taking an assignment closer to home, taking a position in a unit outside their normal specialty, or taking a permanent staff position (even temporarily). Nurses should expect to see a decrease in available positions in certain specialties and an increase in ER and ICU assignments during a second wave.
On the other hand, a second wave could see an increase in patients because of the combination with flu season and those with a compromised immune system are at greater risk. If this is the case, travel nurses would see an influx of highly lucrative crisis positions throughout the country. OR and PACU nurses may need to look for other types of travel nursing assignments, such as a COVID swab nurse, COVID contact tracer, or a telehealth nurse, if elective surgeries are once again suspended.
It’s important for travel nurses to prepare now in case the second wave hits as expected. Your checklist should include:
Ultimately, it is impossible to say what the implications are for travel nurses if a second wave of COVID-19 hits. It’s important that travel nurses stay flexible, have their resumes ready, and be willing to work in unconventional settings.
Looking for a travel nursing assignment? Talk to a recruiter today.
COVID-19, the novel coronavirus, has forever changed travel nursing and perhaps not for the best. Travel nurses from coast to coast had contracts canceled without much notice and without any options except for taking extended time off. Some were lucky to grab a handful of the crisis contract in hotspots such as Seattle or New York City. Now, California, Texas, and Florida are the next predicted hotspots but crisis contracts have been even harder to secure the second time around.
Until recently, travel nurses have been able to generally pick their work locations from a plethora of hospitals and negotiate their contracts. It was a “buyers” market and the buyers were travel nurses. Now, with more travelers fighting for a smaller number of contracts, hospitals can choose not to negotiate with a nurse and the agency but instead select a different applicant.
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Initially, the pandemic closed units and decreased patient censuses in hospitals across the country due to stay-at-home orders but now as the world starts to reopen, travel nurses are still scrounging for contracts. It’s impossible to predict exactly how COVID-19 will continue to change travel nursing but it has already caused the following:
Let’s take a closer look. Imagine there is one ICU position at a well known academic hospital in a major city. Now imagine 100 applicants for that position. Everyone has similar credentials and would be ideal for the position. The first applicant wants to pick their own schedule, the next need specific days off, the third applicant just wants the job. Which one is the hospital going to choose? The third applicant is completely flexible and willing to take the contract with minimal changes.
Hospitals will continue to choose the travel nurses that fit their needs without hesitation or pushback. Hospitals are overwhelmed with other needs and finding travel nurses is generally not high on their priority list. As a result, travel nurse recruiters have to fight for the few available contracts for their nurses. It’s important to have open and good communication with your recruiter for this reason.
This is a prime example of post-COVID travel nursing. Nurses need to understand that with limited contracts; unfortunately, there is not the same flexibility. As hospitals reopen to elective surgeries and census continues to improve, there has been an uptick in the number of available travel nurse contracts. However, the overall number is still lower than previously. With contracts available throughout the country, travel nurses should have their resumes and credentials up to date and ready for submission.
These changes have forced some travel nurses to take permanent positions. Unfortunately, job security has become a must for some. Others have temporarily taken non-clinical roles in health departments doing contact tracing or COVID-19 testing. While for most this is a temporary setback it can be a viable option as the uncertainty of the coronavirus continues.
Interestingly, the current spike in new cases could lead to more crisis contracts for ICU and ER nurses but fewer contracts for OR and pediatric nurses. Why is this? During the height of the coronavirus, pediatric hospitals were virtually empty and ORs were closed. It’s possible this could happen again. It truly is impossible to know but regardless, it is very important for travel nurses to be ready for their next assignment.
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Chase and Lindsay Garrett are “a married travel nurse couple living in an RV on a mission to see the world and become financially free!” These travel nurses have traveled the US in their RV with their cat to work in some of the busiest CVICUs in the country. Lindsay, originally from Pennsylvania, and Chase, from West Virginia, met while attending nursing school at WVU and married in 2015 after several years of dating. They recently quarantined in Florida before accepting their next travel nursing contract.
According to their website, www.wereoutnabout.com, Lindsay and Chase chose travel nursing for three main reasons:
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A common trend amongst travel nurses, Lindsay and Chase, will often take several weeks off in between contracts in order to travel the world. One of their goals is to visit 30 countries before their 30th birthdays. So far, the couple has traveled to 20 countries together including Spain, Malta, Italy, Greece, Iceland, and Norway.
They share their travel nursing adventures on Instagram as @wereoutnabout.
Kathleen Gaines (KG): How has COVID-19 impacted your travel nursing contracts current and/or future?
Lindsay and Chase (L&C): As travel nurses, one of the main reasons we chose this lifestyle was for the traveling part. Between contracts, we usually take a month or two off and travel internationally. We had travel plans made for a trip to Thailand and Cambodia in April which was canceled due to COVID 19. Aside from our fun travel plans, we have found it increasingly difficult to find contracts. As a result of the pandemic and hospitals canceling elective surgeries, multiple travel nursing contracts were canceled and jobs were few and far between. Personally, we have been without a contract since April and are finally starting to see an increase in job needs. The competition for each job is more than ever before because there are so many travel nurses in the same situation as us who are eagerly searching for a job.
KG: Has there ever been that moment during a contract that either of you has wanted to stay and put down roots?
L&C: We absolutely loved working in Savannah GA. The unit we worked on felt like home and if we were ready to end our travel nursing careers, there’s a good chance we might have put down roots there.
KG: What do you wish you knew before starting the travel nurse life?
L&C: We did a lot of research for about 8 months before we started, so we felt pretty prepared. There are definitely certain things you can only learn as you go. We definitely recommend working with more than one company. That ensures that you have multiple recruiters job searching for you which gives you access to multiple jobs and opportunities. We also would advise to make sure you are reviewing the net/take-home pay package rather than the gross pay which is before taxes are taken out. Another tip, if you don’t get something put in your contract before you sign it — it’s not guaranteed. That applies to shift times, request offs, and floating guidelines.
KG: With COVID-19 dampening plans for travel nurses, what is a professional goal you have for the remainder of 2020?
L&C: Professionally, we are both certified critical care nurses and are always looking for opportunities to grow as nurses, learn new skills, and stay up-to-date with the newest therapies.
KG: How much student loan debt did you have upon graduation?
L&C: We had a combined debt of just over $100,000. When we started travel nursing we had $60,000 remaining. We made it a goal to pay off our debt in just one year of travel nursing and thankfully accomplished it. Now we are working on paying off our mortgage.
KG: If you could change one thing about travel nursing, what would it be?
L&C: We come from a state that allows us to have a compact license which makes life so much easier as a travel nurse. However, we wish that all states honored and accepted compact licenses. We’ve all passed the same NCLEX regardless of where we were educated and feel as if this is one of the biggest inhibitions for us personally when we make a decision of where we want to take a contract. If we choose a state where we have to apply and pay for a new license and then keep up with it per the state’s nursing board protocol, it’s less likely that we’ll choose to travel there.
KG: Do you work with one recruiter and travel nurse company or multiple ones?
L&C: As we mentioned previously, working with more than one company is one of the best ways you can increase your opportunities as a travel nurse. This increases transparency because you can compare contracts and pay packages for the same job. If one company is offering you more than another, you are able to negotiate rates to ensure you’re making the most you can as a travel nurse. It also gives you access to specific jobs that other companies/agencies may not be contracted with.
KG: What sacrifices did you make in order to pay off your debt?
L&C: We built a budget prior to travel nursing and worked hard to stick to it. We also focused on buying what we needed and eliminated some of the wants and materialistic things that would have been fun to buy. We’ve always valued experiences over things so although we saved when it came to shopping, we’ve definitely spent money on traveling without regret!
KG: How did you successfully pay off your debts?
L&C: We have a lot of information on our blog (www.wereoutnabout.com) and on our Instagram @wereoutabout where we address this topic quite frequently. The first step is building a budget, evaluating how much money you need to live off of each month, and doing your best to stick to your specific budget!
KG: What experience did you have prior to becoming a travel nurse?
L&C: We both had four years of experience, BSN degrees, and made sure we were certified critical care nurses prior to traveling as it makes you more marketable. We also came from a level 1 trauma center, magnet teaching hospital so we received tons of experience as staff nurses prior to traveling. One of the most important things to consider before traveling is your level of experience and confidence when it comes to being an independent nurse.
KG: Do you feel like asking for similar contracts and schedules as your partner has ever limited opportunities?
L&C: Absolutely not. We worked as CVICU nurses together as staff nurses prior to traveling. We’ve always chosen to work the same shifts because that allows us to have our days off to live our lives and explore the area. When we’re at work, you would never be able to tell we’re a couple or married aside from us having the same last name. We keep it strictly professional at work and our patients and their families are our focus and number one priority. Working together has only helped strengthen us as a couple and as nurses. As far as job availability goes, we’ve always been able to find a job where there are at least two needs for the same specialty and unit. We actually think it’s easier to find two of the same positions rather than if we were both seeking different specialties.