As a native of Joplin, Missouri, you can’t blame me for thinking that Kansas City wouldn’t be all that different from my hometown. It wasn’t until I set foot in North Kansas City Hospital for my first travel nursing contract that I realized how wrong I was. From the pace of life to the city’s highway traffic at rush hour, it all felt a bit foreign to me.
Part of travel nursing’s appeal is the opportunity to venture into parts of the country and ways of life you’ve never experienced before. While some find this in a bustling urban area, this is especially true of rural health communities.
Lora Azzaro, a Kansas City native, has been a traveling nurse with Ethos for the past three years. She moved to Colorado in April 2019 and has since worked in two (soon to be three) rural health facilities in Colorado. From the small town of Salida to the desolate Montrose, Lora shared with me how her two rural health experiences couldn’t have been more opposite, how they compare to her experiences working in her home state, and how she adjusted to her new environments.
______
Why did you become a travel nurse?
I’m in my mid-30s and I didn’t want to stay in Southern Missouri for the rest of my life. I don’t have kids or a family, and I just really like to travel. Why not utilize my career to do something different and see some new places?
Why rural health care?
I knew I wanted to work in Colorado, and after my first contract in Salida, I’d fallen in love with the state. It fits my lifestyle. It’s a personal choice, I think, to be in smaller communities. I thrive in smaller environments.
What was your first travel nursing experience like?
Going to Salida – which is central, high Rockies, a town of about 5,000 – their hospital was something called a critical access hospital. Their population fluctuates seasonally, depending on what people are doing activity-wise, so they only had a two-bed ICU. Their whole hospital was only 25 beds total. They are really serving their local community. The patient population was very local, not as transient as you might think, unless they were there for biking or rafting. Then it would be like, “Oh, they broke their leg out doing something,” or they decided to come to Colorado and smoke pot and climb up a fourteener and then couldn’t breathe.
We had an outpatient infusion we would do on the weekends as ICU nurses because the infusion center was closed. I loved it because when you did have infusion patients, you would see them week after week. You would see patients battling cancer, in there for infections unfortunately, and you really get to know them.
How did your second assignment in Montrose compare?
Very shockingly, honestly. Montrose is on the Western slope. It was more affordable and about 20,000 people. They had an eight-bed ICU, and they were the only hospital in town.
That town had such a severe drug and alcohol problem unlike I have ever seen in my life. In an ICU setting, I knew my security guards better than I knew my respiratory therapist. We were obligated to take in patients who simply had no place else to go. They’re homeless and on meth, intoxicated, on drugs—people who don’t necessarily need medical attention. I don’t know why it was so concentrated in that community, but it was. I was never calling a doctor for a medical reason in Montrose; it was for some type of sedation or restraints.
That kind of patient really takes away from treating someone with an actual medical need. So, that’s just disheartening the hospital has to deal with that.
How did your rural hospital experience compare to working at a larger facility?
The staffing ratio at the larger hospitals can burn people out quickly. You can feel so isolated, unsupported. I worked at a hospital for three months and never even once met the manager of the unit I was working in because I worked night shift.
In a smaller hospital, you have better communication. I’m not saying it’s run better, but for me, being more involved and being more included in the group, I feel like it’s better in a smaller setting.
What aspects of travel nursing have been most rewarding?
In the smaller communities, you really got to know the town and the people. Like Salida, you see the people you’re helping, who want the care you’re providing and they’re grateful for it. That never gets old. Having consistency in a smaller environment is definitely rewarding. I like that integrated community feel. I’ve met a lot of other travel nurses, which is super cool, and they told me about their experiences and their skills.
Being in Colorado is amazing. I’m averaging 5,000 miles of driving a month just seeing the state and camping and doing a million different new activities. With nursing you work three days a week, so you have four days to play. That’s not terrible.
What advice do you have for those considering travel nursing?
You definitely have to know what you know and be able to perform it on the spot. You have to be able to jump in there and get going. You can’t be timid. You really have to be outgoing.
Know what your resources are and have a plan. Do some advanced research on where you want to go and why.
______
Lora has since started her third contract in Steamboat Springs. Apart from her love for Colorado and adventure, Lora told me she has stuck with travel nursing because of the professional experience it has afforded her: “I want to continue to see other hospitals, to get more skills, get more experience and be more diverse in my career,” she said.
