According to Webster a traveler is "someone who is making a journey" and that trip can be domestic or international for pleasure, work, study, humanitarian outreach, a family visit, or medical care. Starting in the 1980's, as the numbers of travelers increased substantially each year, nurses around the world, and in the United States, initiated the development of a nursing specialty that serves to promote the health and safety of all travelers during all stages of their journey. A short history explaining the development of this global specialty can be found on the ATHNA website.
The American Nurses Association defines a nursing specialty by its Scope: the Who, What, Where, Why, and How of the Practice. This FACT SHEET provides a short introduction to the specialty of travel health nursing using that format.
What is Travel Health Nursing?
As defined in Travel Health Nursing: Scope and Standard of Practice 3rd edition, travel health nursing is defined as "the specialized nursing practice that advances the well-being of all travelers in all phases/stages of travel and in all settings." This specialty focuses on the health and safety of travelers through continuous surveillance and assessment of the multiple determinants of health with the intent to promote health & wellness, prevent disease, disability and premature death. Travel health nursing is a highly complex nursing specialty that draws on knowledge from nursing, pharmacology, epidemiology, tropical medicine, primary care, and behavioral psychology to provide evidence based interventions that ensure the health and safety of travelers and the communities they impact. Travel health nurses care for travelers at every stage of their trip: pre-travel, in-transit, and post-travel.
Is Travel Health Nursing the Same as Travel Nurses or Flight Nurses?
No, not at all.
- Travel health nurses provide nursing services to patients who travel domestically or internationally.
- A "travel nurse or traveling nurse" is not a specialty per se, but rather the collective term used for nurses of any specialty who travel themselves from one clinical site to another for employment. "Travel nurses" move around geographically for work in different places whereas travel health nurses are specialized professional nurses caring for all travelers (e.g., tourists, students, employees, volunteers, immigrants and refugees, and family members) who are making journeys for any number of reasons.
- Flight nurses are nurses who assist patients traveling on airlines who may need care on board the aircraft, such as assistance with IV therapies, emergency air ambulance care, and the like.
Who are Travel Health Nurses (THNs)?
THNs represent the myriad of specially educated and trained registered nurses, advanced practice registered nurses, and graduate-level prepared nurses who acquire the additional knowledge and skills to care for travelers pre-travel, during travel, and post-travel. THNs provide most of the pre-travel care in the U.S., seeing patients in preparation for trips domestically and around the world. THNs come from any number of nursing backgrounds and then choose to specialize in the care of all travelers of every age who make any journey. In addition to the delivery of direct patient care services, THNs also function as consultants to businesses, organizations, and governments. They are researchers, faculty members, and nursing leaders. Some are entrepreneurs, serving as owners and operators of their own travel health centers. In the U.S. there are an estimated 25,000 nurses who provide travel health services.
Where Do Travel Health Nurses Practice?
THNs practice in a wide variety of clinical settings that include stand- alone travel health clinics, hospitals, occupational health units, college health settings, community and public health units, the VNA, government departments (FBI, CIA, State Department, etc.), the military, and others. Wherever a nurse might encounter a traveler, a THN may be available to provide pre and post-travel nursing services.
How Can a Consumer Locate a Travel Health Nurse?
Consumers find travel health nurses in a number of different ways, THNs work in occupational health units, so corporate and government employees find them at their worksite. THNs work at colleges and universities and students, faculty and administrators locate their services at those institutions. County and public health organizations maintain listings of travel health nursing services in their region. The VNA and the military offer travel health nursing services. CDC publishes a list of all travel health clinics that offer the yellow fever vaccine in the United States. Healthmap Vaccine Finder and the CDC Flu Finder list travel health clinics according to zip code. Both the International Society of Travel Medicine and IAMAT list travel health clinics around the world by country. In addition to these listings other health professionals in a community, such as primary care providers and various specialists, often refer their patients to travel health nurses for pre and post travel care.
Who are Travel Health Nursing's Patients? Do Nurses See Travelers for Trips within the United States as well as for International Itineraries?
THNs care for patients of every age who travel for any reason to any destination. The patient might be a couple on a Yucatan camping trip, a college student studying in India for nine months, or a civil engineer overseeing dam construction in Ghana. THNs see families leaving tomorrow for funerals in West Africa and others planning multi-generational safari vacations months ahead in Botswana. THNs prepare groups of volunteers, missioners, and relief workers for travel anywhere in the world. THNs also see travelers for many U.S. destinations and activities, including skiing in Aspen, mountaineering on Mt. Hood, performing research in the Florida Everglades, or assisting with disaster relief projects in New Orleans or Houston
What Do Travel Health Nurses Do? How Do Travelers Benefit from Travel Health Nursing Care?
THNs provide what are termed pre-travel and post-travel services. The focus of the specialty is on the primary and secondary prevention of travel-related injury and illness. Most travelers, when they think of pre-travel health care, think only of vaccinations. Immunizations do play a role in pre-travel services, but actually a very small one, for most destinations and itineraries. The majority of risks for the traveler are non-vaccine preventable. The THN has the knowledge and skills to perform a risk assessment for a given itinerary identify important health and safety risks, create an individualized prevention plan, and then provide services that include vaccinations, counselling, and referrals. THNs counsel travelers for prevention and self-care of various trip risks (e.g., food and water borne disease, insect vectors such as malaria, heat and humidity effects, altitude illness, rabies, safety and security risks, outbreaks, cultural effects). At the pre-travel visit the THN will also provide a traveler with destination resources for medical care and alert the traveler to any post-travel issues or considerations. Qualified THNs also see ill or injured travelers after a trip for post-travel evaluation and management in accordance with their education and scope of practice.
Why is the Specialty Important and Needed? What Impact Does the THN Have on the Traveler and Community?
Global travel continues to increase at greater that 4-6% rate per year. Air passengers can carry a transmissible disease to any distant destination or back to their homes within 24 hours. In 2017 there were more than 1.322 billion international trips and U.S. travelers comprised 22% of that number. THNs providing pre-and post-travel services contribute to the health and safety of these travelers and also to the communities to which they travel and return. THNs network with national and international colleagues as well as CDC, WHO, the Pan American Health Organization and other authorities to keep travelers healthy through comprehensive care during all phases/stages of travel. In addition, THNs participate in the monitoring and care of immigrants and refugees and alert authorities for potential infectious disease risks in that population.
How Does a Nurse Become a Travel Health Nurse? Is There a Separate Travel Health Nursing Degree?
ATHNA has prepared the separate Educational Preparation for Travel Health Nursing handout to explain how THNs acquire the knowledge and skills needed for this specialty. In addition, ATHNA has created a Model Core Curriculum Guide that delineates the topics that comprise entry level and advanced THN education.
Currently nurses interested in the specialty enroll in academic and CE courses that supplement their basic nursing education. After ANA grants specialty recognition for travel health nursing, ATHNA will initiate a comprehensive effort to work with U.S. nursing schools to establish 1)more undergraduate courses and concentrations in travel health nursing, 2)a post-baccalaureate certificate, and 3)a graduate degree in the specialty.
In Addition to the United States, Where Else Do Travel Health Nurses Practice?
THNs practice around the world on every continent. In the UK, the Royal College of Nursing includes more than 5000 nurses in its specialty group. Australia, New Zealand and the Netherlands are other countries with sizeable numbers of THNs. The International Society of Travel Medicine includes more than 800 nurses from numerous countries among its interdisciplinary membership.
Does Travel Health Nursing Have a Professional Organization? ANA Specialty Recognition? U.S. Certification?
- The American Association of Travel Health Nurses (ATHNA) is the professional organization that works on behalf of U.S. travel health nurses and their patients. ATHNA establishes, maintains, and promotes the standards for professional travel health nursing practice.
- Now in its 15th year, ATHNA has over 1500 members and provides resources for professional development and advocacy for quality travel health nursing care. ATHNA also sponsors a unique, yearly CE accredited NED: Networking, Education and Development day that is free to members and provides important travel health nursing updates at regional locations around the country. To learn more about ATHNA and membership, please see the "ATHNA Fact Sheet."
- In 2019 ATHNA is actively working with the American Nurses Association to gain official specialty recognition for travel health nursing.
- While at present there is no U.S. nursing certification for this specialty, once ANA recognition has been achieved, ATHNA plans to explore options for U.S. certification that align with other ANCC nursing certifications.
What is the Future of Travel Health Nursing in the United States?
Global travel is only expected to increase in coming years (e.g., more cruises, more adventure travel, more business travelers and more students studying abroad). The U.S. Tourism Association and the World Tourism Organization both predict long term trends of increased travel to all global regions. New travel vaccines are currently under development and more vector borne diseases are now recognized as risks for many travelers (e.g., dengue, Zika, Ross River Fever). Travel health nursing is a dynamic and rapidly evolving specialty due to numerous and ever changing factors that impact the traveling public. Travelers to any destination will require more pre-travel preparation to help insure safe and healthy trips, while returning travelers will need travel health nursing evaluation and management expertise to preserve their health and protect the health of the communities to which they return.
Updated: August 2019