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When Mariette Parsons, RN, tells her patients she's a traveler, she says they often look puzzled. "They're, like, 'You work for a travel agency or something?'" Parsons explains that travel nurses fill assignments all over the United States. A native of Arlington, Virginia, Parsons came to San Diego at the beginning of February 2004. When I talked to her seven months later, she was contemplating a move to Denver. If the general public hasn't yet become familiar with the idea of itinerant health-care professionals, Parsons says most nurses have. She says young nurses ask her what they have to do to follow her example. Parsons, who's only 27 herself, advises them to acquire a few years of nursing experience before they take to the road. "Being a new grad is really where you learn the most. Depending on the hospital, you usually spend about two months in an orientation program with another nurse, where you're with her on a daily basis. You take what you have in your head and apply it to people. Learning something from a book and applying it to a mannequin is all fine and well, but it's not the same." Once a nurse starts to travel, "People assume you know what you're doing," Parsons says. They see travelers "as people who know how to jump from A to B to C to D -- to pick it up and go."

A slender young woman with delicate features and creamy skin, Parsons wore her fine, copper-colored hair pulled into a bun at the back of her head. She told me she was "so, so young" when she began to think of herself as potential nurse material; she has a vague memory of taking a test in elementary school that suggested she was suited to work in a helping profession. "I thought about sociology, and then I realized I felt a little too shy to talk to people too much." But nursing intrigued her, and by the end of high school, she knew she wanted to study it in college.One of her great-great-great-grandfathers had been a doctor, but the men on her mother's side of the family were mostly lawyers. "My dad is in sales, and my mom is an office manager of a company back in Virginia." Both supported their daughter's aspirations. Becoming a physician never appealed to her, Parsons said. At first the educational requirements seemed onerous; then later, while working as a nursing assistant in college, "I noticed that nurses get a lot more time bedside. You're there all day, basically." Doctors "have to see so many people they don't get to spend as much time with the patients as they might want to. But in nursing, you really get that. I appreciate how much time I can spend learning about my patients and their bodies. I need that time to be able to assess changes."

She began attending York College, a small private college in Pennsylvania with a well-respected nursing program, in the fall of 1996. It was around then, she says, that she first became aware of the national nursing shortage. Teachers would exclaim over what a wonderful time it was for the students to be venturing into the job market. "You knew you'd get a job," Parsons recalled, though she and her peers also fretted about the negative implications of the shortfall. "You weren't sure if you'd be working your butt off because there weren't enough nurses. That's something I think about down the road, because I think the nursing shortage is getting worse, not better. And you don't want to be put in a position where there are six travelers and one regular staff person. Then nobody really knows what they're doing."

She graduated with a bachelor's degree in nursing at the end of 2000 and, as predicted, had no trouble finding work, joining the coronary-care staff of the Arlington hospital where she'd worked as an assistant. "I knew I wanted to work with more critically ill patients. And I prefer the ratio of two to one or three to one [common in intensive-care units]. You're not running around as much. Also, it's very interesting trying to determine what the problems are and trying to help fix them, working with the doctors."

After a few years in Arlington, Parsons says, a couple of factors persuaded her to contact a travel-nursing agency. She wanted to live in other parts of the country, and being a travel nurse would make that almost effortless. The agency would find her a job, pay for her moving expenses, cover her health-care insurance, and provide her with a furnished apartment. Moreover, the standard travel-nursing assignment is 13 weeks. Parsons figured she could stand anything that long. If she didn't like a job, she could always move on.

She didn't want the agency to place her just anywhere. "I was afraid I'd end up in some weird small town that I never wanted to go to. I actually had New York City in mind, because I have a lot of friends there." She also thought about Denver, as well as San Diego. "I did like San Francisco as well, but I was, like, 'Well, if I'm going to California, I might as well spoil myself and go where it's warm all the time.' "

Parsons says San Diego quickly rose to the top of her list. Although farthest from Virginia, "It's still a nice, relaxed place," she judged. "The only reason you feel like you're in a city sometimes is if a trolley rolls by you and you're standing next to a tall building. I'm used to Washington, D.C., and New York City, so San Diego feels a lot different to me. There's no old buildings. There's no trash anywhere. And the weather drew me here a lot."

The job that suited her best turned out to be in the medical and surgical intensive-care unit at Sharp's Chula Vista facility (no position was available in a more specialized cardiac-care unit, such as the one she had been working in). "But I was willing to try something new," Parsons said. "Half the point of my moving was so I could try new things. This forced me to do that sooner than I wanted, but it was fine."

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