What Earns a 5-star Facility Rating from Travel Clinicians?
In partnership with the National Association of Travel Healthcare Organizations (NATHO).
About Nomad Health
Since 2021, Nomad has been building a travel clinician marketplace leveraging machine learning based recommendation systems that help match travel clinicians with jobs. Nomad’s technical infrastructure is so robust that we’ve been able to match qualified clinicians in just 62 minutes, from browsing jobs to a signed contract. Our marketplace combines technology-driven precision with human-powered support for the clinicians who prefer it; a true blend of automation, rules, and relationship-focused support.
Working hand-in-hand with Navigators, Nomad’s matching technology ensures clinicians get to where they want to go, faster.
About the National Association of Travel Healthcare Organizations (NATHO)
The National Association of Travel Healthcare Organizations (NATHO) is a non-profit association of travel healthcare organizations that promotes ethical business practices, offers educational opportunities, creates a space for advocacy, and sets the gold standard for conduct in the travel healthcare industry.
Executive summary
Travel clinicians are the backbone of a resilient healthcare workforce. Their clinical expertise, flexibility, and willingness to step into high-demand, complex environments make them invaluable partners for facilities nationwide. But what drives travel clinicians to return to a facility?
Nomad Health, in collaboration with the NATHO, surveyed more than 200 clinicians to answer this question. A thorough analysis revealed predictors of travel clinician contentment and discontentment and where facility improvements can make the biggest impact.
Most travel clinicians reported strong assignment experiences: two-thirds (67%) rated their overall experience 4-5 stars. Satisfaction is most closely tied to three factors:
A supportive and inclusive unit culture
Positive relationships with colleagues
Feeling heard by leadership
Where these are present, clinicians are almost universally willing to extend or return, creating measurable continuity and staffing stability for hospitals. Continuity also protects the bottom line by reducing overhead costs. It’s far more economical to extend a high-quality travel clinician than to enter into a new agreement and onboard another.
The biggest predictors of clinician discontentment are patient safety culture, relationships with leadership, and ineffective performance feedback from unit leadership—particularly communication gaps around patient population, on-call expectations, and extension timing.
Facilities that operationalize a welcoming culture, availability of supplies/equipment, and foster real dialogue with travelers can convert short-term contracts into repeat engagements. Or even conversion to full-time staff—driving down recruitment costs, minimizing staffing gaps, and building 5-star reputations.
In addition, clinicians' willingness to provide feedback and mentorship to fellow travelers remains high; (70%) are open to peer-to-peer support, indicating a strong community ethos that facilities can harness.
Introduction
Purpose: Identify which in-facility experiences most strongly predict 5-star satisfaction among travel clinicians and translate those insights into practical steps for healthcare leaders.
Methodology: Data drawn from Nomad Health’s Facility & Assignment Evaluation, administered in week 9 of assignment. Sample: n=211 (176 RNs; 33 Allied Health) collected July 2023-April 2025; response rate 14.2%. Mixed-methods: Likert items (experience, culture, leadership, safety, resources) and open-ended comments. Analyzed with Voice of the Travel Nurse benchmarks for industry context.
Audience: Hospital leaders, unit managers, and travel clinicians are seeking a neutral, evidence-based view of what drives excellent travel assignments. Co-branded by Nomad Health and NATHO to advance shared standards across the industry.
Overall facility satisfaction
Key findings
- The majority of respondents were satisfied with their facility overall, though opportunities for improvement remain. Notably, (67%) of clinicians rated their overall experience 4 or 5 stars, reflecting a strong travel culture while still highlighting areas where enhancements can be made.
- Orientation quality matters. (78%) rated their orientation as meeting or exceeding expectations.
- Unit culture is decisive. (78%) said the department culture is always/usually supportive and inclusive.
- The highest-rated facilities maintain a strong patient safety culture. (79%) reported an always/usually strong safety culture. According to The Voice of the Travel Nurse report, “Concern for patient safety is a top contributor for nurses wanting to leave the profession.”
- Relationships can drive job satisfaction. (89%) experienced always/usually positive relationships with colleagues. Team dynamics predict extensions and increase team communication, which can positively impact patient outcomes and reduce preventable medical errors.
- Feeling heard by leadership is critical. (76%) always/usually felt heard by leadership overall.
- Resources enable confidence and timely patient care. (78%) always/usually had the equipment and supplies needed.
- Leadership feedback is lacking. Only (66%) received helpful performance feedback. Structured and timely coaching is missing in one-third of placements. This is consistent with findings from The Voice of the Travel Nurse report.
- Retention potential is high. (72%) of respondents said they are interested in extending or returning to a facility when these criteria are met.
Analysis and discussion
Top 3 predictors of clinician contentment
(78%) rated the department’s culture as being always or usually supportive and inclusive.
(76%) of clinicians always or usually felt heard by leadership.
(89%) of relationships with colleagues were always or usually professional and positive.
Clinician feedback shows a clear theme: culture drives continuity and maintains strong patient safety. Facilities rated five stars are not just paying well or located in the right place. They are excelling at the fundamentals of human connection in three core areas: positive colleague interactions, supportive and inclusive unit culture, and feeling heard by leadership.
When these three components exist, travelers extend and return, building staffing stability. For reference, a typical Nomad extension rate is approximately 60%.
An additional benefit, the likelihood of clinical escalations or cancellations is reduced when these fundamentals are deployed.
The cost of missed basics
Where lower-rated facilities stumble is not in advanced strategy but in core management practices and priority care tactics for frontline teams. Of the surveyed clinicians at lower-rated facilities:
(91%) flagged weak patient safety culture.
(91%) said they did not feel heard by leadership.
(79%) reported little or no constructive feedback.
Deficiencies in patient safety culture, limited feedback, and perceived disconnect from leadership significantly undermine staff trust and directly threaten patient safety, posing greater risks than compensation or location concerns.
How facilities deliver on the basics
The three cultural fundamentals: colleague interactions, inclusion, and listening, do not stand alone. They are delivered and reinforced through practical channels of orientation, resources, and community.
Orientation sets the tone, but culture sustains it
Orientation is often the first signal of how a facility values its clinicians and sets the tone for the entire assignment. If it’s not thorough, travelers can feel unprepared, unsupported, and uncertain about expectations. As a result, this can lead to increased stress, decreased confidence, and potentially compromise patient safety and quality of care.
While (78%) of surveyed travelers are satisfied with orientation, open-text comments reveal areas for improvement. Lightweight fixes in transparency and a comprehensive orientation can deliver an outsized impact, setting expectations and reinforcing trust from day one.
Orientation contentment
Resources shape safety
Culture cannot thrive without tools. At facilities where clinicians had the needed supplies and equipment (78%), clinicians described a stronger safety culture and an enhanced ability to promptly respond to patient care orders. Resources are not just operational; they are a direct signal of whether leadership prioritizes patient safety culture, and patients receive timely treatments.
Resource availability
Community builds continuity
Travelers want to belong. With (70%) willing to support peers and (72%) open to extensions, the desire is apparent. Organizations that provide inclusion in huddles, encourage peer mentorship, and create inclusive team dynamics transform that willingness into talent retention. Community amplifies positive interactions, reinforces inclusion, and gives leaders daily opportunities to show they are listening. In an era marked by rising incivility and horizontal violence, it’s clear that clinicians are seeking camaraderie, community, and peer support more than ever.
Willingness to support fellow travel clinicians
Desire to extend or return to the facility
Takeaway for leaders
The message is clear: positive interpersonal relationships that promote patient safety, constructive performance feedback, and proper resourcing are the vehicles that carry culture. Facilities that invest in them strengthen the basics of inclusion, connection, and listening. Orientation may set the tone, but day-to-day support and belonging sustain it. Facility leaders who understand this are not just earning higher ratings—they are building the staffing continuity the industry urgently needs.
Actionable recommendations for healthcare facilities
Create a traveler orientation kit. Develop an individualized orientation plan that aligns with the traveler’s prior experience, clinical competencies, and outstanding learning needs. For example, a one-shift overview covering patient mix, on-call expectations, escalation pathways, EHR essentials, and start-of-shift supply/equipment checklists is an effective framework.
Implement structured feedback. Week 2 and week 6 two-way sessions, one strength and one growth point each.
Codify inclusive behaviors. Assign a “unit buddy,” invite travelers to governance and safety discussions, and encourage team introductions.
Ensure role transparency. Publish patient population mix, conditions, procedures, floating expectations, call coverage, etc., in all job postings.
Activate peer-to-peer support. Create traveler “Ambassadors” who host Q&A for incoming staff; recognize their contribution.
Final word
In a labor market defined by clinician choice, the facilities that win will be those that treat culture as a system, not an afterthought. A strong community that promotes patient safety culture, constructive performance feedback, and proper resourcing is the vehicle that carries culture. These elements are more than operational levers; they are daily proof points that colleagues care, leaders listen, and inclusion is real.
The data is evident: when clinicians feel equipped, supported by peers, and are in a safe environment, they are far more likely to extend the assignment.
By turning these fundamentals into consistent practice, healthcare organizations can transform traveler experiences into lasting loyalty and staffing continuity.
Report limitations
14.2% response rate and RN-heavy sample limit generalizability. Findings are directional, but actionable when paired with local facility diagnostics.
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