Extremely interested in traveling

Travel nursing

Travel nursing and the Travel Nursing Industry developed in response to the nursing shortage in which nurses travel to work temporary short-term nursing positions. The current severe shortage of nurses in the United States has increased the need for this type of position. To recruit qualified Registered Nurses, LPN/LVNs and Allied Health professionals hospitals and travel nurse recruitment/staffing agencies are offering incentives including higher wages, relocation assistance, furnished housing, and bonuses.

There are many reasons healthcare professionals choose to travel including higher pay, professional growth and development, and personal adventure. Travelers typically select from one to several recruitment agencies to act as an intermediary between the traveler and hospitals or other potential employers. There are over 340 Travel Nursing Companies in the U.S. as of 2009. Agencies may submit applications for numerous positions concurrently on behalf of a traveler.

Applying with one of these agencies usually involves a substantial paperwork burden. This includes completing an employment application, work history, verification of licenses and certifications, skill assessments for your nursing specialty, verification of immunizations or titers for common communicable diseases, current TB skin test or chest x-ray, a physician's statement certifying you are fit for work, and numerous other documents required by the agency. However this paperwork need only be completed once per agency. Some agencies will accept much of the paperwork completed for competing agencies. The information provided is then condensed by the agency into a summary/abstract of the traveler's credentials, skills and experience. This summary is usually referred to as a profile.

After completing the agency application process, each agency will search through temporary job postings to identify those that match your profile. The agency, after obtaining your consent, submits your profile by fax or email to the hospital. A human resources employee or department manager will review all profiles submitted for the specific job posting. No single agency has access to all temporary job postings. This is why many travelers choose to apply with several agencies.

The amount of money a hospital pays to the agency is referred to as the Bill Rate. The agency will calculate and subtract their costs, overhead and profit margin from the bill rate and then, with the difference, make a detailed offer to the traveler. Offers should include the specific dates and location of the contract, details of pay, housing or stipend amounts, insurance or other benefits as the agency may choose to include in their offer package. Agencies' costs and profit margins vary widely. This will directly affect the amount of money available to package into an offer for the traveler.

Further, different agencies will package the same amount of money quite differently. One agency may offer luxury housing, high end health insurance, license reimbursement, a rental car and many other perks. Another may not offer health insurance, may provide low quality housing or even no housing at all. It is important to understand that there is no such thing as free housing or other free benefits. All of these things have a cost. Since all costs and compensation must come out of the bill rate, a traveler working for an agency offering a high level of "extras" will probably be paid lower wages than one working for an agency that offers few or no non-wage perks.

If the traveler, tentatively accepts the terms and conditions of the offer, the agency will arrange for a telephone interview between the manager and the traveler in most cases. Assuming a successful interview, a formal contract will be prepared by the agency and sent to the traveler for their signature. Every aspect of compensation, including wages, stipends, reimbursements, housing, insurance, and any other perks is subject to negotiation between both parties and should be adjusted and spelled out in the written contract which ultimately is, with both parties signature, legal acceptance of the terms and conditions of the assignment contract.

Clinical requirements

The usual requirements for becoming a travel nurse are a minimum of one year of clinical experience in one's specialty and licensure in the state of employment, usually granted through reciprocity with the home state's board of nursing. Some travel agencies will reimburse travelers for the cost of the license or other required certifications. While only a minimum of one year of experience is required, it is highly advisable to have two or more years of experience prior to becoming a travel nurse. A travel nurse may receive a minimal orientation to the assignment hospital, most often only one or two days. Some travelers may receive no orientation at all. This is a subject that should be clarified in the interview. Travel nurses are expected to be very experienced and knowledgeable in their specialty by their assignment hospital.

If the nurse's home state has joined the Nurse Licensure Compact (NLCA), the nurse can work in any compact state using their home state license. The nurse must have a license (RN or LPN) in good standing in their resident Compact state. There are currently 23 states participating in NLCA with Missouri pending implementation. The nurse must apply for licensure in each state thye wish to travel and practice to. Some agencies will reimburse the nurse for the license, most re after completion of the contract.

Travel nursing assignment

Travelers typically work under a short-term contract (usually ranging from 4 to 13 weeks). Contracts outside of the U.S. can last 1-2 years. Frequently an extension or a permanent position is offered by the hospital at the end of the contract.

Assignment housing

If travel agencies provide housing it usually consists of a one bedroom furnished apartment although other options can be arranged. Utilities (electric, water, trash) may be included. Telephone, cable TV and sometimes Internet service can be included. Housing often includes basic furnishings and may include a washer and dryer, dishwasher and a microwave but this must be clarified during negotiations. Many companies also provide housewares, which include pots, dishes, utensils and linens.

The housing is typically arranged by the travel nursing agency in the company name. Some companies allow the travel nurse to participate in the search and selection process. Some parts of the country are much harder to secure reasonable housing than others.

Nearly all agencies will offer a housing stipend if the nurse chooses to secure housing independently of the agency. Stipend amounts can be very substantial - often higher than the actual wages - and these may be provided tax free if the traveler has a qualifying tax home. The stipend is attractive to travelers who prefer to obtain their own housing, those who travel in RVs, and to those simply trying to maximize their income and who are able to secure inexpensive housing. Some companies require the traveler to take the housing stipend. The housing stipend or the value of the provided housing will be taxed as part of the pay if the traveler does not have a qualifying tax home.

Assignment reimbursements

A travel allowance is generally paid by the travel agency which may or may not cover all Travel costs.

Some agencies offer healthcare insurance or reimbursement for insurance held elsewhere, the ability to contribute to 401(k)accounts (sometimes with matching funds), licensure reimbursment, referral bonuses for referring other travelers and loyalty reward type programs. Some companies are even starting to add vacation and sick days, stock investment options and continuing education reimbursements.

Salary and benefits

Salary averages are widely variable. Salary may change based on the location, the need of the hospital or nursing unit, the perceived staffing needs by the unit manager and the ability of the traveler to negotiate. Great differences are seen in various locations of the country. Generally, areas in the southern United States pay less than areas in the north or west. Areas where housing costs are high can impact salary ranges, as well. Travel nursing positions often can pay more than stationary nurse jobs depending on locations and demand.

There may be tax benefits, commonly called "Tax Advantage" or "Per Diem" pay, if the traveler maintains a "tax home" while working and living away from that home. The tax-free reimbursement covers meal and incidentals as well as lodging. Some companies only offer the tax free lodging component, while others provide both. A "tax home" is a dwelling that you live in, maintain and return to between assignments. You must have living expenses at your tax home that you duplicate because your business requires you to be away from that home.

Tax-free money is a complicated subject and many travel companies have little understanding of the tax implications for the traveler, often encouraging travelers who do not qualify to take it, leaving them at risk in an IRS audit. It is highly advisable to consult a travel tax expert prior to accepting tax free money.

Considerations

There are additional costs of being a traveler, which include additional licensing costs, traveling costs. These costs may be reimbursed to varying degrees depending on what company you use, your recruiter and your own negotiating skills.

Often nurses will dream of traveling as a way of getting financially ahead and seeing the world. That dream can turn into a nightmare though if a traveler is not prepared and educated. Being a successful traveler requires using good financial planning, a flexible outlook, knowing what companies and recruiters to deal with, what questions to ask, and how to negotiate.

The Professional Association of Nurse Travelers is the non-profit national organization representing nurse travelers in the US. The best inside advice covering pitfalls and workarounds comes from traveler-produced websites, blogs and forums on the web. Travel Nurses may get to go any where in the United States or other countries as well. This can be a big opportunity for many people, so you need to consider traveling when you become a nurse.