Buyer Beware Before You Get into Travel Nursing: Critical Mistakes & Pitfalls to Avoid Before Signing a Travel Nursing Contract!
Travel nursing jobs pay well than full-time in-hospital jobs. The fact that you can travel to different locations as you wish is just the beginning of the many benefits of working as a travel nurse.
Travel nurses enjoy the true freedom to choose whom they want to work for, when and on what terms. YES! You get to choose your days of the week you want to work, you get to choose which shift you want to work and many more benefits.
In this article, you will learn about:
- Education requirements
- Experience and credentials needed for a travel nurse
- Top 20 best paying states for travel nurses
- Understanding Taxation
- How to select the right travel nursing agency
- Pitfalls to avoid before signing a travel nursing contract. Know your recruiter
- Bedside manners: How to thrive against all the turbulence that hits travel nurses
Ready to know all there is to know about travel nursing? Let’s dive right in!
Education, Experience, Specialties and Credentials
Travel nursing, for the most part, is for nurses with at least more than a year experience in general nursing unit and two years for specialty units like ICU, CVICU, PICU and such.
Education needed for travel nursing:
Travel nursing is diverse and does accommodate from LVN, RN, NP & CRNA. The sky is virtually the limit.
Traveling as LPN.
There are hundreds of travel nursing jobs for LPN nurses in many states but most of these jobs are not in acute care hospitals. They tend to be in ambulatory care clinics, long-term care homes, nursing homes and home care services.
This does not necessarily imply that LPN nurses are not capable of delivering safe patient care but has more to do with hospital credentialing bodies pushing to achieve higher magnet status for all hospitals.
Magnet status also has a lot to do with how much hospitals get reimbursed by insurance and governmental bodies.
Traveling with ADN associate degree:
You are a registered nurse and that is what matters in most cases. The slight limitation that may exist for ADN registered nurses is that most hospitals prefer BSN nurses in specialty areas. This is not the case everywhere but it is not uncommon.
Specialty travel nursing assignments tend to pay better than lower acuity units. The reason for this has more to do with how much money the hospital get reimbursed. The hospital gets higher reimbursement for a BSN hour than an ADN-RN hour.
Having said this, you can probably see why it is a good idea to bridge from ADN to BSN.
Travel Nurse with BSN degree
Most specialties that pay higher prefers nurses with BSN, however, you do not get paid more than an ADN nurse – just because you have a BSN.
The advantage may be based on the fact that BSN nurses have better chances of training in specialty areas like CVOR, critical care units, etc. These types of jobs pay higher than lower acuity units.
Nurse Practitioner Travel Nurses:
There are a lot of nurse practitioner travel jobs all over the USA. Orthopedic nurse practitioners make a lot more than the other nurse practitioner specialties. Every specialty pays differently. Each employer pays different from another.
Credentials and Experience Needed to be a Travel Nurse:
Every nurse knows what they have to maintain to be called a nurse – your nursing license. Your professional nursing license is what defines your role in healthcare job market.
Compact Nursing License
Compact licensure was formed in the year 2000 allowing nurses to practice in compact participating states, either physically or electronically, by simply maintaining a single license.
Advanced Practice Nurses (APRN) like nurse practitioners and CRNAs are not eligible for a nursing compact license. LPN/LVN and RN are the only ones eligible.
Recently, the state of Georgia joined the Nursing license compact – May 2017. Here is a table list of all current nursing license compact
|State Name||Date Implemented|
|Arizona||July 1, 2002|
|Arkansas||July 1, 2000|
|Colorado||October 1, 2007|
|Delaware||July 1, 2000|
|Idaho||July 1, 2000|
|Iowa||July 1, 2000|
|Kentucky||June 1, 2007|
|Maine||July 1, 2007|
|Maryland||July 1, 1999|
|Mississippi||July 1, 2001|
|Missouri||June 1, 2010|
|Montana||October 1, 2015|
|Nebraska||January 1, 2001|
|New Hampshire||January 1, 2006|
|New Mexico||January 1, 2004|
|North Carolina||July 1, 2000|
|North Dakota||January 1, 2004|
|Rhode Island||July 1, 2008|
|South Carolina||February 1, 2006|
|South Dakota||January 1, 2001|
|Tennessee||July 1, 2003|
|Texas||January 1, 2000|
|Utah||January 1, 2000|
|Virginia||January 1, 2005|
|Wisconsin||January 1, 2000|
BLS, PALS & ACLS certifications:
Besides carrying a current and a valid license, every nurse must have a current CPR card. BLS applies to all nurses including LPN/LVN.
Pediatric Advanced Life Support (PALS) is required for pediatric and NICU nurses. Emergency room nurses in some hospitals may be required to be PALS certified.
All critical care nurses, cardiac step-down, PACU and emergency department nurses are required to carry Advanced Cardiac Life Support (ACLS) certification. ACLS certification is very important to carry for all nurses working in acute care hospitals. You cannot get ACLS without BLS. They both go hand in hand.
Specialty certifications like Critical Care Registered Nurse (CCRN) are important to have but these are not requirements of a travel nurse. Specialty certifications, however, make a nurse more marketable. Keep your options open.
Top 20 Paying States for Travel Nurses:
We have put together a table of top 20 best paying for travel nurses with thousands of jobs available immediately.
The average annual salary is based on all specialties across the whole state. Same thing applies to the per hour rate.
These figures are only averages. Pay attention to specific states and specific nursing specialties. Despite the high cost of living, California is still the place to be for travel nurses.
|State||Average Annual RN Salary||Average RN Hourly Rate|
Understanding Travel Nursing Pay & Taxation:
When you travel from one state to another and earning money in that state, the issue of taxation can be tricky. A Large number of travel nurses finds this difficult but is simple.
Your home is your tax home: Any nurse traveling more than 50 miles away from their home state are considered a traveler. If you live in large cities like Dallas, Texas or LA, California, you can still be living in the same city and be considered a travel nurse.
Prior to starting your career as a travel nurse, your travel agency will provide you with a form that you are supposed to sign. This form will define your tax home and you can get tax free travel stipends.
The Tax Advantage Plan for Travel Nurses
Tax advantage plan allows you to receive tax-free meals and accommodation stipends while traveling away from your home.
To participate in the Tax Advantage Program you MUST maintain a residence as a renter or owner in your home state or the state which you claim as your home.
This is where you have your permanent resident/address location and state with associated expenses. Your contracts as a travel nurse are considered temporally deployments and you are only living away for word – temporally. This permanent residence is called a Permanent Tax Home as defined by the IRS.
Your pay per hour sounds little but take home per week is a more. How does this work?
Government tax estimation may range that the average cost of meals per day in a certain area is $25.day. Keep an eye on these numbers so you can understand how you get paid more without paying too much taxes. This means the maximum you would spend per day for Meals & Incidentals is $25
$25/day X 7 days = $175 per week. $25 X 30 = $750/ month (Tax Free Reimbursements)
Most travel nursing companies will work out a virtual pay per hour rate to see exactly the take home dollar value per hour.
Let’s say you work 36 hours/week and your pay rate of $28/hour. You also get $475/week in tax-free reimbursements (Meals & Incidentals)
$475/week divided by 36 hours/week worked = $13.19/hr. Virtual pay rate
$28/hr. Actual Pay Rate + $13.19/hr. Virtual pay rate = $38.19/hr. (Actual pay rate + Virtual pay rate). This is how to see how much you get paid per hour.
How to Select the Best Travel Nursing Agent:
Travel nursing agents are out to make money – not to help you for free. With this in mind, you should always know that travel nursing agents might take advantage of an unsuspecting travel nurse.
The good thing is, large travel nursing agents are publically rated and reviewed. In these reviews, the good, the bad and the ugly comes out. These travel nursing agency reviews come from actively traveling nurses.
Most travel nurses tend to be enrolled in more than one agency. The rich data in their reviews is dependable enough.
Having said that, however, small travel nursing agencies tend to be better than large popular ones. Small agencies have a reputation of treating their staff one-on-one. You feel like you are important, not just a number.
Your most important person to get along with is your recruiter. No matter how well rated a company is, a recruiter can mess you up and literally have you work for less. Most recruiters are looking for this opportunity to get you – because this is how they make their money. Beware!
Top Rated Travel Nursing Agencies
There are two travel nursing rating agencies, known for having thorough and non-biased reviews. They are Highway Hypodermics (HH) and Travel Nursing Central (TNC). Of course, there are other rating services like indeed.com, Ziprecruiter.com, and glassdoor.com but these rating systems are not travel nursing specific.
Both companies release data collected throughout the year in January, showing deep though and honest reviews. Definitely, these ratings are best of the best.
In 2017, here are the top 10 travel nursing agencies. Bear in mind that these are large companies with hundreds of employees. It does not mean the small ones that do not get onto this list are not good.
Travel Nursing Central top 10 2017
- FlexCare Medical Staffing
- Medical Solutions
- TotalMed Staffing
- Fusion Medical Staffing
- Host Healthcare
- Medical Staffing Solutions, Inc.
- LiquidAgents Healthcare
- Tailored Healthcare Staffing
- Next Medical Staffing
Highway Hypodermics top 10 list 2017
- Health Providers Choice
- Premier Healthcare Professionals
- Tailored Healthcare Staffing
- Host Healthcare
- IPI Travel
- Advanced Travel Nursing
- Atlas Medical Staffing
- Medical Staffing Solution LLC
10 Ways to know if you are dealing with a bad travel nursing recruiter:
There are many ways you could tell you are dealing with a bad travel nursing recruiter. Pay attention to small things that matter to you and how they respond to your questions or concerns.
Full voicemail or always busy recruiter:
This is one of the most alarming pointers. If your recruiter phone always goes to the voicemail and you find the voicemail is full, beware. That just tells you that many more people just like you have un-addressed issues and they have been calling without being able to talk to the recruiter.
This is not uncommon in travel nursing world. You find recruiters who would threaten you that you made a verbal agreement to take on a contract with a certain hospital.
Such recruiter may threaten you that you are going to be blacklisted by that hospital or hospitals in that region. A lot of times, this happen when the recruiter is screwing you up and detects that you have concerns/may have detected.
Recruiters Who Submit Your Information to Hospitals without Your Consent:
This revolves around the hungry type recruiters whose only interest is the dollar they can squeeze from you. A good recruiter will call you and ask you how you have planned yourself. When you want to work and when you want to be off.
The Hype Type Recruiter:
Even before you take on the first assignment as a travel nurse, if you get this recruiter who promised how you are going to make a bank, beware. Honest recruiters never hype nurses. They are realistic and professional in every word they tell you. Hype types are the ones who can’t wait for you to sign a contract agreement. Beware.
Offering Really Low Rates in the Name of Saving Taxes:
I have heard of recruiters who would offer something like $10/hr. so that your tax-free stipend is higher. Do not accept. It is better to have a rough idea of how much an average travel nurse base rate is in the area you are traveling to. IRS stipulates wages paid must be in correlation with the market value of such an employee. Do not deal with such a recruiter.
Recruiters with Hidden Pay Information:
Some recruiters will tell you that you will get this and that once you sign a contract. Do not accept to sign anything until you have all your answers upfront. Example, make sure your recruiter tells you that YOU ARE GOING TO GET PAID during orientation. Make sure this is written in your contract. Some recruiters will try not to pay you for meals and incidentals during the first week of orientation. Beware!
Secretive Bill Rates:
If you encounter a travel nursing recruiter who will not reveal the bill rates (MOST WILL NOT), question their integrity.
Recruiters Who Ask for Upfront Cost:
You may encounter a recruiter asking you to pay for background checks and medical screening. While some may not even tell you verbally, they may hide it in your agreement to be deducted from your paycheck. They may do this from your first paycheck or they may do it for several pay periods, distributed in small amounts that you may not notice the difference. Be very careful about this as this is a common practice.
Changing Pay Rates:
This can also happen and does happen in travel nursing world. You find that your pay rate changed after you start your assignment. A lot of times, the change is downwards – even if it is a single cent. Before you sign your travel nursing agreement, you should understand exactly how much you would take home in a 36 hours week. This is very important to understand. Ask all the questions you may have upfront before you sign that contract. Be sure to ask and understand IF THERE WILL BE OTHER DEDUCTIONS other than those explained to you. Such deductions may be squeezed in your contract and once you sign it, they can legally deduct. Beware.
Also, if you are working overtime hours, understand the requirements and pay rates. If it is not time and a half, run for your life. Also, understand that overtime pay is regulated by law, not by your recruiter. YOU MUST GET TIME AND A HALF for overtime hours worked and nothing less. Make sure you get this clarified before you sign a contract.
This is the biggest smoking gun and a lot of times, it is not accidental. It is a jungle out there and you could be working for someone if you do not pay attention to your paycheck.
Surviving in Your Travel Assignment: How to Get Along With Your Co-Workers:
Travel nursing is fun. Knowing how to get along with your coworkers in the hospital where you will be assigned is very important. While travel nursing is not for new graduate nurses, even experienced nurses need to understand survival skills.
Bad nursing habits and bedside manners can not only get your travel contract canceled but also get you blacklisted by hospitals. Make sure you get your job done and do not get into unit politics.
- Be punctual at all times to get in and to get out
- Avoid nursing unit gossip and politics. You will do fine
- Don’t be a dirty type. Make sure your work is clean
- Stay off your cellphone while at work. Cellphone addiction can get you in trouble.
- Be careful with hospital policies and procedures. There is nothing like one fits all. Every hospital is different.
- Know your stuff well. If you are the kind who’s always asking how to do this and that, you may seem incompetent. Do not travel if you are not comfortable with your skills.
- Never take an assignment in a unit you have not worked before. This is how to get in trouble. Example, if you are a cardiac ICU RN, do not just accept a neuro ICU assignment if you have never worked in a neuro ICU. How you calibrate a Swan-Ganz catheter in cardiac ICU is different from how you calibrate a Ventriculostomy drain. Your maximum dose for levophed in a medicine ICU is not the same in cardiac ICU. Your blood pressure limits in neuro ICU could be different from those in cardiac ICU.
Closing Thoughts About How to Become a Travel Nurse
Do your research well and never take anything for granted. It is a jungle out there. Be careful dealing with recruiters. They can mess you up or enslave you with legal contracts. Beware.
Make sure your skills are up-to-date. Keep your licenses updated. You may not get anyone to remind you that your license is about to expire. Be proactive, not reactive.
Be safe and do not put your license on the line working in an area you are not familiar with. A one-second mistake can mean life and death. Can mean not only losing your license but also going to jail. Be safe