Agency Nursing

by Meriwhen 5,677 Views | 2 Comments Senior Moderator

Agency nursing (sometimes known as registry nursing) is the provision of nursing services on behalf of an agency. Agency nurses include RNs, LVNs/LPNs and advance practice RNs, and they are found in a variety of facilities and specialties. Agency nursing is a popular choice because of its flexibility and earning potential. However, agency nursing does have disadvantages that need to be considered.

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    Agency Nursing

    Agency nursing (also known as registry nursing) is the provision of nursing services on behalf of a staffing agency. The nurse is an employee of the agency; the agency sends the nurse out to various facilities to practice. Agency nurses can be found in all specialties of nursing. Agency nurses may work part-time or full-time. RNs, LVN/LPNs and advance practice RNs all can do agency nursing. Many nurses choose to work agency as their primary job, or as a secondary job to pick up extra income or experience.

    Nursing Practice

    The nursing practice of the agency nurse depends on the licensure and specialty of the nurse, as well as the specific assignment that the nurse is completing. The wise nurse will keep in mind their state’s scope of nursing practice at all times. In addition, the wise nurse will make it a point to learn the policies and procedures of every facility that they are sent on assignment to.

    Practice Settings

    Wherever you can find a nurse, you could find an agency nurse. Agency nurses get sent to many different types of facilities. The most common types of facilities that agency nurses get sent to are acute care, outpatient, home health and private duty.

    Benefits of Agency Nursing

    The main benefits of agency nursing are earning potential and flexibility. Salaries of agency nurses are often (but not always) higher than those of those of salaried or permanent staff. Many agencies offer same-day or next day pay, which is convenient for a nurse who needs to make quick money. Agency nurses are free to set their own schedules, though some agencies may have minimum scheduling requirements. You can work anywhere from the odd shift here and there to the equivalent of full-time hours. You can schedule yourself weeks in advance, or you can pick up shifts on short notice. You can also cancel yourself from working on short notice.

    Much like per-diem nursing, agency shifts can allow a nurse to have a flexible schedule or more free time, while keeping their skills and resume current. Many nurses that are raising families or going back to school look into agency nursing. Agency nursing is also a good way to break into the job market in a new location, or to make yourself known to a particular facility.

    Some agencies may offer benefits such as medical insurance, retirement plans, and continuing education. In addition, there is the potential for short- and long-term employment contracts to give you some stability. Some agencies offer the option for you to be hired by the facility following completion of a contract. Some agencies are part of a franchise or chain, with locations throughout the state, the region or even nationwide. This allows the nurse to transfer to various locations with minimal problems.

    Keep in mind that the practices of and benefits offered by individual agencies can vary widely. Be sure to check with your agency for the specifics that will apply for you.

    Downsides of Agency Nursing

    The greatest downside of agency nursing is that, much like per-diem work, the hours are not guaranteed. Agency nurses are usually the first ones to be cancelled by a facility, and usually the cancellation is done only a couple of hours before the scheduled shift. Agency nurses are also the first to get sent home should the census drop. If you NEED a stable schedule or income, you should think twice about relying solely on agency nursing to provide this.

    Agency nurses work without benefits or PTO, unless their agency offers benefits independently. Agency nurses are not eligible to join a facility’s union, as they are not facility employees. Therefore, they are not offered the benefits or protection of the union. Also, agency nurses often get the worst assignments or the work that the permanent staff doesn’t want to do.

    It is common for agencies to have non-compete clauses in their employment agreements, such as prohibiting you for working for another agency while in their employ. Or they may penalize you for accepting an employment offer from a facility that you’re sent on assignment to, unless a certain amount of time has passed. The agency cannot stop you from earning a livelihood, but they could take you to court to enforce the terms of any employment agreement that you sign. Therefore, be sure to carefully review the employment agreement before you sign it, and consult legal counsel if necessary.

    Some agencies have less than savory reputations and practices. You should investigate the credentials and reputation of any agency before signing an employment agreement.

    Again, the practices and benefits of individual agencies can vary widely, so check to see how your agency does things.

    Finding an Agency

    To find a nursing agency, look in the Yellow Pages, job websites such as Indeed.com or LinkedIn, or through threads right here at AllNurses. However, our Terms of Service prohibit solicitation by or on behalf of an agency. You can also try searching online via Google or Bing. Suggested search terms include “nursing agency”, “staffing agency” and “nurse registry”.

    Word of mouth is also a great way to find agencies, especially as most agencies offer referral bonuses if their agency nurses bring in new talent. In addition, word of mouth a great way to learn about the agency’s reputation and whether people are happy working for them. Finally, it is not uncommon for agencies to recruit nurses, especially those who have posted their resume online at job sites.

    Basic Education

    To become a nurse in the United States, you need to graduate from a nursing program and pass the NCLEX. You can work for an agency as a RN or a LVN/LPN.

    Experience REQUIRED

    Unfortunately, agency nursing is not well suited for the new graduate nurse or a nurse looking to switch specialties. This is because agencies expect their nurses to be proficient in their area of practice. The orientations provided by both the agency and the work site are usually minimal, more of the “here is how we do things and where everything is located” than Nursing 101. Getting only a day or two of orientation is about average for the agency nurse. Therefore, almost all agencies require at least one year of nursing experience.

    Some agencies, particularly home health, may be willing to take on a new graduate nurse. If you find an agency that will take you on as a new grad, be sure to inquire about the type, quality and length of orientation and training that you will receive. The reality is that you are NOT going to get the same caliber of orientation and training that you would in a hospital’s new grad program. And keep in mind that should something happen while you are on assignment, YOU and not your agency will be held accountable.

    Certification and Professional Organizations

    There are no certifications that are specific to agency nurses. Nurses can obtain certification in their specialty area through the ANCC or other certifying agency.

    As far as I know, there is no professional organization specifically for agency nurses…and if there is, please tell me about it so I can update this! Nurses are free to join whatever professional agency best suits their interests and professional practice.
    Last edit by Joe V on Dec 9, '13
    merlyritesh, delphine22, antania31, and 3 others like this.
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  3. About Meriwhen

    Meriwhen is a psychiatric nurse and an assistant administrator at AllNurses. Meriwhen has worked as an agency nurse for a second job for more than a year. Meriwhen enjoys the flexibility that agency nursing offers, especially for the teething baby that is chewing on Meriwhen’s foot as she types this.

    Meriwhen joined Mar '07 - from 'the Left Coast'. Meriwhen has 'never enough' year(s) of experience and specializes in 'Addictions/dual, crisis stabilization'. Posts: 8,443 Likes: 8,037; Learn more about Meriwhen by visiting their allnursesPage Website


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    2 Comments so far...

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    While it is true that there is no nurse centered organization for agency or registry work, depending on the circumstances, PanTravelers (an association for nurse travelers) has a ton of potentially relevant information.

    One thing you didn't touch on is that in a lot of cases block booking is available through agencies (and in-house hospital per diem as well). This means an agency nurse is scheduled just like any other staffer, with the same expectations of showing up for the scheduled shifts. Block booking is often full time, 36 or 40 hours, and can be more. While the hours are not guaranteed, neither are hours for regular staff. Block booking is ideal for the hospital with enough ongoing needs, ideal for the agency who now doesn't have to deal with daily staffing, and ideal for the nurse who needs steady and predictable work.

    The next step up is the so-called local contract. This is exactly the same as a travel contract (so PanTravelers content about contracts is very pertinent). Hours should be guaranteed (just as they should be for a good travel contract). Generally there are no provisions for travel like tax benefits or provided housing as they are usually not necessary since as a presumptively local person, you wouldn't qualify anyway.

    In some markets like Chicago, there are very few travel contracts available for the national agencies due to the very robust local agency scene. Local contracts are very common and the way to go even if you don't live there but want to travel there for an assignment.

    OK enough said about that. On another subject, what is possible through local agency can blow your mind! I met a husband and wife team at a strike (ironically as I'm pro-union) from Los Angeles. They had both worked exclusively registry for years, and both worked more than full time. The number of hospitals each had worked at in the greater Los Angeles area was staggering. I've worked at perhaps 40 different hospitals in a long career of traveling, but that was nothing compared to the number of facilities these two had worked at in a much shorter time frame. Talk about adaptability and hitting the floor running. Most travelers can just dream of being that competent.

    One other point to mention about travel to agency nursing connection: To get the most financial benefit out of traveling, maintaining an IRS approved tax home (a place to hang your hat) is a good thing. One of the three legs of tax home eligibility (only two legs are required) is working at home. Tax homes are decided in an audit by a preponderance of the evidence, and actually working at home can really help solidify eligibility for business travel related tax benefits that all travel agencies provide. Thus if you live in a market that is big enough to have agencies, working a shift or two when home between assignments is valuable, and also can prop up your income if the time between assignments is lengthy. The ideal is actually being on per diem staff at a hospital, and some hospital per diem annual work requirements do fit well with the demands of being a traveler. Working for a local agency will suffice.

    Again, it is not necessary to work at home to take advantage of traveling tax benefits, but it is ideal. I live in an area with no local agencies for hospital work, and no jobs period. So I have never worked at home, only traveled. While I have never worked in Chicago, I have worked twice for a local agency in California who only staffed three counties north of San Francisco. Basically it was a local contract and I found my own housing. Sometimes even travelers find benefits to working through local agencies who know their client hospitals personally.

    I'd also like to point out that working for local agencies is a great way to get into traveling as it serves as a great objective skills check back. Working for one hospital only doesn't really tell you if you can survive in a different hospital with procedures and a culture that could vary dramatically from your own, and if you can adapt fast enough with a very limited orientation. I did that myself before I started traveling - I was living in the DC-Baltimore area at my first nursing job with lots of agencies. I did fine and went off traveling. Even that local agency work at a couple different hospitals did not fully prepare me for how different hospitals can be from each other, or even how differently the same surgery can be performed by different surgeons (I'm an OR nurse). But seeing different ways of doing things is for me part of the fun of working in new hospitals, and no doubt keeps local agency nurses involved and less likely to go stale as working at only one hospital might encourage.
    Meriwhen likes this.
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    Thanks for the info! You definitely have more agency experience than I do I'm happy you could fill in the gaps I missed.


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