TIPS FROM DAVID MORRISON, AUTHOR OF THE TRAVEL NURSE'S BIBLE

How long have you been a nurse and what areas of nursing did you or do you currently work in?  Graduating from nursing school in 1993, I worked six months in an extended care facility until being accepted into a critical care fellowship in Columbus, Ohio. Since that time, I have worked exclusively in various critical care areas.

David, you and I both started our travel nursing careers in Hawaii, exposed to SCUBA, rainbows and luaus. Not all assignments are paradise but what do you love most about travel nursing?  If you choose your assignments as if you were choosing vacation destinations, it's hard to go wrong. I've never accepted an assignment in a location where I did not have some interest in the surrounding area. Always wanted to see the Grand Canyon? Flagstaff or Phoenix fits the bill. Want to scuba dive in the Keys? Ft. Lauderdale and Miami are easy drives to prime ocean spots. If you don't like the location or work environment, you are often only obligated to stay for three months. But, if you do fit in well with the unit, many locations allow multiple extensions.

"Travel nursing is really the definition of career freedom."

Tell me your biggest challenges or concerns about travel nursing.  I'd say that the difficult assignments are the biggest obstacle in travel. Whether it is for unsafe patient workloads or an uninviting staff, three months can be a challenge when you really dislike your assignment.  I personally have only ever had one assignment where I gave serious consideration to "walking" on my contract. In that instance, I concentrated on making the most of my days off and seeing everything I could in the surrounding area. It was San Francisco, so it wasn't hard to chose from a variety of activities on my days off.

What throws you off balance and how do you know you are out of balance? What brings you back into balance?  Honestly, I feel as if I have been a nurse for so long, that nothing within the job really throws me. No matter how bad it gets, at the end of twelve hours, I'm done.  Anytime I have felt stressed or "out of balance" it has been a personal issue. So the most obvious answer is to eliminate the issue, which of course is not always possible. So I guess it is all about balance, finding something to even things out. If I've had a rough week, then I don't feel guilty about spending an entire day "vegging out" in front of the TV or playing a new video game for four hours (it's a guy thing). Some might hit the gym, read a book, hike, bike or skydive; whatever your release valve may be, you need to have one.

Your book The Travel Nurses Bible is a great resource for nurses. Travel Nursing is not for everyone. The nurse needs to be independent, strong in clinical skills and very adaptable. What advice would you give to new nurses interested in travel nursing?  You need to be able to honestly and accurately assess your skill level as a healthcare practitioner. If you are regularly asking someone else to help with an IV start, Foley or NG insertion, or basic nursing practices, then you are not ready to for the road.

You need to be a fairly independent practitioner and prepared for the possibility of receiving little to no help in your new work environment. Do all assignments expect you to just keep to yourself and do your work with no assistance? No, but you do need to be prepared should that occur.

Tell me your most interesting story as a nurse.  I have a couple instances in my book Travel Nurse Bible about memorable stories from the road, but experience I had in Florida. I was floated to telemetry for the shift. Taking care of double or sometimes triple your baseline workload, can throw any ICU nurse into a rather un-hospitable mood.

At the end of my rounds, I grabbed the antibiotic from the med room and went in to assess my patient. After a quick assessment I realized the IV in my patient's arm wasn’t working. Excusing myself from the room, I stormed down the hallway to grab some IV supplies. By this point, I was starting to get a headache and a bad IV was just the nail in the coffin.

Upon entering the room, I remained pleasant, trying to never let a patient see when I'm having a bad shift. Apparently, I did not do a good enough job in shielding my patient from my feelings that night as she sensed my frustration and calmly asked, "Are you having a bad night?" That was all it took to release a monologue of all the difficulties I had encountered that night.

I started to explain all the things that had gone wrong since I started my shift. As I made my way down her arm, I noticed a small tattoo. I quickly grew very quiet as I looked at the numbers and realized the significance of the ink on her arm. I recognized the unmistakable marking of a person who had been in a concentration camp, the number was preceded by the letter "A", meant she had been at Auschwitz.

I sat there for what seemed like an eternity not knowing what to say. Finally, I just looked up at her and apologized. She looked perplexed and asked why I was apologizing. I told her that after I unloaded all the details of my crappy evening to her, I just realized that nothing I would probably ever encounter, in my lifetime, could possibly compare to what she had been through. She smiled, patted my hand, and told me not to worry about it.

As I started her IV, I learned that she was not yet even a teenager when she arrived at Auschwitz. Her mother, father, and sister were all killed at the camp. She had even written a book about her experiences there, but never found anyone willing to publish it.

I sat with her for another twenty minutes listening intently to her story. After finishing up, I thanked her for the conversation and the reality check. When I left her room I was no longer concentrating on my aching head or my growling stomach. As I think back to her, I wonder if she ever found anyone to publish her words. If not, I know at least one person who will always remember them. I also know one nurse that will never again lose his perspective, no matter how bad his shift might be.

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