Survey Reveals Travel Nurses' Commitment to Patient Care, Travel, and Dissatisfaction with Institutional Setting To get into the minds of travel nurses, Colorado Springs, CO-based travel nurse staffing company q Shift Travel asked 79 travelers open-ended questions about the industry. The company released the findings of its first annual survey March 31, 2003. All the nurses responding to the survey were travelers — some were with q Shift and some with other travel companies. The survey, conducted February and March 2003, included 13 questions about travel nursing and the travel nurse industry. "We felt it was critical to understand and know travel nurses better," says Whitlow. He adds there are challenges facing the travel industry and nursing, in general. The survey offers insight to travel companies about what nurses' concerns and plans are regarding travel, and hospitals, which continue to lose nurses because of nurses' well-publicized dissatisfaction with the way they are treated in the institutional setting. Questions, Answers According to the q Shift survey: When asked why they became travel nurses, 44% said the adventure and opportunities drew them into travel; 36% reported pay; and 20% indicated that they'd chose travel because of job-related and other issues. Nearly all nurses responding had no intention of going back to being hospital and other facility employees within the near future. Ninety-one percent reported that they plan to continue traveling as nurses in 2003. "What struck me most was that they don't want to go back to the permanent staffing environment. They enjoy what they're doing as travelers," says Whitlow. Travel nurses' commitment to travel seems resilient to hospitals' aggressive nurse recruiting efforts, which points to their frustrations with working as employees of healthcare facilities, Whitlow says. Travel companies clamoring for nurses will be happy that 57% of the nurses surveyed said they'd keep traveling, even if hospitals increased nurse pool pay. Still, 30% of the nurses in the survey said they would be more inclined to opt for permanent placement if nurse pay pools were increased, and 13% said they might be more inclined. When asked if they had read or heard about wages declining in some parts of the country in 2002, only 26% of the travel nurses responding said yes. In reality, Whitlow says, there have been pockets around the country where prices have moderated and so has demand for travel nurses. "Hospitals are working within their budget constraints to eliminate so much dependency on travel nursing," says Whitlow. Travel nurses perceptions are that they will be making more money later in the year. Eighty-three percent of nurses expect their wages to increase in 2003 (13% said they thought wages would stay the same, and only 4% thought they might decrease). Another key finding, according to Whitlow, is that while travel nurses are sometimes perceived by hospital staffs to care less about patients and more about money, the opposite is true in most cases. Eighty percent of nurses surveyed said personal touch and care was more important in their role as a travel nurse than was pay. Seventeen percent reported pay was more important, and 3% weighed both equally. A resounding 96% of travelers are in favor of the new lower nurse to patient ratio goals being promoted by JCAHO, but nurses were divided about whether the ratios would be able to be achieved. Most nurses (88%) said they expected travel opportunities to increase in 2003. (However, they're concerned about the availability of travel opportunities.) Fifty-three percent also said that they thought more nurses would be leaving the institutional setting to become travelers. That, in itself, is worrisome for hospitals, Whitlow says. It must have been some pretty strong communication for 53% to say they thought nurses would be leaving hospitals to become travelers, he believes. When asked their concerns about the travel industry, 62% voiced concerns about fewer travel nurse opportunities, 23% about difficult work environments, and 15% about decreasing benefits. Whitlow says that nurses mentioned they worried about hospitals using fewer travels and wondered whether influxes of foreign nurses might dampen US traveling opportunities. They also wondered if there were too many travel companies, according to q Shift. The survey's finding that a significant number of travelers are concerned about staff animosity towards them is often based on the misperception that travel nurses' number one priority is money and not patient care, Whitlow says. But in fact, according to the survey, nurses see travel as a way to get away from the problems they perceive in the institutional setting while still providing patient care. Nurses were most hopeful that hospitals will make these changes in 2003: 34% hoped for improved working conditions for nurses; 26% called for improved patient care; and 20% responded in each of the areas of higher pay and more opportunities for travel nurses. On the other hand, travelers said their wish list for travel agencies in 2003 included better locations (37%), more assignments (18%), better benefits (17%), increased pay (17%), more support (8%), and honesty (3%). Looking for Answers According to Whitlow, there continues to be a travel nurse shortage — even as hospitals are working to cut down their dependence on travelers. "The shortage still exists and is expected to exist another 10 years or more," he says. The catch is that as hospitals cut down on travel nurses, they'll put more pressure on their existing staffs and unwittingly encourage more nurses to seek other options, including travel. The survey, he says, will reinforce the message to hospitals that they need to do more than offer money to attract nurses in the long-term and that travel nurses want more opportunities and better working environments, with welcoming staffs.