By Sonja Hakala, AIRS Senior Strategist

John Lennon once imagined a world with no countries or boundaries separating them. Now, a growing number of people in the healthcare sector are making his imaginings their reality, working as if national borders did not exist.

Maintaining this international flow of medical professionals, especially nurses, has become a critical piece of the staffing structure for the industry in the U.S.

It's Still All About Milk and Honey

"Nurses travel and work internationally for a wide variety of reasons," Bonnie Custen said. She's with Cross Country Travcorps in Boca Raton, FL, one of the country's largest providers of contract professionals for the healthcare industry. "And because the hospitals here in our country are so advanced and high tech, most of these nurses choose to come here. America is the land of milk and honey, after all."

Even folks who are only mildly interested in the inner workings of the U.S. healthcare system know there's a chronic nationwide nursing shortage. According to Custen, the average age of a nurse in this country is now 45 and there are not enough people entering the field to fill present or future domestic needs.

Advanced Technology is Even Sweeter

Currently, the U.S. healthcare system is reaping a staffing benefit from its advanced technology. Workers are eager to come here in order to learn the latest techniques or maintain modern practices while earning more money than they could at home.

"In Germany, for example, they don't have the same kinds of equipment or research that we do over here," Custen said. "And if you're a nurse in a place like St. Thomas, if someone needs potassium, you hand them a banana because that's the best you have."

Testing the Waters, Making a Match

"It's also a good way to test the waters for both the nurse and the hospital," adds Dijana Lesh, senior client manager with Cross Country Travcorps. "We're seeing a growing trend of people who use our services to relocate, taking short-term assignments at different facilities to see if the match is good."

Canadian Healthcare Workers

Even in countries with comparable technology, U.S. healthcare recruiters compete successfully for candidates simply because they can offer better employment opportunities. Healthcare professionals from Canada currently make up the bulk of the traveling nurse corps in the U.S. Canadian nurses are leaving their own healthcare system because of the higher wages in the U.S., a benefit that is augmented by the current exchange rate.

Canada also loses nurses because employers cannot promise workers either full-time or regular hours.

"They call it casual time," Robert Stephenson, an intensive care nurse at Dartmouth-Hitchcock Medical Center in Hanover, NH, explained. He's originally from Ottawa, Ontario. "You might be able to work full-time but no one can promise you that. It can drive you crazy because you don't know from week to week what your paycheck will be."

Custen explains that it's easy to translate Canadian skills to the United States because the educational and licensing requirements are so similar and there's rarely a language or culture problem. In addition, TN (Trade-NAFTA) visas are readily available to Canadian citizens at all U.S./Canada border crossings. Unlike every other visa category bestowed by the U.S. government, the paperwork, fees and application time for a TN are minimal.

A 90-Day Rotation

Traveling medical professionals usually contract for 90-day positions, often with an option to renew. Housing is likely to be provided by the staffing agency and a traveling nurse's rate of pay (which frequently includes signing bonuses) is higher than that of a full-time staff member. The contracting agency also provides benefits such as insurance and retirement as well as traveling expenses between positions.

According to Custen, nurses who travel from job to job enjoy the chance to explore different locales while looking for a place to settle down. "Many people travel to find a home," Custen said. "Or they take positions in places where they have an interest such as mountain climbing or sailing or surfing. Some take their families, contracting for the school year in one place then moving on during the summer."

Love It or Leave It

"People often start out traveling just because they like to travel. But then they fall in love with a place or a person and decide to settle down," Lesh said. She estimates the average traveling nurse stays in the program for two years.

"Relocating every 90 days is hard," Lesh said. "But for international nurses, this represents an excellent opportunity to relocate because we take care of a lot of the details."

For those who do not like to be involved in office politics, contract work is perfect. "If something happens that you don't like, you can always tell yourself that you'll be gone in three months," Custen said.

Hospitals Win Out Too

There are several key advantages for a hospital as well. Recruiters can ask for very specific skill sets and know they'll have an employee that can walk right into a job, ready to go. They can cover short-term absences such as maternity leaves without adding permanently to staff.

In places like Florida, where hospital use fluctuates with seasonal living patterns, medical centers can contract and expand their nursing staffs without keeping people on during slow periods. "We just supplied a hospital in Orlando with 300 employees for the next six months," Custen said.

Because of their experience and adaptability, traveling nurses bring new perspectives into a workplace and this can often have an impact on staff morale. "People often react negatively to change and may start to complain about their workplace," Lesh explained. "But then one of our traveling nurses can step in and say 'This is a lot better than the place I just came from.' It can be an eye-opener for staff."

For those involved with medical staffing, there's a fingers-crossed attitude about traveling nurses. No one knows the future, but everyone hopes this influx of travelers will last.

-- Sonja Hakala is a writer, editor and communication specialist with numerous credentials in journalism and book publishing. She is a Senior Strategist with the AIRS Course Development team and regular contributor to AIRS content. This article is reprinted by permission from AIRS, a global leader in Internet recruitment, tools, news and information. For more information on AIRS, please go to: http://www.CollegeRecruiter.com/pages/airs.php. Copyright © Hanover Capital Management Corporation 1997-2001. All Rights Reserved

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