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It’s no secret that nursing pay, and pay for healthcare professionals in general, shifted dramatically from 2019 until present, 2023. For example, travel nursing pay rose dramatically during the pandemic and is declining dramatically as the pandemic wanes.
I recently had the pleasure of discussing the issue of healthcare pay with Zach Smith, RN, BSN. Zach is the VP of brand at Stability Healthcare, one of the nation’s leading healthcare staffing companies. Zach and I dove deep into the complexities of nursing pay and adjacent issues in the healthcare staffing industry. Zach’s expertise comes from his extensive nursing and business experience. With this unique perspective, Zach provides a wealth of insights into the current state and future directions of nursing and healthcare careers in general. In this article, we’ll summarize this insightful conversation and provide links to video and podcast versions for your convenience.
Before diving in, I want to highlight Stability Healthcare, which Zach represents. With its inception in 2009, Stability Healthcare stands out in the industry for its beautiful website and seamless experience. They’re a true leader among their peers. They blend cutting-edge technology with a personal touch to provide world class service that others rarely achieve in this industry. As a result, they consistently achieve high rankings on our annual list of the best travel nursing companies. This is a testament to their exceptional service and it’s backed by reviews from numerous healthcare professionals.
“My journey from bedside nursing to the business side has been enlightening,” Zach shared as he discussed his transition from hands-on care to advocating for nurses at Stability Healthcare. This segment of our discussion highlighted the critical need for nursing perspectives in decision-making roles at healthcare organizations. Essentially, having someone who understands the front lines involved in shaping policies and practices in healthcare companies has immense benefits for all stakeholders.
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Delving deeper, Zach explained how his experiences as a nurse have informed his approach to addressing the challenges faced by healthcare workers, particularly in terms of work-life balance and job satisfaction. He emphasized the need for healthcare organizations to listen to their healthcare providers in order to create more empathetic and effective policies. Zach also discussed how Stability Healthcare leverages his nursing insights to enhance their services. In doing so, they ensure that their offerings are not just beneficial but also practically applicable to the day-to-day realities of nursing.
We next discussed the pay rate disparities between permanent staff and travelers. Zach observed, “We’re still splitting up the same workforce pie.” He emphasized how the pandemic caused inflation in travel nursing pay. On the one hand, we had the obvious patient census increase which spiked the need for healthcare professionals. Meanwhile, the federal government alone pumped nearly $200 billion to healthcare organizations during that time.
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Next, Zach described the post-pandemic shifts in pay rates. Travel nursing pay has decreased as census normalizes and government funding dries up. Meanwhile, pay for permanent staff appears to be trending up. I pointed out that Kaiser workers recently won a 21% pay increase over 4 years and protective terms around subcontracting and outsourcing from a recent strike.
Further, Zach delved into how these pay disparities have evolved over time, discussing the impact of supply and demand on nursing salaries. He highlighted that while travel nurses often receive higher pay due to their flexibility, willingness to relocate and need to pay for duplicate expenses like housing, this discrepancy can sometimes lead to tensions within the healthcare workforce. To address this, Zach suggested that hospitals and healthcare institutions need to develop more transparent and equitable pay structures that recognize the unique contributions of both permanent and travel nurses.
“It’s about linking arms and standing together,” Zach emphasized the power of collective action. His perspective on the effectiveness of strikes and unity among healthcare workers, regardless of their roles, resonated deeply. He advocated for understanding and mutual support across the healthcare spectrum, highlighting the common challenges faced by all. Expanding on this, Zach discussed the importance of creating environments where healthcare workers feel valued and heard. He mentioned how vital it is for healthcare institutions to foster a culture of collaboration and respect, where differences are not just tolerated but celebrated. Zach also touched upon the importance of mental health support for healthcare workers, advocating for resources and programs that address the emotional and psychological stresses of the job.
Zach reflected on the challenges hospitals face in staffing and technology, saying, “Hospitals are not technology companies; they struggle with modernization.” His insights into the resistance to technological innovation and the need for systems supporting flexibility revealed the hurdles in adapting to the evolving demands of healthcare. Zach further explained how this resistance often stems from a lack of understanding of the potential benefits of technology in streamlining operations and improving patient care. He argued for a more proactive approach towards technology adoption in healthcare, suggesting that hospitals partner with tech companies to develop solutions that are tailored to the unique needs of the healthcare industry. Zach also highlighted the potential of data analytics and AI in enhancing patient care and reducing the administrative burden on healthcare workers.
“Nurses and healthcare workers want flexibility,” Zach stated. He highlighted the critical need for varied roles and schedules to sustain healthcare workers’ well-being. Although he noted a lack of optimism about hospitals’ current capabilities, he called for a paradigm shift towards more innovative and flexible solutions. Zach elaborated on the different forms flexibility could take, such as offering part-time positions, remote work options for administrative roles, and flexible shift patterns. He stressed the importance of healthcare institutions recognizing the diverse needs and life circumstances of their staff. By providing more flexible working conditions, Zach argued, healthcare providers can not only reduce burnout but also attract and retain a more diverse and talented workforce.
On the topic of per diem marketplaces, Zach explained, “The challenge is balancing opportunities with available staff.” He outlined the difficulties in creating a functional per diem marketplace, discussing the need for a balance between shift availability and the qualifications and availability of staff. His insights pointed to the potential benefits and the significant challenges in this endeavor. Zach went on to discuss how a successful per diem marketplace could revolutionize the way healthcare staffing is managed, offering more autonomy to healthcare workers and helping facilities manage staffing shortages more effectively. He also touched upon the technological and logistical hurdles that need to be overcome, such as creating a user-friendly platform that
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In wrapping up our enlightening conversation, it’s clear that Stability Healthcare is not just about innovative technology. Their commitment to maintaining a personal touch in an ever-evolving industry sets them apart. This blend of technology and human connection is what places them at the forefront, as evidenced by their high rankings and positive reviews from healthcare professionals. For anyone interested in exploring what Stability Healthcare offers, I highly recommend visiting stabilityhealthcare.com. My heartfelt thanks to Zach for joining us and sharing such valuable insights. His expertise has undoubtedly shed light on many aspects of the nursing profession, offering guidance and perspective in these changing times.
The post Navigating the Shifting Tides of Nursing Pay: A Conversation with Zach Smith appeared first on BluePipes Blog.
Hey everyone. Welcome to the truth about travel nursing podcast. My name is Kyle Schmidt and I’m your host. This is episode 40 and we have another amazing guest with us today. We are joined today by Ryan Sendow. Ryan is an experienced travel nurse who specializes in psych. He’s currently taking some time off to focus on completing a Nurse Practitioner Program. He’s also the owner or operator of two very intriguing social media accounts that you will definitely want to follow. One is on Instagram and the other is on snapchat. They are both referred to as “Travel Nurse Takeover”. I can’t wait for you to hear about these unique and inspiring social media accounts and find out how you can benefit from them and even contribute to them which is what makes them really so awesome.
But first I want to get a little housecleaning out of the way. As you know, this is episode 40 of the podcast. I want to make sure that you’re aware that the first 38 episodes of the podcast are what are commonly referred to as evergreen content. That’s a fancy way of saying that they aren’t based on current events; that they’ll most likely always be relevant and useful.
The reason is that the first 38 episodes deal almost exclusively with the business of being a travel health care professional. Things like how to find housing how to evaluate pay packages. Tips for finding companies extra time pay rates and much more. So I highly recommend starting at episode 1 and listening from oldest to newest. Trust me there’s tons of great information to help you get the most out of your travel health care career.
Second, I want to invite you to connect with me and with BluePipes on social media. You can find me on Facebook at Facebook.com/kylebluepipes, that’s Facebook.com/kylebluepipes. Send me a friend request I promise to accept it. Of course, you can connect with BluePipes on Facebook at facebook.com/bluepipesinc. That’s facebook.com/bluepipesinc. And on Instagram @bluepipesinc. It’s really one of the best ways to get all of our new content and you know hear about everything that’s going on in our world.
OK, so Ryan, thank you again so much for joining us. Take us back to the beginning and let us know how you got started in travel nursing.
[Ryan] Yeah. Hey guys. Hi listeners. Thank you Kyle for having me on the show. I appreciate it. As far as getting started in travel nursing, I just knew when I was a nursing school that I wanted to do some traveling. I grew up in Michigan for 26 years and when I was 24 years old I wanted to travel and I was ready to get out. I didn’t do much traveling growing up. I came from a poor family. So we didn’t do much traveling so I just knew that I wanted to get out and explore the country a little bit more. And that’s kind of how I started. I didn’t know any travel nurses at the time. Everyone at my nursing school, no one really knew about travel nursing, and the more I looked into it, it was really intriguing to me.
So it really helped me motivate myself in nursing school to know that there will be an opportunity to travel. That my job would afford me to explore the country a bit more and get paid a little bit more. Obviously it was a positive as well. So there was a lot of different factors and I was really excited when I started out in nursing with the intention to become a travel nurse.
[Kyle] That’s great. That’s great. So you mentioned that you were in that you grew up in Michigan did you. What part of Michigan did you grow up in.
[Ryan] I grew up in the metro Detroit area.
[Kyle] Ok. OK. So that’s a big it’s a big city.
[Ryan] Yeah yeah I I love it here. Actually it was when I was growing out to be. To be honest I was like Man I can’t I can’t wait to get out of Michigan. But after traveling I actually appreciate Michigan a lot more. And that’s what’s kind of cool about traveling nurses is that I think you start having appreciative appreciation to where you came and where you.
Travel Nurse Takeover on Instagram
Travel Nurse Takeover on Facebook
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Hey everyone welcome to the truth about travel nursing podcast. My name is Kyle Schmidt. I’m your host and this is Episode 39 of the podcast. This is a very special episode because we have our very first guest. That’s right. Up until now it’s been just me bloviating into this microphone by myself so I’m certain you’re as excited as I am to have a fresh new voice to help us branch out.
And we have a very amazing first guest. We’re joined by Alex McCoy. Alex is a pediatric travel nurse. She runs a website called FitTravelLife.net. That’s FitTravelLife.net. It’s a website where she shares her personal passion for food fitness and travel. One of the website’s goals is to help you stay fit and healthy while you’re on the road which, as I’m sure you know, is actually a really difficult thing to do. Again that’s FitTravelLife.net. She is also the admin of the Fit Travel Life Facebook group. This is a Facebook group for healthcare travelers to connect, support and encourage each other on their health and fitness journey. So, you can find the Facebook group at Facebook.com/groups/fittravellife. Alex, thank you so much for joining us and welcome to the show. How did you get started in travel nursing? Take us back to the beginning.
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Hey Kyle! Thanks so much for having me. I’m super excited to be your very first guest and excited to be on the podcast. So I started traveling a little over two and a half years ago. Initially I was close to home. My husband was finishing grad school and it was more for financial reasons than anything else at the time. And then once he graduated in May of 2017, he’s a physical therapist, we were able to travel together. I do pediatric travel or pediatric Med Surg. We’ve been to Phoenix, Wisconsin, Seattle, Georgia and then I’ve traveled quite a bit around the state of Missouri where I’m from as well. So it’s been a really great experience. We’re very lucky that both of us get to travel together that we both have careers that can work together in that way. It’s just been a lot of fun. I really, really enjoy it and I enjoy learning about the different facilities and how different places do things. I feel like as a nurse I’ve really grown as a traveler so it’s been great.
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Hey everyone, welcome to the truth about travel nursing podcast. Thank you so much for joining us for episode 38 of the podcast. In this episode, we’re going to take a look at the state of the travel nursing job market in 2017. We’re looking at this topic because there is a lot of talk out there that the job market for travel healthcare professionals is slack. That means there are fewer jobs…or the ratio of candidates to jobs is higher now than it was last year.
Just yesterday, I saw a post on social media from a recruiter that said, “ER job posted 2 hours ago and filled in less than that! That’s how things are working right now.” Many travel nurses chimed in to express their frustration with finding jobs. And, as always, there is no shortage of speculation as to what’s going on.
So, in this episode, we’re going to discuss the travel nursing job market and take a look at the possible causes of the newfound slackness in the market. For those that aren’t aware, when the job market is hot and there are more jobs than candidates, we call that a tight labor market. When there are few jobs to candidates we call that slack labor market.
I’ll let you know in advance, for clarity, that my personal belief is that there are a number of factors contributing to the slowness. Some of the factors may be weighing more heavily on the market than others, but I don’t believe that there is any one thing that’s causing the slowness.
Now, this episode is going to be a little different. That’s because I already wrote an entire blog post about this topic back in July of 2017. However, articles like that don’t get very many views. People aren’t searching Google for “travel nursing job market”. If you di, our articles would come up, but people just don’t search for that stuff. And social media is fleeting. So unless something goes viral, an article might get a few hundred views on social media.
So, I’m going to share that article laced with some additional commentary on this podcast. Trust me, this is going to be very interesting. I promise that you’ll discover a lot of helpful information in this episode.
But, before I begin I want to share a great opportunity with you if you are attending the traveler’s conference in Las Vegas this year. The conference is actually just a few days away from the launch of this episode. And if you not familiar, The Travelers Conference as it’s called is held annually in Las Vegas. It’s a great way to meet fellow travelers and network with agencies and recruiters. And trust me, you will learn a lot if you attend. There are tons of helpful classes and presentations. It really is an amazing event. I highly recommend it. You can learn more at travelersconference.com, that’s travelersconference.com.
Anyway, at this year’s event, TRS Healthcare is hosting an after-party on day one of the conference, which is Monday, September 18. The party starts at 7pm at the RockHouse located in The Venetian. They’re going to be buying drinks and auctioning off a Cruise for 2.
All you have to do is stop by their booth, which is number 219, to pick up your invitation. You must have an invitation to get drinks and be entered in the drawing to win the cruise for 2. Now, think about this. There are only going to be a couple of hundred people in this drawing…so you’re chances of winning are much higher than they are for typical drawings like this. I mean, typically a cruise for 2 would have thousands of entrants.
Plus, I think you’re going to love TRS Healthcare. This company was founded by an RN who really is an inspiration. I mean, their Marketing Director wrote an article discussing her story for our blog and I was seriously choked up and inspired. No joke, seriously. If you want to read that article, go to blog.bluepipes.com/trs.
Trust me, these are great folks at TRS Healthcare. In fact, they are routinely ranked as one of the top 20 companies on the main travel nursing rating websites. They’re honest and straightforward. And they definitely take care of their employees. So be sure to check them out the traveler’s conference. That’s TRS Healthcare at booth 219.
Okay, so let’s dive into this article on the travel nursing job market. I’m pretty much just going to read it and interject here and there with some additional commentary where pertinent. Here we go:
You can read the full article here.
Okay, so that’s the end of the article. Again, just to reiterate, both AMN and Cross Country have had their quarterly earnings conference calls since the publication of the article we discussed. And both reported experiencing similar trends. That is, job orders are down, the number of MSP contracts is increasing, their fill rates are up, and prices are up. That said, both companies expressed their belief that the decline in job orders is not a long-term concern.
Now, after we published the article, we received a number of inquiries asking us if we thought it was best for travel nurses to simply work with these large companies. The idea being that if these companies are shielded from downturns, then won’t the travelers who work with them be shielded from downturns?
I think it’s a little bit more complicated than that. First, that strategy has limitations, right? If everyone did that, then there would be no advantage at some point. Essentially, those companies would end up with a glut of travelers and not be able to staff them all.
Second, as we at BluePipes always recommend, you have to work with multiple companies no matter what you do IF you want to get maximum exposure to the job market. Even the big companies don’t have access to all the jobs. In fact, they typically don’t play nice with one another. So AMN is staffing orders for Cross Country and vice versa.
Moreover, there are many companies in the MSP game. While AMN and Cross Country are among the largest, there are a number of other companies out there doing the same thing.
Finally, you have to consider whether or not you want to deal with the differences in service and pay that you’ll experience when you work with the larger companies. As I’ve said before, I am personally inclined to believe that the larger companies are providing great service. How would they be where they are if they provided horrible service? But, and this is a big but, they are routinely rated poorly across almost every rating platform. And you routinely see travelers complaining about poor service and lower pay from them on social media. That’s hard to argue with.
At the end of the day, operating successfully in a market like this requires you to be nimble, flexible and ready to go. That’s one of the main reasons we created BluePipes…to help you manage your career more effectively and efficiently. The platform helps you manage your career documentation and communicate with agencies and recruiters without compromising your contact information to the entire industry. I mean, if you’re looking for a job, just go to BluePipes and update your job availability settings. You’ll have 10 to 20 recruiters contacting you through our platform within a matter of days. And they’ll conduct your job search for you so you don’t waste a bunch of time.
Okay, so, It’ll be very interesting to see how things play out over the next 6 to 12 months, and we’ll keep you posted via our blog and podcast, so be sure to check back with us.
Also, be sure to check out TRS Healthcare. If you’re headed to the travelers conference, stop by booth 219 and get your invitation to their after-party. And get entered into that drawing to win a cruise for 2. If you’re not going to the conference and then visit them at trshealthcare.com, that’s trshealthcare.com
Okay, that’s it for this episode. You can check out the show notes at blog.bluepipes.com/episode38, that’s blog.bluepipes.com/episode38. We’ll link to the article we discussed and some helpful resources there. So until next time, have a safe and prosperous travel healthcare adventure.
Links:
Why TRS Healthcare Supports The Travelers Conference
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Hey everyone. Welcome to The Truth About Travel Nursing Podcast. My name Is Kyle Schmidt and I’m your host. Thank you so much for joining me for episode 37 of the podcast!
In this episode, we’re going to take a detailed look at Guaranteed Hours in travel nursing. Now, I know what you’re thinking. How we could we possibly spend an entire episode discussing guaranteed hours. I mean, it’s cut and dry. The hours are guaranteed! [Please note that this is a transcript of a podcast episode. As such, grammar and spelling are not optimized for written content.]
Not so fast. Unfortunately, it’s not that simple. Like many things in travel nursing, there are nuances and various scenarios that can make this a convoluted topic. So, we’re going to cover Guaranteed Hours in detail so you don’t get caught off guard and you can approach this issue with confidence.
Now, before we get started I want to cover a couple of unrelated topics really quick. First, it’s been nearly 2 years since our last episode! That’s a long freaking time. If you’re like me, then you hate it when podcasts just suddenly go dark on you. I always told myself I would never do that. And then I did it!
Now I know why or how it happens. That is no excuse though. So, my sincerest apologies for going dark. Moving forward, we’re probably not going to produce podcasts on a routine basis. I simply don’t have the time to produce them regularly. However, I promise to produce them more than once every 2 years! I should be able to clear that bar.
The second thing I wanted to let you know about is an amazing offer from Valley Healthcare Staffing to get your California RN License by endorsement. They are currently running a program through November 30 2017 where they will pay for your roundtrip flight out to California, lodge you if necessary, and provide you with a concierge service to help you turn in all the required documentation to obtain Your California RN License.
Oh, and they’ll pay for the license too! Now, there are terms and conditions of course, but even those terms and conditions could be viewed as an amazing benefit to you! We’ll take a look at this amazing deal a little later in this podcast.
But now, let’s dive into to Guaranteed hours. First, what are guaranteed hours? On the surface, the obvious answer is that a certain number of hours are being guaranteed for the travel nurse to work during the course of a contract.
For example, recall that the standard travel nursing contract is for 13 weeks at 36 hours per week for a total of 468 hours. If the recruiter tells you the staffing company offers guaranteed hours, then you would expect the hospital to schedule you exactly in this fashion, right? You’d be scheduled for 36 hours each week for 13 weeks. And if the hospital scheduled you for fewer hours, then you’d get paid for the shortfall anyway.
That’s the gist of guaranteed hours and sort of the surface level expectation. As we’ll see a little later, it doesn’t always work that way. But first, it’s important to understand why guaranteed hours exist.
Here again, the fundamental answer is obvious. Guaranteed hours exist to ensure that the travel nurse can count on a certain number of hours on this contract. More importantly, they exist to ensure that the travel nurse can count on earning a certain amount of money on this contract.
I mean, the travel nurse is leaving their permanent job, and leaving their home. And the expectation is that the travel nurse is incurring duplicate expenses to maintain their tax-home. Therefore, the travel nurse needs a guarantee that this contract isn’t going to be a financial disaster for them. They need a way to evaluate that in advance.
The less obvious reason is that the healthcare staffing agency needs a guarantee too. It’s really expensive to recruit travel healthcare professionals. Honestly, it really is like finding a needle in a haystack. Agencies can easily spend over $1,000 on simply recruiting a candidate to submit for the position. So, agencies really don’t even want to take the initial steps if there isn’t a guarantee.
And then, once they’ve placed the candidate in a position, the agency is on the hook for a lot more. They need to credential the candidate, pay for travel expenses, potentially pay for housing, and a bunch of other fixed and variable costs.
So, at the end of the day, the guaranteed hours actually protect both the agency and the traveler against the possibility that the hospital games the system. It’s supposed to prevent the hospital from getting travelers out there and treating them like a PRN, registry, or on-call nurse.
The bottom line here is that both the agency and the traveler lose when shifts get cancelled. That said, I think it’s fair to say that the agency is in a better position than the traveler when it comes to their ability to avoid the cost of cancelled shifts. So, let’s take a look at how the whole guaranteed hours system works.
So, everything sort of starts with the contract between the agency and the hospital. As we’ve mentioned on this podcast before, agencies and hospitals enter into contracts that govern the terms of service between the two parties. One of those terms is the guaranteed hours policy.
These policies take several forms and there are a couple of layers to them as well. At the highest level, the guaranteed hours clause is going to cover exactly what’s being guaranteed. For example, some hospitals are willing to guarantee all the hours in a contract. Other hospitals are able to cancel up to three shifts during the course of a contract. Still others are able to cancel up to one shift per week. That’s a lot! The point is that there are many variations of what exactly is guaranteed.
The next layer deals with the guidelines for what actually qualifies as a breach of the guaranteed hours clause. For example, some hospitals have clauses that require travelers to float to another unit in order to qualify for the guaranteed hours. So, they may tell you that they don’t have a need in ICU and ask that you float to a StepDown unit or even to a MedSurg floor. If you don’t agree and they cancel your ICU shift, well then that doesn’t qualify as guaranteed hours according to the contract between the agency and hospital.
Another example is when the hospital is able to cancel a shift, but then offer you the option of making it up at a later date. Typically, the later date needs to during the same work week. However, sometimes is can be made up any time during the contract.
Hospitals sometimes have clauses that allow them to schedule or float you to one of the hospital system’s other hospitals. For example, I recall that Dignity Health hear in California had a clause that allowed them to send you to any of their hospitals within a 45 mile radius.
In one case, I worked with a traveler who was getting floated in the middle of his shift from one hospital to another. This poor guy was understandably miserable. It was on the night shift too! We did everything we could to get them to stop it. We ultimately found him a different contract and just bailed on that hospital. They weren’t happy with us, but that’s just not right.
Now, another such stipulation involves leaving shifts voluntarily. If the unit is slow one day and you’re asked if you’d like to leave and you agree, then that’s not going to violate the guaranteed hours policy. I don’t know if that sounds obvious, but I worked with a number of travelers who expected to get paid in that scenario. Unfortunately not.
Finally, guaranteed hours does not mean that the hospital can’t cancel your contract. So, if the hospital cancels the contract six weeks in, they’re not going to pay for the remaining 7 weeks. As I mentioned in episode 16, there is often a cancellation penalty of one to two weeks’ worth of billing, IF, they aren’t cancelling the contract for cause.
Okay, so different hospitals have different policies and there are all these little variables at play, so how do agencies handle it? Because, how the agency handles it is ultimately what’s going to affect you as the travel nurse.
And we have to consider the situation the agency is in. They have all these different contracts with Vendor Management Systems, Managed Service Providers and direct contracts with hospitals. Almost every one of them probably has a different guaranteed hours policy. So, if they want to accurately represent the hospital’s guaranteed hours policy in each contract they send to a travel nurse, then they’ve got their work cut out for them.
So, some agencies will simply guarantee the hours on their own. In other words, the agency will place a straight guarantee for all the hours in their contract between the agency and the nurse. Then, they’ll actually honor that clause no questions asked. If you get called off, they pay you, period.
Now, this sounds amazing on the surface and I honestly believe that it’s among the better ways of handling it. However, it’s pretty much a given that the agency is going to factor the losses they are bound to take on this policy into their pay rates. I mean, shifts are going to get cancelled and those costs can add up super-fast.
So, what does the agency do in this case? Well, they most likely factor a cost to cover this into a standard burden for every single contact. Essentially, it acts as sort of an insurance policy for all of their travelers.
Every traveler the agency works with has a little premium taken out of their pay package. Those who get cancelled are covered. And those who don’t get cancelled are simply paying in the off chance that they will get cancelled. It’s just like an insurance policy only it takes place behind the scenes.
The amount the agency takes out of every pay package is most likely based on their historical experience with cancellations. They’re going to try to hit that number as close to the mark as they can. If they go over the mark, then they run the risk of their pay package being a little less competitive than companies who don’t have this policy.
And once again, we’re back to our most important piece of advice regarding travel nursing contracts and pay packages. In order to accurately compare pay packages, you must consider every variable. In this case, if one agency is offering this type of guarantee, it doesn’t necessarily make it better or worth more. In this case, you’re going to need to decide whether or not this is worth it.
But again, as I mentioned above, I believe this is one of the better approaches for dealing with guaranteed hours. The exact opposite of this solution might be the worst way to deal with guaranteed hours.
You see, some companies will put an iron clad guaranteed hours clause in their contract, but then not live up to it when shifts get cancelled. This sucks because you’ve most likely done your due diligence to make sure the guaranteed hours clause is there. Then, you get cancelled and the company tells you, “Oops, we made a mistake. Actually, the contract with the hospital says they can cancel you…sorry!”
Now, this is really bad form. It really puts you in a bad spot and makes the agency look really bad. At the end of the day, there is really no excuse for this either. I mean, it’s possible that your recruiter doesn’t know this is possible. They may not have experienced it before. However, it’s not like the agency doesn’t know this is possible. They’ve most certainly dealt with the issue numerous times. And even if they’re a new agency, there’s still no excuse. They should know the terms of the contracts they sign and be prepared for dealing with it in a way that delivers good customer service to their travelers.
So, as I mentioned earlier, my personal belief is that the best way to do that is for the agency to offer an across the board guarantee to their travelers and then budget for the losses on the back end. Again, the risk is that their pay packages might be a little lower. Also, they may not budget properly. So, there are some other alternatives.
The first, and maybe most common, alternative is for the agency to match the guaranteed hours clause in the travel nurse’s contract with the guaranteed hours clause in the hospital’s contract. This isn’t exactly easy though. They’re most likely going to need to dig up a hospital contract, review the policy, and enter it into their contract with the travel nurse for every single contract.
Rest assured, if they do it this way, they’re bound to make a mistake or oversite at some point. However, they’ll get it right in the vast majority of cases. And this way, the travel nurse knows what the policy is and can make a decision as to whether or not they want to accept the contract.
Now, another option is for the staffing agency to offer the travel nurse a choice between a higher pay rate without guaranteed hours or a lower pay rate with guaranteed hours. Here again, as the travel nurse, you are essentially paying for an insurance policy to cover losses due to cancelled shifts.
This is a decent solution. The thing that I don’t like about it is that you as the travel nurse have no way of knowing what the guaranteed hours policy is for the hospital in question. If the hospital has a flat out guarantee, then there should be no reason for you to have to pay for anything. The hours are guaranteed. And on the flip side, the fewer hours that are actually guaranteed, the more advantageous this insurance policy could be for you because the hospital could potentially cancel more shifts. Hopefully, agencies that make these offers will let you know these details so you can make an informed decision.
So, you can see how the agency is in a better position to deal with the financial losses of cancelled shifts. They hold the cards in a sense. The have access to the contract between them and the hospital. They’re the ones who have control of the money. And they’re the ones who can choose which approach they’re going to use to deal with any issues that arise.
That’s just the nature of the game. It isn’t a judgment against agencies. As we’ve seen, there are many options that allow them to treat travelers fairly. It’s just a matter of whether or not they actually use those options. And the vast majority of companies will use one of the better options.
BluePipes: Professional Networking and Career Management Tools for Healthcare Professionals
So, what can you do as a travel nurse to ensure you’re covering all your bases on this issue? That’s what we want to talk about next. But first, I’m dying to tell you about this offer from Valley Healthcare Staffing to pay for your roundtrip flight to California and pay for your license fees to get your California RN license.
So, just a little background on getting your California RN license by endorsement. Several years ago, California was a walkthrough state. You could have your license the same day as long you submitted all the paperwork. Then, it was found that California had a large number of nurses practicing who had felonies and suspended licenses in other states.
California decided they needed to wait for the results of fingerprints and license checks in order to grant someone a license. You could still get your license pretty quickly if you showed up in person to do the Live-Scan fingerprints because these fingerprint results are received immediately.
But then, California decided to adopt a new software system for managing and tracking the licensing process. This system is called Breeze. Simply put, it was a complete disaster. Some people were waiting over 6 months to get their license. There were public hearings, an official investigation, I mean, it was bad.
And it’s still not very good. It’s not uncommon for it to take 9 to 12 weeks, or even longer, to get your California RN license issued. Showing up in person is still the quicker route. But if something happens to your application, it’s missing something, or there are questions, good freaking luck. They are so log jammed that it takes them weeks to inform you and you’ll have a really difficult time getting a hold of someone.
Now, I’m telling you all this because it’s part of what makes Valley Healthcare’s offer so special. You see, their offices are literally a stone’s throw away from the California Board of Nursing’s Office. They’re in the same business park. And Valley has been walking applications into the Board’s offices for years. They walk in on a weekly basis just to check on the progress of pending applications. They’re able to find out if there are any problems and address them immediately. Essentially your application gets guided through the process by Valley. This way, you should have your license within 6 weeks!
Again, they are going to pay for your round trip flight to Sacramento, pick you up and take you to their office, give you a meal, help you take care of all the paperwork, take you to the board of nursing, get all the paperwork turned in and pay for your license fee.
If your travel time is less than five hours, they’ll take you back to the airport so you can return home the same day. If your travel time is longer than 5 hours, they’ll get you a hotel room and take you to the airport the following day.
As I mentioned earlier, the offer has terms and conditions. I also said that the conditions could be viewed as a bonus. Well, that’s because the offer requires that you let Valley land you one of their over 1200 hot winter needs in California starting before December 31st.
I was able to view a list of these jobs. They’re hiring for over 20 specialties. 19 of the 20 specialties I viewed had pay package over $2,000 per week. Many of them were in excess of $2,300 per week. Plus, Valley has one of the best benefits packages in the business. You get day one United Health coverage, vision and dental coverage. And that’s United’s Silver plan, which is a higher level coverage than most agencies offer. Valley also reimburses your gym membership fees and offers a 401k with 5% match.
Now, it does require a little flexibility on your part but I think it’s well worth it to get this highly desirable RN license under your belt. California has over 10% of the nation’s population. It’s got more travel assignments than any other state and pays the highest rates. So, definitely check out this offer. Go to valleyrocks.com/bluepipes….that’s valleyrocks.com/blupipes. And remember, this deal won’t last forever. The offer expires November 30 2017. Again, go to valleyrocks.com/bluepipes and take advantage of this absolutely amazing program.
Okay, so let’s look at some of the steps travel nurses can take to protect themselves from issues pertaining to guaranteed hours…or the lack thereof. One of the common recommendations that a lot people make is to check with the manager about guaranteed hours during the interview. I have to tell you, I’m not a big fan of this approach.
It’s one thing to ask the Unit Manager about cancellations in general. Like, how often do travelers get cancelled? Are travelers cancelled first? That kind of stuff. But it’s something different to ask them what the guaranteed hours policy is. Many, if not most, unit managers do not know. It’s generally the purview of some bean-counter or administrator in the staffing office. So, asking the unit manager gives them some work do or forces them to tell you they don’t know. And I don’t think that’s a good thing.
Moreover, at the end of the day it doesn’t matter what the hospital’s policy is. You are going to be governed by the contract between you and the agency. The agency can put whatever they want in that contract.
Perhaps more importantly, it’s your agency’s job to deal with this issue, not yours! I guess at the end of the day, it’s fine to ask the unit manager. But ideally, you’ll already have that information before you go into the interview. The agency should be providing it upfront. So remember, always ask about the guaranteed hours policy for the hospital your recruiter is pitching.
Let your recruiter know that you know these policies can vary from hospital to hospital. That should at least get the recruiter to vocalize what the agency’s policy is. You can then tell them that you will expect them to adhere to that policy moving forward. If something happens and the agency doesn’t abide by the policy, then you’ll be able to reference this conversation.
Next, always check the contract. Never assume the guaranteed hours clause for one contract will be the same as it was for the last contract. As I mentioned earlier, some agencies will match their guaranteed hours clause to the hospital’s.
Moreover, I also recommend that you check for clauses regarding penalties for missed shifts. Now, missed shifts is a topic for another episode, but in general, many agencies have clauses allowing them to make pay deductions for missed shifts in order to cover the cost of things like housing, travel expenses and other fixed costs. You want to make sure that the term “missed shifts” is defined in a way that it cannot be construed to mean “cancelled shifts”.
You see, employers can make deductions from the paychecks of hourly paid employees if they have clearly defined the rules in their employment agreements. So, or goal here is to make sure that they aren’t able to deduct for cancelled shifts.
After doing all of this, you may still find yourself in a situation where you’re not getting paid for cancelled shifts despite the fact that your guaranteed hours clause indicates you should be getting paid. In fact, agencies may even try to deduct for the cost of things like company provided housing, medical insurance and other fixed costs. They’ll argue if you don’t work, then you don’t get paid.
If this happens to you, then your only course of action is to obtain legal assistance or file a complaint with the state’s labor board. The latter is probably easier and less costly. Unfortunately, it comes to this sometimes, albeit not often.
So, let’s finish up with an example from a travel nursing social media group. The following quote from a travel nurse is actually what inspired me to do this episode. The travel nurse said:
So i need opinions because I’m confused. Signed a contract with guaranteed hours, found out the contract my company signed with the hospital states i can be cancelled twice every two weeks. So my question is do i get paid if i don’t work since my contract says I’m guaranteed my hours? Because, they’re not paying me…
Now, I don’t want you guys to find yourself in this situation. So please, have these conversations with your recruiter in advance. That way, you’ll always be able to reference that conversation. Moreover, always check the contract to make sure At the end of the day, you’ll be able to rely on your contract to ensure you receive what’s been agreed to.
Okay, that’s it for this episode. I hope you found this discussion useful. I hope it saves you from headaches and confusion in the future. Again, please check out that amazing offer from Valley Healthcare and get your California license secured fast and for free…and land high paying job to boot…go to valleyrocks.com/bluepipes that’s valleyrocks.com/bluepipes.
Links
TTATN 016: Travel Nursing Contract Cancellations
Travel Nursing Pay – Choosing Between Guaranteed Hours or a Higher Rate
Travel Nursing Pay – Considerations for Guaranteed Hours
Travel Nursing Pay Video
The post TTATN 37: Travel Nursing Guaranteed Hours appeared first on BluePipes Blog.
Hello and welcome to another episode of The Truth About Travel Nursing Podcast. This is your host, Kyle Schmidt. Thank you so much for joining us for episode 36 of the podcast. In this episode, we’re going to discuss one of the most important aspects of travel healthcare, getting paid. Specifically, we’re going to discuss how payroll works, how and why paycheck errors occur, how you can resolve payroll errors and, better yet, how you can avoid paycheck errors altogether.
Now, if you’ve been a travel healthcare professional for very long, then there is a really good chance that you’ve encountered a paycheck error or at least some difficulty with payroll processing. I mean, I see it mentioned all the time in forums and on social media. In fact, here is a quote from one that I saw recently:
“I’ve spent 3 hours today trying to get my payroll situation straight with AMN. It’s still not straight. I’m over it!!!! This has truly ruined my travel nursing experience and I don’t think I will travel as a nurse again. I’d rather work at Walmart at this point!!!! Thanks for letting me vent!”
Now, to be fair, many of the responses to this post were from travelers who’ve been with AMN for long periods and have never experienced a payroll related problem. For example, one response was, “I traveled with AMN for 8 years and never had a payroll problem or any other problem either.”
The reason I chose this particular quote is because demonstrates that even the largest companies in the business experience problems related to payroll. And these are the companies that typically have the most advanced payroll systems, processes and procedures in place. I mean, say what you will about the largest companies in the business, but one thing is for sure, they got big by developing some excellent processes and procedures.
So, why do payroll errors occur so often in the travel healthcare industry and at all levels of the industry. Well, there are several factors that make processing payroll in the healthcare staffing industry both unique and complicated. So, let’s take a look at those first.
For starters, healthcare staffing companies are working with distributed workforces. “Distributed” is a fancy way of saying remote. In other words, the workers don’t come in physically to the office. They all work in remote locations. In fact, you will most likely never visit your travel healthcare agency’s offices.
Why is this important? Well, when a company is working with in-house staff, they are easily able to get all the documents they need completed properly. If there is a problem, they simply call the employee into the office and take care of the problem real time. And that goes for really any problem. If there is a problem with a timecard, they simply deal with it right there on the spot. If there is a problem with the direct deposit form that the employee filled out, again, they deal with that right there on the spot.
When workers are distributed, you need to contact them via telephone or email. So, they’re less accessible. And there is always a back and forth. For example, the worker might send the required form back, but it’s not complete, or there is an error. If the person is right there in the same room, everything can be taken care of on the spot. If not, then the form needs to be emailed again, contact needs to be made and so on. Basically, it just adds an extra layer of difficulty to the process.
Okay, so another issue to consider is that travel nursing companies aren’t really able to maintain truly standardized time reporting for their staff. This is because agencies are working with tons of different clients, all of whom have different processes and procedures of their own. Basically, we’re talking about the hospitals here.
Some hospitals start their work weeks on different days than others. Some hospitals use electronic time reporting systems like kronos or some other system. Other hospitals still use paper timecards. Some hospitals require travelers to get timecards signed by their unit manager and then make the travelers responsible for sending the timecards into the agency. Other hospitals require travelers to turn their timecards into the hospital’s staffing office which is then supposed to submit a report to the agency.
And let me tell you, some hospitals are the worst at getting time reported to the agency. I mean, some hospitals will get the time reported to the agency promptly on like Monday morning of the following week. And at other hospitals, agencies need to beat down the doors just to get someone to say that they’ll send them the time sheet…and it still may not get sent on time.
And here again, if you were on site working with the agency, then you would simply turn your timecard in and it would all be taken care of. Being remote means you can’t do that. And having the hospital involved in the process essentially adds a middleman that can cause all kinds of problems.
Also, all of these time reports are coming to the agency in a different format. Some reports come in excel spreadsheets, other reports come on the hospital’s timecard, some reports come on the agency’s own timecard. Some are handwritten, some are typed.
And they often break the hours down differently. For example, one hospital in California might record a 12 hour shift as 12 total hours while another hospital might record it as 8 regular hours and 4 overtime hours.
Now, another big issue to consider is that there is a pretty narrow window to get payroll processed. So, the typical work week is Sunday through Saturday, right? And the agency typically has until Wednesday to get all of the payroll details entered into their payroll processing system. It’s possible that they can get stuff entered on Thursday, but the absolute latest cutoff might be early Thursday afternoon.
And this is because the vast majority of agencies process their payroll using what’s known as an ACH transfer. ACH stands for Automated Clearing House. And this is a system that that processes transfers in batches as opposed to one at a time. It typically takes 1 to 3 days for an ACH transfer to hit the receiver’s account. And of course most agencies are going to use one of the big payroll processing companies like ADP or Paychex…so these services get these ACH transfers processed pretty quickly.
But, nonetheless, the point is that this pretty much gives the agency Monday, Tuesday and maybe Wednesday to get all the time cards reported in good order and get all the data entered into the payroll system to run the transfer in time for it to show up in your account by Friday. So again, this is one of the problems with working with all these different hospitals. Agencies really want to get these timecards as soon as they possibly can and sometimes hospitals just don’t care, so they lag.
Okay, so another thing to consider is that travel nursing pay packages are much more complicated than standard pay packages. And, of course, that complicates payroll processing. You know, travelers get an hourly base rate which is normal of course. But some travelers are in states that pay overtime after 8 hours in a day and others are in states that don’t pay daily overtime like this. So, payroll needs to get that entered properly.
And more importantly, travel pay includes all the tax free stipends. So, you have different travelers with different taxable hourly wages, different M&IE stipends, different lodging stipends, different travel stipends and on and on. And then there are penalties for missed shifts, and pay backs for makeup shifts. There are special rates for extra hours that are worked in addition to the contracted hours. There are bonuses and so on.
So, some of these payroll processing systems just aren’t equipped to deal with a lot of this stuff so it needs to be tracked and entered manually. I mean, at the end of the day, there are so many ways that errors can potentially be made…and that’s why there are generally more errors with travel nursing paychecks than there are with paychecks for other professions.
So, what can we do about it? How should we expect the agency to react and handle these issues? How can we ensure that we avoid these issues? And what can we do to ensure they get resolved quickly when they do happen?
I think the best place to start is with what we can expect out of agencies when these errors occur. Now, this is difficult to say but, it has to be said, when a payroll error is the traveler’s fault, then we’re pretty much going to be at the mercy of the agency. We really don’t have a leg to stand on. Sure, we can get another agency to work with on the next contract if the agency doesn’t take of the issue the way we want them to, but at the end of the day, we still wouldn’t be able to expect different results from the new agency.
That said, some agencies certainly do go above and beyond and totally resolve paycheck issues even when they are not the agency’s fault. But I think it’s fair to say that every agency would have its limits in this regard. So, let’s approach this issue with the mindset that travelers have to do their part to ensure that everything is taken care of on their end. And with that in mind, let’s take a look at some recommendations for avoiding and resolving payroll issues.
The first thing is to make sure that you know your pay package inside and out. You know exactly what you’re due and when it’s due. In fact, I always urge travelers to set calendar reminders for themselves to check and make sure that payments happen when and how they’re supposed to.
Now, I say this because payroll errors often get made without anybody noticing. I know that sounds crazy, but trust me, it happens a lot. And it goes both ways!
You know, I once had a traveler get an extra $700 a week for an entire 13 week contract. Basically, the setting for this traveler’s travel stipend got set as a weekly payment instead of a one-time payment. They never said anything and I never noticed it. And I could give hundreds of other stories like this, going both ways, from different travelers working with different agencies.
The point is that it’s really important to check your paychecks to make sure they’re correct. Set a calendar reminder to check for travel stipends when they’re due, your bonuses, any reimbursements you’re due, like if your company reimburses you for utilities at an apartment, and even check to make sure your extra-hours are paid correctly as well. Every paycheck should be scrutinized for accuracy.
Okay, so the next thing to do is to make sure that you adhere to the facility’s timecard policy. As I mentioned earlier, different facilities have different processes and procedures in place for time reporting. It’s really important to familiarize yourself with each facility’s process and follow the rules to a T. Failing to do so can result in paycheck errors and issues that your fault, so you’ll lose the upper hand in coming to a resolution.
Next, it’s also important to adhere to the agency’s time-card policy as well. I know it sounds crazy, but most agencies are going to have their own time reporting rules in addition to the rules that the hospital maintains. For example, some agencies might ask that you to call in or check in with your recruiter by a certain day each week to make sure that your timecard was received. Or, they might ask that you fax in a copy of your timesheet to them even if the hospital has said you don’t have to do that. Agencies typically have really good reasons for maintaining these policies and at the end of the day, they’re all intended to ensure that you get paid correctly and on time.
Now, that said, I actually always recommend that travelers keep a report of their own time whether the agency asks you to or not. And I also recommend that you send a copy of your own personal timecard to your recruiter on weekly basis and have them verify that they’ve received it.
To do this, ask your recruiter for a copy of the agency’s official timecard. Every agency has their own timecard. Make a bunch of copies to last you through the course of your contract. Each week, fill the timecard out thoroughly and simply use your phone to send a copy to your recruiter.
Take a picture and either email or fax it to them. Or, use a document scanning app like Camscanner to make a pdf and email it to your recruiter. You know, we discussed a bunch of apps for travel nurses in a blog post titled 59 apps for travel nurses and I’ll link to that blog post on the show notes page for this episode so that you can check out a bunch of document management apps for your phone.
Anyway, basically you’re going to get a copy of your own time card over to agency as early in the week as possible and verify that they received it. Of course, in some cases, this is going to be required anyway. And if it’s required, then you need to follow the rules provided by the agency. Again, I’m recommending that you send it in even when it’s not required.
And the reason is that it really helps to ensure that you get paid on time and correctly. As I mentioned earlier, hospitals can be really slow to get timecards over to your agency. Moreover, hospitals often send timecards over with mistakes on them. And it’s amazing how often those mistakes are in the hospitals favor, right? They always underreport hours.
So, having a record of time that comes straight from you helps the agency out in a couple of ways. First, they can match what you reported to what the hospital reported. If your report differs from what the hospital reported, then they should investigate the discrepancy and get it worked out.
Of course, without your time report, they might have no clue that there was a discrepancy in the first place. For example, maybe you worked an extra shift and it didn’t get reported on your timecard. The agency would receive a timecard that just looked normal, all the contracted hours had been worked. But with your timecard, they would be able to see the difference between what you reported and what the hospital reported.
Also, having a timecard from you will often help the agency collect a timecard from the hospital when the hospital is lagging. For example, when the agency doesn’t receive a timecard from the hospital, they will often contact the staffing office at the hospital or maybe even the vendor management service. The representatives there might give the agency the run-around. If the agency can say, “Hey, look, we’ve got a copy of the timecard right here, maybe we can fax it over to you to verify or get this taken care of.” I mean, that might be all it takes to get the VMS or the hospital to work things out.
And finally, some agencies will use your time card to make sure you get paid on time. So, if the hospital or the VMS fails to send the official timecard to the agency, then the agency may just take your timecard on good faith and get you paid. So, it’s a really good idea to keep your own time card. Also, hold on to them for a while in case you notice something fishy later down the road.
Okay, so the next thing I always recommend to ensure that you’re getting paid correctly and on time is to get a bank account with a national bank. And this really comes into play when you’re resolving paycheck issues. You know, a lot of travel nurses have bank accounts with small regional banks or credit unions. And personally, I live these banks. I mean, I’m all for supporting small local businesses and all that.
However, when you’re out there traveling, these banks can be a real pain. They tend to process electronic transfers of all types much more slowly than the larger banks. The sometimes have more stringent holding periods on deposited funds which means you won’t be able to access your funds as readily. And of course, they most likely won’t have branches in your travel locations or in your agency’s location. And we’ll discuss why that’s important in just a bit.
First, the next thing I recommend to ensure that you can get paycheck errors resolved quickly is to check for paycheck errors as early as possible. Basically, you want to figure out when your deposit typically hits your account. In most cases, the deposit will hit sometime late Thursday night or early Friday morning.
Now, the best case scenario is when the agency has an online system that you can log into to review your pay stub. This way, you’re able to see a breakdown of everything so you know exactly what’s going on. So, if your agency has one of these systems, then be sure to familiarize yourself with the functionality and how everything is displayed. Most agencies have these systems in place these days, so that’s a really good thing.
If your agency doesn’t have one of these systems, then you’ll need to check your deposit and try and figure out if the deposited amount is correct by either working backwards on your own or calling your recruiter to request a breakdown.
The reason that it’s so important to check your paycheck as early as possible is because it will give you enough time to deal with the issue with the maximum number of possible resolutions available. As you’ll see in a bit, some of the solutions that we’ll discuss have deadlines. And because paychecks usually get deposited on Fridays, missing the deadlines can mean that there isn’t a resolution available until Monday at the earliest.
Okay, so let’s talk about the possible solutions. You know, many agencies and recruiters will just act like there is nothing they can do. Again, if the error is your fault, then you don’t have a lot of leverage to get them to do something about it. But if the error is the agency’s fault, then I’m of the belief that they should do everything in their power to rectify the situation.
That said, many agencies still won’t do anything to rectify the problem. They’ll just act like there is nothing to do, like they’re powerless. The most common thing they say is that there is nothing they can do until they run they’re next payroll processing is run. For some agencies that’s weekly and for other agencies that’s every two weeks. This is where knowing about the options that are available can be really helpful for you.
One option is that they can request their payroll processing service to run an ACH transfer off schedule. Basically, the agency will fix everything they need to fix for you in their payroll system and they’ll send the request over to the processing service. There may be a fee involved, but it can be done.
As I mentioned earlier, these transfers typically take anywhere from 1 to 3 business days to post. It could be sooner, but that’s the norm. So, remember that if you need the money immediately.
Another option is a wire transfer. Wire transfers are a quick way to send cash from one account to another, but they’re a bit tedious and a little costly. Basically, you’d need to provide the agency with the wire instructions for your bank account. These instructions are typically the name of the bank, locations of your account branch, account number and the banks ABA number. The ABA number is a nine digit number and often called the routing number. Your agency would then call their bank and initiate the wire transfer for the amount you’re owed.
The cutoff for federal wire transfers is 4:30 pm pacific time, but some banks require that they be submitted and or received earlier for processing the same day. As long as the request is submitted on time, the funds will be available for your bank to deposit the same day. Different banks post them at different time, but the transfer should be posted to your account within 1 day. And, they’re federally guaranteed so there should be no hold periods on the funds.
One thing to know about wires is that banks often charge on both sides of the transaction. So, there is a cost for receiving them. You should make sure your agency covers this cost if it’s charged to you.
Okay, so your agency could also make a cash deposit to your account for you. In this case, they simply walk cash into a branch of your bank and make the deposit on your behalf. The funds are available immediately because it’s cash. Of course, this is one of the reasons it’s so nice to have a large national bank, they’ll almost certainly have branches in your agency’s city.
Alright, so another option is a cashier’s check. A cashier’s check can only be obtained from a bank and the money is guaranteed by the bank. So, they can often be easily cashed anywhere and they can be deposited without a hold.
Now, a money order is similar and it can be used as well. Money orders can be obtained in many locations including post offices and convenience stores. But they’re typically more expensive than a cashier’s check and the guarantee on the funds is only as good as the place it was obtained. So, banks typically put a hold on money orders. I’d recommend against them, but they’re an option nonetheless.
Alright, your agency could also cut a live a check for you. Essentially, they’ll just run all the numbers into their payroll system and instead of sending an ACH, they’ll just print a check and the corresponding pay stub. They can then deposit it to your account by walking it in to a local branch or they can overnight the check to you. Again, there will be a hold on the check in most cases, but it’s better than waiting 1 to 2 weeks to get your money.
Finally, the last set of options might be the best. Of course, there’s an app for that as saying goes. Basically, there are all kinds of amazingly easy and cheap ways to send people money now. The best services are Square Cash, Venmo, Google Wallet and Paypal. Each of them works a little differently. But they can all be used to send and receive cash quickly and easily. And we’ll link to all of these services on the show notes page as well.
I mean, personally I would recommend that all agencies get set up with one or all of these services. It’s a great way to ensure that your travelers are taken care of when payroll errors arise. Essentially, the agency can run the numbers into their payroll system to calculate the amount of what’s owed to you. Then, they can send that exact amount via one of these services. Then, they’ll offset the amount owed on the paycheck by the amount they send you, which in this case will zero out the check just as if it had been direct deposited.
Okay, so clearly you can see that there are tons of options for rectifying payroll errors that can be accomplished with minimal effort and cost. It’s just a matter of whether or not the agency is willing to do it. If you run into a situation where there is a payroll error caused by the agency and they’re giving you the run around, then toss all of these options out there to see if they’ll work with you. If they’re not willing to work with you, then it’s time to find a new agency in my opinion. I mean, all services, agencies or otherwise, should be chomping at the bit to make things right for their customers when the service is to blame.
Okay, so that’s a great place to wrap up this week’s episode. We’ve covered a ton about how why payroll errors happen so much in travel healthcare and how you can avoid them and resolve them when they do happen. I certainly hope you never run into this problem, but I hope the information comes in handy if you do run into a problem.
As always, we’ll have links to everything we discussed in the episode along with the transcript of the show up on the show note page. The link is blog.bluepipes.com/episode26. You can also leave any questions or comments there and I’ll gladly address them. While you’re there, be sure to join BluePipes and take advantage of all the networking and career management tools designed to help simplify your travel nursing career and your healthcare career in general!
If you’ve been enjoying this podcast, then I would greatly appreciate it if you would provide us with a review on whatever platform you’re listening through. Whether it’s iTunes or stitcher, it really goes a long way toward helping us move up in the rankings so we can get this information out to more travelers and keep the show going.
Again, thanks so much for listening and until next time, have a safe and prosperous travel healthcare adventure.
Payment Services
Square Cash
Venmo
Google Wallet
Paypal
59 Apps That Help Travel Nurses Simplify, Save Money and Have Fun
The post TTATN 036: How To Avoid And Resolve Travel Nursing Paycheck Errors appeared first on BluePipes Blog.
Hello everybody! Welcome to another episode of The Truth About Travel Nursing Podcast. This is your host, Kyle Schmidt, and I want to thank you so much for joining me for episode 35 of the podcast. In this episode we’re going to have a highly detailed discussion about a question that every travel nurse and potential travel nurse will ask at one point or another, “How much money do travel nurses make?”
Let me tell you, if this were almost any other industry, the answer to the question would be clear-cut and straightforward. We wouldn’t even have much of a conversation to have; we’d just look at some simple numbers and be done with it. But determining how much money travel nurses make is actually a really convoluted task. So, we’ll take a look at all the factors at play and then provide some breakdowns of some sample travel nursing pay packages to illustrate. I really think that this will help travelers and those interested in travel develop proper expectations so that they can make better decisions when it comes to pay packages and ultimately achieve a better grasp of their own personal finances.
Okay, so before we start, let’s take a quick look at some of the news from around the travel healthcare industry. For starters, in the beginning of October, 2015, which was a few weeks ago, Staffing Industry Analysts released a statement that they were revising their annual revenue estimates for the healthcare staffing industry. Now, the healthcare staffing industry includes everything from travel nursing, to locum tenens, to per diem nursing and everything else.
Anyway, they’re now saying that revenue is projected to grow by 17% in 2015 compared to 2014. And travel nursing is projected to lead the pack with 23% growth. And, just so you know, Staffing Industry Analysts estimated that the healthcare staffing industry generated about $10.5 billion to $11 billion in revenue in 2014. So, that would mean the industry would generate $12 billion to $13.5 billion in 2015. That’s a lot of revenue.
Alright, in other news, the mergers and acquisitions in the healthcare staffing space continue to add up. Cross Country Healthcare is purchasing a company called MediScan. They’re a company that’s involved in the traditional type of healthcare staffing that we’re all familiar with, which is staffing at the hospitals, but they’re also heavily involved with providing medical staff for public and charter schools. That’s a growing segment of the healthcare staffing industry and Cross Country is paying $33 million for MediScan, $28 million in cash and another $7 million worth of stock options. According to Cross Country, MediScan generates about $40 million in annual revenue.
Okay, so another interesting thing that happened last week was that the stocks of healthcare staffing companies had a real roller coaster ride. So, AMN was upgraded to a buy rating at Zacks. Of course, that spurs buying in the sector as a whole. But then, on Thursday, shares of AMN and the other healthcare staffing stocks plunged. AMN was down as much as 25% at one point.
Basically, what happened was that several hospitals, who are of course the customers of the healthcare staffing companies, all had some bad news surrounding them. Community Health Systems released revenue projections that were below estimates. Envision Healthcare Holdings released an earnings report that was below estimates. And Tenet Healthcare was downgraded by an analyst. So, investors got spooked thinking that negative news for all these hospital companies could lead to bad things down the road for the healthcare staffing agencies.
Now, the last piece of news I want to discuss doesn’t actually pertain to the healthcare staffing industry per se, but it does pertain to staffing. North Shore University Health System in the Chicago area has been using predictive analytics for on-demand healthcare staffing. So, basically, this system predicts the demand for staff 4 hours in advance. Of course, this has a huge impact on nurses who tend to be the ones most affected by this type of staffing. Essentially, you’re on-call with the hospital with 4 hours advance notice.
There was a quote in the article that I found a little amusing. Dr. Daniel Chertok, the senior data scientist for the hospital system, said, “Not all nurses are happy about on-demand scheduling.” I mean, are any nurses happy about on-demand scheduling? That sounds like an absolute nightmare to me. Anyway, these systems are of course designed to save money by helping the hospital staff at optimal levels at all times.
Okay, so as always, we’ll link to all of those stories in the show notes page if you’re interested in checking them out and doing additional research.
Alright, so let’s take a look at the question that’s on everyone’s mind at some point or another, “How much money do travel nurses make?” For starters, why is it that I contend that this is anything but a straightforward question. I mean, heck, I actually contend that this question is totally convoluted! Why is that?
Well, for starters, when someone asks the question, “How much money do travel nurses make?” their frame of reference for asking the question is permanent employment. In other words, when we ask this question, we’re looking to get a straightforward answer that we can then compare to something else. And that something else is invariably a permanent job.
For example, a nurse who’s interested in travel nursing might ask how much travel nurses make. And a recruiter or some healthcare staffing agency website might give them an answer like $75,000 a year 0r $100,000 a year. And the understandable tendency here is for the nurse to say, “Wow! That’s way more than I make at my permanent job!! Travel Nursing is awesome!!”
But in reality, travel nursing and travel healthcare in general, are so much different than permanent nursing. And many of these differences have a significant impact on the value of the travel nursing compensation package. And that’s a big part of what we’re going to discuss in this episode. What are these differences and how can we accurately determine how much these pay packages are actually worth relative to the permanent pay packages we’re all used to.
Okay, so before we go down that path, I want to take a quick look at some of the answers you’ll find across the internet to the question of how much travel nurses make. I think it’s important to look at these things because I want to make sure that you’re getting all the information available. But more importantly, I think that taking a look at these answers will help us discover how to interpret these things when they come up for us.
Alright, so the most common way for people to do research these days is to simply go to Google and search for what they’re looking for. So, if you were to go to Google and search for the term “travel nursing pay”, the first thing you’d see in the organic search results, below the ads, would be what Google calls a “Quick Answer Box” from the website TravelNursing.org.
So, just so that you know, a Quick Answer Box is when Google presents a snippet of information from a website that Google believes will provide an answer to the question you are asking. In this particular case, the answer is as follows. And this is the answer that Google is currently presenting as of October 2015, when we’re doing this podcast. Google’s search results may change, but it’s been like this for a well over a year now, so here it is:
“Regardless of location and specialty, you can often expect to make a travel nurse salary of about $75,000 a year, based on a 48 hour work year and average $40 an hour. And, of course, a travel nurse salary can even go up from there depending on location, specialty, and overtime pay.”
Now, again, this answer comes from TraveNursing.org. The website is a lead generator for the healthcare staffing industry. Remember, lead generators are in the business of getting people to enter their contact information so that it can be sold to third parties. Of course, this company has an incentive to make things sound totally wonderful and amazing…because they want you to enter your contact information. Now, Google obviously hasn’t figured that out yet, but they probably will eventually.
That said, we can’t conclude that the information is inaccurate just because the source has an agenda. And like I said, we’re going to take a detailed look at those inaccuracies in a bit. But for now, I just want to point out that the numbers in this statement don’t actually add up.
The annual salary is quoted at $75,000. But then they go on to say that it’s based on a 48 hour work year. I have no idea what a 48 hour work year is. But it also says that the average pay is $40 per hour. I cannot get these numbers add up any way I crunch them.
I mean, my assumption is that they meant a 48 week work year. And 48 weeks at 40 hours per week and $40 per hour comes out to $76,800. But it’s so rare for Registered Nurses to ever work 40 hour work weeks. You’re either working 48 or 36.
Anyway, another thing to note about this answer is that it makes it sound as though this is the absolute minimum you could expect to make. It says, “of course a travel nurse salary can even go up from there.” I mean, there is so much that isn’t being taken into consideration here. We’ll discuss what that is in a second. First, I want to take a quick look at some of the other answers.
So, Simply Hired says the average salary for travel nurse jobs is $55,000. Buzzle, which is a website that’s kind-of like about.com, says that new nurses can make $40,000 to $50,000 a year as travelers while experienced nurses can earn more than $90,000. 50 States Staffing, which is a subsidiary of Nightengale Nursing, says, “Traveling RN’s earn outstanding wages — far surpassing the *$64,000 median annual income in 2010 for nurses overall. Factor in the top salaries, 401(k), insurance, bonuses, free housing, travel allowance, free CEUs— and travel RN’s can make up to $100,000 annually.” And the last one I want to point out is from NurseChoice. They’re a subsidiary of American Mobile. They have an infographic on their site that says at an average of 48 hours per week for 48 weeks at $43 per hour, you’ll make $99,840 for the year.
Okay, so as you can see, there is a ton of disparity in these numbers. Now, the disparity is actually a good thing because there actually is quite a bit of disparity. It’s just not really for the reasons that are indicated. And more importantly, there are tons of factors that make travel nursing different than permanent nursing when it comes to determining how much travel nurses make. So, let’s take a detailed look at what’s going on here.
Okay, so, the first to consider when discussing how much travel nurses make is that travel nurses typically incur costs that permanent employees do not incur. Let’s take a look at some of these costs.
Perhaps the biggest cost that travel nurses will incur is the cost of their tax home. As we discussed in great detail in episode 18 of the podcast, one of the main way to qualify for the tax-free stipends that travel nursing companies pay is to incur fair market value costs associated with your declared tax home. Specifically, this means paying your mortgage or rent back at your tax-home. If you don’t do this, then it can be really difficult to maintain your status to qualify for the tax-free reimbursements offered by the agencies.
And of course, if you’re doing this, then it typically goes beyond just your mortgage or rent. There will be various bills you’ll need to pay, the water bill, perhaps the electricity bill and so on. You may also need to pay for landscaping and upkeep on the property.
So, the next cost associated with travel nursing contracts is the cost of traveling itself. You’re going to travel from one location to the next and you may even travel home any number of times during the course of a year. Whether you travel by plane, train or automobile, there will be costs involved. And the more times you travel the more the costs will rack up.
Another difference to consider between travel nursing and permanent pay packages is that most travel nursing jobs do not offer any paid time off or paid sick leave while most permanent jobs do. And this is actually really important when it comes to travel nursing because travelers often find themselves off of work for a week or two in between new assignments. Now, there are some cases when paid sick leave and/or paid time off are offered to travelers. In fact, paid sick leave is now required in the state of California. But, this is still something to be aware of, especially as it pertains to paid vacation which is really rare for travelers to receive.
Okay, so another potential cost to consider as a traveler is medical benefits. Many travelers opt to get their own medical benefits. This is because you could potentially change agencies pretty often in order to land the assignments you really want to work. Each time you change agencies, you’ll change medical insurance, so it could be pretty difficult to maintain continuity of care. And, in many cases, if you don’t take the medical benefits offered by the agency, then they might give you more money instead.
Okay, so another cost to consider is the cost of licenses, certifications, and clinical records like titers or physical exams. Most permanent employers cover the cost of these items. However, many travelers end up paying for these things out of their own pockets. And even if the agency pays for them, they almost always deduct the cost from the compensation package when they’re working out the pay package for the assignment.
Okay, so the last cost difference between permanent and travel nursing jobs that I want to point out is the cost that’s involved with the lower taxable wages that travel nursing pay packages typically offer. We’ve discussed this in detail before, but basically, the taxable hourly rate that you’re paid is what your social security payments and unemployment benefits are based off of when or if you need to use them. So, lower taxable wages means that less money is being paid into those coffers, which means less money will be paid out when the time comes. And, you know that’s not going to come out of your pocket right now; you’re not going to see that immediately. But I think it’s only fair to point it out because it can indeed end up being a cost you incur down the road.
Now, I can already hear the recruiters and agencies saying that they provide most of these things for free. And, you know, as I’ve discussed many times on the podcast, nothing is really free. If they’ll give you housing or money instead, then it’s not really free. More importantly, the cost of everything comes out of the bill rate for the assignment. But more importantly, the point here is that you really can’t add in the value of these things when someone is asking how much travel nurses make.
Again, that’s because the frame of reference that people are using when they ask that question is the pay package for a permanent job. And when you have a permanent, you’re not paying for two separate houses; you know…you get paid time off; the 401 k benefits are in addition to the salary you’re quoted, right?
And the point here is that this is what a lot of agencies and marketers do. I mean, go back to the statement from 50 states staffing earlier, they literally say:
“Factor in the top salaries, 401(k), insurance, bonuses, free housing, travel allowance, free CEUs— and travel RN’s can make up to $100,000 annually.”
Again, there are really two things going on here. First, we wouldn’t typically add the value of insurance and 401ks and stuff like that to permanent pay packages when we were quoting them. And second, some of these things like housing and travel allowances are actually additional costs, so it’s not really fair to add them to the value of the salary, or call them a part of what you stand to make as a travel nurse.
Now, all of that said, it’s certainly possible for travel nurses to make $100,000, or even more, in a year even after all of these costs have been factored in. But, this level of annual income is indeed the exception, not the rule for travel nurses. And there are a whole slew of other variables that go into whether or not this is possible. So, let’s take a look at those variables now.
Okay, so I think the biggest factor to consider when it comes to the annual pay potential of travelers is the state of the travel nursing job market. If the job market is really hot, like it is right now in 2015, then there are going to be many more assignments with crisis rates or rapid response rates. These are increased rates that hospitals are willing to pay because they’re in dire need of travelers. Hospitals are also going to be more prone to increasing their normal bill rates for a while too. And they’ll offer more assignments with completion bonuses.
And all of these things will increase the pay significantly. To give you an idea, according to one source I found on American Mobile’s website, the average bill rate for a travel nurse is $65 per hour. And that sounds about right to me given all the bill rates that I’ve seen in my day. But crisis rates and rapid response rates tend to be anywhere from $75 to $85 per hour and sometimes they can get to be over $100 per hour. Heck, I’ve seen some assignments advertised recently with blended pay rates of $94 per hour. I’m guessing the bill rate for that is at least $130 per hour.
Obviously, that has a huge impact on pay rates. But again, even in a hot job market, not every job is like this, there are just more of them. So, you can’t necessarily bank on these jobs for an entire year. It’s more reasonable to anticipate that you’ll get 3 to 6 months out of the year on these rates.
Okay, so the next thing to be aware of is that different specialties have different bill rates. We discussed this in episode 17 when we discussed bill rates, so we won’t go into great detail here. But the bottom line is that specialties like Med Surg, Psych, PostPartum, and Peds, tend to have lower bill rates, not by much, maybe $2 to $5 less per hour, but they’re lower nonetheless.
More importantly, some specialties tend to have more of the higher paying rapid response and crisis rate assignments. Specialties like L&D, NICU, and PICU tend to lead the way with ICU, ER and OR doing pretty well too. And it’s important to note that this is as a percentage of all the jobs for the specialty in question. So, for example, there might be more rapid response jobs for ICU than L&D total, but a higher percentage of L&D jobs might be rapid response.
Okay, so the next variable that affects how much travel nurses make is the location of the assignment. And this is kind-of a big one. Many nurses from places like Mississippi or Arkansas will see the standard pay rates out in California and think they can make a killing out there. But the cost of living is astronomical in most of California compared to the south. So, at the end of the day, this could ultimately be a wash and in some cases I had nurses tell me they saved more at home in Mississippi than they did on a travel assignment in California. So, that’s definitely something to watch out for, especially given the fact that a significant percentage of travel nursing jobs are in places like California, Washington State, New York and the Northeast.
Okay, so the last thing I want to touch on is that the number of work weeks you work in a year will greatly impact how much you make for the year. And this is really important for travel nurses because there is a really good chance that you’ll be switching jobs and or locations multiple times throughout the year. Each time, there may be travel involved that keeps you off of work for a week. Or your next assignment might not start for a week or two after the last assignment ends. So, you’re not getting paid those weeks.
You know, I worked with many travelers who had difficulty working for 48 weeks out of the year each year. And that’s understandable. You definitely want to have your planned vacations. And then there would be these gaps for travel from one assignment location to the next or because the new job had a later start date or even got pushed back. I mean, missing just 2 weeks like this could result in $3000 to $4000 less on an annual basis.
Okay, so with all of that in mind, let’s take a look at some numbers to get an idea of how much travel nurses make. The first set of numbers we’re going to look at comes straight from American Mobile. They have a web page where they’re marketing to potential client hospitals. On this page, they break down the cost of a permanent employee versus the cost of a travel nurse.
And they even provide the pay of they’re going to give to the travel nurse based on a bill rate of $65 per hour. They quote a pay rate of $35 per hour. Plus, they say they’re going to give the traveler health, dental and life benefits, housing 401k matching, and tuition reimbursement. They also say that they’re factoring in social security, workers comp, and unemployment costs as well as liability insurance, recruitment costs and other administrative costs. All of these items total $30 per hour.
Okay, so the main figure we have is $35 per hour. Now, for all the examples we discuss on this podcast, I’m going to assume that you’re able to work 48 weeks in the year. I wrote a blog post in which I assumed a 46 week year because I think that’s more realistic for most travelers. I’ll link to that blog post in the show notes and you can review it there if you’d like. But here, I’m going to use 48 weeks which is what all the marketers and agencies seem to prefer.
So, $35 per hour for 36 hours per week for 48 weeks is $60, 480. Now, it’s fair to say that a portion of that $35 pay rate is going to be the M&IE stipend. My experience is that AMN usually goes with $250 per week for M&IE. So, assuming that it’s a contract for 36 hours per week it is to $6.94 per hour. I’m pointing this out because we want to make an apples to apples comparison with permanent jobs and permanent jobs don’t give you tax free money. $250 per week for 48 weeks is $12,000. So, you’re not going to pay taxes on $12,000 of that income. If we assume a 25% tax bracket, that saves you $3,000 in taxes. Therefore, this would be like a permanent job that paid $63,480.
Okay, so remember that you’d need to pay for the expenses at your tax home and anything else. And of course, there is the rare instance in which you may not be paying taxes at a tax home year round, but instead only for a portion of the year. If that’s the case, then you can add the value of the housing to your annual pay. But my experience indicates that the vast majority of travelers are either paying for a tax home or they’re unfortunately not playing by the rules. I’m going to proceed as if you’re playing by the rules and that’s what all the agencies and marketers should be doing to.
In any case, you can see that the figure we’ve come to is much less than some of the figures that were advertised to travel nurses on various websites. I mean, even if we assumed that you were going to work 48 hours per week for 48 weeks, it would come to $80,640, which is about $19,000 less than advertised to travelers on nursechoice.com which is AMN’s subsidiary.
Okay, so that’s an example straight from AMN’s website. And while I’m sure it’s correct, my experience indicates that they’re being a little overly optimistic with the amount of the pay package they’re quoting. So, I’m going to breakdown a pay package based on a bill rate of $65 per hour that I think is more realistic. We’re going to work these numbers out for a standard contract of 36 hours per week for 13 weeks.
For starters, let’s take out the agency’s gross profit margin. As I’ve mentioned previously, these usually run between 20% and 25%. So, let’s use 20%. 20% of $65 is $13 per hour. So, right off the bat, we’re left with $52 per hour to work with.
Okay, next, I’m going to use a total cost of $4.95 per hour for some of the standard burdens and payroll costs. And here we’re talking about things like the non-billable orientation hours, liability insurance, licensing and credentialing costs, FICA payroll costs, and state disability, unemployment and worker’s compensation costs. Now, we discussed how to calculate these figures in episode 14 and we also have a detailed blog post about these costs that I’ll link to in the show notes. But for now, we’re just going to use this number for all our calculations. It can be off by a dollar or two per hour, but I think $4.95 is a pretty standard number to use for these costs.
Okay, so now we’re down to $47.05 per hour.
Next, let’s assume a travel stipend of $700. That’s $1.50 per hour, so we’re down to $45.55 left out of the $65 we started with.
Next, let’s factor in the cost of medical benefits. I’m going to use a fairly common cost for this variable of $350 per month. So, that’s $1050 for the entire 3 month contract which comes out to $2.24 per hour worked. That brings us down to $43.30 per hour.
Now, I’m going to stop here. In American Mobile’s example, they said they were paying the nurse $35 per hour. We’re at $43.30 already, so the difference is $8.30 per hour. Essentially, this is the amount that we have left to provide housing. So, $8.30 per hour at 468 total hours comes out to $3884 for the entire contract which is $1294 per month.
My experience is that housing is much more expensive than that. In fact, it’s pretty common for companies like American Mobile to offer at least $1500 for a housing stipend. And my experience is that it’s going to cost at least $2000 per month to secure a fully furnished 1 bedroom apartment that’s worth of a travel healthcare professional.
And that comes out to $12.82 per hour for housing. So, if we subtract that from the $43.30 we had, then we’re left with $30.47 per hour for the travel nurse’s pay. Now, I think that most travel nurses would say that this is a much more common offer that they here out there. That’s $30 to $31 per hour, plus company hosing or a $2000 monthly lodging stipend, plus a $700 travel stipend, plus medical benefits. And it doesn’t even include some of things that AMN included in their example, like 401k matching and tuition reimbursement.
In any case, at $31 per hour, we’re looking at annual pay of $53,568 if you worked 36 hours per week for 48 weeks. Again, this may be less or more depending on your situation with your expenses at your tax home.
Now, I’m going to run through the next examples much more quickly. Essentially, I’m going to keep all the same costs. $4.95 per for burdens and payroll costs, $1.50 per hour for the travel stipend, $2.24 per hour for medical benefits and $12.82 per hour for housing comes to $21.51 for those costs.
With that in mind, let’s look at a low end bill rate of $58 per hour. While this is low, it’s a pretty common rate in much of the country. Again, the first thing we’re going to do is subtract the agency’s gross profit margin. So, 20% of 58 is $11.60 per hour and we’re left with $46.40. Then, we subtract the $21.51 and we’re left with $24.89. Now, I’m sure that there are travel nurses out there who have been offered a rate of $24 to $25 per hour plus housing. This is how that happens, a bill rate of $58 per hour.
Now, to be fair, these bill rates are often in states that have cheaper housing costs. So the housing in these states might actually only cost around $1500 per month. That saves $500 that can be added to the pay rate which would bring the pay rate up by $3.20 per hour. So, we’re looking at $28.09 per hour if that’s the case.
So, in this example, the annual pay would be about $43,000 to $48,500.
Okay, so now let’s take a look at an assignment with a rapid response rate of $85 per hour. Again, we’re going to start by taking out the 20% gross profit margin. That’s $17 per hour, so we’re left with $68 per hour. Then, we subtract the cost $21.51 we’re using for our example and we’re left with $46.49 per hour for the pay package.
So, in this example, the annual pay would be $80,334 per hour.
Alright, so what does all this mean? Well, I think it’s fair to say that we really have to do some finagling with the numbers to arrive at some of the higher figures that are on found in the top search results served up by google and found elsewhere on the internet.
Now, it’s also possible that you can avoid the costs associated with maintaining duplicate expenses. Again though, that’s really difficult to do and I don’t think we should be advertising to folks who are the exception to the rule. It’s also possible that you’re able to save a bunch on housing by finding your own housing and pocketing the difference. But here again, that’s not necessarily what these marketers advertise, right? So, the whole point here is that the numbers that are widely cited are grossly oversimplified. Each person’s circumstances will be unique. But hopefully, this episode gives you an idea of how to approach the issue to that you’re not caught off guard.
Okay, so that’s a good place for us to wrap up this episode. As always, we’ll have the transcript of this episode up on the show notes page along with useful links to some of the stuff we discussed today. The show notes page will be found at blog.bluepipes.com/episode35.
While you’re there, be sure to join BluePipes and take advantage of all he amazing tools designed to help you manage your healthcare careers more effectively and efficiently. And for recruiters, remember, you can join for free to. BluePipes is a professional networking site like LinkedIn, so we don’t sell candidate contact information to recruiters or other third parties, but it’s a great way to build a professional network in the travel healthcare industry and the healthcare industry in general.
Of course, we always welcome your questions and comments about this topic on the show notes page as well. So please let us know if you think there is something we missed or if there are any questions you have by posting in the comments section at the bottom of the show notes page.
And again, thank you very much for listening. If you’ve been enjoying the podcast then we would greatly appreciate your providing us with a rating on whatever platform you’re listening on whether it be itunes or stitcher, or some other platform, the ratings really do go a long way towards helping us move up in the rankings so we can reach more listeners with actionable and helpful information. And a special thanks to those of you have already left ratings, I really do appreciate it so thanks.
Okay, until next time, have a safe and prosperous travel healthcare adventure.
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The post TTATN 035: What Is The Annual Salary Of A Travel Nurse? appeared first on BluePipes Blog.
Hey everyone! Welcome to The Truth About Travel Nursing Podcast. I’m your host, Kyle Schmidt, and I want to thank you so much for joining me for episode 34 of the podcast. In this episode, we’re going to take an in depth look at the General Services Administration Per Diem Tables. These are often called the GSA Tables, GSA being the acronym for the General Services Administration. These tables are commonly referred to by agencies and travelers alike when discussing the tax-free stipends that are a part of travel nursing pay packages.
More importantly, there is a lot of confusion and misinformation out there about what these tables are used for and exactly how they relate to the tax-free stipends. Also, there are a lot of little nuances and issues to be aware of with these tables especially as they relate to travel healthcare. And while we’ve touched on this issue in previous episodes, again, in this episode we’ll go into detail so that you can approach this issue with confidence.
Okay, before we get into that, let’s take a quick look at some news around the travel healthcare industry. For starters, AMN Healthcare, which is commonly referred to as American Mobile, has recently completed a couple of purchases. They completed the purchase of MillicanSolutions which is a physician and medical leadership search firm focused on academic medical centers and children’s hospitals. That acquisition included cash payments totaling $4 million.
They also completed the purchase of a company called The First String Healthcare. This company provides temporary and perm placement of nurse leaders and executives. They were purchased for $6.5 million and additional incentives of up to $4 million.
Meanwhile, Susan Salka, who is the CEO and President of American Mobile was named to the Staffing Industry Analysts Global Power 100 – Women In Staffing. This is basically a list of influencers and power players in the global staffing industry.
And over at Randstad Healthcare, they brought in a new President named Abigail Tremble. In case you’re not familiar, Randstad Holding is a Dutch company. They’re a global staffing firm doing business in virtually all sectors. The most recent valuation I saw was $22.9 billion. One of their holdings is Randstad US, which is their US operation. And Randstad Healthcare is part of that branch.
Okay, so let’s get into our discussion on the GSA Tables. The first thing we want to do is to identify exactly what the GSA Tables are. I mean, what’s really going on here. Well, the General Services Administration, or the GSA, is a huge federal government agency that’s responsible for all kinds of stuff. For example, they negotiate rates for goods and services that the government purchases and/or utilizes. They also maintain government facilities and they have a fleet of over 200,000 government vehicles.
So, they’re kind-of like this hub for goods and services that get utilized by the federal government. Now, as such, they’re obviously in a good position to know how much things might cost throughout the United States. As a result, they’re also in charge of setting the “Per Diem” rates for government employees.
So, what is a “Per Diem Rate”? Well, a “Per Diem Rate” is the maximum amount of money that can be given to a government employee as a tax-free reimbursement for lodging, meals and incidental expenditures while the employee is traveling away from their tax home on government business.
Now, the GSA sets these rates for the Continental United States. And the acronym for that is CONUS and it’s commonly used when discussing these rates. And these rates are set by region or by county. I mean, different parts of the country have varying levels of cost associated with them, so the rates vary from place to place.
Now, it’s important to note that Alaska and Hawaii are not included on the GSA’s tables. That’s because they’re not part of the Continental United States. But, they do have per diem rates. And those rates, along with the rates for all US territories, are set by the Department of Defense. The easiest way to find those rates is either by Googling them directly, like Hawaii per diem rates, or by visiting the GSA’s main page where you’ll find a link to the DoD’s tables.
Oaky, so all of that said, these same rates are typically applied or utilized by the IRS when it comes to private citizens. So, essentially, the government is saying, “Hey look, we have these tables set up for our own government employees who travel for work, let’s apply those to private citizens who are in similar circumstances.” And that’s how they make their way into the world of travel nursing, right? Travelers are traveling away from their tax homes for the purpose of work and so their employers can reimburse them tax-free for the cost of lodging and M&IE.
Oaky, so already at this point in the conversation, I think there is a lot of room for confusion and we’ve just scratched the surface. I mean, I know this, because this was confusing to me when I first started out in the industry and I spoke to a lot of confused travelers who were also confused by these issues and I see things written on social media sites and forums all the time that are incorrect. So, let’s take a look at the terms and concepts in detail so we can get some clarity.
Alright, so for starters, the first thing to know is that the term “Per Diems” actually refers to two different classifications of costs. The first is Lodging and the second is Meals and Incidental Expenditures which is commonly referred to as M&IE. So, when you go to look at the GSA Tables, you’re going to see two sets of data for each location, one for lodging and one for M&IE.
Alright, so when you go to the GSA website, and we’ll link to it on the show notes page for this episode, there are several ways that you can look up the rates that you’re interested in finding. You can enter a city and select a state. You can enter a zip code. Or you can select a state from the map. If you select a state from the map, it will give you the opportunity to enter a city or zip code on the next page.
Remember, the rates are typically listed by county. So, entering the city itself or the zip code is most helpful, because you’re typically not going to know the county that you’re going to be in. But when you enter the city or the zip code, the system will return the result of the county that the city is listed in. And you just have to sort of trust the system, right? For example, if you enter Fullerton, California, the system will return Los Angeles County with no real mention of Fullerton. You just have to take their word for it. This isn’t a big deal, but it tends to confuse some folks, understandably I think.
So, once you have a table up, you’ll notice that there is 1 column for the M&IE per diem rate, but there are 12 columns for the lodging per diem rates. There is a column for each month of the year. And that’s because the lodging rates vary from month to month in some locations due to seasonal issues. For example, some areas are more popular in the summer or the winter for any number of reasons, so more people travel there during those times and it tends to spike the lodging rates in the area due to the increased demand.
Okay, so another thing that people often wonder is what specifically these rates are for. And the rates that you’re looking on these tables are the rates that the employer is allowed to reimburse without the exchange of receipts per day, okay, that’s per day, not per week, or per anything else.
Next, I think that there is understandably some confusion regarding the terminology and how it gets used. For starters, many folks in the healthcare industry get confused by the use the term “Per Diem” because this term has its own meaning in healthcare. We often use the term Per Diem in healthcare to refer to “on-call” staffing, right? So you might work per diem as a nurse. And we use the term this way because it’s a Latin term that means “per day.” So be careful not to confuse those two meanings.
Next, these per diem rates get referred to in many different ways. Some people simply call them per diem rates. The problem here is that you don’t know whether they’re referring to lodging or M&IE or both. This can be particularly confusing when you’re speaking with recruiters about pay packages. This is why we recommend that everyone, and recruiters especially, refer to them specifically as lodging and M&IE.
Now, similarly, some people will refer to them as the “lodging stipend” or the “housing stipend” or the “M&IE stipend”. Now, these are more clear to me and I think this is the way that they should always be referred to, but the confusion comes in that some people have heard the term “per diems” and so when you talk about stipends, they’re thinking, “Well, what about the per diems?” So it’s important to make sure that everyone is on the same page. Again, this means using clearly descriptive terms like lodging stipend and M&IE stipend…or lodging per diem and M&IE per diem.
And the worst one to me is when people just use the term stipend as a catchall phrase. A lot of recruiters do this. And you have to know that this is really confusing for the travelers you work with. Typically, when the term stipend is used as a stand-alone term, it’s being used to refer to the M&IE stipend. But, it’s really tough to tell, so it’s just flat out confusing. Again, it’s best to use descriptive terms so everyone knows what’s being talked about.
And of course, that brings us to the term stipend. This is another term that causes confusion with this issue. Stipend is term that refers to a lump sum payment. So, note the difference between “per diem” which means per day on the one hand and “stipend” which means a lump sum payment.
So, healthcare staffing companies usually pay their tax-free reimbursements as stipends, right? They pay them out weekly, bi-weekly, or as lump sums in the case of the travel stipend. I mean, I suppose it’s okay for a recruiter to say that you’ll be paid $250 weekly for the M&IE per diem, but personally, I prefer stipend, because these are lump sum payments and using the term “stipends” ensures that we don’t confuse it with the work-related term for on-call staffing. That said, the most important thing is to be descriptive so that everyone is on the same page.
Okay, so the next thing that tends to cause a lot of confusion is how these stipends are paid out. I think one of the biggest sources of confusion here comes when folks go to the GSA tables and look up a location and then compare the GSA rate with the per diem rate they’re being offered from a travel nursing company.
For example, maybe you get offered an M&IE stipend of $300 per week in Los Angeles, CA. Then, you go to the GSA tables and see that the M&IE per diem rate is $64 per day. Multiply that by 7 days in a week, I mean, you’re going to be there all 7 days, and it comes out to $448. You see that and you think, “I’m getting ripped off!” And that is not the case. I mean, you could be getting ripped off, but this alone certainly isn’t proof of getting ripped off.
Again, the GSA Tables show the maximum amounts that employers are allowed to pay without the exchange of receipts. This doesn’t mean that they’re required to pay this amount. It also doesn’t mean that they’re getting this amount from the hospital. And it doesn’t mean that the government is somehow paying agencies this much to reimburse to travelers. These are all claims or questions that I’ve heard at one point or another.
Instead, remember that the stipends the agency pays are largely contingent on the bill rate for the assignment in question. So, if the bill rate is lower, then they don’t have as much to pay and if it’s higher, they have more to pay. Let’s look at a really stark example to illustrate.
Again, let’s look at Los Angeles, California. I can tell you that there are many hospitals there that have bill rates in the low to mid 60s. So, they might be anywhere from $60 per hour to $65 per hour. And remember that the average contract is 36 hours per week, 13 weeks, 3 months and 468 total hours. So that’s 156 hours per month. At a rate of $65 per hour, the agency will be able to bill $10,140.
Meanwhile, the GSA tables indicate that the agency could pay as much as $64 per day for M&IE. That’s $1920 per month. And they could pay as much as $150 per day for lodging. That’s $4,500 per month. So, just between those two variables that’s $6,420. And remember, they only have $10,140 to work with.
They still need to pay your taxable base rate, let’s say that’s $20 per hour. That’s, $3120, for the month. So, we’re already at $9560 per month and we haven’t even gotten into all of the other bells, whistles and costs. I mean, there is the travel stipend, the medical benefits, the payroll taxes, the non-billable orientation, compliance and credentialing costs and on and on before we even get to the agency’s gross profit margin.
So, how do they determine how much they’re going to pay for these stipends? Well, as we discussed in great detail in episode 14 when we discussed travel pay packages from the agency’s perspective, they’re going to start by entering the bill rate into their rate calculator. They’re going to enter all the variables in terms of contracted hours and the costs they must incorporate into the package including things like the base rate, the payroll taxes, the medical benefits, etc. Then they’re going to determine how much they can pay for the lodging and M&IE per diems. And they’re going to do all of this while keeping their gross profit margin above some level that they’ve deemed necessary. Again, this is usually 20% to 25%, but it could be a bit lower or a bit higher. It all depends and this is where your negotiating skills come into play.
So, that’s kind-of the basics of how they do it. If you want a detailed break-down, then I encourage you to check out episode 14. And I’ll also link to some helpful blog posts on the topic on the show notes page.
Okay, so there is another side the coin here when it comes to these GSA tables. And the other side of the coin is what happens when the bill rate for the assignment is much higher than the $65 we discussed earlier. I mean, we’ve discussed crisis rates, rapid response rates and other high paying assignments. These can sometimes have bill rates that are $85, $90, heck, I’m hearing of L&D travel assignments with bill rates slightly higher than $100 per hour.
So, when you get offered a pay package for an assignment like this, the agency may increase the taxable base rate and leave the tax-free stipends the same. Or they may increase both a bit. Either way, the point is that they may not just throw all of that extra money into the tax-free stipends to get them up to the maximums indicated on the GSA tables.
And of course, this begs the question, “Why wouldn’t they?” I mean, it sounds as though they’re supposed to be able to, right? Well, many agencies do not see it that way and they have a logical reason to feel this way. Here’s the logic.
The GSA rates are based on short term business travelers. In other words, the assumption is that the business travelers are going to be staying in a hotel and eating out at restaurants. Obviously, both of these things are more expensive than getting an apartment and shopping at the grocery store.
That’s why the rates are so high. I mean, sure, Los Angeles is expensive. But you can certainly get a nice one bedroom apartment that’s fully furnished for much less than $4500 a month, right?
So with that in mind, remember from previous episodes that agencies are supposed to have a reasonable belief that you’re incurring these expenses that they’re paying the reimbursements for. And the fact that they themselves provide apartments for some of their travelers would be proof that they know how much these things cost. So if they’re paying through the roof, or the maximum rate, for these things, then that could be perceived as fishy, right?
Moreover, they may be paying other travelers in the same area less money for the lodging and M&IE stipends. For example, maybe the agency has 2 travelers on assignment in Los Angeles, California. One of them has a contract with a bill rate of $65, the other has a contract with a bill rate of $90. If they pay them both the same base rate, but the one with the higher bill rate gets higher stipends, then that might possibly be viewed as wage recharacterization.
And I want to make sure I’m clear here. These companies are essentially treating their stipends consistently. They basically determine what they believe to be reasonable for the lodging and M&IE stipends in any given area and then pay those rates consistently. So, when a high bill rate pops up, they add more money to the taxable wage as opposed to bringing the stipends up to the maximums allowed by the GSA tables.
Now, whether or not any of this flat out required by the tax laws, I don’t know. But then, I’m not a tax professional, so please remember that all of this information is for information purposes only. But what I can say is that it’s usually the largest companies that maintain these policies, right? So they have huge legal teams advising them and I have to think that there is at least some cause for concern there.
Okay, so the next thing I think we should discuss about the GSA tables pertains to the variations in the lodging rates that we discussed a second ago. Remember, some areas have seasonal variations in lodging rates because supply and demand issues cause price fluctuations in these areas throughout the year.
So, I have heard that some agencies and recruiters will say that they need to reduce the lodging stipend of the traveler when these variations kick in. I’ve heard this most often when it comes to contract extensions. When the pay gets negotiated for a contract extension, for example, the agency will say that the GSA stipends went down, so they have to reduce the stipend that they’re paying to the traveler.
Now, if your agency is paying you the maximum amount possible for the stipend, then I can certainly see this being the case. But this is extremely rare. So, in a general sense, I’m calling shenanigans on this one. If your agency pulls this tactic, then be sure to check the GSA tables and let them know that they were never paying the maximum amount to begin with, so why would they have to institute a reduction if they’re still paying less than the allowable limit.
Okay so this last set of issues pertains to how these GSA tables pertain to your own personal income taxes. Remember though, I’m not a registered tax adviser, so this is for informational purposes only. You need to seek the help of a tax adviser to get advice for your unique circumstances.
That said, one of the many questions that travel nurse almost always have is whether or not they need to pay taxes if they spend less then they receive in tax-free reimbursements. Now, the simple answer is that know you do not need to declare the difference on your taxes and pay income taxes on it. However, it’s important to note that you should be keeping receipts for your lodging expenses in order to verify that you did indeed incur some expenses on this item. So, you should be keeping lease agreements, hotel and motel receipts or something like that. Apparently, you do not need to keep the receipts for M&IE.
However, what if the agency reimburses less than the maximum allowed by the GSA, which they do in most cases, but you end up spending more than the agency reimburses you? Can you declare the difference on taxes as a tax write-off? Yes, you should be able to. However, you’ll need to be able to demonstrate the costs were incurred with receipts for everything.
So, this is why I think it’s best to save all your receipts. I mean, if you’re securing your own lodging, then it’s a must to have a record of those expenses. Many tax advisers will say that you don’t need them for M&IE items, but I think it’s best especially if you might spend more than the agency reimburses.
Okay, so that’s a really good place to wrap this episode up. We’ve covered a lot of information about the mysterious GSA tables. I hope this added clarity to the topic so you can approach it with more confidence.
As always, we’ll have the transcript along with various useful links up on the show notes page. You’ll find that at blog.bluepipes.com/episode34. Please feel free to post any questions or comments you might have about this topic on the show notes page. There is a comments section down at the bottom there. And while you’re there be sure to join BluePipes to take advantage of all the helpful tools and services designed to help you manage your travel healthcare more effectively and efficiently.
Again, I want to thank you so much for listening to the podcast. And a special thank you to those of you who have provided as with a review. I greatly appreciate that. If you’ve been enjoying the show, then it would mean the world to me if you could provide a review on whatever platform you use to listen on. Whether it be iTunes or Stitcher or some other platform, it really helps a lot. We move up in the rankings so we can share this information with more travelers and keep the show going.
Alright, until next time, have a safe and prosperous travel healthcare adventure.
TTATN 014: Travel Nursing Pay From the Agency’s Perspective
GSA Tables
DoD Tables
6 Things Travel Nurses Should Know About GSA Rates
Sample Breakdown of a Travel Nursing Pay Package
AMN Buys MillicanSolutions
AMN Buys The First String Healthcare
Susan Salka Named to Global Power 100
The post TTATN 034: What Travel Nurses Ought To Know About GSA Tables appeared first on BluePipes Blog.
Hey everyone! Welcome to The Truth About Travel Nursing Podcast. This is Kyle Schmidt. I’m your host and I want to thank you so much for joining us for episode 33 of the podcast. In this episode, we’re going to discuss 10 of the most common myths and fibs about travel nursing. We’ve touched on a few of these throughout previous episodes, but my hope is that exposing these myths and fibs in great detail will help us gain a better understanding why they exist, what to watch out for and ultimately help us approach travel nursing with greater confidence so that we can get more out of our travel experience. [Please note that this is a transcript of a podcast episode. As such, grammar and spelling are not optimized for written content.]
Now, before we start, I want to try something new on the podcast. I thought it would be a good idea to open the shows with a quick mention of some news and current events that are pertinent to the travel healthcare industry. I’m hoping that this will add an extra dynamic to the podcast that will be beneficial to you.
Essentially, up to this point, we’ve covered information that would commonly be referred to as “Evergreen”. In other words, we’re talking about things that are pretty much always going to be relevant barring any groundbreaking changes in the industry. But meanwhile, in the real world, there are things happening in the industry in real time that could be very beneficial for you to know about or that you might simply be interested in hearing about.
So, we’re going to do our best to share some of these things with you. Now, we won’t be going into great detail with these issues like we do with the general subject matter of the podcasts. However, we’ll provide links when possible in the show notes of each episode so that you can do some further research if you’d like. Moreover, if you have a news story that you think is pertinent to travel nursing, then please email it over to us so that we can review and share with everyone else. Ad, you know, remember that travel healthcare is a pretty small industry, so there may not always be news or current events to share. But again, when there is, I think you’ll find it both helpful and/or interesting.
So, for today’s news, I wanted to quickly mention California’s new Paid Sick Leave Law. It’s actually a little bit old as far as a news story goes, but many travelers and agencies are unaware of it. Essentially, the state of California enacted a Paid Sick Leave Law that requires employers to provide paid sick leave to nearly all employees. And yes, travel healthcare professionals qualify as a covered class of employee.
Let me be clear, this means that employers are required to provide paid sick leave to travel healthcare professionals. Of course, only the hours that you work in California will qualify. In other words, if you’re on contract and working in Wisconsin, then this law does not apply. Again, it applies only to the hours you’re working in California.
Also, it doesn’t matter where the agency is located. If they are staffing in California, then they are required to abide by the rules of the law.
Now, I think we could devote an entire episode to this topic and answering all the questions involved. But like I said, the news segment will be quick. We just want to make you aware of what’s going on. And in this case, we’ve published a detailed article on BluePipes Blog on this topic. So, we’ll link to it in the show notes. I encourage you to give it a look if you’re interested in the details.
Okay, so let’s jump into these myths and fibs about travel nursing. The first myth we’re going to cover is commonly referred to as the 50 Mile Rule. We’ve discussed it very briefly on previous episodes in which we simply stated that there is no such rule.
But basically, this myth claims that travel healthcare professionals can qualify to receive the tax-free reimbursements offered by travel healthcare companies simply by living 50 miles or more from the place that they’ll be contracted to work. Now, we went into great detail about what it takes to qualify for tax-free reimbursements in episode 18. We also have a whole section on BluePipes Blog devoted to the subject. We’ll link to both of those in the show notes.
For our discussion here, we’re just going to say that the most basic rule for qualifying for tax-free reimbursements as stated in IRS publication 463 is that you can accept them if, “you need to sleep or rest to meet the demands of your work while away from home.” Also, it’s important to note that you have to actually incur an expense to get reimbursed. There is no scenario under which you can commute to and from your home to a job and receive tax-free reimbursements.
Okay, so let’s take a look at why this myth exists and some of the supporting arguments that are provided by those who espouse it. First, there are many hospitals that have their own internal rules for who can be considered a traveler at the hospital. For example, the hospital might have a rule that says that travel nurses must have an address that is at least 50 or 75 miles from the hospital. So, some agencies and recruiters might be confusing such rules to mean that the hospital must be instituting them because of the tax-free reimbursements.
But, for starters, hospitals don’t set tax laws, the IRS does. And more importantly, hospitals maintain these rules for an entirely different set of reasons. For example, the hospital figures that anyone within 50 miles of the hospital should be signing on as a per diem nurse, not a traveler. And they do that because per diem rates are lower than travel rates. Or the hospital may figure that the person should just apply for a full time job instead of working as a traveler. Basically, there are number of reasons that hospitals have for maintaining these rules and none of them have to do with tax issues because the hospital has no involvement with the tax issues anyway.
Okay, so another potential reason that this myth exists is that there are certain states that have a 50 mile rule for their state legislators to qualify to receive the tax –free reimbursements paid by the state. I mean, you know, the state capital might be really far away from the state legislator’s home, so they could qualify for tax-free reimbursements while in the capital on business. But the bottom line here is that these are just state rules for paying these things out and in this sense the state is acting as an employer. At the end of the day, it’s the federal government who has the final say in this.
Now, the third reason is quite similar. You see, some agencies have their own rules as far as distance from the job is concerned when it comes to paying out the reimbursements. Agencies do this because the IRS requires employers to exhibit some level of due diligence when paying out tax-free reimbursements. In other words, the employer isn’t supposed to be paying out tax-free reimbursements if they know for sure that the individual doesn’t qualify for them.
And employers are supposed to maintain a set of internal policies designed to ensure that they’re making sure their employees qualify. This is why most agencies will have their travelers sign a document attesting to the fact that the traveler qualifies to receive the stipends. But here again, these are rules established by the employer. They mean nothing to the IRS.
Now, the next reason that this myth exists is a little tricky. You see, the IRS does have a rule that in order to deduct the costs associated with moving your residence, the commute from your current address to your new job must be more than 50 miles greater than the commute from your current address to your old job. The problem is that you’re not moving when you’re a travel nurse and we’re not talking about deducting moving expenses on your tax records. Instead, you’re traveling away from your tax home for work and you’re going to be receiving tax-free reimbursements for things like lodging and meal expenses. So, this rule doesn’t apply here.
Okay, the last reason for the 50 mile myth that we’re going to discuss is a duplicitous one. Simply put, some recruiters toss it out there as a way to get travelers to accept an assignment that’s close to their home. For example, let’s say a recruiter places a job ad on a site like indeed.com. Then, a candidate who’s not really interested in travel assignments but who lives fairly close by responds to the ad. The recruiter might just tell them it’s totally cool for them to take the assignment and the tax-free money, just to convince them to take the assignment.
Of course, you might be wondering why the recruiter would do this. Why wouldn’t they just offer to pay the candidate all taxable? Well, if you recall from episode 4, this could get the agency in trouble for wage recharacterization. Remember, it’s not okay for an agency to offer one base for travel healthcare and then increase that base by the amount of the stipend money for a local candidate on the same exact job. That’s an indication that the agency is recharacterizing wages, which is not cool for the IRS. This is why many agencies will not offer all w2 wages; they don’t want to get mixed up with all of this.
Okay, so that’s the logic behind the 50 mile myth. Hopefully, this helps you approach any such claim with the information you’ll need to confidently confront the issue. So, let’s move on to the second myth we’re going to discuss here and that’s the myth that you can work at home for a week or two every year in order to continue to receive tax free money in the same area.
Here again, we discussed this one briefly in episode 18, but we’re going to go into a little more detail here. And think it’s important to do so because I actually came across a post in a forum on travel nursing in which the poster cited our podcast when talking about this topic, but there was some confusion on the issue. So, let’s take a look at an example.
Let’s say your tax home, a tax home where you are paying duplicate expenses, is in Columbia, South Carolina. And let’s say you take a 13 week assignment in Los Angeles, California and end up extending 2 more times. So, essentially, you’re in LA for 9 months. Now let’s say that you return home for 3 or 4 weeks during the holidays and while you’re there you pick up some per diem shifts at the local hospital.
Now, after that 3 or 4 week period, you return to Los Angeles for another contract and keep extending or finding new contracts in the Los Angeles area for the next 6 to 9 months. If you do this, your tax home is going to shift to Los Angeles. Remember, your tax home is first and foremost the place where you conduct your income deriving business. So, your tax home and your family home can be two different things and in this particular case they would be.
So, what people typically want to know is exactly how much time they can work in any one metropolitan area. And that’s the key here…it goes my metropolitan area, not by state. So, San Diego and Los Angeles are different areas. So, how long can you work in one metropolitan area before your tax home shifts there? The bottom line is that there is no steadfast written rule from the IRS on this issue. However, based on court rulings, there are some general rules of thumb.
Now, for starters, it depends on whether or not you’re paying legitimate duplicate expenses back at your tax home in the form of rent, a mortgage, bills, etc. If you are, then one general rule of thumb is that you shouldn’t work in any one metropolitan area for more than 12 months in a rolling 24 month period. So, you can’t just go back and work in the same city as a traveler for years on end by simply taking short breaks in between. Your tax home will shift there.
Now, if you don’t pay duplicate expenses on year a round basis, then the amount of time you can stay in any one location is going to depend largely on the amount of time that you stay, work and pay taxes at your declared tax home. In this case, the common example is that you might return to one metropolitan area, like Tampa, Florida for example, on an annual basis to work seasonal contracts with the hospitals there. You make that your tax home and while you’re there, you pay full taxes on your income. You maintain all your personal business there as well. Your mailing address, your vehicle registration, doctors, voting registration, etc. are all kept there. Now, if you do that, you can take travel assignments and the tax-free reimbursements, but you can’t work in any one location for longer than you work at your declared tax home in Tampa, Florida. So, you’d actually have to move around quite a bit. So, you probably wouldn’t be able to take contract extensions unless they were really short.
Okay, so the third myth we’re going to discuss is another tax related issue. The myth is that it’s okay for travel healthcare professionals to receive a really low taxable wage in order to “maximize the tax advantage”. Now, this is actually one that I think we’ve discussed in pretty good detail on previous episodes. So we’re not going to really go into all the nuances here.
Simply put, when an employer is paying tax-free reimbursements, they’re required to pay a taxable wage that is in line with what the professional in question might reasonably expect to make in the regular employment market. And here again, there are no steadfast guidelines. And remember, it will be different for Registered Nurses than it is for OR Techs or LPNs for that matter.
That said, you’ll find a lot of information out there indicating that anywhere from $18 to $22 per hour is the minimum taxable wage that should be received by Registered Nurses. And remember, your taxable wage is just one part of your travel healthcare compensation package. So, while that figure sounds low, the pay packages almost always make up for it and then some with the tax-free reimbursements.
Also, it’s important to note that the most common way for you as a traveler to get audited for this is if your agency gets audited. Everyone that worked for the agency will get caught up in the dragnet. That said, it’s also possible to get audited on an individual level as well. So, don’t go for this. The benefits simply aren’t worth it.
Now, the fourth myth we’re going to discuss is that The Joint Commission, or TJC, which is the acronym, certifies documentation, or provides approval for documentation. Just in case you’re not aware, TJC is a non-profit accreditation organization focused on healthcare organizations. Essentially, they certify that healthcare organizations are meeting minimum standards through a licensing process.
Again, the idea that TJC certifies paperwork is a myth. TJC does not certify or approve documentation. So, let’s take a look at some background about exactly what we’re talking about here.
As you know, there is a ton of paperwork and documentation that needs to be completed when you work with a new agency. And in most cases these days, there is also a lot of paperwork that needs to be completed when you start with a new hospital. Now, agencies typically have you complete the standard set of documentation that has become pretty commonplace throughout the industry. This includes a skills checklist, some basic background questions, a skills assessment test for the specialty you’re working, and a set of training modules and exams commonly referred to as Core Measures. The Core Measures encompass a wide range of topics from fire safety to national patient safety goals and a lot of other stuff. Now, most of this paperwork is required on some level by TJC. So, you have to do it.
However, TJC does not certify certain providers of content, or exams. They simply require that healthcare organizations provide training on these subject areas and test for competency. Healthcare organizations must have a reasonable expectation that the training and testing meets TJC guidelines. So, it’s actually possible for organizations to develop their own documentation, but they typically use outsourced providers because it’s more cost effective.
But again, the bottom line is that there is no approval or certification of documentation by TJC. And, you know, this is why you won’t see the big content and exam providers advertise that they’re TJC certified. So, companies like Prophecy and API don’t claim that their documentation and content are TJC approved or certified.
Now it’s also important to note that sometimes there is some overlap in the paperwork between the agency and the hospital. In other words, you may end up completing Core Measure training and exams for the agency and then do it again for the hospital. And there really is no reason for this. And this brings us to the fifth common myth in travel nursing.
This myth is that all the documentation you must complete with the agency must completed through the agency. In other words, documentation is not mobile or transportable. Or another way to put it is that an agency can’t accept your documentation from another agency or another source; they need to be the ones who administer the paperwork.
Okay, so this is pretty much not true. At least, it’s not true according to anything that I’m aware of in TJC’s certification manual for healthcare staffing agencies. As long as the agency can demonstrate there is a reasonable belief that the documentation came from a reliable source and meets the criteria, then they can accept the documentation. Now, of course, I welcome anyone to correct me on that with demonstrable proof from the manual or an official statement from TJC, but my understanding from the manual and having conferred with some of the top TJC certification consultants in the healthcare staffing industry indicates that agencies can indeed accept such documentation in lieu of completing the agency’s own paperwork.
So, let’s look at an example. You know, unit exams or specialty competency exams as well as the core measure exams and training are supposed to be administered annually. So, if you were take one with agency A in January, and then move to agency B in May of the same year, then you should be able to transport that documentation. And I mean, especially if the agencies in question used the same testing service. But either way, it should be acceptable.
And you know, as further proof, one of the biggest service providers in this area has a program that enables this process to happen. So, I know that I’ve mentioned Prophecy several times. They’re one of the commonly used testing and training companies in the healthcare staffing industry. Well, they have a program that they conduct in accordance with the website MightyNurse.com.
Essentially, in March of 2013, MightyNurse.com announced that that they were partnering with Prophecy to provide members of the MightyNurse Community with free skills assessment testing. I’m going to read a few quotes from the press release to clarify exactly what’s going on.
“Mighty Nurse has become the first online community to offer free skills assessment testing through a partnership with Prophecy Healthcare, Inc. Members of the Mighty Nurse online community have free access to a skills assessment test once per year. The 54 skills tests cover 20+ nursing specialties including RN, LPN/LVN and CNA. Members can also purchase additional online skills assessment tests for a nominal fee. By completing an online skills test with Mighty Nurse, nurses will own that record for up to one year and can use it with any potential employer.”
Mariah Scott, the COO, at Shiftwise which is the company that owns MightyNurse said the following “This saves time for nurses, and gives them control in managing their careers. We’re proud to be the only nursing community with this offering.”
And Ron Gonzalez, Founder/CEO Prophecy Healthcare, Inc. said “Our partnership with Mighty Nurse provides nurses with an invaluable career resource tool. We hope that the ability to take ownership of their knowledge set and credential management translates into propelling their careers forward in the specialties they wish to pursue.”
So, if these two companies are essentially providing a service that allows nurses to transport their documentation from one employer to another, do you really think that they would do this if it was against TJC policies or regulations? Of course they wouldn’t.
Now, we’ll link to all of this on the show notes page so you can check it out. But, I have to warn you that MightyNurse is owned by Shiftwise and Shiftwise is owned by American Mobile Healthcare. And so there are some lead generator concerns there. In other words, pay close attention as to how the service can use your information before signing up. Also, it appears as though agencies can request a copy of your exams without your consent. I could be wrong about that, but they have a landing page where agencies can request a copy of exams for a price.
Okay, so let’s move on to the sixth myth in travel nursing and this is another paperwork myth. The myth is that an agency must have all the paperwork, tests and all, prior to submitting you for an assignment or even talking about jobs or pay packages with you. Now, some agencies might have their own policy on this, but the myth is that there is some law or regulation that requires them to obtain the paperwork. That’s just nonsense.
I mean, the bottom line is that you don’t need to complete any paperwork to find out what an agency has to offer. You should even be able to get some sample pay quotes. You should only have to fill out paperwork in order to get submitted for an assignment. Or, better yet, as we mentioned on previous episodes, find recruiters that will work with your BluePipes documentation to save you the time and trouble and help you get submitted quicker.
Okay, so the seventh myth we’re going to discuss is that travel nurses MUST float. Now, this one is really more of a fib. That’s because there are assignments that require you to be open to floating and there are those that do not. And there are even some scenarios where the hospital will require floating in order to honor the guaranteed hours clause in their contract with the agency and they’ll give you the option to decline floating and thereby take the risk of getting called off.
All that said, I worked with many travelers when I was a recruiter who refused to float. They always asked about it during the interview and simply declined assignments where they were required to float.
However, I do think that it’s fair to say that it will be much easier to land assignments if you are open to floating. And of course, you should only be floated to units where you are qualified. And moreover, hospitals that are floating you to units that you aren’t qualified to work are essentially violating TJC rules. I mean, a big part of TJC is about ensuring that professionals are competent to perform in the settings their put in. So, if you haven’t taken a specialty exam of filled out a skills checklist for a particular unit, then how are they supposed to know that you’re okay to be there. In these cases, your agency really should be going to bat for you because it’s their TJC certification on the line as well.
So again, the bottom line is that floating makes it much easier, but it isn’t required 100% of the time.
Alright, myth number eight is that travelers only get paid time and a half of their base taxable rate for the extra hours they work. This simply isn’t true. As we discussed in great detail in episode 4 of the podcast, there are many different ways to pay out extra hours for travel nurses and ultimately, you should be looking to make as much or more than your fully blended contracted rate for the extra hours that you work. We’re not going to go into the details here in this episode, but you can review episode 4 to get all the information you need. For now, just know that there are plenty of companies that will pay you much more than one and a half times your base rate for any extra hours work. And remember, extra hours are any hours that you work in addition to your contracted hours.
Okay, so the ninth myth that we’re going to cover is the, “mythical pay package myth.” I like to call this one the “White Whale Pay Package.” Basically, every so often you’ll see someone talk about a travel nurse or a per diem nurse making exorbitant amounts of money. And I understand that this is possible on a short term basis with strike work. However, when someone says they’re on contract making this much money or they’re making this kind of money over the course of the normal year, then something is definitely mythical.
So, just how much money are we talking about here. Well, let me read a quote from one of the social media groups on travel nursing to illustrate.
“So I just had to get this off of my chest and let someone know. So I’m working in California on a tele unit. Most of the nurses on the unit work per diem and live out of state. I met a nurse from Georgia and the other from Florida. They fly out here for 2-3 weeks at a time just to work. The nurse from Georgia showed me her pay stub and she brought home after taxes $21,000 for 2 weeks. Now she did work 172 hours but dang!!! I almost lost my mind!!! I have never seen a nurses paycheck that big. She said right now she’s over the $200,000 mark for the year. Am I doing this travel nursing wrong?!?!? I just had to share.”
Now, I’m not saying registered nurses never make over $200,000 in a year. They certainly do. In fact, there was a story in 2011 about a California Correctional Registered Nurse who grossed $270,000 for the year. But they did that by working 2,450 overtime hours in addition to their 2000 scheduled hours. That’s a total of 4,450 hours which would come out to an average of $60 per hour.
However, the figures that our story describes are staggeringly different. So, let’s took a look at how different they are. For starters, the claim is that the nurses are working PRN on a Telemetry Unit. So, if they are working PRN, then they do not get paid tax-free reimbursements so all the income is taxable. So, working backwards from the net pay figure to the gross pay figure using a paycheck calculator shows that the gross pay would need to be anywhere from $41,000 to $42,000.
So, let’s put that into perspective. First off, that’s an average of $244 per hour. Remember in our example where the correctional nurse made over $200,000, they did it with an average hourly rate of $60 per hour.
Second, our story is basically claiming that the nurse is making over $20,000 per week. So, if they were to do this for a 48 week period, which is basically one year, then they would make $960,000 for the year. I’m sorry, but I just don’t see that as being a possibility.
We all know how tight hospitals are when it comes to costs. For this price, this hospital could hire 4 new grad RNs, fully train them, and have them work the entire year, whether they needed them or not, and come away spending less money than they do for the 1 person in this story.
Now, even if we assumed that the people in this story were getting tax-free reimbursements, they would still need to get paid an average of $210 per hour. And of course, if they were getting tax-free reimbursements, then they would be working through an agency, which means the agency would have to get it’s cut. So, the bill rate for the agency would have to in the neighborhood of $250-$270 per hour.
So, any way you cut it, I’m calling shenanigans on this story and others like it. Now, in the show notes, we’ll link to a highly detailed blog post in which we broke down this story so that you can see all the detailed figures if you’re interested.
Okay, so the tenth travel nursing myth occurs when a travel nursing agency tells you that they’ll just offer another candidate the job in question if you don’t like what they have to offer. So, first let’s look at a couple of scenarios for this one. I once came across a conversation in one of the forums in which a travel nurse was complaining about the Prophecy’s Core Mandatory training and exams. You know, these exams are really detailed and actually take quite a bit of time to complete. So, the nurse was basically looking for agencies to work with who didn’t use Prophecy as their testing service. And that’s fair enough; it’s understandable.
Of course, all the recruiters who worked for agencies that used Prophecy were up in arms and they tossed out the standard myths and fibs about the paperwork. They said that they used Prophecy because they were certified or approved by TJC for example. And one of them said the following:
“Well I was just making the point that no one will lose. If you opt not to take a job, we will offer it to someone else. We all have options.”
So, for starters, this is a terrible angle to take when you’re providing a service. But that aside, there are several things wrong with this statement. First, agencies don’t offer jobs, hospitals do. Second, agencies are competing with one another to land the same jobs, so there is a very good chance that this particular agency would indeed lose out if a traveler declines to work with them. Third, it’s not as though agencies submit only one candidate per job. In fact, agencies will submit as many qualified and interested candidates ass they have for any given job. Again, it’s the hospital’s job to decide on the best candidate and the more candidates that an agency submits, the greater their chances of landing a job. The point is that the agency is going to submit multiple candidates if they have them. And therein lies the rub. Chances are that the agency won’t actually have any other candidates to submit for the assignment.
Now, this fib often comes up during compensation negotiations. You know, the recruiter might say that they have other candidates willing to accept the job for the rate being offered. The indication being that they won’t submit you if you want more money; they’ll just submit the other candidates. So, just be aware of these issues and don’t let this fib hamper your negotiating approach.
Okay, so the eleventh and final myth that we’re going to discuss on this episode is that travel nursing companies offer free things. You’ve heard this one a thousand times, no doubt. You’ve read it in marketing ads and seen it on job postings. As we covered in great detail in episode 3, nothing is free. Everything has to be accounted for when comparing and evaluating pay packages.
And one of the things that I love about this myth is that you’ll see an agency advertise free housing or free travel expenses on their website. Then, right next to that advertisement will be another advertisement talking about how much travel nursing pay packages are worth, with a calculation that includes the value of the housing and travel expenses. It’s like, what? I thought that was free?
Okay, so that does it for this episode, another long one with tons of information. I hope that hearing about these myths and fibs, the logic behind them and the reasons that they’re actually myths or fibs will help you approach your conversations with recruiters and agencies with more confidence and ultimately get more out of your time as a travel healthcare professional.
As always, we’ll have thee transcript of this episode up on the show notes page. We’ll also have links to all the resources we discussed in this episode. The show notes page can be found at blog.bluepipes.com/episode33. While you’re there, be sure to join BluePipes to take advantage of all the tools and features designed to simplify your travel and healthcare career.
Again, I want to thank you so much for listening to the podcast. If you’ve been enjoying the podcast, then I would greatly appreciate your providing us with a review on whatever platform you’re listening on. Whether it’s itunes or stitcher or some other platform, the reviews really go a long way to help us get the word out and move up in the search rankings so that we can get this information out to more travelers.
And to those of you who have already left a review, thank you so much. It really does mean a lot to me. Thank you so much for taking the time.
Okay, so until the next episode, have a safe and prosperous travel healthcare adventure.
Links:
MightyNurse Skills Testing
MightyNurse Skills Testing Signup
MightyNurse Skills Testing Agency Request
California Correctional Nurse Makes $270,000 a year
Is This The Highest Paying Travel Nursing Job Ever?
Travel Nursing Salary and Pay Category on BluePipes
Travel Nurse Taxes and Tax Free Money Category on BluePipes
TTATN 004 : Wage Recharacterization and Negotiating Travel Nursing Overtime Pay
TTATN 018: Travel Nursing Tax Free Money
TTATN 003: The Best Way to Evaluate and Compare Travel Nursing Pay Packages
The post TTATN 033: The Top 11 Myths and Fibs in Travel Nursing appeared first on BluePipes Blog.
Hey everyone! Welcome to The Truth About Travel Nursing Podcast. This is Kyle Schmidt and I’m your host. Thanks so much for joining us for episode 32 of the podcast. In this episode, we’re going to discuss everything travel nurses need to know about resumes. Specifically, we’re going to discuss the unique nature of travel nursing resumes and how you can create a truly awesome travel nursing resume. We’re also going to take a look at what you need to know about handling your travel nursing experience on your nursing resume when you make the transition back to permanent employment. [ Please note: This is the transcript of a Podcast. As such, it is not edited as written content. ]
Okay, so the first thing we’re going to do is take a look at the unique nature of travel nursing resumes. We’re going to start here because if we were to start by discussing what you should include on your travel nursing resume, then you’d have tons of questions. You might even think I was crazy with all the recommendations.
And that’s because travel nursing resumes and the circumstances surrounding them are really unique. I mean, even standard nursing resumes are unique and we’ll discuss that later in the episode. In any case, the bottom line is that the standard resume rules do not apply. And that’s one of the biggest problems with the travel nursing resumes that agencies receive. The resumes almost always conform to the general standards we all know. And what that means for the agency and the travel nursing recruiter is that they rarely get the information they need out of a resume.
So, with that in mind let’s take a look at some of these unique circumstances. First, remember that we discussed travel nursing applicant tracking systems in our last episode, Episode 31. In that episode, I mentioned that the resume you send to the travel nursing agency rarely if ever gets sent to the hospital. Instead, the applicant tracking system used by the agency will typically generate a resume based on the information you enter in the online application.
So, you might be wondering why you even need a resume for travel nursing. I mean, what’s the point if it doesn’t get sent to the hospital? Well, as we discussed in Episode 31, if you have a really great travel nursing resume, then it can make it much easier for you to onboard with a new agency. There are several reasons for this.
First, the recruiter you send your resume to may be willing to enter all the data into their applicant tracking system so that you don’t have to. Remember, some recruiters are willing to do this and others aren’t. There are many experienced travel nurses out there who swear that they never fill out job applications and I believe them. They simply send their resume with all the details. If a recruiter requires an application, the traveler simply moves on to the next recruiter or agency.
Now, the second reason that having a thorough travel nursing resume can make it easier for you to onboard is that the recruiter may think your resume is so good that they’re willing to submit it to the hospital if there is a major time crunch to get your profile submitted. You see, in some cases, the agency my feel the need to get your profile submitted so quickly that they’re willing to forgo the application just to get you in front of the hospital. While this is rare, it happens often enough that there is a good chance you run into the scenario.
So, for example, they may pitch you on a hot assignment that you might be interested in. And maybe you tell them that you want to be submitted. If there is a big enough sense of urgency for the position, they’ll just take your resume and your skills checklist and send it right over. That way, you don’t have to fill out the job application unless you actually get the job offer.
And the third way that having a thorough travel nursing resume can make it easier for you to onboard is that even if you end up having to fill out an online job application, having all of the required data on hand will make it much easier for you to get it done. Moreover, it will ensure that it gets done correctly and as quickly as possible. And this is really important and here’s why.
For starters, there is tons of information that you’ll need to keep track of if you travel for very long at all. The more traveling you do, the more data you’ll have to keep track of. As you fill out applications moving forward, it will become very difficult without all of that data handy. You’ll end up piecing things together and having to do tons of research to gather all the information.
Now, on a side note, having all this information available isn’t just important for your travel nursing career; it’s also important if you ever intend to go perm again. Many hospitals will require much of the same information once you actually get a job offer. In fact, some hospitals require their candidates to provide all of the employer details they require, whatever those may be, for every single hospital that the candidate has worked with over the last 7 to 10 years.
In other words, it’s not going to be enough to just say, “I worked with agency X.” These hospitals want to know the information for the hospitals, not the agency. I can’t tell you the number of times that my former travelers would call and ask for details regarding the hospitals they worked with while they were traveling with me because they needed the details for a permanent employment opportunity. It happened quite often. That said, you may never run into this issue, but it’s just good to be prepared when you do run into it.
Okay, so another reason that it’s important to get this information entered quickly on your travel nursing applications is that entering the required information on your own will ensure that the recruiter has everything they need so they can get you submitted more quickly. In the cases when you do fill out an application, entering all the information will ensure that the recruiter doesn’t have to go out and do a bunch of research to find what they need. They won’t have to call you and ask for the details they need, which you may or may not have.
Now, I know you’re probably thinking that’s the recruiter’s job; why shouldn’t they be doing that? Well, that’s fine, but it will most certainly delay your profile getting set up, which will delay your being submitted for any jobs that you’re interested in. So ultimately, it could cause some missed opportunities.
Okay, so those are the ways that having a great travel nursing resume can be beneficial. Again, a great resume might prompt the recruiter to fill in the data for you so that you can avoid completing their whole application. Or, the recruiter may just use your awesome resume to get you submitted. This is rare, but it does happen. And finally, having all this data available will be a huge help when you have to fill out these applications on your own. As a result, you’ll end up spending less time and you’ll be able to get submitted more quickly.
Now, the next unique thing to consider when it comes to travel nursing resumes is the length. Simply put, LENGTH DOES NOT MATTER! I cannot stress this enough. And I know how difficult it is to let go of the length issue. I mean, the first rule of resumes that you typically hear people provide is, “Be sure it all fits on one page.”
Now, for starters, the one page rule is antiquated even for general resumes. It really depends on the situation you’re in. I mean, if you’re at a job fair, which most nurses won’t be, or maybe at a convention, which is much more realistic for nurses and other healthcare professionals, then having a one page resume is a good idea. It’s easy to hand out. But when you’re submitting online applications, the length of your resume is not all that big of a deal. Everyone from Forbes to Careerealism and other career related authorities attest to that. And we’ll link to those sites on the show notes page so you can see what we’re talking about.
When it comes to travel nursing resumes, length definitely does not matter. As I mentioned in episode 31, the applicant tracking systems that agencies use generate resumes that are massive. I wish I could show one to you. They use huge fonts and there is tons of space between the lines and sections. There are page-breaks all over the place. I mean, it’s pretty common for a typical one page resume to take up two to three pages once the information has been entered into the applicant tracking system.
So again, the most important thing is to get all the data onto your resume. Don’t worry about how long it is.
Okay, so another unique circumstance with travel nursing resumes has to do with the information that you’ll be including on them. Some of the information that you’ll want to include will be information that is actually recommended against being provided on normal resumes. And here again, you just have to abandon the standard recommendations for resumes.
So, with all of that in mind, let’s take a look at the details you should include on your travel nursing resume. Now, I have a list of 33 items that you’re going to want to include and that doesn’t count the obvious like your name, address and contact information. You don’t have to write everything down here. Remember, we’ll have the transcript up on the show notes page. And I’ll also link to a blog post titled 33 Items To Include On Your Travel Nursing Resume on the show notes page. And we’ll also link to all our blog posts that deal with Travel Nursing Resumes and general nursing resumes as well.
Okay, so let’s start with information pertaining to your licenses and certifications. You should have a heading specifically for Licenses and Certifications on your travel nursing resume. Under it, you should include the following.
First, list EVERY license and certification you have by their correct significations. For example, call it an “RN License”, not a “Nursing License”. How is the reviewer supposed to know whether you have an RN or an LPN license if it’s called a “Nursing License”? This is an example that I saw quite frequently when I was recruiting.
And again, be sure to list everything you have, even obscure things that you think may not be worth listing. For example, if you have a Crisis Prevention Certification from CPI, then list it. List anything. I mean, sometimes folks think that hospitals are only interested in the standard things like ACLS and BLS, but it’s quite common that they’re looking for other certifications as well. Moreover, your recruiter might not think to ask if you have any other certifications if you don’t list them. Sure, this would be a rookie mistake on the recruiter’s part, but it happens.
Second, be sure to list the license or certification number if applicable; some licenses and certifications have them and others don’t. And the one that always gets asked about is the RN license. I’ve seen tons of people claim that Nursing license numbers are a privacy issue. And while I certainly understand the concern, that’s simply not the case.
Nursing license numbers are a matter of public record. Anybody can look up an RN license number on the state board of nursing’s website with just a name. And of course, you’re certainly going to provide your name on the resume.
In fact, when the license number isn’t included on the resume, the recruiter will almost certainly need to look it up. This is because hospitals often require the license number to be present in the submission profile. They also require a copy of the license verification that can be printed off the state board’s website. They require this to ensure that the candidate is licensed and that there are no disciplinary actions registered with the state.
So, basically, including the license number just makes it much easier for the recruiter to get the profile submitted. It’s much easier to look your license up by license number than by name, especially if you have a common name. There could be multiple people with the same name. In which case, the recruiter would have to also use the address as a secondary verification. And, you know, this could just lead to confusion. I mean, they may confuse you with someone else, and maybe that someone else has disciplinary actions. So, it’s always best to include the license number, again, it’s a matter of public record anyway.
Okay, so the third item you’ll want to list for each license or certification you have is the licensing or certifying body. Again, this is important because most hospitals will accept certifications from only specific licensing bodies. One of the common ones is the American Heart Association. So, most hospitals won’t accept a BLS from the American Red Cross for example. Because they have this requirement, many of them want to see exactly which body your certifications and licenses are through.
The fourth thing you want to include for your licenses and certifications are the expiration dates. Here again, many hospitals require this detail to be present in the submission profile, so it should be included on your travel nursing resume. Now, if there is no expiration, then list the date that the license or certification was obtained.
Finally, if you have a compact nursing license, then you should clearly state it. Just in case you’re not aware, certain states are part of what’s called the Nurse Licensure Compact. If you obtain a compact license from one of these states then you can practice in all the compact states and there are currently 24 or 25 states that participate.
Now, many folks who reside in compact states and therefore have a compact license are not aware that it’s possible to be licensed in a compact state and not actually qualify for compact status. You see, in order to qualify for compact status, you have to reside in the state. You have to establish residency and declare it your resident state. So, for that reason, it’s a good to indicate if your license is compact. Simply write “Compact” in parentheses in the license description.
Okay, so that’s what you’ll want to include for your licenses and certifications. The next thing you’ll want to do is to clearly state your specialty or specialties if you have multiple. Here again, I recommend a separate heading for this. Call it Specialty or Specialties if you have multiple. Simply write the specialty acronym and full name and include the number of years of experience you have.
Now, you could get a little creative here and include some of the more specialized skills you’ve picked up here. For example, you might list that you have experience with swan ganz if you’re a StepDown nurse. But, this isn’t really necessary because remember, your profile will almost certainly include a skills checklist where all these details will be included.
Okay, so the next section we’re going to look at is your work history. Now, this is a big one with tons of different variables including some that run totally contrary to conventional resume recommendations. Again though, travel nursing is unique. So, under your work experience, you want to include the following details for each job you’ve held.
First, you’ll want to write out hospital’s full official name. While this may sound like common sense, many hospitals go by shortened nicknames and it’s really common for travelers to use that name. The problem is that it makes it very difficult for those not in the know to look up the hospital if they need to. It’s also unprofessional. It’s best to always use the full official name.
Second, be sure to include your official job title. Again, this one might seem obvious, but if so, you’d be surprised often it’s left off of resumes.
Third, you want to include the exact start and end dates. So, for example, you’re going to make it 4/4/2008 not 4/2008. Listing the month alone doesn’t cut it for some hospitals. In fact, there are some hospitals that require a description for what was going on during any gap of employment of more than 30 days. If it’s 29 days, they don’t care, but for 30 or more, they want an explanation. I know this sounds crazy, but that’s what agencies are dealing with. So, be sure to list the exact dates.
Fourth, list the details pertaining to the type of facility or hospital you worked at. For example, was it a Short Term Acute Care Facility, Long Term Acute Care, Children’s Hospital, Women’s Hospital, Surgery Center, or whatever? Also, was it a teaching hospital? If so, you should clearly indicate that. Next, if it was a trauma hospital, then state that and include the trauma level. Finally, you’ll want to include the number of beds in the entire facility.
Okay, so fifth, you’re going to want to include some specific information about the units you worked in at each hospital. Of course, you’re going to want to include the unit you worked in. And it’s important to use the specialty of the unit, not what the unit was called at the hospital. For example, use MedSurg, or ICU as opposed to 4 West or 3 East. Nobody outside the hospital knows what those hospital specific unit names mean and employers want to know about the units you worked.
Next, include the number of beds in the unit. And if the unit took trauma patients, then clearly state that. Also, include your typical caseload or the nurse to patient ratio that you were working with.
Okay, so sixth, list some of your specific duties. This is basically the job description part of it. And be sure to provide specifics as opposed to generalizations. For example, “Worked with Swan Ganz” instead of “provided patient care”. You know, you can include the patient types, like Neuro, Cardiac, Rehab, and stuff like that. You could include the patient age range. And, if you took Charge duty, then clearly list it. And that’s a big one actually. Many hospitals really want to know if you have ever taken Charge Duty…so much so that they’ll sometimes ask specifically if you have.
Okay, so the seventh thing to include would be the types of computer and/or charting systems you used. You can list these in a separate heading if you want, that’s how we do it on our BluePipes resume. Or, you could include them in each job description.
Now, the eighth thing to include when it comes to your work experience is definitely contrary to the conventional resume recommendations. You’re going to want to include your supervisor name and contact number if the supervisor can be contacted. And you’ll also want to include reference names, job titles, and contact information as well.
Now, finally, you’re going to want to include the employment type for each employer. Was it a perm position, PRN, or a travel assignment? If it was a travel assignment, then list the agency’s name and contact information as well.
Now, you may be wondering why in the heck you need to include some of these details. Well, most of them are required by one hospital or another. And some of them, like the references and supervisors, are needed by the agency so they can get their work done. For example, the agency needs to check your references before they can submit your profile.
In any case, these are all details that agencies will ask for on their applications. And our goal with our travel nursing resume is include everything that the agency needs so that we can minimize our time with the onboarding process and hopefully increase the speed with which we get submitted so that we stand a better chance of landing the jobs that we want.
Okay, so the next heading you’ll want to include on your resume will be for your education. And in this section, you’re going to include the following for each education institution that was a part of your nursing degree: the institution’s full official name, the full address, the telephone number, the dates of attendance, and the name of the degree you achieved. And this last one is important. Many hospitals want to know whether you have an ASN or a BSN and they may pass on the profile if they don’t see this information.
Okay, so the last things that we’re going to discuss for inclusion on your travel nursing resume are basically some miscellaneous items. For example, you’re going to want to include any professional affiliations and any professional honors and awards you’ve received. And finally, you’re going to want to include any gaps in employment of 30 days or more with a brief description of what you were doing at the time.
Now, I know a lot of these things sound strange. However, remember our goal. We want to get everything they need and require to them on our resume in order to minimize the time we spend onboarding and maximize our speed to submission to improve our chances at landing the jobs.
And of course, you’re welcome to leave some of these details off if you want. It’s your resume after all. But, don’t be surprised if someone calls you to get the information at some point or another.
And look, I know this is a ton of information. But again, it’s all required by someone somewhere. And if you don’t want to deal with remembering all of this or formatting your resume with all of this stuff, then you can always use BluePipes. It’s free and easy. Your profile will help you recognize and record all of these details and it will generate an awesome resume and job application.
And one of the cool things is that with BluePipes, the standard resume items will be on the resume and the standard job application items will be on the job application. So, you can actually maintain a somewhat normal looking resume, but still provide all the information they need. For example, the references and supervisors would be included on your BluePipes job application, but not on your resume. And of course, you can also use the skills checklists and all the other document management tools to help you simplify your travel healthcare career. And all of that is free for you as a healthcare professional.
Okay, so that’s how you can create a resume that really knocks ‘em dead when it comes to travel nursing. But, what do you do with your resume if and when you want to return to permanent nursing? This is actually a really tough issue to address. For starters, travel nursing assignments could be confused with short term employment, which is a big problem or red flag for employers. They’ll think you can’t hold down a job.
However, at the same time, you’ve gained all this awesome experience that would be great to highlight on your resume because it will make you really stand out from the crowd. I mean, you’ll probably have worked at some totally amazing hospitals by the time you’re done travel nursing and you’ll have picked up tons of amazing experience that you’ll really to describe.
So, I don’t think there is any one correct way to do this. But let’s take a look at some of the potential ways that you can handle it and talk about some of the advantages and disadvantages of each.
First, you could prominently list the hospitals in your work history. The advantage is that you’ll get to display all that awesome experience. The disadvantage is that your resume might turn out to be too long. I mean, even though it’s okay to have a resume that’s longer than 1 or even longer than two pages, there is a limit to everything. I mean, 7 pages is probably pushing it, right?
Also, you technically didn’t work for the hospitals. You worked for the agencies. So listing it this way isn’t entirely correct. I think that these problems pretty much mean that you shouldn’t be doing it this way.
So, the second option is that you could list the agencies you worked for prominently. Basically, you would just list the agencies that you worked for, the dates of employment you worked with them and provide the details for the agencies. Then, you might right a blurb or some bullet points about your experiences with them.
The advantage is that this is technically correct; the agencies were in fact your employers. Also, it could make it look like you had more stable employment. However, a potential disadvantage is that you may have worked with multiple agencies during your time as a traveler, and maybe you bounced back and forth between several agencies, so if you listed the agencies as your employers, then it might still look like you engaged in short term employment and you might still end up with a resume that’s too long. And finally, you don’t get the opportunity to really highlight all that awesome experience.
Okay, so the third way you can list your travel nursing experience on your resume is to put it all under one heading and call it Travel Nursing or Travel Nurse, or something like that. So, basically, you’d just put Travel Nurse, from this date to that date and then write a description.
Obviously, this lets you shorten it up quite a bit and I think that’s the real advantage here. However, it’s technically not correct. I mean you’re not necessarily providing your actual employers. Also, you’re not citing much of that awesome experience you gained. I feel like it just kind-of glosses over your travel nursing experience.
But, that said, this is the approach that is recommended by Donna Cardillo. If you’ve not heard of Donna she is a popular nursing career advisor and speaker. She writes for nurse.com which is owned by CareerBuilder and she has her own blog. We’ll link to the article in the show notes that you can review it yourself.
Now, the last option for listing your travel nursing experience on your nursing resume is to list the agencies as your employers, and then list each assignment that you worked for the agency under the agency’s heading. This is actually the way that you should be doing it on your travel nursing resume and it’s also an option for your permanent nursing resume as well.
And moreover, this is the way that the BluePipes profile builder is set up too. Our profile asks if the job you’re entering was an agency job, and if so, you can enter your assignments for that agency. Then, the system will nest those assignments under the agency heading.
Obviously, the disadvantage is that your resume could be really long. Again, not a problem for travel nursing, but the jury is out for permanent nursing. It sort-of handles the problem of short-term-employment, but if you bounced around to many different agencies, then the resume will still look choppy.
But there are several advantages as well. For starters, it’s technically correct. In fact, it’s perfectly accurate this way. It also allows you to highlight all that amazing experience you gained.
Okay, so those are the options you have. It’ll be up to you to decide what to do and everyone’s circumstances might be different. The longer you work as a traveler, the more agencies you work with, the more hospitals you work with, all of these things could affect your decision here. In any case, you should still be able to use the BluePipes resume builder for your permanent resume. In fact, we have thousands of nurses doing that. It’s actually really flexible, you just have to play around with it a little.
Okay, so that’s a really good place wrap up this episode. We’ve covered a lot of information about creating an awesome travel nursing resume and some considerations for putting that experience on your permanent nursing resume. I hope that the information we covered will help you manage your travel nursing career easier and more efficiently and help you land your most desired travel nursing jobs.
As always, we’ll have links to everything we discussed in the episode along with the transcript of the show up on the show note page. The link is blog.bluepipes.com/episode32. You can also leave any questions or comments there and I’ll gladly address them.
I want to thank you so much for listening to the podcast. You make all of this possible. And if you’ve been enjoying this podcast, then I would greatly appreciate it if you would provide us with a review on whatever platform you’re listening through. Whether it’s iTunes or stitcher or any other platform, it really goes a long way toward helping us move up in the rankings so we can get this information out to more travelers and keep the show going.
Again, thanks so much for listening and until next time, have a safe and prosperous travel healthcare adventure.
How Long Should a Resume Be – Careerealism
Forbes On Resume Length
Donna Cardillo on Travel Nursing Experience on Resume
Sample Travel Nursing Resume – Free Template
Critical Details for Your Travel Nurse Resume
33 Items to Include on Your Travel Nursing Resume
6 Nursing Resume Considerations for Travel Nurses Transitioning to Permanent
Nursing Resume Length and Feedback on Resume Details
Sample Nursing Resume – RN Resume
Travel Nursing Resume Length
Nursing Resume Objective or Summary?
How to Write an Effective Nursing Resume Summary
Top 10 Details to Include on a Nursing Resume
16 Tips for Your Nursing Resume and Applicant Tracking Systems
How to Write an Exceptional New-Grad Nursing Resume
9 Mistakes to Avoid on Your Nursing Resume
The post TTATN 032: How To Write An Amazing Travel Nursing Resume appeared first on BluePipes Blog.
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