Getting to the heart of travel healthcare.

A podcast hosted by Sunny & Matt

Podcast Transcript


EP14

Your license as a nurse or allied health professional is your livelihood. And when you travel to multiple states, it can get complicated. We talk licensure on the Cardium podcast with Annie Elliston and Jeff West.

Navigating Licensure in Travel Healthcare

February 19, 2020



TRANSCRIPT

Voice Over: Welcome to Cardium from Aureus Medical, the podcast that gets to the heart of travel healthcare and asks, what's your why? With each episode, we explore the topics and issues that impact healthcare professionals in the fields of nursing and allied health. Now, here are your hosts, Sunny and Matt.

Matt: Welcome to another episode of Cardium. If you're a subscriber, welcome back, we're glad you're here. If you're a new subscriber, if you're new to the podcast, we welcome you, we hope you subscribe like and post on our Facebook page. Sunny, happy day to you.

Sunny: Happy day to you.

Matt: How are you today?

Sunny: I'm great, thank you.

Matt: Good. The topic today is going to be one that you deal with a lot daily in your daily life, and something that the folks that we get to work with every day deal with in their work life.

Sunny: Yeah, licenses.

Matt: Yeah. You know a lot about it?

Sunny: Yeah, I do. And also, a former caregiver having to get a license, that was always exciting and scary at the same time.

Matt: Yeah. I think that the topic, since it talks to so many people out there, I think it's going to be one that will be a really good one, podcast that stays pretty eternal because there's a lot of good information here, and the folks that we brought in today I think are going to offer a lot of advice specifically when it comes to healthcare professionals that travel. I think there's a lot of good information there, so I think that there's a lot of good information that people can listen to.

Sunny: Yeah, and I think it's important for anyone who is working in healthcare to stay invested and also know what's going on with their licensure, but also to stay relevant as to what they have to do to remain current, but also what changes could impact their license as well.

Matt: Yeah, certainly is a tool of the trade, and I think that, again, super relevant information. Well, let's bring our guests on board if you're ready.

Sunny: I am ready.

Matt: Perfect. Well, our first guest today has been a guest of ours in the past. She joined us on episode two, Annie Ellison, welcome back.

Sunny: Welcome. Welcome you guys, nice to see you.

Matt: Good to see you.

Annie: Yeah.

Matt: As a reminder, Annie is the director of clinical operations with Aureus Medical group, and she has been a registered nurse for over 34 years.

Sunny: Yeah, and also joining us today is Jeff West, he has spent 14 years in the healthcare staffing industry, first as a recruiter, and now as regional manager with Aureus Medical group. His wealth of knowledge acquired from his years of building relationships with nurses and hospital hiring managers gives him a broad perspective of travel nursing, and has enabled him to share best practices with nurses in the field and recruiters he coaches. Jeff holds a master's in organizational leadership, a bachelor's in broadcast journalism, and a minor in communications. He has served as a panelist at TravCon and a speaker during the Staffing Industry Analysts Healthcare Staffing Summit. Welcome, Jeff.

Jeff: Thanks. It's awesome being here.

Matt: Glad you're both here. Well, you guys know a lot about the topic that we're going to cover today, license and certification. So, we're going to ask you a lot of questions, and I know our audience will love hearing the answers and hopefully get some new information maybe they don't necessarily know about. We've talked to a lot of healthcare professionals over the course of the day and the week, so a lot of good information here.

Sunny: Yeah. First off, keeping up with changes to licenses and certification, that takes a lot. So, what is probably the best way to do that?

Annie: I think the best way to do that is to always have your current information available, for nurses, there's an online website called Nursys, that is a general housing area for all of their licensures that they would hold within States. And as far as folks with certifications, the same can hold true in regards to maintaining all of your expiration dates and requirements for continuing education to uphold those certifications. So, it's really important for folks that hold these very valuable licenses and certifications to be an advocate for themselves, and to ensure that they have clear understanding of all the requirements that they need to meet and the timely nature that it needs to be taken care of.

Sunny: As a lay person, you're going on to these .gov websites, and you're like, oh my gosh, there's a lot of statutes and a lot of things I got to read through, and you're paging through. Jeff, I'm going to throw this at you. How do you narrow that down for your travelers, how do you go, okay, this is simply what you need to have? What are some tips there?

Jeff: Well, I would narrow it down to, what do you want your travel future and career to be? So, if you want to go to Texas and Alabama and Montana, be proactive getting those licenses. Some licenses can be very easy to get, there are walk through state and you can have in a day, and then some licenses, the application process can be very long and take days just to hear transcripts and all that stuff sent over timely, and then you have to follow up consistently. So, I would say, really map it out and be open with that, if I want to take my first assignment in California, you need the license, because you can't get a job without a license. So, you might have to take a job in a couple of other states before you get that license or during that process. I think being proactive with you know, all of the certifications, as Annie said, being organized with your expiration dates is very, very important just so you can consistently travel without major breaks or waiting for license.

Matt: Yeah. I think when we talk about being proactive, I think that that's great information, but also part of proactive, and I'll throw this question to both of you. We talk about hits on the license, and that's something that people wonder, especially healthcare professionals who maybe been in this industry for 20, 30 years. When is a good time, if they're keeping up and being proactive, what's a proactive approach to talking and discussing hits on a license, and when do you disclose, that and what does that mean to a traveling healthcare professional? What's the impact to their career?

Annie: Right. That's a great question, Matt, and unfortunately, a lot of people do have to deal with this. I think initially, if you suspect you have had a hit on your license or you've been informed that you've been reported, it is up to you to contact the state board proactively. Otherwise, you can wait for them to contact you, but if you show initiative, that's certainly very, very helpful in managing that process and in working with them in regards to what that may be. If you are currently working and know you're under investigation, or you would like to pursue travel or work in different states, it's very important for you to have met all the disciplinary actions along the way in regards to what those requirements may be. So, if you're under investigation and you're cooperating, most likely they will potentially give you permission to continue to work while the investigation's going. I think that's very important that you follow the requirements of the investigation.

Annie: In addition, once you've established you're under investigation, or maybe you have actions on your license, it's up to you to be very compliant with what those are. So, if you are under, or if you are on probation or under suspension or have fines to pay or classes to take, it is your duly responsibility to ensure that you are following up on all of those things in timely manner and very honest with the organization you're working for, whether it be an agency or a permanent job in regards to what those are so that it shows that you are in compliance and doing everything within your power to meet the expectations of what those disciplinary actions are.

Matt: Yeah, that's interesting because I think that when we start to talk about hits on a license, it might be a presumption out there that any type of hit is an automatic disqualifier, especially when you start talking about travel healthcare professionals, and we won't go through all of them.

Annie: Sure.

Matt: But maybe some of the examples that you see on a daily basis, either Annie or Jeff, that that would not necessarily be a disqualifier, but something that they would want to disclose right away to their agency, their recruiter.

Annie: Right. And it can be anything from a civil action back when you were in high school and maybe you had a minor in possession, or an unfortunate DUI or something like that, or in regards to something that happened along the way within your healthcare practice. All of those things are potential information that upon a background check or a license or certification investigation, would come forth. So, it really behooves you to be very honest up front in regards to that those incidents take place and what the requirements or the disciplinary actions were on the forefront so that as you go along the way, for example, either nurses or allied folks that are applying for licenses or certifications, there's always that question, have you had an occurrence in the past? Always be very, very truthful on that because if you're not truthful at that juncture, then it just propels into the next stages of that can be considered another hit on your license if you falsified some documentation in regards to that information. So, ensure that you've been duly honest, and convey that early on if you're talking to travel agencies about potential assignments that this has taken place, and in that situation then we can coach you through that process.

Annie: Jeff can probably talk a little bit about what needs to take place when they start talking to us and they convey that information.

Jeff: Yeah. And from a recruiter perspective, just to piggyback what Annie said, that the open and honest trust and communication, and transparency is so important. And we talk a lot about that just from a finding jobs perspective and in the job search, and there are some things, as Annie said, that as long as you're open and upfront and transparent from the get go, you can work through a lot, because as long as you are taking care of the things that you need to take care of on your end, we can help you through that. Whereas, if it's not disclosed up front and it comes up maybe two days before your start, four weeks after we actually place you, then it may be too late in the process to continue on with that assignment. So, being very proactive in communicating that upfront with all of your recruiter communication is actually on your side and the right thing to do, than wonder if, I wonder if it'll come up on a search or whatever, because most likely it will, and then it's actually a more difficult situation as it drags on.

Matt: Yeah. It really is about starting that relationship off strong, being upfront as both of you pointed out, and to work through those early rather than finding out late. And I love the point Annie, that you said about, if you fail to disclose early, then it's a snowball effect almost, right?

Annie: Absolutely. To piggy tail off, Jeff, it then deems further ramifications towards your license if that does happen.

Sunny: I'm glad that you brought up some of the examples too that were more, not just necessarily within their healthcare practice, but also things that might have occurred within their personal lives too. Because I don't think, especially if you are newer into your career, that you don't realize that your personal actions like your DUIs, or your theft, or things like that, such as domestic affairs can impact your license, and can be considered a hit in your license. I don't think for those that are newer into your career, you to think about your professional in all realms of your life areas, and you need to remember how you carry yourself. So, for those that are new in your career, think about that.

Annie: Exactly. That's great, Sunny, because I think once those actions have taken place, there are certain determinations that can follow through, which can be a fine or can be a pending additional education in regards to classes, or it can be a probationary period or a suspension or even a revulsion or a surrender. So, all of those things are potential, but once again, meeting the demands of the discipline is what's ultimately important so that we can work with that person. So, once they've cleared of all of the disciplinary actions, then we could work with them, and we have the legal documents indicating that that has taken place.

Sunny: And not only pass, but also don't forget to disclose any upcoming trial dates that could be coming too.

Annie: Exactly right. If you are aware that a situation has occurred, whether personally or professionally, and that you have been reported, like we spoke earlier, it's very important that you are very transparent with your agency that that is a potential, because the last thing we want to do is have you on an assignment where then it is necessary to take you off of that assignment because additional ramifications have taken place.

Jeff: And just to chime in, use your agency as a resource. Most agencies have a clinical nurse or clinical nurses like Annie available, and so if you really are looking for some guidance and some direction, using people like Annie, and like I said, most agencies have a clinical nurse on staff, really to talk through it with a nurse to nurse communication, that can go a long way and making sure that yo your future's where you want it to be.

Annie: Exactly. That's a great point Jeff, because I think if they have the guidance into how to communicate with the state board or the certification or licensure committee of their governing body, will then be very helpful. And we can help them with that process so they understand where they need to go to get the materials that we would need to review.

Sunny: Talking about all of this, what are some proactive steps the healthcare provider can take to protect their license and certification?

Annie: I think that's a great question. We spoke a little bit about that in session two, about if you are on assignment or situations have occurred to be extremely communicative and very transparent upfront with your recruiter, so that we can be brought in, and early on in the situation and guide through that if maybe they've been accused of some diversion of narcotics or practicing outside of their scope or not completing a treatment or a task that is part of their required duties, to let us know as soon as those conversations are taking place so we can follow along and talk with them and then also talk with the client or the facility where they're at, to help that process carry out during that internal investigation. It certainly doesn't mean bad outcomes every time at all, but it just means that we need to be informed so we can follow along to ensure that we're keeping you safe and patients safe and the facility's happy and safe as well.

Jeff: And Matt too, one of our favorite authors, take extreme ownership over it. We're big Jocko fans.

Matt: Yes, we are.

Jeff: So, take extreme ownership over your license and certifications because every agency will have fail safes and audits to make sure that we're reaching out to you saying your BLS is expiring in two weeks, do you have something lined up or planned from a class perspective? But if you're working in the middle of nowhere, Montana or anywhere, there may not be a BLS class within 100 miles in a few days. So, waiting until the last minute also can reflect poorly on you as a traveler and the agency because we're not being proactive in getting that. So, talk to your recruiter and make sure that you are proactive, okay, my BLS is expiring in two months, does a hospital offer classes or are they available, and really talking through that upfront if you see that you're taking an assignment and you have certifications expiring. And then from a license perspective, obviously making sure the license is active, but if you have compact privileges and maybe you're moving and changing your permanent residence is that compact privilege going away because you're changing your permanent residence?

Jeff: Really taking the extreme ownership on that and taking care of it, like I said, we'll be there for you as an agency, but in the end, it's your livelihood, so you got to take ownership of that and make sure that all your I’s are dotted and T’s are crossed and you’re ready to roll.

Matt: Yeah. I think that that really sums it up very well, owning your profession.

Annie: Absolutely.

Matt: And Annie, certainly, your 34 years as an RN, you've had to deal with renewing-

Annie: Absolutely.

Matt: ... and being aware of that, maybe not to the extreme situations of being in the middle of nowhere of Montana perhaps, but knowing that your BLS is going to expire, what is your plan? And at the end of the day, ultimately, you are your best keeper. The agencies can help with facility there, they can help, but you are your best keeper of those up and coming expirations.

Annie: Absolutely. I just wanted to talk a little bit about the upfront part of this in regards to working in other states or endorsement or certifications. And so, I think when we talk about being responsible in regards to that process, often a lot of travelers will apply online through a portal for their certification or their licensure, and feel like they've completed the process, but it's your responsibility to go back in a timely fashion on a weekly basis while you're going through the application process to ensure that all of the requirements are met. For example, for my current role here as a director of our company, I had to apply for five or six other nursing licenses. And so, it was my responsibility on a weekly basis to go back and look into the portal to make sure that my fingerprints were received or my transcripts were received in the manner in which they wanted them, also along with the application fees and all the other indicators were met in a timely manner.

Annie: We've seen this happen several times where we'll put travelers on assignments, they obtain a temporary license at time of application, or even for certified people, and they don't keep up with that process, and then we check into it or we're notified that they have been denied. And so, that really does not set up a good situation for obviously the traveler on the assignment or our facilities that they're at.

Sunny: Yeah. I think I hear often, why didn't someone tell me or why didn't ... and the reality is there's one person often that's receiving hundreds of applications, and they might be responsible for maybe a certain area or certain sec, but you're one person responsible for your license for that area. And you, as Jeff says, has to take ownership, and you're a big girl or big boy and this is your career, and you're an adult, so you have to take ownership. That might sound harsh or whatever, but that's the reality of it.

Annie: Yes. Sunny, you're right. They're not going to chase you down with a phone call and repeated messages, they're going to put notification on the portal or maybe an email, but it's your responsibility to respond to that type of information.

Sunny: Yeah.

Jeff: And especially on the travel healthcare industry, I mean, you will work for other companies, you will switch agencies, and so if maybe you worked for one agency for two years and you make the decision to take a job with another company, that new company doesn't have your old records. So, making that transition is 100% on the traveler to make sure that they have all of their documentation and certification licensure ready for their new employer.

Sunny: Yeah. Excellent point, Jeff. I mean, it's your responsibility to be the record keeper, you've got to move from ... I mean, it's like telling a patient, are you going to rely on your doctor to keep track of your health? No, you have to be the record keeper because sometimes you're going to move from one person to another to another, and you've got to be the record keeper of your health because you're the best person looking out.

Matt: Yeah, you're the best advocate. Jeff, I was wanting to pivot a little bit, maybe you could add a little color from the travel company perspective, what does an agency look for when initially talking to a healthcare professional that wants to travel with them from a licensure and certification point of view. What is an agency looking for?

Jeff: I'm a big first impressions person, so if that first call or that first email, first text is talking about how organized, proactive you are, and some of those license certifications are sent over and you're on top of them from the get go, then as a recruiter, that first impression reflection is spot on. And it's something that if someone is really, really ingrained in making it happen, and in tune with that, you'll see that on the recruiter side, and it will get reflected and reciprocated right back to ya. But if you don't know what your licenses are, if their actives or compact, or when they're expiring, or ... I think I have a TNCC, I'm not really sure though if it's still active, that really reflects poorly on your first impression from an agency perspective because we could be sending you to positions where it's required or preferred. You get a job and all of a sudden it's inactive, and then we've got to pull you from the assignment or we have to scramble to get something active.

Jeff: So, I'd say that first impression is very, very important when you're having that conversation upfront.

Matt: Really an awareness from the healthcare professional side of what they have, what they're capable of doing. Although the recruiters are very well versed and should be well versed about, someone comes to them, they want to travel, they want to go to a certain state or whatever, being your own advocate and understanding what your capabilities are within your profession is probably a great way to start that relationship between the professional and the recruiter. So yeah, without a doubt.

Jeff: Yeah. And just to provide some additional color to that, I mean, know yourself as a nurse, know what area of the hospital, or what size of facility you work best in it. The last thing you want to do, and we teach all the recruiters in the industry when I've taught some of the classes at some of the conventions, make sure we're setting up people for success. You don't want to send some with critical access ER experience into a level one ER, I would think that they would probably not even get the job if they interviewed, but if it did happen, as a traveler taking ownership over your license, that's a big red flag of, jeez, they offered me a job in a level one and I've never worked in level one. That's your license on the line out there, whereas you may be going into an environment that you know is unsafe or that you've never been experienced, you might be over your head, and then it's not a good situation for the patient, the hospital, yourself as the nurse, the agencies you're working for, everyone involved.

Jeff: So, just something to think about as you're doing over going over your job search.

Sunny: Great point. We have a lot of listeners with a wide span of experience, and so I'm going to side step a little bit and maybe do a little education here. So, throwing this out to either of you, can you explain the difference between a licensure by endorsement, licensure by examination and compact license? Because we have nursing students, nurses and also physical therapy. So, if you can explain the differences, that would be great.

Annie: Correct. Right. Currently, there are a group of States that have agreed that if a traveler holds an active license in a state that's a cooperating state with this eNLC, that they can work in another state on a temporary basis under the jurisdiction of their primary state license. And so, that is working through your multi-state license with the eNLC agreement. If you wanted to work in another state as your primary residence, or it's a single state or you're going to need a license in that state and you have a current active license, you would apply for a license by endorsement. That is a process that once you passed your NCLEX and you've graduated from an accredited university and you have an active license that's in good standing in your state, then you can apply for a license by endorsement for nurses. That process, once again is an online application process. Each state has their certain requirements that are necessary in regards to fulfilling that endorsement licensure.

Annie: And once again, it's ensuring that you follow through that process. For example, some states question you in regards to, have you paid your state taxes, are you current on your student loans? So, ensuring that you meet all the requirements of the state and then apply for that endorsement license. And then for the new first graduate or a new graduate, they would take the NCLEX and what state they take that in, they're typically granted a license in that state.

Sunny: Okay, thank you. I know that with physical therapy, it's a similar process with compact privileges where if they're resident in a state that is allowing the compact, then they can also pay for a compact privilege to go to another state. Is that correct?

Annie: Correct. I think there are several states are now cooperating with that. Yes.

Sunny: Yeah. And then they also have the ability to do licensure by endorsement too. Is that correct?

Annie: Yes.

Sunny: Okay.

Matt: Yeah, that's great information. I think that that's for new grads, people entering into their career, there's a lot of common knowledge out there because they're graduating with a class. But when we start looking at a national level, the effect and where they might go, start to dream big about where they may want to go, either on a permanent world travel eventually, there's a lot of opportunity out there, and just knowing that, asking the right questions would be huge. From nuances of the state, good to know about the specifics about how state licensure works. Is there something that if you guys could give a message to all the people out there that are seeking at least a state license, what are some good things to start off with stepping off on the right foot that you would advise a health care professional as they're seeking a state license outside of the licenses or within the compact that they carry today?

Annie: That's a great question, Matt. Like for example, the eNLC has 11 criteria that people must meet to either practice under that multi-state license or to apply for the RN licensed by endorsement. So, it's doing your investigative work and knowing what the criteria are, to ensure that you meet the criteria. For example, sometimes new graduates, whether it's in a certification or in a nurse field, will go to the state to take their initial licensure or certification in that state. So for example, I graduated from a university in Nebraska, but my goal is to live and work in California. I would wait and take my national and collects boards in California, so my primary license would be in California. Often, that is a great potential to get started in that state if it's super important to you, as opposed to waiting and filing for endorsement, because every state has different requirements and some states require you to have worked two years or some designated amount of time before you can apply to work under an endorsement license. So, that may put you in a little bit of a holding pattern if your dream is to work in a certain state.

Matt: Yeah, I think that's good to know because you might have to wait, and if you think that you're going be moving to California next week after you've just graduated, that's not realistic, and it's good to know that early. Likewise, it's good to know that early if you do want to travel. And I think Jeff, from your perspective in your recruiting world, people might have the big dream that they want to work in California, because why not, but being from Nebraska. Any tricks of the trade of someone who's been in the industry for five years, they want to go to another state, they've got the dream to travel to a coast or maybe visit a part of the country they've never been before. Best practices, something you'd like to pass on as far as advice on that front?

Jeff: I think from an interview perspective, it's important to have the license in hand because there's a lot of hospitals and VMS MSPs out there that they may interview without the license if it's a fast licensed state. But if it really comes down to say, there's multiple candidates out for a job, and it's down between two candidates and you are one of them, and the person you're competing with has an active license and you don't, and other than that, it's a perfect comparison, they'll take the person with the active license just because they have it. And so, that would be my biggest tip, it's a interview tip too, and how to get a job tip. But if you can have it active in hand when you are pursuing those jobs in those States, I think it will possibly set your resume from maybe number three or four to number one.

Matt: And understanding the potential delays about acquiring, to Annie's point, to your point, is huge. Again, it might take a while if you're really eager to get out there January 1, you may not have enough time. You may want to consider other options while you're going through that acquisition of that license.

Sunny: Yes, knowing those timelines of planning ahead, and that's where working with your recruiter who has been in the field a long time might go, hey, if you're going out to California, I know it's going to take several months, so if you're wanting to go, let's say in August and it's now January, you're going to want to apply right now.

Annie: Yes. Start the process early and stay diligent.

Sunny: Yes. Hey Jeff, we've got quite a few states that take a little bit to get their license. What are some of those states, and why is that?

Jeff: Traditionally, out there, they'll say, I mean, the California RN licenses one of the longest to get, I don't know every single state specifically off hand, but I know the California one traditionally has been mentioned with the longest, but we've also seen it come through in six weeks. There's been instances out there that it might take seven, eight months. Those longer time frames of seven, eight months is to our points early on, is the unorganization on the applicant side. It may be that transcripts aren't getting sent back over, maybe there are other licensed states on the Nursys website is not organized or up to date, and maybe the fingerprints aren't done timely.

Jeff: Those types of things usually falls back on the applicant, if things are to a “t” and done immediately when they need to be done ... California could be done in six to eight weeks, and it also depends on some of the government holidays that are out there. I mean, we're coming up on some Thanksgiving and Christmas and New Year's, I mean, there's three in two months, and President's Day, and I mean all of those government holidays. That puts all of those state licensed boards a day behind. And in some of those big states where there's tons and hundreds and hundreds of applicants a day, that can put them back a week or two.

Matt: And Jeff, you're talking from the nurse perspective, which I think that a lot of our listeners are nurses, from an allied health side of things too, imaging department, the laboratory, respiratory therapy, there's a lot of delays on that side as well. I think not only ... it could be miss organization, you mentioned at the beginning of the podcast, it's one person, and they're there manually going through the applications for the license and double checking those things. So again, whether you're a nurse, whether you're in the allied health fields, it's really important to understand if you really want to go there, understand the timeline and the pressure that you're up against because the dream might have to be pushed back a little bit, but just be prepared and be honest with your recruiter about what you want to do, and then realistic expectations of when you can get there.

Annie: Definitely.

Sunny: We've been talking a lot about licensure, but I think we need to give a little love to the other areas with allied and the national certifications, because not every healthcare provider has a license. Lab has I think 11 states that have licenses, so not all of them. We've got certifications or registries and our other allied areas, and so looking at those national certifications, there're some that are harder to get and others are not. What are some recommendations that you have for keeping those up, and how, as a recruiter, do we recommend or as a clinical professional, do we tell our traveler, this is what you need to get for this particular state because each state differs? I mean, how do we leverage that?

Annie: Well, I think it's important to work with your recruiter in regards to what the expectations are for that state. I know certain states, we have folks that have worked for our agency for a period of time, I know Texas is one of them, and they require the clinical department to look through the file and to sign off on it with a provider licensure number. And so, based on their employee file and their history with us, we're happy to do so. So, it's knowing the specifications of each date and what is required in regards to the certifications, and if you need certain amount of hours or those types of things are all taken into consideration as well. And then once again, additional educational, and then also as we talked earlier about being very transparent in answering the questions on the applications. And certain stage, to your point Sunny, do require certifications or registries, others don't. So, it just depends on those state statutes and your recruiter in that region would be the best person to help coach you through those types of decisions and what needs to take place.

Matt: And getting back to it again with certifications on the allied health side too, really understanding what it takes to make sure that certification is in good standing. Many occasions are simply just the continuing education and pay your fee every year.

Annie: Right.

Matt: And while that seems simple, everything we spoke about today, sometimes people lose track of that. Again, being an advocate, taking extreme ownership of your certification is a huge part of that, and I think that if there's any doubt there, recruiters are a great resource of where people can be pointed to and how they can at least make sure that they're staying on top of it, but then really engaging and knowing that, yes, I have to get my fingerprints in and I have to follow up with those fingerprints, or I have to make sure that the check cleared when I sent it in for my certification, if that's how I paid, or that I do have something scheduled for my continuing education, where I might not be in an area that offers that. I might have to look at online options. So, I think that there's a lot of things there, but again, it comes down to your self advocacy.

Annie: Absolutely Matt. And I think to your point, we all know many, many seasoned travelers that we've all worked with now along the way in our various roles here. And once again, you're accumulating numerous certifications or registries or licenses. Like for myself, I have eight now, and so just in my own management, every state requires different continuing education and has a different expiration date. And so, I'm constantly losing sleep at 3:00 in the morning, trying to make sure that I am staying current in regards to all of those types of requirements that each state will garner so that I can keep all of my licenses in good standing, and there have been very different requirements to do so.

Sunny: What can you imagine as a traveler when your addresses are always changing, and so you're like, oh my gosh. So, I would imagine as a traveler, you're going to want to make sure you have a reliable address that you can get things shipped to or mailed to, and have someone checking that because you're not at that address all the time, or an email address that's consistent. So, if you're a graduate, you don't want to use that school address, you don't want to rely on that, so you want to make sure that you're having a consistent way of communicating with these boards.

Annie: Definitely.

Sunny: So that way they're sending you that information saying, hey, this is expiring. You have some way of going, oh my gosh I have this reminder to tell me that I need to get that updated.

Matt: Certainly, some of the other creative ways as you are traveling Sunny, when we speak about that is being creative of where you get your continuing education, some of the national shows. NSH for example, for histology, there's offerings of continuing education classes. If NSH is in your area, take a weekend or take the week to attend a few classes, get in there, be proactive with it. CLMA for the lab also, is another one. It's not always in the same place of the country, so if you happen to be in that region, and it works for you to get there, take advantage of those classes, get those knocked out so you can get it done. I know Jeff, you have personally attended shows where people are not only getting great information about travel healthcare, but they're also getting that information as far as continuing education of those same shows. Am I right?

Jeff: Yeah. And a perfect example of that is TravCon. It's in September in Las Vegas every year, and there's tons of continuing education classes that you can go there, meet a lot of agency representatives, meet a lot of other traveling healthcare professionals, but also out a lot of those continuing ed courses that are required for certification, license renewals, all that stuff over a three, four time day span in Las Vegas. And that's every year in early September.

Matt: You're a TravCon hero, I think you've got a reputation of going to TravCon, and you've attended several years, is that-

Jeff: I'm a high five hero out there, a lot of high fives, a lot of Plinko, a lot of Starbucks gift cards out there, it's a good time. It's a great conference to attend to that brings the entire travel industry together.

Matt: And the fact that you can get out there, meet people who you work with, but then also get that continuing ed and have it be a resource for you, kill two birds with one stone, what a great opportunity for people, so take advantage of that.

Jeff: And something else with that as well is, when you're interviewing for jobs and you have maybe a TravCon trip planned, when interviewing managers hear that and hear you being proactive, don't look at that as a bad thing, look at that as a good thing because managers, when they hear that, they instantly think, okay, this person is going out, they're bettering themselves, being proactive with the time off request to go and go to those conferences, whether it be the ER Conference, AORN, TravCon, all of those self-improvement conferences, that really can reflect well when you're interviewing with a manager. And as long as you're proactive and asking for that time off, a lot of times they're cool with it as long as you talk through it with them.

Matt: Yeah. And being aware that doesn't have to be a national conference, state shows are great. The Nebraska state-

Sunny: Online courses.

Matt: ... online courses, there's a lot of opportunities out there, but it comes back again to, you have to be exploring those. Your recruiter will offer you a bit of guidance, but you also have to be proactive there for sure.

Sunny: Yeah. I'm just going to wrap this up, is there any biggest pain points that you want to give our listeners about licenses and certs from your point of view that you want us to take away?

Annie: I think knowing the value that you have and holding this very precious certification license, registry, whatever, so that you understand the value of that and how important it is to sustain that it is active and unencumbered with any types of actions towards it. We talked a lot about how to manage it if that is the case, but once again, I think the overall message from me is to be an advocate for yourself and to maintain some sense of responsibility in regards to the requirements that are necessary to ensure the safety of that license.

Jeff: I would say organization is extremely key, because you can't be proactive unless you're organized. And so, staying organized and knowing where all your license certifications are, whether you store them online, have hard copies of them, I would encourage both.

Sunny: It's probably a good [crosstalk]

Jeff: Yeah, as with any social security card or passports we have, you're like, oh my gosh, where are they? And you got to go order more birth certificates, all those types of things. So, you want to be as organized as possible so you can be as proactive as possible.

Sunny: Good.

Matt: That's great information. Well, thank you again. I mean, we really love having you guys here and it's great information. I think there was a lot to learn here, and I think Sunny and I, even though we've been in the business for a while, I think that we learned something today, and we really hope our audience does too. Before we let you guys go, we like to ask all of our guests just one question. Annie, you've been through this before, so I'll ask you first. You've given us your why on episode two. Annie, anything you'd like to add to your why?

Annie: I appreciate that Matt. I just would like to, in addition say to my why, that my goal as nurse and as a licensed healthcare professional for many, many years in many different modalities is to maintain patient safety and to provide compassionate quality care to everybody. Everybody deserves that healthcare worker that cares for them, like their mother, their father, their sister, their brother. And so, that's always my goal, and I bring that to the table here in regards to working with the travelers as well. That's my why, is to try and make a difference so that we ensure that that type of care is delivered.

Matt: That's a great one. Thank you. I appreciate that.

Sunny: And Jeff, what's your why?

Jeff: My why is twofold. First of all, I think from a recruiter side, it's all about the patient and all about the patient care that is delivered, and putting the best employee, best traveler where they want to be, fulfill their goals and take care of the patient and their family, and then my family as well and to provide for my wife and two daughters. This really rung true six and a half years ago when my daughter was born at 28 weeks and was in the NICU for two and a half months. You really, really see how important that patient care side is and how special nurses and doctors, and all the healthcare professionals, [inaudible] therapist, everything was ... it's so important. I mean, when you're sitting there absolutely helpless in a labor and delivery suite, and 12 people come in and a bunch of NICU staff, NICU doctors, and your baby is born, and they aren't making any sounds, it can ... I'm shaking here, is the table shaking, can you hear?

Jeff: Because it was such a unique experience and a crazy experience, and you feel helpless. There's nothing you can do as a parent in that situation and all your trust goes into the health care workers and your faith that you have to take care of the situation. I'll never forget the first night there, Blake was our nurse, and I asked her, I said, "We have a year and a half year old at home, I have another daughter at home. Do I stay here or do we go home?" I didn't know, am I a bad parent if I go home? It was our nurse Blake that night, and then a few other nurses that were in there, and they really helped coach you as a parent, what they do to take care of your daughter, and you can go home because you won't sleep in there, because the alarms are going off constantly, and if you sleep in there, you're just going to freak out every time they go off, and that it was okay, and that you can call as often as you want to check up.

Jeff: And so, my wife and I split time between home, work and the hospital, and just did shifts here and there, but it was the nurses that really were your connection to your daughter all day every day. My wife was twofold, and it came to one fold after that experience because everything came together.

Sunny: That's amazing.

Matt: That's a great why. Well, thank you both again. We'd love to have you back sometime in the future on a future podcast. And Annie, if you get a three-peat, it's going to be great. Thank you both again.

Jeff: Thank you.

Matt: Really do appreciate it. We also love to hear the why's from the Travel Healthcare community, let's listen in.

Nicolette: Hi, I'm Nicolette Fonseca. I graduated last May 2018. I am currently on my first travel assignment actually in Southeast Kansas, and I love travel because it gives me the freedom to work in whatever setting that I want to work in, and travel to places that I've never been and meet cool new people, and that means that I can have a greater impact on the patients in our country. I think that's absolutely wonderful, and I love being a new grad doing it, because that means I get more experienced than what I got in PT school, and I'm not pressured to narrow in on a certain specialty yet. I think that's absolutely amazing.

Nicolette: I want to be there for people, to help them get back to doing whatever it is that they want to do. I want to be there every step of the way, if they want to get back to disco dancing like I did with one of my patients on a clinical, I want to be there. If they want to get back to picking up their dog so they can just have somebody snuggle with at night, I want to help them with that, and I love it. I love being a cheerleader for people and get them up and moving and experiencing the world in a different way than how I experience my world.

Matt: That's going to wrap up today's podcast. We'd love to hear from you, so please drop us a review. We'd love to know your thoughts on today's topic or anything else you'd like to discuss. Sunny, until next time.

Sunny: Till next time. Thanks everyone.

Matt: Good bye everybody.

Sunny: Thank you.

Matt: Thanks.

Voice Over: You've been listening to Cardium from Aureus Medical with your hosts, Sunny and Matt. We're the podcast that gets to the heart of travel healthcare. To subscribe, access show notes, or to learn more, visit cardiumpodcast.com, C-A-R-D-I-U-M podcast.com. Or wherever you're listening, be sure to rate us, review and subscribe. Thanks for tuning in. Until next time.

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