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The Traveling RN

By Jacqueline M. Duda, Freelance Writer - Nursing Spectrum

March 13, 2006

Moving into a new apartment every thirteen weeks is no big deal for Marianne Toppen, RN, a former neonatal intensive care unit (NICU) staff nurse at the University of Maryland Medical Center (UMMC) and her husband, Ted, a retired Baltimore pharmacist. They simply show up, grab the keys, and settle in. The pair travel light and switch residences with chameleon-like resilience.

"Our life fits into our car," she says.

The two empty-nesters were originally in the market for a new place to live. After leaving Maryland, 45-year-old Toppen joined the ranks of nearly 20,000 traveling nurses and "hit the road." She has lived in six different states over the last four years and applied 20 years of nursing experience at state-of-the-art teaching and research hospitals across the country.

What began as a one-year experiment transformed into a four-year travel extravaganza. Toppen relishes the geographic flexibility and the thrill of contemplating their next move. Never keen on Baltimore snowstorms, she favors sunny West Coast cities and basks in the warmth of her latest assignment at the University of California at San Diego Medical Center (UCSD).

Travel nursing is attractive to those with an appetite for new experiences and a wanderlust personality, appealing to experienced nurses seeking jobs with other hospitals, looking for alternative places to live, or wanting to see the country. Retired nurses sometimes opt to work full-time schedules in warm climates during the winter and return home to relax during the summer. Families with young children can travel in the summer when the kids are out of school.

The nationwide nursing shortage has sparked an increased demand for registered nurses. Hundreds of companies currently service traveling health care professionals, giving hospitals the opportunity to match critical staffing needs, especially in specialty areas such as the NICU, with seasoned professionals. Jan Hebert, RN, NICU nurse manager at UCSD, says travel nurses help bridge gaps by bringing in experienced RNs to cover staff on short-term leave and also to help meet the needs of the recent increases in NICU patient volume.

Taking flight

Toppen spent more than a year planning her initial decision to travel. Intense research led her to Cross Country Healthcare, an agency with nearly three decades of travel experience. Recruiter Jean Beauchamp was instrumental in helping her get started with a phone interview and skills assessment. "I also provide helpful tips whenever I can. I give first-time callers the 20-cent tour," says Beauchamp. She matched Toppen's credentials and skills with hospitals looking for NICU nurses, and once a decision was made, Beauchamp helped Toppen with licensure, housing stipends, and other details, simplifying the mandatory preparations and the documentation process.

Travel nursing - the Toppen way

NICU nursing is a small specialty area, increasing the likelihood that you'll run into old friends. Finding former Maryland colleagues in unfamiliar territory was a welcome surprise for Toppen. She usually requests assignments that mirror the university-based teaching atmosphere of UMMC.

"It's exciting to be part of groundbreaking studies that may change the future of the way nurses care for NICU babies," says Toppen. She has learned a great deal from research projects such as Parent Infant Nurturing Touch (PINT), a UCSD nursing-based study giving parents the option to learn kangaroo care and gentle infant massage, nurturing their preemie's growth and development through touch.

Toppen enjoys meeting and bonding with NICU families in different regions and learning about other cultures. Her six-year tenure in Maryland helped prepare her for the cultural cross sections she would encounter while traveling. She learned Spanish from her interactions with Hispanic families in a small Oxnard (Calif.) farming community. A highly successful in-vitro program in Southern California brought quadruplets and triplets to the NICU where Toppen was assigned, and San Diego offers an eclectic mix of Hispanics, Navy parents, and young professionals.

"I'll take these new experiences with me to Long Beach [her next assignment] and build on them. Traveling has addressed my need for adventure, increased my professional knowledge base, and made me a more well-rounded person," she explains.

But despite demographic and cultural differences, Toppen says one thing remains the same among NICU families. No family wants to be there [in the NICU], no one expects it, and everyone wants a healthy baby. Parents, whether they speak English, have one baby or three, all need guidance through the NICU maze.

Getting acquainted

After arriving in a new city, Toppen heads straight for Barnes and Noble for local maps and entertainment guides. The library is a great resource, as well.

"Do what the locals do, and find out where the local hangouts are. It's how you meet people," she says. Travelers themselves often become a little society, with sometimes four or five living at the same apartment complex and working at the same hospital.

Toppen also totes a little familiarity along. She alters the generic appearance of their furnished apartments by rearranging the furniture, Feng Shui-style, and using dishes, linens, and pots and pans from their Baltimore home.

Don't be afraid to go for a drive in unfamiliar territory or to meet new people. Successful adaptation demands an inquisitive nature. "Traveling, for me, is like a working vacation that makes time off feel valuable. It's a perfect balance, something we all strive for." But she is quick to add that it's not easy. Frequently changing jobs and residences can be stressful. And having a personality geared for exploration and discovery is critical for this gig. If you crave familiarity and routine, then traveling isn't for you.

Toppen has been offered a permanent position after each of her assignments, but her wandering spirit keeps her on the road. "I'm addicted to traveling and eager for new assignments and new routines." She affectionately refers to her husband, Ted, who helps with the moves and finds all the good restaurants, as her "sherpa." "I can't imagine doing this without him. I'd be too lonely."

In each new apartment, Toppen attaches her favorite bumper sticker to the fridge that pretty much sums up her thoughts on traveling.

"Not all who wander are lost."