Professional Documents
Culture Documents
The Lived Experiences and the Factors Affecting Assimilation of Travel Nurses into the Culture
Kristen Eden
Bethel College
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ASSIMILATION OF TRAVEL NURSES
Abstract
Travel nursing has become a popular means for hospitals to bridge staffing shortages and
continue to provide patient care. Though travel nursing may be an exciting career option for
registered nurses, there are challenges that must be considered before choosing this career. The
purpose of this study is to explore the lived experiences and the factors affecting assimilation of
travel nurses into the culture of their assigned nursing units. This qualitative descriptive study
will employ interviews with travel nurses to explore their lived experiences, including the
benefits and challenges faced by travel nurses, and assimilation into the culture of the assigned
destination units or facility. The information gleaned from these interviews may be used to assist
nurses who are contemplating a career in travel nursing to be prepared to face the opportunities
enculturation
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The Lived Experiences and the Factors Affecting Assimilation of Travel Nurses into the Culture
Travel nursing is a popular trend in nursing. It allows health care managers to fill staffing
gaps when shortages would otherwise cause an interruption in safe and quality nursing care in an
organization (Randolph, 2003). Travel nursing gives nurses the opportunity to travel to new
destinations, gain experience by learning to thrive in new environments, and earn extra
compensation while filling difficult positions (Hinson-Smith, 2003). The purpose of this research
is to explore the lived experiences and the factors affecting assimilation of travel nurses into the
Data gathered may be useful to assist future travel nurses with their decision to venture
into travel nursing. It may also be useful to help prepare first-time travel nurses to face the
challenges of assimilating into the culture of their assigned unit and to feel comfortable and safe
while practicing. Previously published research was reviewed for content related to travel
nursing. For data gathering, travel nurses will be interviewed to describe their lived experiences
working in their assigned clinical agencies. Their responses will be evaluated for themes that will
Background
destination to practice nursing by contracting with an agency that places the nurse in an
assignment (Morrison, 2011). This process involves assimilation, which is defined as “a much-
contested notion whereby on entering a new country immigrant groups are encouraged, through
social and cultural practices and/or political machinations, to adopt the culture, values, and social
behaviors of the host nation in order to benefit from full citizen status” (Holohan, 2012, p. 92).
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For example, in this study, the host nation would be the host nursing unit and the travel nurse
Though travel nursing has become very popular since the late 1990s, there is little
research published on travel nurse satisfaction and retention (Faller, Gates, Georges, & Connelly,
2011). Factors, such as the nurse’s level of experience, support systems, and destination facility
reputation, all affect how the travel nurse will thrive in the new work environment (Dawson,
1996). There are many reasons why nurses choose travel nursing; including dissatisfaction with
the current work environment, increased pay, and flexibility in work schedule (Faller, Gates,
When travel nursing began in the 1970’s, travel nurses were often provided with housing
near the hospital (Professional Association of Nurse Travelers, 2016). This provided a fun living
experience for the travelers, as they had many people to spend their time off with during their
sojourn. This is no longer the case, though often travelers choose to take work assignments with
other travel nurses and find their housing together. Because of this lack of community previously
offered to travel nurses, it is important for hospital staff to embrace the traveler and include them
While travel nursing is a wonderful opportunity for growth in a nurse's career, it can
often be a stressful situation for those who are not prepared for the challenges they will face
while travel nursing (Fraleigh, 2010). The proposed qualitative study will explore the issues
faced by travel nurses and provide more information for future nurses to consider when choosing
a career in travel nursing. Travel nurses will be interviewed related to their assimilation and
feelings of acceptance by nurses and management in their assigned clinical unit or facility.
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Problem
Travel nursing has become a popular means for hospitals to bridge staffing shortages and
continue to provide patient care. While temporary nurses make up 30% of the United States
nursing workforce, only 2% of these temporary staffing registered nurses (RNs) are travel nurses
working in the acute care setting (Faller, Dent, & Gogek, 2017). Travel nurses, or temporary
nursing staff (TNS) as they are referred to in the business sector, cost the medical industry in the
US approximately $3.6 billion dollars a year. Policy makers and healthcare managers may see
this as a problem and decide to find more effective ways of dealing with staffing shortages. They
may also choose to support further research on the effects of using TNS in their facilities to
determine whether or not the use of travel nurses is the wisest decision for their units and
Travel nurses provide healthcare facilities with a plethora of experience, strong nursing
skill sets, and ability to thrive in high-stress, chaotic situations while providing quality care.
Though travel nursing is a wonderful and exciting career option for RNs, there are challenges
that must be considered before choosing this career (Fraleigh, 2010). These challenges include
handling stressful situations with minimal support (Cottingham, 2017), acclimating to new
environments frequently (Hinson-Smith, 2003), and leaving behind family and friends (Travel
Nursing, 2009). To provide the best possible care, travel nurses must be able to face the
challenges and continue to provide excellent care to their patients. Lack of published research on
the lived experiences, and the factors affecting assimilation of travel nurses into the culture of
The purpose of this qualitative, phenomenological research study is to explore the lived
experiences and the factors affecting assimilation of travel nurses into the culture of assigned
nursing units.
Most of the research articles were obtained from Bethel College’s online library source. Specific
literature sources include EBSCOhost, Ovid, and Cumulative Index to Nursing and Allied Health
Literature (CINAHL). Key words and themes included in the research were travel nursing,
assimilation, culture, temporary staffing, temporary nursing, and enculturation. The nursing
Empirical Review
Travel nursing has become a popular health care trend as managers of health care
facilities find themselves needing to fill positions quickly with qualified RNs. Travel nursing,
however, can pose many risks for RNs. This descriptive qualitative research study will explore
the factors behind what makes travel nurses feel a sense of assimilation into their assigned unit’s
culture.
Faller et al. (2011) suggested factors, such as years of experience, the proximity of travel
destination to RNs home life, and family presence, affect a travel nurse's satisfaction with their
travel nursing assignment. Faller et al. also stated that nurse-to-patient ratios were an important
determinate as to whether a travel nurse succeeded during their assignment or become burned
out. One conclusion of their research study was Magnet status hospitals showed an increase in
nurses' perception of quality care and an improvement in staff and patient satisfaction (Faller et
al., 2011).
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Randolph (2003) stated that nurse-to-patient ratios greatly affected job satisfaction of
both staff and travel RNs. Randolph explored reasons to consider travel nursing and how travel
nurses can benefit a facility. Because travel nurses can jump right in and start doing the job of a
regular staff member with minimal training, it is more economical and practical to hire a travel
nurse instead of a new graduate nurse when there is an acute shortage, such as when a staff nurse
Tuttas (2013) stated that the amount of nonproductive nursing labor drastically decreased
when hospitals staffed with travel nurses. Multiple week-long orientations and continuing
education are not required for travel nurses to perform their duties, whereas a new graduate RN
will require both of these to be compliant with hospital policy. Because of the decreased
onboarding time required, staffing with travel nurses makes a financially savvy decision.
Hospitals also save money on paid vacation and sick time, reimbursement for certifications, and
healthcare benefits because these are only offered to nurses by their travel agency instead of the
Cottingham (2017) described how travel nurses help fill the gap in the healthcare
industry. The shortage of nurses continues to grow. As the current nursing population ages and
retires, an estimated 74 million patients will require nursing care services. Cottingham explained
how new nurses are leaving the field because of the stressful work that is typical of nursing. This
has made travel nursing more enticing to new RNs who are looking for some adventure and an
increase in pay.
Wood (2015) indicated that a 10% increase in travel nursing growth is expected to occur,
leading to an increasing number of options for travel nurses from which to choose. Factors that
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contribute to this growth are the improving economy, increase in insured patients due to the
Affordable Care Act (ACA), and the aging population who require increased healthcare services.
Travel nursing has several job opportunities and pay packages that are competitive. These
benefits are often successful in enticing nurses to try travel nursing (Wood, 2015).
Challenges
Goldstein (2014) recognized that one of the greatest challenges that travel nurses face is
the assimilation or fitting in on the unit he or she is assigned to work. Often staff nurses are
skeptical about welcoming a travel nurse into their unit. There can be jealousy because the travel
nurse seems to be making more money than the regular staff members, creating animosity
between the unit staff and traveler. With this in mind, it should be the job of the unit manager
and charge nurses to educate their staff on how the travel nurse will benefit their unit and to
encourage acceptance and warmth towards the new member of the team (Goldstein, 2014).
Mazurenko et al. (2015) found that poor communication between travel nurses and
permanent staff nurses hindered quality patient care. Often travel nurses reported experiencing
abuse and lack of trust and support from the staff nurses and inadequate support from
management. The same study found that travel nurses may negatively affect the quality of care
and organizational loyalty. Suggestions to improve the care provided by TNS include effective
orientation for the travel nurse including hospital policies and procedures, assessment of
individual nurses’ skill sets, and encouraging the development of trusting relationships between
lower levels of organizational commitment and higher levels of stress compared to their
permanent staff nurse counterparts. Reasons for this included attituded among permanent staff
members towards travelers, less continuing education, and poor orientation to the contracted
facility.
The Joint Commission (2012) recommended RNs should have a minimum of two years
of nursing experience before considering travel nursing. Goldstein (2014) confirmed that to be
fully prepared to face the challenges of travel nursing, RNs should have at least two years of
experience in nursing care. This requirement will ensure that the travel nurse is prepared to
handle the clinical aspects of the unit's care. Nurses with two years of experience are also more
familiar with medication interactions and adverse reactions, which improves the quality of care
Extracurricular Activities
Travel nurses should ensure that their time away from the nursing unit is enjoyable
(Travel Nursing, 2009). Bringing along a pet on assignments, making new friends, exploring the
assignment destination, and staying connected with family and friends back home are all great
ways for the traveler to avoid feeling lonely and homesick. This will boost morale and
discourage call-offs or even termination of assignment by the travel nurse (Travel Nursing,
2009).
Orientation
Travel nurses are often given very little orientation to the assigned unit and facility. They
are expected to have around one to three shifts orienting to the facility, charting system, and unit
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policies and procedures before practicing independently. This can be daunting for new and
experienced nurses.
Small gestures, such as welcoming the traveler with a smile, showing them where to store
belongings, and introducing the traveler to the permanent staff, are some ways the manager can
make the travel nurse feel welcome and secure in their new workplace. The traveler should be
told who to go to for questions and support, such as phone numbers to call in case of a code and
orientation to documentation system, and hospital/facility tour to be the most important things
for a traveler to be oriented to. Administration, hospital policies and general human
resources/employee benefits were the least important things for travel nurses. Travel nurses often
felt that the orientation they received to the hospital should be unit specific and cover only the
information that will be useful for the traveler to practice safely, assuming the traveler is
competent in the nursing skills required for the patient population on the unit (Goodwin, 2004).
Goldstein (2014) stated that the travel nurse should be given a minimum of two days of
general orientation that includes familiarizing the nurse with the electronic medical record
(EMR) service used by the hospital for charting. Knowledge of the facility's EMR is very
important to nurse managers in their selection of a travel nurse. The traveler should also be given
a two-day unit orientation, where the travel nurse can familiarize themselves with the unit's
environment, staff, and equipment. This knowledge of a facility’s unit will allow the travel nurse
to have a sense of readiness to take on the patient assignment and perform their duties safely and
effectively. It will give them a sense that they are part of the healthcare system as they assimilate
Tuttas (2011) stated that the travel nurse needs to be enculturated into the nursing unit
where they are assigned to work. She stated enculturation of travel nurses into the assigned unit
as "as essential component of integration into the work arrangement of professional contract
nurses” (Tuttas, 2011, p. 24). For the culture of the unit to be conducive to excellent patient care,
the culture must include teamwork, true collaboration, leadership, and skilled communication.
Tuttas explained that the unit staff must be receptive towards the travel nurse for the traveler to
feel comfortable being enculturated into the assigned unit (Tuttas, 2011).
Goldstein (2014) suggested that the unit manager should prepare the unit's staff to
welcome the travel nurse. They should use the traveler’s first name and explain how the traveler
will be used to benefit the unit, encouraging staff to treat the travel nurse as a colleague.
Contract Issues
Though there is a projected increase in the need for travel nurses, there can be times
when facilities hire a travel nurse for a 13-week contract and find that they do not need the nurse
for that length of time. This can be an issue for not only the healthcare facility, but also the travel
nurse. Rosenstock (2016) found that travel nurses were blacklisted by healthcare facilities that
did not want to honor the entirety of the contract because of financial reasons, though the travel
nurses were not found to have practiced unsafely or having caused problems on the unit where
they were hired. Rosenstock proposed that this treatment of travel nurses is devastating to their
career and should be prevented at all costs. If the hiring manager of the facility thinks they will
need the traveler for a shorter period of time, this should be addressed in the contract and
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discussed with the travel nurse and the travel agency. The traveler might also be willing to move
to another location within the hospital system where there is a need. In addition, most reputable
travel agencies will shorten the length of the contract if the hiring facility is honest about their
Theoretical Review
The theoretical literature used to support the need for research on the topic of travel
nurses' assimilation comes from Leininger’s theory of culture care and sensitivity. Leininger
(2009) studied how culture affects groups of people and impacts the care they need. Leininger’s
work has affected how nurses care for patients from varied cultures and backgrounds (Nelson,
2006). As nurses have their own culture, so do travel nurses. This qualitative research will focus
on the culture of travel nurses, and how they assimilate into the culture of the units, to which
The theory of culture care diversity and universality is necessary for nurses to provide
culturally competent care. Leininger (2009) claimed, “…cultural care knowledge and practices
have meaningful functions and structural patterns derived from the cultural values, world views,
social structures, and environmental contexts of diverse cultures.” These aspects of culture will
be studied when interviewing travel nurses. The goal will be to ascertain whether travel nurses
feel that they have a unique culture and whether they feel cared for as employees within the
Travel nurses provide hospitals and other clinical agencies with the staffing needed
during times of shortages and short-term leave of staff. Travel nursing offers RNs opportunities
to explore new places and build clinical skills as they frequently adapt to new clinical settings,
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staff, and management. Knowing the challenges and benefits of travel nursing is important
before signing a contract. The nurse must be prepared to act independently, make friends
quickly, and thrive in unknown environments to safely and effectively practice as a travel nurse.
Assimilation by the travel nurse into the culture of the assigned unit is important for the
traveler to feel supported and safe practicing in the new work environment. Leininger (2009)
explained that culture is the values, beliefs, norms, patterns, and practices of a defined group of
people. Every nursing unit has a culture that is specific to their location and staff. The traveler
must learn to assimilate into the culture of the unit by observing and practicing these aspects of
Theoretical Framework
Leininger developed the theory of culture care diversity and universality in the 1950s in
response to a lack of culturally sensitive nursing care provided by nurses. She studied more than
52 cultures and described their cultural practices related to health and lifestyle. Leininger’s
culture care model will be used as the theoretical framework to guide this study (see Appendix
A). The norms and patterns related to travel nursing are described in the conceptual definitions
section.
The concept of assimilation is important to the study of how travel nurses relate to the
healthcare team. Buscemi (2011) elaborated on Leininger’s theory of culture diversity and
universality. He described her view of assimilation as that of a person or group choosing to take
on some of the feature of another culture without abandoning their own culture in its entirety
(Buscemi, 2011).
This view of assimilation of culture can relate to travel nurses in a variety of ways.
Leininger’s sunrise model (see Appendix A) depicts the aspects of culture as they relate to the
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many social structures within that culture. The three aspects of culture that may be most pertinent
to the study of how travel nurses assimilate into the culture of the assigned nursing units are:
technological factors, kinship and social factors, and cultural values and lifeways.
When beginning an assignment as a travel nurse, the RN must first become familiar and
quickly proficient with the EMR of the facility. This allows them to communicate with other
members of the healthcare team and record data important to the ongoing care of the patient.
Some travel nurses are given a thorough orientation to the facility’s EMR while others are
expected to have an understanding of the system before they begin the assignment. Learning how
the staff is expected to utilize the system is important to the assimilation of travel nurses if they
The kinship and social factors that define a nursing unit’s culture may be the most
difficult for the travel nurse to accept as their own and assimilate into. While the travel nurse
may be appreciated by the permanent staff, there is often a hesitation to immediately accept the
travel nurse into the social sphere of the nursing unit. This may negatively impact the travel
nurse’s morale, as they may feel isolated and without support from their peers. It is important for
unit leadership to encourage a welcoming atmosphere for the travel nurse. It is also important for
the travel nurse to make efforts to include themselves into the social dimensions of the host unit.
Travel nurses often have a unique social culture outside of the host unit as well. It is common to
find online social groups dedicated to travel nurses where support is given and activities are
posted so that travel nurses are not without fun activities to do while they are away from their
primary social groups, such as their friends and family from home.
Finally, the cultural values and lifeways of a unit must be adapted by the travel nurse in
order for the traveler to feel fully part of the unit’s culture. Some of these values may be the
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value of acceptance and respect of all members of the healthcare team outside of nursing.
Lifeways might include the way report is given from one shift to another, or how tasks are
managed during the shift. For the travel nurse to assimilate into the culture of the unit, they must
As the examples indicate, nurses develop their own culture, seen through language and
technological factors, kinship, and cultural values and lifeways. Leininger’s sunrise model is an
excellent guide to explore these factors and others regarding the lived experiences and
Definitions
Conceptual Definitions
Leininger (1996) defined culture as “the lifeways of a particular group with its values,
beliefs, norms, patterns, and practices that are learned, shared, and transmitted
intergenerationally” (p. 73). This research study will explore how the culture of a unit affects
travel nurses and their ability to assimilate into the culture of the unit and feel comfortable
practicing. How the travel nurse relates to the permanent staff, management, and fellow travelers
at their assigned facility affects the culture of the unit and facility.
The values that travel nurses and permanent staff RNs should both possess are a
commitment to excellent patient care. Though the review of the literature indicates that
temporary staff or travel RNs do not share the same commitment to the organization as do
permanent staff members, they should respect the process of providing good nursing care to their
patients (Mazurenko et al., 2015; Yeh et al., 2007). This will encourage a sense of collegiality
and teamwork as well as respect among both types of RNs practicing in the facility.
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The patterns and norms of a nursing unit’s culture may be specific and highly regarded as
important to the way the unit is run. Travel nurses must respect these norms if they are to
assimilate into the culture of the unit. One such example is shift report. Some facilities have
policies that require nurses to do bedside reporting. Others do not have this requirement. Some
have a time dedicated at the beginning of the shift to give an overview of the patient population
and any pertinent information about patients such as do not resuscitate status, high-fall risks, and
discharge plans. The travel nurse must respect these practices of the unit despite them being
potentially different from how the traveler has previously been used to.
Operational Definitions
For the proposed study, travel nursing is a career choice by RNs to take their knowledge
and skills to an alternate destination to practice for a short period. Travel nurses work with
agencies that place them in facilities and offer benefits, such as housing and compensation for
meals and incidentals. Culture is the way of life on a nursing unit--how nurses interact with each
other and those around them including their patients. Assimilation is the way the travel nurse
becomes a part of the unit during their short stay as a contracted employee. Their feelings of
Research Questions
To avoid bias to this qualitative research study, a definitive hypothesis will not be given.
However, the goal of the study is to determine the lived experiences and the factors affecting
travel nurses and their assimilation into the culture of their assigned nursing unit. Two open-
RQ2. What was your experience as you assimilated into the culture of the assigned nursing unit?
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Prompts
Prompts will be used if sufficient information is not delivered with the open-ended
questions:
6. Describe a memorable moment as a travel nurse of being accepted or not accepted into a
unit’s culture?
Methodology
Design
A descriptive, phenomenological qualitative research design will be used for the study.
This method has been chosen because it allows the participants to describe, in detail, their
experiences as travel nurses (Grove, Burns, & Gray, 2013). Colaizzi’s strategy for
questions. Prompts will be used if sufficient information is not delivered with the open-ended
questions. Participants will be encouraged to dialogue freely and describe their experiences.
Each interview will last from 45 minutes to an hour. This will be conducted by the primary
researcher. The need for a second contact will be arranged to discuss the data collected in the
first interview and to make sure that the collected data reflects their experiences. The level of
data saturation will be determined by the researcher and the research advisor. Data saturation
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will be determined by consensus between the researcher and the research advisor. The
anticipated sample size is 15 participants. The verbatim transcripts will be double-checked by the
A convenience sample will be obtained from one of the online travel nursing Facebook
group pages. An announcement will be posted on the Facebook group page requesting
participation in a nursing research study regarding factors that contribute to travel nurses’
assimilation into the culture of their assigned unit. The researcher will also use the snowball
method for gathering participants and will start with acquaintances who have experienced travel
nursing.
data will be avoided by carefully recording the participants’ responses using a recording device.
Numbers will be assigned to the participants (as P1, P2 and so on) so that data will remain
organized and identities will remain anonymous. Printed informed consents will be kept in
envelopes separate from the transcribed interviews and notes. Electronic documents will be
carefully transcribed verbatim and kept in a password protected locked file on a secured hard
Online participants will be asked via Facebook messenger if they would be willing to
participate in a telephone interview on the topic of travel nurse assimilation. The acquaintances
of the researcher and participants found using the snowball method will be asked to participate in
person or over the phone. They will not be intimidated into participating in the study in any way.
Participants will be sent a consent form electronically regarding the specifics of the study and
will be informed about the anonymity of the results. Participants agreeing to telephone
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interviews will be asked for their email address to send informed consent. The interview will
Speziale and Carpenter (2007) described the following steps for Colaizzi’s process for
1. Each transcript will be read and re-read to obtain a general sense of the entire content.
2. For each transcript, significant statements that pertain to the phenomenon under study will be
extracted. These statements will be recorded on a separate sheet noting their page and line
numbers.
4. The formulated meanings will be sorted into categories, clusters of themes, and themes.
5. The findings of the study will be integrated into an exhaustive description of the phenomenon.
7. In the end, validation of the findings will be sought from the research participants to compare
the researcher's descriptive results with their experiences. Findings will be shared with
participants via email if requested. A copy of the finished research study will be sent to them
The data obtained will be from recorded interviews that have been transcribed into a
Word® document. The data will be analyzed for themes and trends in the responses. Emergent
themes will be analyzed for categories of clusters, the frequency of occurrence by individual
word or phrases, and frequency of occurrence by clustered category (see Appendix B). To
prevent bias, an effort will be made to encourage participants to respond to the lived experiences
of a travel nurse rather than just answering the prompts. Demographic information will be
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calculated for frequency and percentage and displayed in a table. Significant information will be
Setting
The setting for the interviews will be online, face-to-face and over the phone. Participants
will be asked to find a quiet, comfortable place to answer the research questions. For telephone
interviews, the researcher will be located in her own home in a comfortable setting where it is
feasible to actively listen and record the interview. The online setting was chosen to conduct
most of the interviews because of the broad population that will be found in this setting using a
Facebook group page. Travel nurses from all over the United States subscribe to websites on
travel nursing. This will potentially allow the researcher to gather travel nurse participants who
Sample
The sample for this study will be both male and female RNs over 18 years of age who are
employed by a travel nurse company or who have had previous experience as a travel nurse. A
convenience sample of nurses of varied levels of experience will be interviewed about their lived
experiences as travel nurses and the factors influencing their feelings of acceptance or
assimilation into the culture of their assigned nursing unit. To stratify the sample, and increase
the transferability of the results, the goal is to acquire as many nurses of varying age, gender,
education level, degree, experience, type of nursing, and ethnicity until data saturation is
obtained. Websites, social media groups, personal acquaintances, forum groups and snowball
Participants will be requested to join the study via social media using the Facebook
website, previous contacts, and snowball sampling. The researcher through contacts knows some
of the nurses while working as a travel nurse. Members willing to participate in the study will be
entered into the study. Participants will be interviewed until data saturation occurs. Permission
for recording will be obtained through the informed consent and verbal request. The travel nurse
Ethical Considerations
Permission to conduct the study will be obtained from the Bethel College Institutional
Review Board (IRB). The researcher has completed the National Institute of Health (NIH)
certificate (see Appendix C). Only after verbal acceptance will the researcher begin to request
interviews from the travel nurses. An informed consent (see Appendix D) will be sent via email
to the online participants. Consents for others will be collected face-to-face. Once signed,
participants will be asked to send or give the signed form back to the researcher via scanned
email. For the online interviews, confidentiality will be maintained by recording the interviews.
Names will be excluded from the interview documents. The recorded interviews will be
transcribed onto a Word® document, which will be saved onto a locked computer in a zip file.
This will ensure that participants’ responses will remain anonymous. The data will be stored,
password protected, in the researcher’s possession for three years and then permanently
destroyed. Any written paperwork will be double-locked and kept safe until destroyed with the
The researcher will use 1:1 interviews and telephone interviews to glean information on
the personal experiences of the participants’ experiences as travel nurses (see Appendix E). The
participant’s answers will be recorded, transcribed, and evaluated for themes related to
assimilation, acceptance, and culture. The questions have been developed by the researcher and
are based on a thorough literature review of travel nurses and their assimilation into the culture
of the assigned unit. The research tool has been developed and validated with the guidance of
Potential Limitations
Some of the interviews will likely be conducted via telephone. The weakness of this
method is that the researcher and participant will not be interviewing in person. This may prevent
the researcher from making inferences about body language and assessing any extraneous
environmental variables that might be present during the interview. Finding a sufficient sample
size and demographic variability could be a limitation. Limited experience of the researcher in
the qualitative inquiry may be another limitation. Sometimes words may not be heard clearly on
Potential Implications
Results from this study may benefit future nurses interested in pursuing a career in travel
nursing. The information provided may give them a clearer understanding of the challenges and
benefits offered by this alternative. This study may also provide travel companies with a resource
to refer their new travel nurse clients to when explaining the lived experiences that are common
for travel nurses. Nurse managers may find this study helpful when deciding to hire their first
travel nurse.
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This study may give nurses thinking about travel nursing a greater insight into the life of
a travel nurse. It may allow them to gain a better understanding of the challenges and benefits of
travel nursing before they choose to accept the assignment. This study may also assist travel
companies to better prepare their travel nurses before beginning a travel assignment.
Conclusion
Travel nursing allows health care managers to fill staffing gaps when shortages would
otherwise cause an interruption in safe and quality nursing care in an organization. A large gap
in published nursing research on the topic of travel nursing was found after a thorough review of
the literature. There seem to be pros and cons in travel nursing. Exploring the lived experiences
and the factors affecting assimilation of travel nurses into the culture of assigned nursing units
may help add to the current literature. This study may help future travel nurses assimilate
Buscemi, C. (2011). Acculturation: State of the science in nursing. Journal of Cultural Diversity,
https://www.researchgate.net/publication/51482180_Acculturation_state_of_the_science
_in_nursing
Cottingham, J. (2017). Health care demands push growth of NLR's travel nurse. Arkansas
com.contentproxy.phoenix.edu/docview/1905640461?accountid=458
Dawson, M. (1996). Travel nursing guide. Travel nursing: Having the right stuff. Nursing, 26(6),
62.
Faller, M., Dent, B., & Gogek, J. (2017). A single-hospital study of travel nurses and quality:
What is their impact on the patient experience? Nurse Leader, 15(4), 271-275.
doi:10.1016/j.mnl.2017.03.016
Faller, M. S., Gates, M. G., Georges, J. M., & Connelly, C. D. (2011). Work-related burnout, job
satisfaction, intent to leave, and nurse-assessed quality of care among travel nurses.
Faller, M. S., Gates, M. G., Georges, J. M., & Connelly, C. D. (2012). On the move: Exploring
doi:10.1097/01.NUMA.0000415492.43449.99
Fraleigh, J. (2010). Ten don’ts: Steer clear of these travel nursing pitfalls. Healthcare Traveler,
traveler/news/modernmedicine/modern-medicine-now/ten-donts-steer-clear-these-travel-
nursi?page=full
25
ASSIMILATION OF TRAVEL NURSES
Goldstein, P. C. (2014). Nurse managers' expectations and utilization of travel nurses. Medsurg
Goodwin, E. A. (2004). Perceived orientation needs of travel nurses. Available from ProQuest
com.contentproxy.phoenix.edu/docview/305116179?accountid=134061
Grove, S., Burns, N., & Gray, J. (2013). The practice of nursing research: Appraisal, synthesis,
Hinson-Smith, V. (2003). Check off these benefits of travel nursing. Nursing Management, 33,
https://us.sagepub.com/en-us/nam/encyclopedia-of-global-studies/book230735
Leininger, M. (1996). Culture care theory, research, and practice. Nursing Science Quarterly,
Leininger, M. (2009). Leininger’s theory of nursing: Cultural care diversity and universality.
Mazurenko, O., Liu, D., & Perna, C. (2015). Patient care outcomes and temporary nurses.
Morrison, D. (2011). What it takes to be a travel nurse today. Healthcare Traveler, 19(1), 14.
traveler/content/tags/career/what-it-takes-be-travel-nurse-today
26
ASSIMILATION OF TRAVEL NURSES
Nelson, J. (2006). Madeleine Leininger’s cultural care theory: The theory of culture care
diversity and universality. International Journal for Human Caring, 10(4), 50-56.
Retrieved from
https://scholar.google.com/scholar?hl=en&as_sdt=0%2C15&q=Nelson%2C+J.+%28200
6%29.+Madeleine+Leininger%E2%80%99s+cultural+care+theory%3A+The+theory+of
+culture+care+diversity+and+universality.+International+Journal+for+Human+Caring%
2C+10%284%29%2C+50-56.&btnG=
Professional Association of Nurse Travelers. (2016). History of travel nursing. PAN Travelers.
Randolph, L. (2003). Great expectations. Nursing Management, 34, 13-14. Retrieved from
https://search-proquest-
com.contentproxy.phoenix.edu/docview/231385762?accountid=134061
Randolph, L. (2003). Why consider travel nurses? Nursing Management, 34, 4-5. doi:
10.1097/00006247-200303001-00001
Rosenstock, F. N. (2016). Blacklisting: The dirty side of travel nursing. Nephrology News and
Speziale, H. J., & Carpenter, D. R. (2007). Qualitative research in nursing: Advancing the
humanistic imperative (4th ed.). Philadelphia, PA: Lippincott, Williams, and Wilkins.
The Joint Commission. (2012). Health care staffing services certification handbook. Certification
https://www.jointcommission.org/assets/1/18/2012_HCSS_Certification_Guide.pdf
Travel Nursing. (2009). Association of operating room nurses. AORN Journal, 90(1), 143. doi:
http://dx.doi.org/10.1016/S0001-2092(09)00443-8
27
ASSIMILATION OF TRAVEL NURSES
Tuttas, C. (2011). Enculturation of professional contract nurses: A concept analysis. Nursing
com.contentproxy.phoenix.edu/docview/851884159?accountid=134061
Tuttas, C. (2013). Travel nurses and 21st-century nurse staffing. Nurse Leader, 11(4), 43-46.
doi:10.1016/j.mnl.2013.01.011
Wood, D. (2015). Why travel nursing jobs are booming again. NurseZone Newsletter, 12.
Yeh, Y., Ko, J., Chang, Y., & Chen, C. (2007). Job stress and work attitudes between temporary
and permanently employed nurses. Stress & Health: Journal of the International Society
Leininger's Sunrise Model by M. Leininger (1996) in Culture care theory, research, and practice.
Study Title: The Lived Experiences and the Factors Affecting Assimilation of Travel Nurses
into the Culture of Assigned Nursing Units
Investigators: Kristen Eden, RN, BSN
MSN Nursing Student, Bethel College School of Nursing, Mishawaka, Indiana
Kristen Eden is an MSN nursing student at Bethel College. She is studying the lived
experiences and the factors affecting assimilation of travel nurses into the culture of assigned
nursing units. By participating in this study, you may provide important information to the future
nurses regarding travel nurse opportunity.
The Institutional Review Board at Bethel College, Mishawaka, IN, approved the study
and procedures. The study involves no foreseeable risks or harm to you. You are asked to
participate in a 45-60 minute interview. The interview will be recorded for transcription
purposes and the recording will be deleted after use. You are free to ask questions about the
study or about being a participant and you may call or contact Dr. Sam Abraham at the address
or phone numbers listed below if you have any further questions.
You are being asked to take part in this study because you are 18 years of age or older
and you are a travel nurse. Your participation in this study is voluntary; you are under no
obligation to participate. You have the right to withdraw at any time.
This consent and the interview notes will be kept separately to ensure confidentiality by
not associating your name with the transcribed documents. This consent and completed papers
will be safely stored in a secure location by the researcher for three years and then destroyed
permanently. The results from this study may be used for dissemination in conferences or
publication in a nursing journal.
By signing this informed consent, I agree that I have read and understand the content,
have had all of my questions concerning this research answered, and I agree to participate in
this study. I have been given a copy of this consent form and may contact the student Kristen
Eden through the phone number or e-mail listed below.
____________________________________ _________________
Signature of Participant Date
I have explained this study to the above participant, have sought his/her understanding
for informed consent, and have provided him/her with his/her copy of this form.
___________________________________ ________________
Signature of Researcher Date
The Lived Experiences and the Factors Affecting Assimilation of Travel Nurses into the Culture
of Assigned Nursing Units
2.) Age:
3. Gender:
▢Male ▢Female
Qualitative Questions:
Please tell me about your experiences as a travel nurse. What was your experience as you
Prompts:
accepted/supported?
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ASSIMILATION OF TRAVEL NURSES
5. What were your fears about being accepted/supported?
6. Describe a memorable moment as a travel nurse of being accepted or not accepted into a
unit’s culture?