One Thing That Every Nurse Should Have

You’re probably thinking a stethoscope or a pen, but it’s something much more boring and important than that: professional liability insurance.

Disclaimer: In keeping with the theme of this post, I am not providing legal advice.

In an age where people will sue if you look at them the wrong way, insurance is more important than ever. Professional liability insurance adds a layer of protection that could save your career and financial well-being. For the same price as an evening out at the bar or dinner with friends, you can have professional liability insurance for the year. This can potentially protect you from hundreds of thousands of dollars in legal action, court and lawyer fees, and save your license from carrying blemishes.

My employer says that they carry a professional liability insurance policy. Aren’t I covered?

Yes, but let’s take a look deeper. Many health systems have their own liability insurance policies that cover everyone who works at the facility, but it’s definitely beneficial to have a personal policy as well. The incentive for hospitals is to settle if a case is ever brought against them. This usually keeps their name out of the news, the problem goes away, and they often don’t have to admit fault. However, if ever a case were to be brought up in which would require something to be reported to the nursing board, you run the risk of having your license reported as well because you are included in the case that was settled. If you have your own policy, you will have more individualized protection, the incentive of which aimed at protecting you and your integrity.

Travelers, nursing students, and new hires are often the first to be thrown under the bus if something goes wrong. You definitely want to have that extra bit of security, knowing that your interests are being safeguarded in the unfortunate case that you’re involved in a legal matter.

It’s alarming when I find that some of my colleagues do not have professional liability insurance – many of which because they don’t know it exists. The reason being, I have seen the benefits of the protection, having encountered a number of nurses who have had cases brought against them, whether that be individually or as part of a group, where their licenses remain unblemished and they endured no financial hardships as a result of the proceedings.

For me, the goal is to never have use the service, but it’s comforting to know that they’ll have my back if push comes to shove. That sense of comfort is well worth the price (my annual premium is a little over $150). If you are a contractor or self-employed, your rates may be higher. There are other factors that play into determining your risk-factor and your premiums, but ultimately that’s up to their underwriters.

For those interested in acquiring professional liability insurance (and I hope you are after reading this), it’ll only take a quick phone call. The company I use is Nurses Service Organization, or NSO. Check out them out NSO.com.

I am not receiving any kick backs or referral fees for this recommendation. This is simply the company I use. Feel free to shop around, but I’ve had good experiences with them.

Navigating New Traveler Orientation

Congratulations on accepting and starting your new assignment!

Whether this is your first or your fiftieth assignment, there will be some nerves when starting somewhere new. Much of this has to do with the uncertainty of things and needing to assimilate rather quickly. Having just finished orientation for my new assignment (yay!), I have a little bit of a refresher on these feelings and some insight on how things unfold during orientation. Below are some tips on how to best approach your new traveler orientation.

1. Get Your Mind Right

Go in with expectation that no one will have any answers for you. Every answer you get is more than you expected to have received. Yes, this a bit of a hyperbole, but you need to understand that everyone you talk to has a very specific job to do, and they probably don’t have the answers to your questions, which are probably unrelated to their area of expertise.

You need to remain flexible and patient as information reveals itself as time goes on. If you’ve reached the end of orientation and still have questions about getting paid, log-ins, or schedule, then ask away. Everything else can probably be resolved down the road (i.e. when you’re on the unit, a different class).

2. Expect a Short Orientation

Remember, the incentive for hospitals to use travelers stems from a traveler’s ability to have a near-immediate impact on the staffing situation of a facility despite minimal on-boarding time and training. As a traveler, you are expected to be a quick fix and fill the holes in their schedules as soon as possible. For this reason, it is not uncommon to have a three-day orientation, most of which is classroom-based, discussing policies, culture, and charting systems.

Depending on how the facility chooses to prioritize material, you may only be given a brief unit orientation (i.e. one half-day). Again, everything is up to the discretion of the facility, and you may get lucky and have a bit longer orientation. However, in my experience, one week is usually plenty as long as you understand that you can’t possibly know everything and will often need to learn on-the-fly during your shifts.

3. Start to Make Allies

Orientation is a good place to begin making friends, but more importantly allies. You’ll probably need these people to make scheduling trades with down the road. It’ll also be nice to have a buddy when you’re first let loose on the unit. Having a familiar face when starting at a new place on day one can make all the difference! For more tips on how to make friends and create allies with permanent staffers, be sure to check out Closing the Gap Between You and the Permanent Staff.

Conclusion

Before you leave orientation, you should have a grasp of the following concepts:

  • How to clock in/out
  • Scheduling
    • When and where your schedule will be posted
    • How to pick up extra shifts
  • Computer log-ins
  • Documentation basics
  • Basic overview of nursing policies
  • Dress code
  • Where to report for your shifts
  • Parking

Anything else is really going to be overkill and make you crazy if you worry about it. You already know how to be a nurse (and a good one at that), the rest is just “fitting in” to this particular system. Again, just take your time, be patient, and enjoy getting paid to sit and listen to someone talk for a few hours.

Best of luck on your new assignment!

Top 5 Travel Nurse Questions

This is a crosspost from my youtube channel where I briefly talk about the five questions people frequently ask me in regards to travel nursing. 

1. What is a travel nurse?

A travel nurse is like a contractor or a substitute teacher where you’re only there for a short period of time. You do all the functions of a nurse, but you move from hospital to hospital throughout your assignments.

Read more: Travel Nursing: What’s That About?

2. How long is an assignment?

Length of assignments varies depending on your contract and the needs of the facility. However, the standard length is typically 13 weeks or 3 months. Of course, it can be shorter or longer, and many times you have the option to extend.

3. Do you have a choice as to where they send you?

Yes, of course. You are in complete control of where you work. Recruiters can suggest openings that they have available, but you absolutely have the final say. It’s not like the military where you get stationed somewhere. You work alongside your recruiter to help form your wishlist and you choose from any availability they have.

4. How does housing work?

There are two options here.

  1. The first is to accept the company housing where they’ll most likely put you up in an extended stay or leased apartment that they have available. This will come out of your paycheck and will offer you less flexibility to move in and move out dates, but it’s a lot less stressful than finding a place on your own.
  2. Your other option is to take the housing stipends and put that towards your rent. You can find short-term rentals on Craigslist, Facebook Housing Groups, Airbnb, FurnishedFinder, VRBO, or at local apartment complexes. You’ll usually come out ahead financially when you take this option. As a rule of thumb, try not to spend more than one week’s salary on housing.

Read more: Finding Housing as a Travel Nurse

5. What do I do for taxes?

I use a CPA that specializes in traveling healthcare providers. They send me a pdf to fill out prior to our phone conference. When I’m done filling it out, I set up my appointment. We have our phone call, which takes an hour or so. Then they do the rest and will send me some stuff to sign when they’re all done. I’ve used them since I started traveling. I’d definitely suggest checking them out at TravelTax.com. They have a ton of resources; just try your best not to get overwhelmed!

 

 

An Epic Tale: Making Your Patient List Work For You

Throughout my travels, I’ve come across many facilities, each with their different method of documentation. Some still use paper charts. Some use electronic medical records (EMRs). Some use a combination of paper charts and EMRs in a hybrid fashion.

Whatever the current state of the system in place, it seems that the trend is moving towards technology and EMRs. Reimbursement from insurance companies, safety, and the widespread access of an electronic record seem to be the rationales at the forefront of this shift. It’s something that we, as healthcare professionals, need to embrace because it’s not going away anytime soon.

One of the benefits of traveling is that you get to see what tools and processes other facilities use to handle similar issues. A huge tool in healthcare as mentioned earlier is the EMR, my favorite by far being Epic. To me, Epic seems to be the quickest to pick up and has the best flow to facilitate your workday. Epic is an EMR that is all built on the same database enabling seamless communication and functionality. It’s also pretty popular around the US which helps when moving around to different facilities because you’ll already be familiar with the system they’re using.

Although it is the same program, Epic allows for a great deal of customization based on the needs of the healthcare system which might take a little bit of time to adjust to when using a new facility’s version. However, it’s usually just a change in color schemes, how things are organized, and varying layouts. Moreover, the appearance may be different, but the overall functionality will remain consistent.

Probably my favorite feature in Epic that I use as an inpatient nurse is the patient list. It’s probably the first thing you learn when you go through training, but there’s tons of customization that you can do here that I don’t think many people take advantage of. Having just worked an Epic conversion (the health system was changing from their previous program to Epic), I’ve seen this many times over the last couple weeks.

The reasons why it’s so important to customize your lists and make them your own is because it saves time when navigating the chart, highlights all your important items given your patient population and role, and helps keep you organized when giving and receiving report.

Since I was just helping others adapt to the program and it’s fresh on my brain, I figured I’d share my preferences as an inpatient nurse on a telemetry unit for you to use as a template and tweak to your needs.

I tend to organize my list in a way that resembles an SBAR report style and then I’ll fill in my assessment in the blank areas. Remember that some of the headers may not be available at your facility based on the version they use or the options they’ve selected. Do your best to find them if they’re named something different or use a substitute for something similar if you like.

Also, remember that this is the list I use while working the floor as a staff nurse. You might find it useful to tweak some of the things listed below if you have a different role (e.g. charge nurse, break relief).

Top to bottom indicates columns left to right

(*) = Optional

  • Unit (*) – shows unit, beneficial if you’re rounding on patients in multiple units
  • Room/Bed
  • Patient Name + Age + Sex OR Name/Age/Sex – either separate columns or as a combination
  • Code Status – (e.g. full, DNR)
  • Allergies – lists patient allergies
  • Isolation – (e.g. contact, airborne, droplet)
  • MRN – medical record number
  • Chief Complaint (CC) – usually what patient says is their reason for coming to the hospital
  • Problem – pulls in problems from problem list
  • Diagnosis – reason for admission
  • Med Due AND/OR Med Overdue – flag appears when a medication is due or overdue, respectively
  • New Orders – flag appears when a new order has been written for a patient
  • Treatment Team OR Attending – shows all those responsible for the care of the patient, may list phone numbers or pagers
  • Diet – (e.g. NPO, clear liquids, regular)
  • Insulin Meds (*) – nice for tracking the patients who need blood sugars at meal times
  • Foley (*) – Foley catheter in place
  • Telemetry (*) – requires cardiac monitoring
  • Level of Care (*) – (e.g. med-surg, tele, ICU, step-down)
  • Current Level of Function (CLOF) – beneficial for seeing how well your patients move (e.g. bed bound, ambulatory)
  • Fall Risk – indicates patients at risk for falling (although everyone is a fall risk…)
  • Braden Score – shows latest score, indicates patients at risk for skin breakdown
  • MEWS (*) – last Modified Early Warning Score, shows risk for sepsis, beneficial to RRT nurses or general
  • K (*) – shows most recent potassium level, beneficial on tele floors
  • Mg (*) – shows most recent mag level, beneficial on tele floors
  • Hgb (*) – shows most recent hemoglobin level, beneficial for just about any population

 

Here’s a little preview of what your final product might look like:

Inpatient Med/Surg Floor Nurse
Capture

As nurses, we’re flexible. Constantly adapting to the newest equipment, medical regimens, protocols, etc. Technology is no different. Be sure to go with the path of progress and avoid resisting change for the sake of “this is how we’ve always done it.” Allow it to facilitate your daily workflow so you can spend more time doing what you love: caring for others!

Top 3 Reasons to Start Travel Nursing

Everyone has their reasons for embarking on a new career path. The beauty of nursing is that it can take you in so many directions, not just geographically, but also professionally (e.g. job title and responsibilities). Your nursing license has the flexibility to adjust, transform, and mold to your needs and gives you the option to remain active, vibrant, and fluid throughout the profession. Travel nursing is a huge tool at your disposal for creating this environment of growth for yourself.

Many claim that the main hurdle preventing them from starting a career in travel nursing is that it never seems like “the right time”. If you ever seek the advice of self-help “gurus”, they’ll always say that “the right time” is now, if not yesterday, last week, or last year. Whereas, if you ask me, I’d agree in saying that there’s never a “right time”. Change is scary, and stability is comfortable. However, no growth comes from your comfort zone. It’s definitely easier to come up with a million excuses or alternative plans that indirectly act as stalling tactics for a much-needed change, and I get that. I stalled for nearly a year before I said, “Let’s do it – now is as good a time as ever;” drafted my resignation letter; and signed my first contract. For me, that realization and the subsequent transition into the travel nurse world have been the most liberating experiences imaginable.

I understand that it can be quite intimidating to shift into this lifestyle. I understand that it can remove you from all that you’ve known – your family, your friends, your hometown, your facility, your unit, your coworkers, your favorite pizza place, etc. I understand, too, that in some cases, it is truly not a period in your life where this degree of flexibility is feasible due to various obligations. However, let’s look at some of the circumstances that make starting a career as a travel nurse both practical and enticing.

1. Travel More

The desire to travel is probably the most popular reason for pursuing a career in travel nursing (shocker – I know). Traveling allows you to become well-rounded and immersed in other cultures, ways of life, and landscapes. When you couple that wanderlust with a way to fund your adventures, travel nursing becomes a no-brainer.

When choosing assignments far away from home, your new environment can serve as a “vacation” with the ability to make money 3-5 times per week, depending on contract requirements. Often, nurses with low seniority at their permanent job may find themselves frustrated when not getting their requested vacation time off and opt to go per diem or start travel nursing for more flexibility.

As a side note: you have the ability to request days off prior to signing a travel contract and can also space out time between assignments to allow for trips and breaks.

2. Permanently Relocate

Life has the ability to pull us in different geographic locations. Sometimes, it’s to be closer to family. Sometimes, it’s to follow a significant other’s job. Sometimes, it’s to avoid subjecting yourself to bad weather (I’m looking at you winters in the northeast). Whatever the reason, occasionally, you need to move.

If you’ve ever had to try to find a job long-distance, you know that this can be a challenge. It’s hard enough to get a callback when you live down the street. If your resume says that you’re out of town, you might never get that opportunity to interview, no matter how qualified you are.

Travel nursing in your target location gives you some time to scope out the area, see where you might want to live, research where you might want to work, have an in-person interview without having to fly in, and even give you an opportunity to have an “on-the-job interview” (i.e. getting a permanent job offer after completing an assignment if you find it’s a good fit).

3. You’re “Over It”

This is going to mean something different for everyone. Obviously, no job is perfect and nurses are quite resilient, but everyone has their “tipping point” where enough is enough. These don’t always have to be negative. For example, you might feel that you’ve learned all you can at your small community hospital and want a change of pace as you look for a larger teaching hospital to pursue. Other times, certain issues can run you down and cause you to resent your current situation. Whether it be the job politics, struggling to get that 2% raise come evaluation time, or something else more personal, you feel it in your bones that it’s time to move on and wish to avoid staying in one place for too long.

Nursing Advocacy: Keeping Yourself Intact

One of the core responsibilities of a nurse to his or her patients is advocacy. Nurses are expected to go to bat for their patients, acting as a liaison while addressing concerns with doctors, physician assistants, and advanced practice registered nurses as they arise and sometimes even before these issues come to light. This is often easier for bedside nurses to accomplish because they have more one-on-one time with their patients and are able to dive deeper into the aspects of their care that matter most to them. Essentially, it’s the duty of the nurse, equipped with this knowledge, to defend the integrity of patients’ and their wishes, preferences, and beliefs while engaged in conversations with other members of the care team and, oftentimes, families for when patients are unable to voice their own concerns and where an advanced directive or POLST is available. Many facilities have implemented multidisciplinary rounds, which seems to create a more transparent and facilitated environment for advocacy where many aspects of the healthcare team are able to construct, assess, and/or revise plans and goals that are patient-centered and collaborative. These have shown to have improved outcomes for patients, which of course is the goal for healthcare in general.

oxygen2

What about advocacy for nurses? Who is there telling everyone what you need or that you need to zoom out and take a break? Sometimes there isn’t that person, so you need to be your own advocate as well. For something so imperative to nursing fundamentals, nurses often forget to speak up for themselves as they are caught in their selfless frame of mind? Nurses need to care for themselves if they are ever to care for others, and sometimes this means speaking up or toning it down. If you’ve ever been on an airplane, you’ve heard the phrase, “Please put on your oxygen mask before helping those around you.” As a nurse, you need to ensure that you are satisfying the needs that make you human. Looking below at Maslow’s Hierarchy of Needs, you’ll see that the foundation of human needs are physiological and safety in nature. This means that calling the doctor for your patient who hasn’t urinated in eight hours is okay, but you should probably address the fact that you haven’t gone to the bathroom at all during your twelve-hour shift as well.

maslow-hierachy-of-needs(1)

This is not an attempt to tell you how to live your life or bring you back on a trip down memory lane through nursing school theory. It’s simply a plea that you look out for yourself (as a nurse and a human being) so that you prevent burnout and are able to better care for your patients. Without further delay from rambling, let’s dive into some of the topics that travel nurses might need to address most regularly.

Patient Assignments

This is probably the biggest ticket item on most traveler nurse complaints. Many nurses claim that the assignments can be skewed to favor permanent staff, where travelers receive all or most of the “heavy” patients  (e.g. tracheostomies, isolations, total cares, the confused old lady who bites – you get the drift) or are left open for admissions. Sometimes, this is true. It depends on the culture of the unit. This is also not the case in other instances. Sometimes, travelers are given the easier patients in lieu of more complex patients, especially on the more specialized units where they might not trust the traveler to know the protocols or care considerations for that type of patient. Regardless of your situation, you need to speak up if you are uncomfortable with your assignment. As the saying goes, “the squeaky wheel gets the grease” and in this case, you want to make sure you’re doing so respectfully, addressing any concerns you may have to ensure that you, your patients, and your license are safe.

Contracts

A lot goes into securing a contract. There are many details that need to be ironed out, and the traveler needs to examine an assignment’s  details (e.g. pay, location, facility, shift, duration) and make efforts to prioritize their needs. A good recruiter will take your preferences and advocate for you as well. However, oftentimes, there can be “too many hands in the pot” and communication and output suffer. This is when it’s important to check in to make sure that everything is going according to plan. Also, if you have in inside track to those who are processing the contract on the hospital end (i.e. knowing the staffing coordinator and/or nurse manager when signing an extension), it may be reasonable to confirm that things are coming along and press the issue if things have not come together just yet.

Housing

For whatever reason, this topic seems to have somewhat of a charged aura around it. While browsing Facebook groups that attempt to put travelers and landlords in touch for the purpose of short-term leases, it seems to be an all-on attack of landlords who list their properties in these venues because the travelers feel as though they are being taken advantage of. Is this true? Probably not. Should you do your research to ensure that you aren’t getting taken advantage of? Absolutely. It’s important to know that you got a fair deal that is mutually beneficial. The landlord has a tenant and the traveler has a place to stay. The landlord’s expenses of homeownership are accounted for and the price is at market value. Of course, there are details that would increase or decrease rent like whole place vs. private room vs. shared space, downtown vs. outskirts, parking vs. no parking, utilities included vs. utilities not included, vs. furnished vs. unfurnished, etc. Again, it’s all about priorities, speaking up for what you need in a respectful way, and negotiating if necessary. Remember, no one is forcing you to stay in one particular place, so make sure it’s a good fit before you sign anything and if it’s not, move on; and keep a good relationship with the landlord when you do sign a lease so that issues can be addressed at a later time as well.

Personal Life

Travel nursing can be an adjustment. It’s important to find the balance to take care of yourself. In order to do that, sometimes you need to put yourself first and think about what it is you truly need. For example, it might be the first time you’ve worked on night shift and need to figure out your sleep schedule. Others in your life should be respectful of that, and if they aren’t or just simply don’t get it, you might need to explain what you need from them in order to get your rest. Make sure you’re consuming a healthy diet as well. This might be another struggle if you share a kitchen or don’t have access to the tools or facilities you’re used to. However, you need to make conscious efforts to make things work in this situation. Since you’re traveling away from home, your support network might be lacking in terms of proximity. In this case, technology is our friend. Text messaging, FaceTime, Skype, etc. have made being away from the ones we love just a bit more bearable. Use these tools to your advantage and possibly schedule some time to video chat and catch up with those special people. Try your best to form relationships with those in your travel location as well whether it be at the gym, work, park, hiking trail, or cafe as it will add much more to your experience and well-being.

Travel Nursing: What’s That About?

“Oh, you’re a travel nurse? What’s that?”

That is typically how people or my patients respond when I first mention I’m a traveling nurse. At least once, I experience the following exchange with one of my patients while on assignment:

“So how long have you worked at XYZ Hospital?”

“To be honest, only a few weeks. I’ve been a nurse much longer than that – don’t worry. I’m actually a traveling nurse, so I’ll only be here a few months. You’re in great hands though because the people here are wonderful.”

From there, it sparks people’s interest. Some claim that they could tell that I “wasn’t from around here” or “[they] couldn’t tell because you blend right in” or “[they] knew it because of your accent” or “Wait, but, you don’t even have a New Jersey accent” or a combination of the above. Eventually, the conversation moves away from me and moves towards what travel nursing entails. Below is typically how I would explain it, with further details.

What is Travel Nursing?

I usually tell them that travel nursing is like the “band-aid” of nurse staffing issues. When a hospital has a problem with fully staffing a unit or units, they often utilize contract workers for temporary positions until they can resolve the shortage. Per Diem (or in-house, as needed) positions won’t entirely be sufficient because many times they aren’t required to work as much as the hospital might need in their particular situation. They also can’t force staff to work overtime to meet their needs. Travelers offer that little time-out to alleviate the pressure. We are nurses that bounce from place to place in order to meet the needs of the facilities and the communities they serve for a period of time.

When Do Facilities Need Travel Nurses?

Most times, there’s no crisis on the horizon. When someone retires or transfers, they have to fill that position of the retiree. If they have trouble doing so, and the unit was already tight, they might go ahead and get some help in the meantime until a qualified candidate comes along. When they find that qualified candidate (full-time), it takes some time to train him/her (up to 6 months). During this orientation period, you generally tie up two nurses, the nurse doing the training and the trainee. Orientation periods for traveling nurses are usually much briefer, and in my experience, last no more than one week. As a result, a traveling nurse carries a smaller opportunity cost than a full-time candidate, resulting in a more reasonable “quick fix” in tight staffing situations.

Other times, these facilities have good staffing, but there has been a sudden rise in a number of patients staying at the hospital. This is most common in the winter months due to the flu and the colder weather making those with respiratory issues more susceptible to becoming sick. These contracts can be a little longer due to the patient surplus, rather than staffing inadequacies. For example, if they hire a full-time candidate for a temporary problem, then the hospital could be wasting time and resources because, at this point, the hospital will be overstaffed once the winter is over.

How Does a Nurse Find the Right Facility?

That’s a great question. The facility has identified that they require a number of nurses to meet their needs. Now they need to find those nurses. This is where staffing agencies come in.

Staffing agencies work as middlemen for both the facility and the nurse. They put nurses who are in need of jobs in front of hospitals in need of nurses. They are very important in this whole process. These agencies do a lot of behind the scenes work. They maintain relationships with facilities and their staffing personnel, ensure credentials are up to date, manage payroll, find viable positions, help with housing (if needed), and many more things. Sometimes, facilities have exclusive relationships with companies called vendors. If the vendors are unable to adequately staff the needs with their own nurses, they will open up the contract to other companies in order to fill the need. The relationships of all the parties in the process are shown below:

Capture 1.PNG

I recommend you find an agency and recruiter you are comfortable with and that meshes well with your values and personality.  It’s not uncommon to work with more than one agency at a time while you’re looking for a job, however. Sometimes the agency you’ve worked with doesn’t have access to the contract that you really want. In those cases, it’s important to have eyes out there looking for potential jobs for you. That’s not to say there’s no loyalty, but this is your livelihood. Some recruiters will try to make you feel bad for working for someone else on a contract, but that’s all the more reason to leave. Nothing in these work relationships should ever be driven by personal reasons. As long as you are transparent with all parties involved and professional, then there should be no reason to worry. Remember: YOU are your greatest asset.

How Does Pay Work?

Remember back to when we discussed that the facilities reach out to these agencies and vendors? They also name what they’re willing to pay in regards to specialty, experience, and availability. When the agencies receive these pay rates, they reach out to their nurses and let them know what these facilities are offering in exchange for their care. If it’s a good fit, then the contract is drafted and signed. When thinking about contracts, it’s important to remember that the Facility/Agency contract and Agency/Nurse contract are different entities. When it comes to pay, the facility pays the agency, then the agency pays the traveler, following a similar pattern to the relationship pictured earlier. However, since these agencies offer their services, there’s obviously a portion that is deducted as a service fee. Some companies structure it in a way that is a percentage of the total contract and others set it up as a flat fee for a contract, regardless the size of the total package.

Some new travelers tend to get upset about these cuts, stating things like “But I’m the one who is making them their money. I’m the one on the unit. I’m the nurse. I should get all of it.” In reality, that’s just being greedy, and without the help of these agencies, we wouldn’t have jobs. Also, think back to the services they provide. They offer a service and deliver their service. As far as I’m concerned, what’s fair is fair. I understand that there are profits that the company must make and goals to meet. As long as I take home my fair share, it’s more than fine with me. I understand that there are many people involved long before I ever step foot in the hospital. Just to name a few, there are recruiters, managers, compliance coordinators, salespersons, and things like rent and utilities. It’s very important to understand that it’s very much a mutual relationship where we both benefit.

From the bit that gets taken out by the agency (and possibly vendor), the rest is for the nurse (and government in taxes). The goal is to have the least amount of taxable income possible so that you can take home as much as possible and pay the least taxes as legally possible. There are a lot of tax implications (and I am not a CPA), but the basic rule of thumb is that you need to have duplicated expenses of living at home and on the road in order to receive tax-free stipends (please see TravelTax.com for more).

To better illustrate, please see the image below:

pie chart

Please keep in mind that this is a VERY rough estimate and that there are many variables, including contract specifics, the business model of agency, presence of vendor, qualification of tax-free stipends, etc.  I promise to go in more depth on the breakdown of pay in later posts.

Key Points

  • Travel Nurses aid in the management of staffing issues in temporary positions
  • The Nurse/Agency relationship is important when landing a contract
  • Facility pays the agency who in turn pays the traveler