Meet the award-winning Clinical Excellence team
The Clinical Excellence (CE) team are experienced nurses and allied health clinicians dedicated to helping travelers be the best healthcare professionals they aspire to be. To us, every clinician matters.
Nomad is proud to say that our CE team is a recipient of the 2023 American Staffing Association Elevate Award for the "Best Job Training Program in U.S. Staffing."
This award recognizes excellence in training, reskilling, and upskilling Nomad travelers in over 30 specialties. Simply put, we're really good at helping our travelers be confident and prepared for their assignments.
Hourig Karalian, MSN, BSN, RN
Director of Clinical Excellence
Hourig is a passionate nursing leader with over 20 years of experience across the entire continuum of care, including acute settings, skilled nursing, academia, and the travel staffing industry. Committed to safe, high-quality, and patient-centered practice, she integrates evidence-based approaches, innovation, and mentorship to consistently elevate clinical excellence. She enjoys providing clinical guidance, developing competency education and developing programs that recognize and retain high quality clinicians.
A graduate of Villanova University (BSN) and New York University (MSN), Hourig is currently part of the DNP-Executive Leadership program at the University of Pennsylvania. She brings a strong clinical foundation in Medical ICU, Medical/Surgical, Telemetry, and Geriatrics. Her professional journey, from bedside nurse to clinical instructor and director, is driven by a dedication to empowering clinicians. Having worked through the COVID-19 pandemic and as a former traveler herself, she brings firsthand insight into the challenges frontline staff face and is devoted to eliminating barriers.
The Personal Side
Why Nomad: Nomad puts clinicians in the driver's seat by allowing them to choose their next adventure. The culture consistently demonstrates alignment with having the best clinicians provide high-quality care, and she values her kind, smart, and innovative colleagues. Clinical Pet Peeve: Alarms that ring without a response and IV tubing lines (spaghetti). Favorite Self-Care Act: Exercise, Shopping vintage and antiques, Interior decorating.
JoAnne Salreno, BS, ASN, RN
Manager, Clinical Excellence
JoAnne is a dedicated and experienced nurse who has been providing care since 2019. With a diverse skill set, she specializes in a range of clinical areas including the Surgical Intensive Care Unit, Operating Room, Pre-Op, and Post-Anesthesia Care Unit. Since December 2021, she has been working with Nomad Health further expanding her expertise and adaptability in various healthcare settings. She provides coaching, guidance, support, and education to clinicians at Nomad on and off assignment. JoAnne is an alumnus of Youngstown State University (BA) and Mercy College of Ohio (ASN) and currently studying for her Masters of Science in Nursing.
The Personal Side
Why Nomad: I love working for Nomad as it gives me a chance to not only advocate for patients as a nurse, but for fellow clinicians.
Clinical pet peeve: Not emptying the dirty linens at the end of the shift.
Favorite self-care act: Doing the NY Times Crossword in the morning.
Tiff Miller, AAS, RRT, RRT-NPS
Manager, Clinical Excellence
Tiffany is an experienced respiratory therapist with nearly a decade of high-acuity pediatric practice in ER and ICU settings at Children’s Medical Center in Dallas. She holds the NBRC RRT-NPS credential and brings advanced expertise in pediatric airway management, mechanical ventilation, and critical care. Now focused on clinical strategy and education, she is dedicated to advancing safe, evidence-based practice and advocating for the essential contributions of allied health professionals. Tiffany’s work is driven by a commitment to supporting clinicians and improving systems that elevate the standard of respiratory care.
The Personal Side
Why Nomad: To move to the other side of healthcare and help build a supportive, intuitive experience for Allied Health clinicians searching for travel opportunities.
Clinical Pet Peeve: “Albuterol for fun” and low SpO₂ alarms caused by probes in the bed instead of on the patient.
Favorite Self-Care Act: My nightly ritual — neck stretcher + red light mask + legs up the wall. I love a good habit stack!
Briana Bonicelli, MSN, RN
Briana Bonicelli, MSN, RN, is an accomplished nursing leader with over 20 years of progressive clinical and leadership experience in adult critical care, cardiac telemetry, and healthcare staffing. She specializes in clinician performance management, compliance, and quality assurance. Briana has held senior roles within leading healthcare staffing agencies, where she was recognized for her strategic leadership and expertise in clinical coaching, risk mitigation, and process improvement.
The Personal Side
Why Nomad: After spending many years at the bedside caring for patients, I now find purpose in caring for the nurses on assignment—supporting them so they can deliver exceptional care. I am passionate about impacting patient outcomes by ensuring high-quality clinicians are placed at the bedside.
Clinical Pet Peeve: Messy rooms and tangled swan/central line tubing.
Favorite Self-Care Act: Working out.
Frequently asked questions about Clinical Excellence at Nomad Health
- When you apply for a job and travel with Nomad, you’ll have various Navigators—who are experts in their roles—assist you along the way. A Clinical Navigator is a special type of Navigator that has a clinical background and can provide services such as clinical skills assessments, specialty-specific education, and test remediation. As clinicians, we’ve been in your shoes and understand the hospital environment—the long hours, patient care challenges, coping with stressors, etc. Because of this shared experience, we can evaluate your skills and advocate for you in ways that only another healthcare professional can.
- If you’re on assignment with Nomad, you can ask your On-Assignment Navigator to have a Clinical Navigator reach out to you.