Confused about negotiations

NedRN · Oct 3, 2017

Negotiation requires a position of strength. You have profit making potential they cannot have without you. But that is not really enough. What price will the market bear? How would you know unless you receive offers from other agencies? If you say Acme Agency is offering $10 an hour more for an assignment at the same hospital or city, do you think you might negotiate effectively? Call lots of agencies, and pick three to five recruiters with whom you communicate well with - if you cannot communicate, you also cannot negotiate. Shuffle through the offers and pick the best ones. You are not limited by compensation, one that you work well with is worth a pay cut, but the opposite often occurs.

It is important to know what an offer really means. Use PanTravelers Calculator to be able to compare very different offers on a level playing field. It will also teach you what numbers are important. It will also help in negotiating. Free. There is an article on negotiating a travel contract there too, but it requires a paid membership - might be worth it.

A final thought, don't get too hung up on pay your first assignment. You want a successful first assignment on your work history to make you a proven success as a traveler. A high paid assignment may be high paid for good reason, it is very tough. Seasoned travelers may be avoiding it as you were offered it. That increased risk of failure is not worth it until you learn about your own ability to adapt to very different work environments. Money will automatically get better as you gain experience - even without being a hardass negotiator.

I gather you are operating room. Good place for travelers right now and you will earn good money.

gnovime · Oct 3, 2017

NedRN - Do you recommend doing the paid PanTravelers membership? I see it mentions you have access to their contract lawyer but hard to tell if that's truly useful or not.

One of my recruiters is wanting to try to get me into Kaiser for my first travel position (home health) as he says that once I've done a couple assignments for Kaiser that's golden for my travel resume, though it's also higher paid than most of the other contracts so makes me think it might be possibly trial by fire

NedRN · Oct 3, 2017

I like Kaiser personally. But I'm OR. Most other specialties have to float, up to every four hours. That is tough, especially for a new traveler so many travelers hate them. Pay is good so I'd suggest giving it a try.

Kaiser is the largest hospital chain in California. There is zero resume enhancement over any other hospital. Name brands that look impressive on a resume might include hospitals like Duke, UCSF, UCLA, Hopkins, and Stanford. I've worked at those hospitals and other name brand hospitals, and there is nothing about them better than any other teaching hospital, but they do have name recognition so are fun to have on your resume. Even none healthcare professionals will be impressed. But they are not necessary to do well as a traveler. They were not a priority for me, just happened to have a location I wanted to try.

Kaiser has a vendor manager that 99 percent of all contracts go through - American Mobile. Good and bad with vendor managers, but a plus is that they have a uniform contract with Kaiser so other than crisis needs, it is easy to tell what agency really pays the best as they all have the same bill rate. New travelers do OK with American Mobile the agency, but I wouldn't recommend that you work a Kaiser assignment through them. Believe it or not, you are likely to find better money at a subcontracting agency (there are lots of agencies with that contract). An even better reason not to work Kaiser for them is that they may blackball you from working at another agency next time you want to work at Kaiser. Work for a subcontracting agency and you can switch freely.

Everyone has different reasons for everything they do. Joining an organization at a contributing level is no different. Some join PanTravelers to support their mission of educating travelers - tax deductible as a professional organization and a non-profit. Legal help if you have a contract dispute with an agency is like any other type of insurance, a complete waste of money unless you need it. If an article such as the negotiating one or some other tip found there helps increase your pay by as little as one dollar an hour, that is $2,000 a year extra! There is a discount offered for contributing members for the annual Travelers Conference in Las Vegas. PanTravelers is full of unbiased straight truths as they do not accept advertising of any sort, or contributions by agencies. That is pretty valuable when trying to sort through recruiter BS.

My suggestion is to try it for one year. Cheap, and you may have learned enough to not need it after that. You can also get a wealth of information as a free member.

gnovime · Oct 4, 2017

Thanks Ned. Yeah I've been a free member on PanTraveler for years but now that I'm finally rolling along I might as well get the paid membership for a year.

No floating worries for me as I'll be home health. Might be floated 50 miles out of my usual patient area but that's something else altogether lol. I completely hear you on the name brand "elites." I started my career at one of these in one of the very first Magnet hospitals. Lowest paying hospital for nurses in the whole city and horrendous treatment of nurses. You better believe though when Magnet rolled through, patient ratios were top notch and every t was crossed. When they're gone? Back to normal.

Good advise on the Kaiser/AM situation. I've read about the subcontracting situations with different systems with people saying to cut out the middle man but I guess in this situation the middle man is the better option, or should I say middle middle man.

NedRN · Oct 4, 2017

It certainly seems to be common sense to cut out middlemen, but the way it works in real life is counterintuitive. The real reason is the same even without a vendor manager involved and involves largely the costs of running a large agency versus a smaller one, and the decisions an agency makes about how much gross profit to keep for themselves (versus paying travelers) or for their shareholders - there are lots of viable business strategies, but of course we want to work for the lowest cost agency that also likes to pay more to attract the better and more experienced travelers. The industry average gross profit margin is about 25%, but the spread is as wide as 15% to 45%. That is where the same bill rate at a more efficient agency gets you higher pay (could be total or take home) versus an agency like American Mobile.

The vendor manager in the middle is almost irrelevant as far as the effective bill rates, no matter their take (usually on the order of 4% of the bill rate). If a hospital or health organization wants quality travelers, they have to compete with other facilities. So the bill rate to the agencies has to be competitive to get good (or sufficient number of) travelers. But when the vendor manager is also a large agency like American Mobile, perhaps they can do some different accounting with that 4%, but they still have to meet their costs and reward the shareholders. It is easy to see that that 4% is easily overwhelmed by the 15 to 45% spread in gross profit margins.

For the most part, long time travelers with large agencies do not lurk on traveler forums. Their career path is set and they are content. And honestly, going steady with a large agency can be quite good. Travelers that demonstrate proven ability to complete travel assignments are rewarded with the higher paying assignments, and their pay is going to be better than a new traveler at the same large agency.

Once in a while, someone from a large agency will stumble by and post here about how wrong I am and how much they make, and they are not wrong either. But it is a different pathway, and has its own risks and rewards. I started out myself with Cross Country for almost four years and never looked at another agency - until I got burned. Fortunately it was during a time of huge need for travelers and with my experience (and name brand hospitals), I had no trouble getting higher paying jobs than I ever got with Cross Country. But I won't say I wasted my time with them either.

bagladyrn, RN · Oct 4, 2017

Hey Ned! I resemble that remark! What do you mean we don't lurk?

NedRN · Oct 4, 2017

"For the most part" I said. You are certainly the biggest exception (that I know of) and I thought of you when I wrote the post. Hopefully I was diplomatic!

gnovime · Oct 4, 2017

I got contacted by a recruiter from an AMN subsidiary, should I avoid any AMN company for Kaiser or just American Mobile?

NedRN · Oct 4, 2017

I would avoid. No harm in getting a quote as long as you don't do all the profile paperwork. Then you can make an informed decision.

gnovime · Oct 21, 2017

Do most travelers hardly negotiate their contracts? I'm looking to sign my first contract and some of the details didn't make sense to me like OT rate. I talked to a traveler that raves about the agency and has been with them 3 or so years. She's never negotiated anything and thinks a $30 total OT/Holiday rate is fair ($20 taxed at 1.5x). The agency won't budge with me on it and part of me says not to push it this is your first contract, as everything else looks good, you'll have more leverage after I have the first one under my belt. The contract language is a bit grating, but have heard nothing but good about the agency.

NedRN · Oct 21, 2017

If there is no OT available and/or you don't like OT, there is little point to negotiating. However, since this agency is ignoring common sense and will not budge, they are not someone I would want to work for. It is not a good experience if you feel they are taking undue advantage. Even though money is not your primary objective on your first assignment.

Hopefully you have been talking to other agencies and have other options. If you still have a staff job, consider dumping this agency and regrouping. This can be an awkward time to look for assignments with holiday season so close. January would be better and give you time to discuss these new found issues with other recruiters before you are submitted.

OT can be a nutty subject. Kind of crazy to be making $50 to $70 an hour including your stipends for 36/40 hours and then they think paying $30 for working extra hours is a good and fair incentive.