BE A NURSE, SEE THE WORLD TRAVELING RNS ALLEVIATE STAFF SHORTAGES WHILE EXPANDING THEIR HORIZONS.

Byline: Mariko Thompson Staff Writer

SHELLEY LILLARD'S resume might read: Has bedside manner, will travel.

Lillard, 28, is a travel nurse who hops from city to city, hospital to hospital. For the next few months, she'll work in the labor and delivery department at Kaiser Permanente in Panorama City. On her days off, the Kansas City native hits the beach and other seaside attractions.

``I worked as a staff nurse in Kansas City, and I was getting bored with what I was doing,'' Lillard said. ``I wanted to gain experience by going to different places and learning more about how they do things.''

Itinerant nurses with suitcases in hand have become one of the solutions to the nursing shortage in California. Staffing agencies recruit travel nurses both at home and abroad with the promise of better pay, flexible schedules and a nomadic life of adventure. Hospitals desperate for experienced registered nurses are turning to agency employees more and more.

This isn't the average temp job where workers earn a check while waiting for the full-time position to come along. For nurses of all ages, traveling is becoming a preference, not a stop-gap measure.

``I can tell you there is a movement to choose traveling,'' said Karen Flaster, chief operating officer of HRN Services Inc., a staffing agency in Beverly Hills. ``It is attracting attention as one more career choice.''

Temporary trend

According to the National Sample Survey of Registered Nurses released in 2002, the number of nurses who received their primary source of employment through temporary staffing agencies increased 36 percent between 1996 and 2000. The survey did not distinguish between travel nurses, who typically work 13-week assignments, and registry nurses, who work by the shift.

California has about 226,000 registered nurses, and 81 percent are employed, according to the survey. At the same time, about 14 percent of hospital RN positions in Southern California remain unfilled because of the dearth of qualified applicants, said Jim Lott, executive vice president of the Hospital Association of Southern California.

Lott says more needs to be done to make nursing an attractive profession for young people. The average age of registered nurses, now at 48, continues to climb. State nursing schools graduate only 5,000 RNs a year, a number he says needs to double to fill the need.

``We have to start in the elementary and middle schools and show that this is a viable profession,'' Lott said. ``This is one field that's completely recession-proof. We're always going to need nurses.''

Lisebeth Jacobs, a registered nurse and senior spokeswoman for the California Nurses Association, counters that there are plenty of registered nurses. The shortage has been created by untenable working conditions in hospitals, she said. Jacobs points to a recent state survey that looked at why RNs leave nursing. The top reasons include unsafe staffing loads and mandatory overtime, she said.

``The existence of these travelers and their increasing number shows there are nurses willing to work in hospitals, but not in regular positions that tie them down because of the way the conditions are,'' Jacobs said. ``Being a traveler is an out. You can leave after a 12-week contract.''

Money talks

To woo registered nurses to their rolls, agencies promise top dollar. On its Web site, Elite Travel Nurse says nurses can increase their hourly wage by as much as $7 per hour. Medical Express and O'Grady Peyton International entice travel nurses with rates up to $40 an hour.

In 2001, the California Employment Development Department estimated that the average hourly wage for registered nurses and nurse practitioners ranged between $23 and $32 per hour.

Though pay depends on the hospital and location, travel nurses tend to make more per hour than staff nurses. Their living and travel expenses are paid. Most agencies also offer benefits packages to their employees.

Hospitals who hire travel nurses not only pay higher wages, they also pay an additional 5 percent to 15 percent to the agency, Lott said. Even when factoring in benefits paid to a staff nurse, the cost of hiring a travel nurse is higher, he said.

In addition to the financial impact, hiring nurses through temporary staffing agencies raises concerns about quality of care. Travel nurses are preferable to registry nurses because they spend a longer period of time at the same hospital. But hospitals would prefer to hire a staff nurse, who knows the community and the hospital's system, Lott said.

``It's better for patient care in the long run if we can hire the nurse,'' he said. You've got both financial and quality-of-care incentives. There's simply not enough bodies.''

Jennifer Fedele, department administrator for labor and delivery at Kaiser Permanente in Panorama City, was relieved to learn she could hire a travel nurse. Trying to find an RN to cover night shifts in labor and delivery can be a challenge. Lillard, who arrived in April, is currently the only travel nurse working at the hospital.

``I look for someone who really loves labor and delivery,'' Fedele said. ``She's so easygoing and laid back. She adapts extremely well.''

In order to acclimate to a new setting quickly, travel nurses must have confidence in their skills, Lillard said.

``They expect you to hit the ground running,'' she said.

Lillard signed up with a temporary staffing agency because she wanted to see more of the country. She had never traveled to either the East or West Coast. Her first assignment, which ended in March, was in San Francisco. She's enjoyed exploring the Golden State, though there are days when living in an apartment with furniture that's not her own makes her homesick.

After her contract is finished at Kaiser, Lillard plans to take a break and return to Kansas City. Her next stop? Whatever catches her fancy.

``I'll go home for a while, maybe for two or three weeks, then take it from there,'' she said. ``I'm leaving my options open.''

CAPTION(S):

3 photos

Photo:

(1 -- cover -- color) RNs on the GO

Traveling nurses help hospitals, see the sights

Tina Burch/Staff Photographer

(2) no caption (Stethoscope)

(3) The contracts for traveling nurses are usually about 13 weeks in length - and the assignments usually pay more, as well.

Andy Holzman/Staff Photographer