Nurses at every educational level who practice travel health nursing find it necessary to take specialty specific coursework in addition to the basic courses required for their state licensure as RNs or APRNs. The specialty of travel health nursing necessitates that all travel health nurses master a body of knowledge distinct from their foundation of professional nursing education. At present, through undergraduate classes, short courses, CE activities and self-directed learning, RNs acquire the knowledge and skills to provide the complete pre-travel consultation. Specialty educational content includes awareness of and resources for national and international standards of travel health care, pre-travel and post-travel assessment of the traveler and itinerary, basic research methods and statistics, global epidemiology of health and safety risks to the traveler, vaccinology, behavioral measures for the prevention of travel-related injury and illness, and techniques for customized, motivating health counseling designed to maximize the health and safety of diverse travelers with diverse itineraries. If not previously acquired through basic nursing education or through employment, internet search skills, knowledge of world geography, cultural competency, and excellent written and verbal communication skills must be developed. Travel health nurses must know current CDC travel health and safety guidelines that include ACIP pre-travel vaccine recommendations and requirements, as well as destination-specific and activity-specific risks and prevention recommendations. In their clinical and administrative roles, travel health nurses understand the role and guidelines of WHO, international differences in pre- and post- travel standards, medical statistics, global health epidemiology, tropical disease transmission and avoidance, personal injury risks, behavioral health principles, transcultural considerations, and preventive and therapeutic pharmacology. Travel health nurses are familiar with specialized map reading, global geography including specific health concerns and likely activities in selected destinations, health risk analysis, individual traveler and group prevention counseling, tropical disease triage, and complex vaccination care and schedules for multiple age groups and foreign-borne travelers.
Travel health nurses pursue any number of post-licensure educational options to gain mastery and maintain currency in the specialty. Travel health nurses consult the ATHNA Model Core Curriculum, the CDC Health Information for International Travel and the ISTM Body of Knowledge as just three of the primary resources for acquiring and maintaining current knowledge. Additional resources include subscriptions to travel health journals, memberships in ISTM and ATHNA, participation in travel health webinars, courses and journal clubs, and attendance at national and international travel health, vaccinology and tropical disease conferences.
Comprehensive academic programs for travel health nursing in the United States continue to lag behind international learning options. As a result, U.S. nurses seeking more knowledge and skills in this specialty post-licensure undertake international courses in a variety of ways at present. They travel to the University of Glasgow to attend the certificate program at the Royal College of Physicians and Surgeons, Faculty of Travel Medicine, attend courses at the London School of Tropical Medicine, and participate in summer courses offered by McGill University and the University of British Columbia. In addition they seek out and attend select relevant sessions of annual conferences of AAOHN, ACHA, the Wilderness Medicine Society (WMS), and AANP. Some corporations offer in- house training and several CE accredited short courses are offered year round by U.S. travel health nursing experts.
The graduate- level prepared RN in this specialty has completed a masters, DNP, ED or PhD program that included academic courses in advanced research methods, statistics, epidemiology, advanced pharmacology, advanced counseling theories, and graduate- level courses in global health, tropical disease, injury prevention and health education. Additional coursework can include any number of graduate- level management, education or clinical courses, such as health administration, finance, grant writing, project management, adult learning, advanced courses in infectious disease, courses in chronic disease management and behavioral studies.
APRNs who practice travel health will need to complete a course of study that meets the requirements for state licensure and their professional certification (pediatrics, geriatrics, family, etc.). In addition, APRNs will need to master all the travel health knowledge and skills of the RN and take additional graduate-level courses appropriate to their role as prescribing clinician, practice director, educator and / or researcher. APRNs who provide post-travel care will also need to take advanced course work in tropical disease diagnosis and management. Language courses to facilitate communication with different travel populations are also valuable.
Presently there are no academic centers in the United States that offer a nursing concentration in travel health. Initially, to address this gap, ATHNA developed a travel health nursing Model Core Curriculum that outlines the knowledge, skills and attitudes required for competent practice. First written in 2002, over the years this curriculum has served as a foundation for a number of short courses, orientation and training programs, and CE activities offered by nurse experts, travel health companies, government agencies and academics. Posted on the ATHNA website, it is available for use by individuals and groups seeking to educate nurses in the specialty, to inform and engage many more U.S. nurses in the care of travelers, and to educate travelers about quality travel health nursing care and the specialty. This curriculum is periodically validated by travel health nursing experts and against other international curricula (e.g., ISTM Body of Knowledge, University of Glasgow course), updated regularly, and can be accessed on this ATHNA website.
As of yet, no U.S. nursing certification comparable to those offered by the American Nurses Credentialing Center exists. Nurses who seek a specialty credential for professional development, employment or promotion apply for one of three international, interdisciplinary alternatives: the ISTM Certificate of Knowledge (CTH®), the ASTMH Certificate of Knowledge in Clinical Tropical Medicine and Travelers' Health (CTropMed®) or the University of Glasgow Certification in Travel Health. ANA recognition of the specialty of travel health nursing is the crucial first step necessary to develop a certification process in alignment with other U.S. specialty nursing certifications. In addition, this travel health nursing certification will be based on the U.S. standards of care, a practice that does not currently exist. The travel health nurse's attainment of this credential will document the highest skills and knowledge of travel health nursing as practiced in this country.
Commitment to Lifelong Learning
Travel health is a dynamic and ever-changing specialty. Travel health nurses are devoted to the health and education of persons and groups who travel internationally, and travel health nursing professionals focus on the multiple determinants impacting travel health that include infectious disease, environmental risks and personal safety.Travel health nurses know that yesterday's knowledge of global health and safety risks may not serve to protect today or tomorrow's world traveler; failure to keep current with itinerary hazards and customized risk reduction measures for the various traveling populations (e.g., students, boomers, pregnant travelers, persons with HIV) can result in excess travel-related illness, injury, even death.
Continuing Education Opportunities
A number of opportunities exist in the U.S. and in Canada for nurses to gain knowledge and expertise in travel health care. Here are some of the most recognized avenues that new and more seasoned nursing professionals utilize to advance their education and training in travel health:
- Join ATHNA and regularly check the ATHNA website for education, news and links to important educational resources for travel health nurses. Participate in ATHNA's free, one day clinical update NED: Networking, Education and Development Day. Earn up to four free CE credits each year though website based programming.
- Regularly check the websites of the CDC www.cdc.gov/travel, PHAC at www.travelhealth.gc.ca, the Immunization Action Coalition www.immunize.org, and Immunize Canada at www.immunize.ca for updates, educational opportunities, and essential information on travel health and immunizations.
- Subscribe to Mortality and Morbidity Weekly Review (MMWR at www.cdc.gov/mmwr) and Canada Communicable Disease Report to receive infection disease and travel-related disease reports and updates (CCDR) at www.phac-aspc.gc.ca/publicat/ccdr-rmtc/maillist-eng.php
- Visit the website (www.ISTM.org) and consider joining the International Society of Travel Medicine. The ISTM offers a variety of benefits to members including: the Journal of Travel Medicine, Expert Opinions, announcements of conferences and an active on-line listserv forum for discussion of travel medicine clinical and other issues. ISTM also offers the exam for a Certificate in Travel Health®/CTH® The ISTM has nurse members from the U.S., Canada and other countries.
- Participate in one of the growing number of travel medicine conferences offered in the United States, Canada and abroad. Note that other nursing specialty nursing organizations such as The American Association of Occupational Health Nurses (AAOHN) and the American College Health Association (ACHA) now include ongoing education in travel health care as part of their conferences, journals and websites. ATHNA lists these opportunities on its Courses and Conferences section of the website.
- Read the lay literature. There are wonderful books and articles that address the challenges of international travel. Gina Kolata's Flu: The Story of the Great Influenza Pandemic, Steven Johnson's The Ghost Map (about the London Cholera outbreak and the beginning of Epidemiology as a discipline) and David Oshinsky's Pulitzer Prize winning Polio: An American Story are just three examples.
- Travel and work internationally to gain a better understand of health and safety risks - and prevention measures - around the world.
- Enroll in nursing and public health courses such as epidemiology, statistics, global health, tropical diseases, health promotion, nursing research, surveillance of international injury and illness, etc.
- Participate in relevant research projects such as vaccine clinical trials, self-care management research, and surveillance of international injury and illness.
- Read ATHNA's blog, TravelBytes, a peer reviewed referenced resource on timely travel health nursing topics that have included: Why Are They Spraying My Aircraft Cabin?, Interesting and Unusual Travel Terms, Equitable Care for Transgender Travelers, and Ross River Virus Disease
- Read the ATHNA Glossary on this website to expand your travel health vocabulary.
Updated: April 2019