According to the American Association of Critical-Care Nurses (AACN), the current situation is unlike the previous shortages the specialty has endured. In the past, staffing cries have hit some regional pockets much harder than others. A case in point involves facilities the South that experience an influx of snowbirds and tourists during the winter months.

When the cyclical need still exists, facilities nationwide are trying to fill positions throughout the year. And, more than ever before, administrators are relying on travelers as a solution. "The scope of opportunities for critical care nurses is huge right now, and it has grown extensively over the past couple of years," says Scott O'Carroll, president and founder of Procare USA, based in Farmington, Connecticut. "The poor staffing outlook for hospitals could mean even more career possibilities for traveling critical care nurses in the near future."

Recognizing the Need
Some of the subspecialties hardest hit by the staffing shortage include pediatric, neonatal, and adult intensive care; open-heart care; and cardiac catheterization labs. In fact, AACN notes a 45 percent increase in travelers practicing within adult critical care units last year and 50 percent more in pediatric and neonatal intensive care units. That does not even account for the 140 percent increase in the numbers of mobile practitioners working in the country's emergency departments.

The outlook for travelers in telemetry is particularly bright. In the past years, beds in the step-down units were filled with patients who were well on their way to complete recovery, no longer requiring extensive nursing care. Today, however, the telemetry unit does not look much different from the traditional ICU, and nurses find themselves administering many of the same services.

"Historically, critical acre patients would remain in ICU longer, but now they are being moved into telemetry much faster and much sicker," comments Mr. O'Carroll. "It is very difficult to keep these units staffed."

Meeting Professional Challenges
For many traveling critical care nurses, it is the sense of unpredictability and complex patient populations that draws them to this specialty. Others enjoy the opportunity to hone their assessment skills and improve their critical thinking and problem-solving abilities.

After all, patient populations in ICU and open-heart units, especially, present complex cases that can impact a routine shift without a moment's notice. Extremely susceptible to complications, these individuals often experience multiple system failures, requiring providers to constantly monitor their progress and make split-second care decisions.

"You're constantly assessing patients," says Allison Jones, BSN, RN, a traveler with q-Shift Travel Nurses, formerly Guarding Care Travel Nurses. "Every hour, you are assessing different physiological systems and any deviations from normal body processes."

"In critical care, you always have to think about the patients and what is in their best interests," adds Lara Yates, BSN, RN, a traveler with StarMed on assignment at St. Luke's Hospital in Bethlehem, Pennsylvania. "This can pose a significant - and rewarding - challenge."

Last year, Lara realized just how true these words were. On her first assignment, she observed an ICU patient who was failing to respond to the current treatment. "I could tell she was underserved at the time. Able to discern what was going on, I decided what could be the appropriate treatment and expressed my thoughts to the physician, who agreed with me. That was a terrific boost to my confidence."

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