Getting to the heart of travel healthcare.

A podcast hosted by Sunny & Matt

Podcast Transcript


EP09

Cardium welcomes Tom Hamilton and Kent Johnson who talk about the unique nature of strike coverage in travel healthcare, what it’s like to work a strike assignment, and what you should know.

Working a Strike Assignment: Is It for You?

December 11, 2019



TRANSCRIPT

Voice Over: Welcome to Cardium from Aureus Medical, that 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. Thank you for being part of the Cardium family. If you're a new listener, thanks for stopping by. We hope you enjoy the podcast and we would love for you to subscribe so you can enjoy future podcasts. Joining me today as always, Sunny. Welcome, Sunny.

Sunny: Hey Matt, how are you?

Matt: I'm great. I'm doing very well. How are you today?

Sunny: I am doing great and I'm excited about today's topic.

Matt: Yep, we've got another great topic today and something that I personally am not familiar with and don't have experience with. So I'm eager to learn some new information.

Sunny: I am too and let me tell you, I have probably a weird perception of what this topic is and my perception is based on the movie, The Replacements, if you've seen that.

Matt: I have seen that. Excellent movie. Excellent movie.

Sunny: It is.

Matt: So strike coverage. Our topic today is pretty relevant for The Replacements. Yeah.

Sunny: Yeah. So I am a novice to this and so my perception of it is people who are not happy about it and I think the guest that we have is going to change that perception.

Matt: Yeah. I think that when we talk about strike coverage, I think that we have a perception, an idea made up in our mind and what we believe that to be. I think part of our audience will probably feel the same way. So I think our guest for today will really shed some light on from our world of healthcare professionals and what they do in their profession as how they help and how there's a lot of positivity wrapped up into that.

Sunny: Yeah because I think there are a lot of people that are like me that don't know a lot about what strikes are that they have just the movie or just the news part of it that can really taint your view and really don't know that there's a movement behind it or that there is more knowledge or benefits to the reason why there's a strike. There's more to it than just what is painted and so I think this will be an interesting.

Matt: Yeah, there's a lot of layers to it.

Sunny: Yep, exactly. Well, no further ado. Let's introduce our guests today. We have Tom Hamilton and Kent Johnson with us. So let's start with Tom.

Tom: Thank you for having me today. My background has been in this industry since 2008 and it has been primarily in the imaging division.

Sunny: Welcome Tom.

Matt: You're a recruiter. Is that correct?

Tom: I am a recruiter in this industry and I have remained a recruiter for just the imaging during this time.

Matt: Great, great. Welcome.

Sunny: Nice. What about you Kent? Tell us about you.

Kent: Yeah, thanks for having me. I'm on my 20th year as a recruiter in the industry and I've specialized in staff in Cath Lab RNs and EP and IRRNs for the last dozen years or so.

Matt: Wow, 20 years Kent.

Kent: 20 years. Yeah.

Matt: So you started when you were 10.

Kent: Thank you, but not quite right.

Matt: Yeah. Cool. Well welcome to both of you gentlemen and we're really excited to hear the insight that you've got on today's topic, the topic of today's podcast, which is strike coverage. So we'll get right into it, Sunny.

Sunny: Yeah. So tell us what are some of the possible reasons for a strike?

Tom: The reason for a strike can be basically the labor unions that are organized within inside the hospital. There can be multiple divisions within that. Sometimes a hospital can have nine different labor unions or divisions within even the imaging division because you'll have your doctors that have theirs, the techs that have theirs, the nursing that have theirs, the front office staff that may even have theirs. So basically what it comes down to is that the contract that's in place is coming up for renewal and there are just some items on the agenda that the facility and the contracted employee are in disagreement on.

Sunny: Got it.

Matt: Interesting. So healthcare professionals out there a strike something. When you're talking about a disagreement, is there a general trend about what disagreement they may be having? Is it something out there that's just, okay. We generally see in strike coverage that there's a disagreement about wages or benefits or hospital working conditions. I mean, again from a novice point of view.

Kent: Good question. The hospital conditions are good. I mean hospital is patient care. I mean that is a big business so that really is never the agenda. It usually comes down to wages, benefits, their retirement programs such as their pension plan that they've had in place, free healthcare for life. I mean sometimes these folks that are on staff there have that even after they retire until their death in that same hospital system as well. So the layers and why they are in disagreement can be one of many items.

Matt: Yeah, it doesn't sound like that that one shoe fits all for the reasons of a strike, which I think is pretty interesting. Again, lots of different layers there and a lot of different reasons. I guess Kent, from your point of view, 20 years of experience. That's a lot.

Kent: Yeah.

Matt: I know you've covered a lot. In your experience, especially with healthcare facilities systems, what are we looking like for a strike length? I mean again, Sunny and I, we were discussing before the podcast. Are we talking six months? Are we talking a day? What's been your experience?

Kent: Yeah, well my experience, I wanted to add to the reasons. One of the reason that I saw on the last strike coverage that we did was the conditions, the safety of the nurses in the units when they're on the floor, particularly maybe in the emergency room. Sometimes emotions are very high and the patients that come in and patients' families that come in can create some times a very possibly dangerous working environment. So it's the security and the safety of the employees on campus or at the facility sometimes comes into play as well as a reason to strike. So in addition to wages and benefits, that kind of thing.

Sunny: Okay.

Matt: I mean that's a valid reason.

Sunny: Yeah.

Kent: Yeah.

Matt: Against safety concerns, working conditions.

Kent: You wouldn't think about safety concerns in a hospital, but think about how emotionally people can get emotionally charged they can get in an emergency room with others involved. So to answer your question about the length of contracts. In my experience, usually the unions and the nurses will vote on a specific timeframe. Sometimes it's just a single day. We're going to go on strike for a single day.

Kent: It puts the hospitals in a bind where they need to spend a lot of money to bring in coverage because it can't just shut down the hospital. It's not shutting down a factory. So they need to bring in the coverage to keep the place going, to care for the patients while they strike for one day. That's probably the most common length is just a single day and then it kind of escalates from there. If the union doesn't achieve what they're looking to get out of it, then they'll maybe the next time they'll vote for a week-long strike.

Sunny: That's an important thing to remember too is because this is a hospital. It's 24/7, care doesn't stop. Patients are still there. They're in their beds and so when someone's going on strike, obviously there's some notice. We know it's brewing, people are aware, and so if we know that's going to happen, obviously we have to get someone that's going to take the place of those caregivers.

Kent: Yeah, contractually the unions are obligated to provide some form of notice to the hospitals about when the strike will occur, then for how long. Occasionally you do see a strike that lasts as an open ended strike.

Matt: Oh really?

Kent: With no definite end date. That happened last time in Minnesota in 2016 where it ended up lasting for six weeks I believe.

Sunny: Okay.

Matt: So a day, the contrast between a day and six weeks. It's a pretty broad range.

Kent: The backstory behind that one, that was around Labor Day of 2016 is that a few months earlier they had voted for one week. Okay. So they went on strike for one week and then they went back to the negotiating tables between the union and the health system didn't come to an agreement and so that's when the union voted for an open ended strike.

Matt: Wow.

Tom: Well and to Kent's point, what we've seen on the allied side is that we'll get the 10 day notice so that we do have a little bit of a frontage there as to know what's when it's going to take place and what we've seen is typically a three to five day strike basis where they go out, interrupt the hospital for a work week and then come back whether or not it is resolved. At that time, everyone returns back to work. They then sit down at the bargaining table again and then hopefully they're able to get it resolved. If not, they then will give notice a month later, two months down the road again if things just aren't moving forward. Then we'll see again, usually a three to five day work stoppage within the hospital.

Sunny: Okay. Good. So when they do go on strike, who covers?

Kent: Strike workers. So there are agencies that specialize in strike coverage and they'll have their whole list of nurses, in my experience nurses that are ready to go on a with a few days notice, a week notice or whatever, "Hey get ready. There's a work stoppage possible." Most of these people are already credentialed and ready to go and are able to tell their current employers, "Hey, I'm going to be out for a few days." Then they just pack up, pop on a plane and on the work site.

Sunny: Okay. What's in it for that healthcare professional who covers?

Kent: What's in it for health care professional is just the fact that they can come in for a short amount of time, help a facility that's in need because everyone that's in healthcare is there to help people. So even when there's issues that are taking place and the healthcare workers that are at that hospital are stepping up, the contract people that come in come in to help during that interim. They're there almost to support the people that are on strike in a sense because they're coming in to continue to make sure the workflow takes place, but then also that the folks that are in need are being taken care of. So there's no real resentment there. Or I guess sometimes a strike worker thinks they're coming into a hostile environment.

Sunny: Yeah, that's what I picture when I think of like The Replacements. I'm like, are there picket lines? Are there people like go home? We're trying to strike.

Kent: These are folks that are in the industry, they're going to return back to work. They're going to return back to the hospital. They're not trying to take someone's job.

Tom: Right.

Kent: They're there to cover. Destroy the hospital or the folks that are on strike. I mean, it's a very calm environment. They're just things that are being negotiated. So this is the way in which they're able to get the hospital to say, "Hey, we really do need to get this resolved so that we can get this contract back in place and move forward."

Tom: Yeah. It's all that pressure and a pain point by the strike workers coming in and they're obviously rewarded financially quite well, but it allows them to put the pressure and push the pain point with the health system to renegotiate the contract, whatever the beef is.

Matt: Yeah. From a healthcare facility point of view, when you talk about what's in it, as Sunny asked for the healthcare professional providing the coverage, I think the pain point financially it hurts obviously if you have to pay for additional coverage, but also there's the pressure of that patient care too. I mean, you've got to provide patient care as people that need help. I think that, again Sunny and I when we were talking, we were talking about picket lines and is a hostile environment and that type of thing, but all healthcare professionals that are covering each other and they understand that the patient comes first. So it really is an interesting dichotomy there if you will about people covering, but we're not trying to take away your job, but we do have to provide patient care and the hospital's under financial pressure. So again, there's a lot of moving parts, a lot of labor.

Kent: Some units can shut down. We typically think of in maybe an emergency room or an L and D unit or whatever, but there's operating rooms or cath lab departments that the cardiologists or interventionalists can simply stop doing procedures for a few days and postpone the procedures, obviously not the emergent kind. If it's an elective procedure, they can put it off. So that affects not only the nurses, but then also the cardiologist who that's how he earns his living or her living is to do procedures and now they have postponing that and have to play catch up later on.

Tom: Yeah. Your outpatient centers, they'll reschedule. What they'll do is try and defer some of those folks that were coming in and just push that back and just take care of those that are in house or the emergent. I mean the hospital is still going to be very constructive during this time. So no one's patient care or help or if they need assistance is going to be diminished at all during this time.

Matt: It's interesting. I think it's a really interesting point. We talk about the healthcare professionals, those that are providing the care and I think there's probably a lot of curiosity of, "Okay, well, where are those people coming from? How does someone get into strike coverage?" That's because not everybody's done that. They may have been on strike themselves as if the union has decided to strike. As Tom pointed out, a 10 day notice, but how does someone on the other side of that say I want to be the person that can provide help with when that union does decide to strike? Who does that, how do they get into that?

Tom: Basically the agencies that are involved or the folks that are helped to contract with the hospital, they go out and market or recruit. Like Kent, we would both go out and recruit for these interim displacements of folks and then basically just help them to say, "Hey, here's what's going on in this hospital. We need you to come in for this length of time. Are you available to do it?" We help to just establish a relationship with them, let them know what you're going to do is just go ahead and do your CT, your MR, oncology work, whatever it is. You're going to go in and work your modality. We just need you for a short amount of time. Typically we fly them in, they drive in whatnot, put them in a hotel.

Tom: They come over and work. Usually they do 12 hour shifts. What we've seen on our side on the allied side is they do 12 hour shifts. That way they only are working two shifts. There's not a call schedule. They can kind of defer that. Maybe a cath lab in cancer area you would have that, but typically just on the allied or the imaging site itself you're going to just come in, work your 12 hour shift and then be done. So a lot of it's just education up front and then once that you build your rapport, your database, you get folks that like to do that because what they can do is leave their full time job, take a look at another hospital, see how things are operating there, take a three or five day break from theirs.

Tom: It's very lucrative for the traveler to come in during this time. Come in, help, move back to their job, and go forward. There's other folks that are wanting to stay active in the healthcare market and this allows them to stay up, stay involved. Maybe they've retired or they're only doing work from time to time. So it allows them to stay involved and still be an asset to the healthcare market.

Matt: I'm sorry to interrupt Kent, but I think you mentioned something interesting Tom. I was going to ask, Kent, people taking vacation across the country to come in and fly in to help with strike coverage. Let's say California or Minnesota or whatever. So that actually happens then. People are taking vacation from their full time job in North Carolina to fly out and do strike coverage.

Kent: I was going to I was going to add to your question about how do people get into it. Referrals like anything else. If I am working in a facility and one of my fellow nurses or allied techs has done a strike coverage, done a strike action, and then oftentimes just go up and ask, "Hey, which agency you're working with and how'd you get into it?" Referrals in our businesses just, that's our bread and butter. So that's how they get into it a lot of times. Your comment about taking time off. Yeah. A lot of these people have PTO saved up or vacation days saved up and by burning a couple of those in exchange for going halfway across the country and doing a strike action, the bonus payout is pretty lucrative. So it's worth their time. Are the kids at home taken care of? Is mom or dad, the other significant other, are they going to be okay while I'm gone for three, four or five days or whatever? If they can make a work, it's definitely worth their time to swing it.

Matt: Yeah sounds like it.

Sunny: Something that's coming to mind when a traveler walks into any type of normal assignment, you think of orientation, you think of they have everything situated, they're compliance their onboarding, all of that. So when they're walking into a strike situation, give us an idea of what that is like. Their environment, obviously orientation is going to be a little bit different if at all, the hospital staff, all of that support from your and housing. How does that all work?

Kent: It can vary a little bit from strike action to strike action, but the one I was involved with the agencies have onsite coverage, onsite premise. So someone like me would be on at the facility to help bring onboarding people as they come in. Most of the times the hospitals will have stations set up for orientation. So you get your passport if you will, and you start at stage one or station one and you complete one process and move on to station two and station three. So they're running them through 15 stations or however many stations there are until their passports all signed off on and then they come out the other end, clear just to go to the individual units and get some more onsite or unit orientation.

Sunny: Okay.

Kent: What we've seen on the allied side is that our orientation can take place at the hospital if we're able to bring them in and they've got the ability to do it inside the hospital. They've got conference rooms and stuff there so that the managers can continue to work. They can bounce in during a short brief with the folks that they're going to be working with. Go there. We've also done it in the hotels where they've set up. We'll set up in the conference room, we'll come in there. Sometimes that helps because it keeps them away from the folks that are going to be going out on strike. So it doesn't cause any issues within the department that day. Then they're able to spend more time, but basically they'll come in, they'll break down, you'll break out into whatever department you're working with, with your manager.

Kent: They'll go through the equipment they work with, what's expected, what they're looking for, how many patients eight, 10, 12, what their workload is, what they're looking to do, answer any questions compliance wise. We get that done up front so that when they come out, we've got their packets. We give those to the hospitals. So the folks that are coming in, the strike workers don't have to worry about that and we just move forward from there. It's a very smooth process. In the 20 or plus more that I've worked of these, they just seem to get easier and easier and maybe that's because we've gotten better at it. The hospitals are better at it and we just make sure that everyone's ready to go on day one.

Sunny: Also I think there's something unique that you do that's different than others that I've heard about. So you do an extra touch that I think is unique to you. You want to tell us a little bit about that?

Kent: Well what I've personally done in my time on the strikes is I'm always there. We're always on site. We always make sure that we're at the same hotel where everyone's going to be staying at. We get together usually before the strike goes out, we go out to dinner, and just everyone gets to know each other. Whether you're working in different departments or not, you're going to be a core unit for that week. It's important that everyone gets together and knows each other before they get started. It just kind of helps break down the barriers of communication. In that way if the shuttles wait, "Hey we know that we're waiting on this person or that person so that nobody gets left behind."

Kent: It's full team ahead and full team back. As they're taking the transfers there, we fly everybody in and make sure they're taken care of. That's the nice thing was Aureus has a staffing travel agency where we can take care of those flights. We don't depend on anyone else for that. There's no car rental during this time because you're working your shifts for 12 hours, 12 hours out. So we take the shuttles. We have those organized so that they're brought over safely to the hospital. They're picked up, returned safely back. So there's just a lot of little unique things that touches it. We make sure that our folks are taken care of. They've got our cell phones, they've got our work phone, we've got pager phones. So these folks were never without being able to reach somebody that can help answer a question during their time.

Sunny: Yeah. When I heard that story, you said something a little bit about that earlier when we were talking and I just thought that was unique and so I wanted to make sure that mentioned because not everybody does that. So I thought just a nice applaud to you. So good job.

Kent: Thank you.

Matt: Yeah, it sounds like not all recruiters are created equal. I mean, we know this, right? The support, I think that the audience subscribers listeners would want to know what can I expect from my recruiter because if this is different. This is a different assignment as Sunny has mentioned and I think both of you gentlemen mentioned, you're going to be in a hotel. You're going to be taking shuttles, it's going to be three, four, five days maybe if that. Maybe one day, maybe weeks, maybe it transitions into weeks. So is there anything else from a recruiter point of view that people that are looking for strike coverage, what they would want to ask their recruiter as far as the environment that they would be walking into?

Kent: We hit on housing a little bit earlier and usually shared housing in a hotel room. So two people to a room and oftentimes they don't know each other. I understand that maybe this doesn't apply to every situation, is that right Tom?

Tom: I would correct. Everyone has their privacy. They work the shift, but everyone has their own private hotel room. We don't ask anyone to hang out with someone they don't know during the week.

Matt: So it depends.

Kent: I'm wondering if it's because it's nursing, there's just so many more of them. The sheer volume. You have to double up on housing.

Matt: Good point.

Kent: Yeah. That's probably what I experienced, but the interesting about the strike workers that go into a facility is that there's a sense of comradery. We're all in this together. How are we going to get through this? Let's make the best of it because we know it's a challenging situation. Plus it's only a week, a few days generally. It's not an extended period of time. So I think everyone can play nice in the sandbox and get along for those few days and respect each other's personal space and personal belongings in that type of situation.

Sunny: Just to piggyback off that too, from my experience working more on the MSP side a lot of the agencies they do have more of what they call team nursing. So they do have a lot of that shared housing on those type of situation. Whereas allied I do think have more of a different experience. So it is a different situation depending on what that agency handles.

Tom: Kent I'm sorry. Kent's right on that because they can bring in a thousand nurses.

Matt: Wow.

Tom: Whereas we're seeing typically 15 to 30 on the allied side. So ours are much smaller groups where, I mean it's much more unique. Whereas they're coming in and taking over the hospital completely.

Kent: Sort of a 15 passenger van I'm talking about a full bus.

Sunny: Volume that's just a little different, oh my gosh yeah.

Kent: A little different. Oftentimes we're fortunate to have the ability to swap our workers from one work site to a different one. So if we know there's a couple of people that work really well together, we want to have them working in the same facility maybe bunking together. They're comfortable with it, they know each other. They've crossed paths at other facilities on regular assignments over the last 10, 15 years or whatever. So we try and do that as best we can so that it mitigates or minimizes any potential personality issues, if you will.

Sunny: I'm going to ask, I don't know if this is a safe question amongst agency.

Kent: It's a safe environment.

Sunny: Okay.

Kent: You're in a safe space.

Sunny: Thanks. So when strike coverage happens, do agencies work together to partner up to get the job done?

Kent: Generally not in my experience. It's pretty much these are our people. This is my group of people. We're going to take care of our own first. However you do it is up to you, but I haven't seen too much. Again, when you're on the units themselves, there's no animosity or competition between them. They still get together and say, let's achieve the job. Let's take the job done.

Matt: They're professionals. They're professionals working in an environment together, but whether they come from different agencies, all of that is thrown out the window as they're on the unit. They're in there delivering that patient care.

Tom: It's interesting that Kent says that because on the allied side we have teamed up with other agencies when needed. We know there's other folks out there that can help. Our pools of people are different. So it allows us to put more phone calls out and then when we get there, we'll do the orientation together. There's no reason to have to go through it twice with a different agency just because those folks are there and we see these same agencies at different strikes. So we have good comradery. We're there to help the hospital. That is the end game is to help the hospital move through this as fluidly as they can, get these folks up and running so that they can get done, get out, have some time before they get started on all of the demands that are going to be there or asked of them during that week.

Sunny: I bet it's probably because of the volume is so different. Like just so much tackling such a large amount of numbers that it's easier to a team on a smaller volume than it is for a larger volume. So that makes sense. Then once you get there, it's a different. I was just curious about that. So because of the nature of the circumstances.

Tom: There was a time when I was doing a strike few years back where I thought that they were just personally picking on me. I was out every holiday. I was flying out after I got married. There were just different times when you're just like, what is it? Did they have like my calendar and they know what's going on? They made it just a nice time for the hospital to be able to take those dates. We were literally out at Christmas, New Years, Valentine's Day, 4th of July. I mean, it was like.

Sunny: When's Tom's anniversary? Let's strike on that day.

Matt: I think that just highlights, there is no strike season. It can happen anytime. Different organizations, different systems. The one the unions have decided upon that there is no strike season. So the folks that are listening and they're thinking, well I have vacation because the kids are taken care of over the summer, so hopefully the strike coverage happens over the summer. It can happen summer, winter, Tom's anniversary, whenever.

Tom: The great thing though with that was that I spent so much time with so many of the same people. I mean those are folks that have become friends of mine. I've snow skied with a few of them. I mean there's things like that where you just start to get to know people where you're like, "Hey, I'm going to be out in Colorado during this time. What are you doing? Come on out, let's get after it." So I mean it's just got a neat, where that relationship changes from just being a business relationship to a personal relationship with business benefits.

Sunny: How about that?

Tom: How about that?

Matt: Interesting.

Kent: I think sometimes there are some pain points when it comes to a strike season if it's around a holiday.

Matt: Sure.

Kent: That allows the full time workers to take that time off. That doesn't suck I guess and it does add some extra pressure onto the facility to make sure that they get workers in that may not want to go there. I've even witnessed where there's been a strike brewing on one part of the country and another strike brewing in another part of the country and they're almost working together to say we're going to strike at the same time to really put the pressure on the individual health systems saying you're going to have to figure this out because we're giving you notice to go on strike and the pool of strike workers is now depleted.

Matt: Sure.

Kent: Half are going one way and half ago and the other. So things do kind of work in that way sometimes.

Matt: Yeah it's really interesting just that this is a whole new world for the listeners who maybe they've been on strike before but they've never covered. There's a lot here and I think Kent you mentioned someone that is looking to do a strike coverage and they can take some time off, either take a vacation, a mini vacation. It's not really a vacation because they're going to do straight coverage. Those folks get to go back to their normal job.

Kent: Right.

Matt: For the healthcare professionals that are traveling, have selected traveling as this part of their career, what is something that they can do. They don't know the strike length. How can they situate themselves as best as possible for when that strike ends? Now they're probably between assignments, they're on strike coverage. What should they be doing? They don't know how long the strike is going to be conducted and so what's the next step for them and what should they be prepared for?

Kent: Well if you're a contracted employee, you're always looking for the next gig, for the next job. You go where the work's at and so you're always out there. Fortunately for those individuals that have chosen this as their career at this time, there's plenty of opportunities still. It looks like the will be for a long time, whether it be in strike work or just regular contracting.

Matt: So stay in touch with your recruiter.

Kent: Yes, definitely.

Matt: Make sure that they understand and it sounds like you two gentlemen, you're very in tune with the people that are on strike. So you know when it's going to end, these folks are going to be looking, unless they're going back to their perm job. They're looking for their next assignment. So you guys are very in tune with that and that's probably the best advice that we could give any listener that would be looking at what's next. What's next is your next assignment.

Sunny: Yeah.

Kent: Being able to communicate via text and email is so convenient. So even if they're middle of the night, they're getting off at a 7:00 PM shift and they're firing off a quick text to their recruiter that will pick up the next morning or whatever, or later that evening. Communicating can be very, very simple. Very easy.

Sunny: This next question, and you may not know the answer to it, is more of a kind of overview question. So whether you're on the side of management or the striking employee, how do you move forward with having issues on the table without a resolution? If you're striking because we're neutral, you're neutral. So how do you move forward?

Tom: Whether you're on the management side or you're on the tech side, the level of professionalism that these folks have doesn't go away. I mean, they will continue to work together. Is there probably some strife in those relationships? Yeah, maybe they're not sitting down and having lunch together for a few days after they get back and stuff. There's a shop steward like anything in the labor unions and that person is taking these opportunities that the folks that it's under contract want to have put forward. Whatever the changes are that they want to have. So the open dialogue, the professionalism, these are folks that are educate, there to people. I mean that's the great thing is health care helps people.

Tom: These people are there to help people. They work together. They go through their changes. I mean internally even in our office we have issues that that come aboard with each other, but we work together, we move through them. So I think that there probably is some lingering dialogue or maybe some things that don't maybe get told for a few days or whatever. I'm just guessing here, but I do know that there is definitely a strain in the relationships with these folks.

Kent: It doesn't matter which industry you're in, there's always going to be some conflict and disagreement between management and the workers and the managers understand that. When someone goes into management, you understand that there's going to be conflict. In the healthcare industry, when there are unions or any industry where there are unions, you understand that a strike is as possible. A work stoppage definitely comes with the gig. It's possible, but like Tom said you approach professionally, you do your piece and you make the best of it and move on.

Sunny: I think it's important to remember that as with any travel gig, you go in there without any view on anything. You're just in there to do the job period. I just want to say thank you to both of you.

Matt: Yeah thank you gentlemen.

Sunny: This has been excellent. You guys were great and a lot of information definitely changed my view. Definitely know that there's no picket lines and encounters not going to greet me or anyone at the hospital door.

Matt: Even though you did quote a really good movie. I think we learned a lot today that it's not an exactly like The Replacements.

Sunny: Not exactly like The Replacements at all. So at the end of every episode we always, and it's the Heart of Cardium, we talk about the why and it's the purpose of why we do what we do. This is my favorite part, and I always say this, but so I'm going to ask each one of you and I'm going to start with Kent and I want to ask you why, what is your why?

Kent: Well having done it for 20 years, I have had the opportunity to work with some fantastic individuals, most of whom I've never seen. If they come through town and I happen to have a chance to meet with them, I do. Most of them, it's always just over the phone and digital or email and whatnot. Some of these individuals I've worked with for at least a decade or so and seeing the stages of life they've gone through and how I've been able to help them achieve their goals, whether it be financially or personally. Sometimes it's getting a worker to part of the country so they can visit with family, maybe a sick mom or dad. Or they're nearing retirement and they're really looking to pad their retirement fund a little bit. You get to know these individuals on a personal level.

Kent: Sometimes it can be even moving emotionally, if it's an individual that has something significant happening in their life, whether good or bad. So for me, every day is a little bit different. No one day is the same as the next and to be able to interact with people at that level is truly rewarding for me.

Sunny: That's awesome.

Matt: Great. Thank you Kent.

Sunny: Thank you. What about you Tom? What's your why?

Tom: My why, this industry is just appealing. The people you work with, whether it's internal in our organization at Aureus or the folks I work with in the field, the hospital systems I work with, they're just engaging. The knowledge that they bring to me when I have a question regarding, "Hey, what's going on with me here? Why, why do I feel this or whatever." Or just being able to reach out when someone in my family has needed assistance and like, "Hey, what are the questions that I can bring to the table to the doctor when I'm going to meet with them?" They will help you in length at do this or that, or they've been involved with it or they know who to get you in touch with as to what's going on.

Tom: It's just an industry that is forever giving back on both sides of it and I just couldn't be more grateful for having gotten introduced to this and to where I'm at today.

Sunny: Thank you. That's amazing. Thank you.

Matt: Yeah, thank you. Thank you both again. Vast knowledge, lots of layers to it and we really appreciate you sharing it and shedding some light for Sunny and I and the listeners out there. It's also the part of our podcast where we'd like to hear from healthcare professionals, professionals out in the field. Let's take a listen to Maribel. Maribel is a CT technologist.

Maribel: I'm a very outgoing person, so for me to be in an office all day just with four or five people and that's all I get all day, it's just not enough for me. So for me to get out in the world to different states, different areas, different cultures, different climates. I'm from Florida. You go from Florida to Rochester in December. It's just everything. The diversity of it is why I do it. I'm never ever going to get bored doing what I do.

Sunny: We love to hear from you. So please drop us a review and let us know what your thoughts are on today's topic or anything else you'd like to discuss. Visit us at our web site, www.cardiumpodcast.com. Thank you.

Matt: Bye bye everybody.

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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