The Travel Nursing Career Path I Didn’t Know Existed

I started my nursing career in the CVICU taking care of ECMO patients. I loved the technical complexity, the acuity, and the feeling that I was taking care of some of the sickest patients in the hospital. When I later moved into travel nursing and spent five years on the road, I kept looking for a way to combine the two. But the hospitals I traveled to weren’t willing to hand ECMO patients to a travel nurse, no matter how much ECMO experience I had. So I accepted that those skills would atrophy and that if I truly wanted to take care of ECMO patients again, I’d have to quit traveling.

Years later, I found out that it was possible to travel and take care of ECMO patients, but that it lived in a specialty corner of travel nursing I’d never come across.

Traveling ECMO specialists exist, and according to the specialists I spoke with, they’ve been flying around the country for nearly two decades to run circuits at hospitals that need extra hands. I’d never heard of them, and I’ve come to realize that most ECMO nurses or travel nurses haven’t either.

Curious to know how this world compared to the regular travel nursing I already knew, I interviewed two working traveling ECMO specialists, Katy Trottier and Cameron Meeks. Here’s what I learned.

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Standard travel nursing has a clear rhythm. Generally, travelers sign a 13-week contract, move to a new city, get set up in temporary housing, work at one hospital in one unit with one patient population, and settle in for about three months before their contract ends and they pick their next assignment.

Traveling ECMO specialists work on short notice rather than on an advance-planning cycle. When a hospital calls, the goal is often to have someone on the ground within 24 hours, sometimes faster. Cameron Meeks, a traveling ECMO specialist based in Cincinnati, said the turnaround can be dramatic. “Sometimes at 8 o’clock in the morning, they’ll add a shift to my schedule, and I’ll be on a flight three or four hours later,” he said.

A specialist might spend several consecutive days at one hospital before heading home, or finish one trip and go directly to another program in a different state without stopping home first. In some cases, a single week can span three different programs across three states.

The model differs in a few other structural ways as well:

• They work to a monthly total. Regular travel nursing follows a strict weekly rhythm of three 12-hour shifts or 36 hours a week. Traveling ECMO specialists work to a monthly total instead. At their company, most full-time specialists commit to around 12 shifts a month, but the distribution across weeks isn’t fixed. A specialist might work six shifts one week and one the next, depending on where hospitals need coverage.
• They keep a home base. Where regular travel nurses set up temporary housing in the city where their assignment lives, traveling ECMO specialists keep a permanent home base. The only real requirement is that it be within a reasonable drive of a well-connected airport, which lets them cover assignments nationwide from wherever they live. Because deployments are short and unpredictable, they typically stay in hotels or other short-term rentals rather than lining up longer-term arrangements.
• They cover every age. Most specialists take care of neonates, pediatric, and adult ECMO patients. Katy Trottier, a traveling ECMO specialist based in Wisconsin, trained originally in pediatric ECMO and did additional training and precepting before expanding her practice to include adult and neonatal patients. She said the range keeps the work interesting: in a single week she might go from managing a 900-gram neonate at a children’s hospital to running the circuit on an adult in cardiogenic shock at a completely different program.
• They own the pump. On most ECMO teams, there’s a bedside RN handling all the standard critical care nursing responsibilities (meds, vitals, family communication, patient-side monitoring) and an ECMO specialist responsible for the circuit itself (pump, oxygenator, anticoagulation trending, cannulation site, and the safety of the extracorporeal side of the equation). Traveling ECMO specialists can be a nurse, RT, or perfusionist, and their focus is on the circuit, working alongside a bedside RN who handles the patient.

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Travel nurses exist because hospitals need coverage during vacation stretches, flu season surges, maternity leaves, and unexpected census spikes. The rationale for traveling ECMO specialists is essentially the same, but with the timeline and complexity dialed up.

ECMO census is famously feast or famine. A program might have one patient on support for three weeks, then get four consults in a single day. When that spike hits, the hospital needs a qualified specialist at the bedside stat.

Unlike a general census surge, there’s no floating a nurse from another unit to help out since they haven’t been trained on ECMO. And bringing in a general travel nurse rarely solves the problem either. In my five years on the road, no hospital would assign me an ECMO patient regardless of the experience on my resume. The work is too complex and too high-stakes to accept unverified competency, and there’s no clean way to vet whether a nurse who ran ECMO at a different program a few years ago is still safe to run one today. Skills decay quickly without regular use, so a past training checkoff doesn’t translate into current readiness.

When a hospital runs out of in-house ECMO coverage, they’re left choosing between a list of bad options: refuse an incoming transfer, stretch the existing team past what’s safe, mandate overtime, or decline to cannulate a patient who might otherwise have a chance at survival. Flying in a specialist on short notice isn’t cheap, but next to that list, it’s the option where the main trade-off is measured in dollars rather than in patient outcomes or staff burnout.

Awareness of this career path is limited even among the people best positioned to fill it. For over a decade, I straddled both worlds, ECMO and travel nursing, and never came across this path despite wanting to find a way to combine the two.

Cameron Meeks had a similar experience, finding out about it by chance while exploring standard travel nursing options. On a whim, he searched for a traveling ECMO specialist role, and a listing popped up. “I didn’t even think that this position existed,” he said.

In Katy Trottier’s case, the specialty found her. She learned about it only after an ECMO-focused staffing company found her resume and reached out.

For a field that actively depends on these specialists, this awareness gap is a real problem. Given the unpredictable nature of ECMO census, these specialists are the ones filling the gaps and keeping programs running.

Further compounding this issue is that ECMO is growing fast. Adult ECMO runs reported to the ELSO Registry rose from 851 in 2009 to 17,975 in 2021, roughly a 21-fold increase in just over a decade. As programs expand, the need for qualified specialists will grow with them. If the nurses who could thrive in this role don’t know it exists, the field is going to feel that gap.

For any ECMO nurse who’s ever wanted to travel without giving up their specialty, this is the path. No skill decay from time away from the pump, no drifting into lower-acuity assignments to fill a schedule. Plus, this role provides consistent time at the top of your license, with more clinical variety in a single quarter than most bedside jobs offer in a year.

The path is sometimes open to ICU nurses without ECMO experience too. Some specialty companies will take a clinician with a strong critical care background and put them through their own in-house training. For anyone who’s drawn to ECMO but doesn’t want to spend years anchored to one hospital to build up the experience, this is a real door in.

I love ECMO and I believe in it. I’ve watched it carry patients through recoveries that felt like a long shot, and I’ve watched it give families more time with people they thought they were losing. I would have taken this job in a heartbeat if I’d known it existed. I didn’t, and neither did any of the ECMO nurses I worked with. If this article changes that for even a handful of the nurses reading it, that’s a win for the patients this therapy is built to save.

Disclosure: The author is the founder of Systole Media, a healthcare communications firm whose clients include a company in the traveling ECMO staffing space. Nurse.org received no compensation for this article.

🤔 Nurses: have you worked alongside a traveling ECMO specialist? Share your experience in the comments below.