Help with new contract am I getting screwed?

meanmaryjean, DNP, RN · Nov 20, 2013

Is this your first contract?

Nzuri · Nov 20, 2013

No. I started with this agency in May. I am currently on assignment in a state that pays higher than a lot of other states, so I do understand that I have gotten a little spoiled over the last 6 months. I just want to make sure that they aren't taking advantage of me because I still am fairly new to traveling.

meanmaryjean, DNP, RN · Nov 20, 2013

My understanding is that TX is a much lower cost of living state. A friend who is traveling in a similar market reports a similar contract.

meandragonbrett · Nov 20, 2013

That looks like you're coming out at $33.57 per hour when you take into account your per diem and housing stipends.

I would ask that they base your OT/Call back on $33.57 per hour x1.5. They aren't losing any money by doing that.

I generally don't consider contracts that pay less than $35/hour PLUS housing...that's just me though.

Have you talked to other agencies to get quotes for the area? That will tell you if they are paying you the going rates or if they are lowballing you.

NedRN · Nov 20, 2013

The only thing that looks off to me is the housing stipend. But there is no way to tell about the overall compensation unless you get some quotes from other agencies. If it is just about the money and it is less than you are used to, why consider this assignment at all? Just to point out the obvious, it is in Texas, one of the worst states to work in as a generalization. San Antonio is a cool town, but so are lots of other places.

Nzuri · Nov 20, 2013

I'm not just about the money, but I know the world doesn't run off of rainbows and clown farts either. I as I mentioned before, I know I have gotten a little spoiled from my current contract. What makes Texas such a bad place to work?

NedRN · Nov 20, 2013

Well, that might take a book. Reading traveler comments about working in Texas is pretty much like reading about Las Vegas hospitals. It is more a question of which hospital is least bad than which one is good to work at. I know a number of travelers from Texas who live there but refuse to work there.

In a nutshell, bad staffing ratios, poor treatment by management (zero unions), physicians that think they are God's gift and more arrogant and dismissive of nurses than is usual in most states, and a really bad nursing board. Trouble with the board there will impact your ability to work in other places, and hospitals will report stupid stuff like late meds.

There are some other legal issues with working there. Standard private professional liability policies for nurses are $100 a year for one million in coverage in the vast majority of the states, in Texas it shoots up to $250 a year for $250,000 of coverage. I believe it has something to do with naming nurses in injury claims.

Finally, there is a notorious legal blacklist that most hospitals subscribe to. If you have any issue, even a trivial one that they decide to list on this blacklist, it will impair you from getting most good jobs in Texas. Not such a concern for a traveler, unless you want many assignments there.

If you do make such a jump (personally I don't think it is worth it when you can work in good states for more money), I would highly recommend getting professional Liability Insurance just for the component that gives you legal representation in front of the board should you be reported (probably good advice in any state, but especially Texas).

Spend a week in San Antonio between assignments instead!

jskgx2 · Nov 21, 2013

I find Texas a great place to work. I recently stopped traveling in April for grad school and decided to take a full time charge position in Dallas. I traveled to San Antonio and although I too heard stories I actually had a nice time. I also spent a great deal of time (3 assignments) in Houston where the pay is generally higher. My personal experience is don't believe the hype. Texas is a wonderful place to travel, the only area I advise against is hospitals close to the coast in which there are over-worked, under staffed, and not suitable for any professional nurse. Also, in reference to the blackmail list that only happens with the hospitals in the Dallas area in which I've been nursing here for years at various hospitals and PRN facilities and never had a problem. Lastly, Dallas is the most underpaid city for travelers so I would suggest Houston or Austin. Once again I spent 13 weeks in San Antonio and lived 5 mins from the medical district and enjoyed my stay. Pay was not great but I didn't sign up to travel for the pay. Hope this helps!

NedRN · Nov 21, 2013

I'm glad you are happy in Texas. I have to say that every agency and hospital (even the ones you don't like) have happy employees. So that doesn't take away anything I said and I think your post generally reinforces my views of Texas.

As far as the blacklist goes, it was the Dallas Fort Worth hospital association that set up a for profit CRA (credit reporting agency) that established the blacklist. It is legal because of a loophole in the federal CRA law. While I certainly cannot speak for the culture of various hospitals in utilizing the blacklist, from what I've read, it is indeed strongest in the DFW area. That said, the vast majority of hospital in Texas are customers of the CRA, and effectively the DFW hospital association is the state hospital association. There are several really long threads elsewhere on AllNurses about this blacklist, and it is not "only" the DFW area that is affected.

I know a fair bit about this CRA and the law, and have spoken at length to the CRA. What is scary is that they have already expanded their services nationwide. I have personally lobbied federal representatives supporting efforts to close this CRA loophole.

Again, the blacklist is not necessarily the best stand alone rationale to avoid Texas as a traveler, but it is a scary state for a nurse - primarily the board issue for me. I can't afford to have my license taken away because of the whim of a disgruntled manager. Statistically unlikely, but given the prevalent working conditions in Texas and the generally low pay, I don't see a good reason to work there. I prefer to visit on my way to better working environments.

As a final argument, unless you are in Austin, the politics are far from progressive. I tend to think most nurses sway blue, so working in such a red state would be politically and socially unpleasant for those that are sensitive to issues. Just look at what they are doing to ObamaCare. Besides costing the health of their citizens, they are also costing nurses jobs. I don't want to support such practices by working there.

I don't object to anyone else's personal choices or preferences of course, just stating mine.

nitengale166 · Nov 22, 2013

NedRN;

Thank you so much for your comments. I am hoping to start traveling in January and having this information on TX is extremely helpful. It was on my radar to work there in the future but I will save my time there as tourist only. I had never considered the political red vs. blue climate would be a factor for consideration when choosing an assignment. Thanks for the eye-opener.

NedRN · Nov 23, 2013

I like working in California for that very reason as most of the people you work with are progressive, even many of the doctors. Same for the NE states. Interestingly, unions, high pay, and progressive politics go together, thus progressive states pay the best.

I admit politics is not a primary assignment criteria for me though, just adding reasons not to work in Texas. If I lived there, I would be highly annoyed at their state politics all of the time - not healthy! While the risks of working in Texas are real, even if it is 6 times as risky as working in other states, statistically you are unlikely to have a problem. But when you add unpleasant working conditions, it just seems like there are better choices. If all nurses made rational choices (many can't of course with families in Texas), ultimately supply and demand would raise wages in Texas to the point it could be worth it to put up with the working conditions. That is what happens with individual troubled hospitals as eventually only rapid response companies work there and the pay is high to compensate for the poor working conditions.

As a new traveler, don't chase pay your first assignment. Go for a known traveler friendly hospital (hopefully you will have signed up with agencies that enable good choices) to get your feet wet in a safe environment first. A successful assignment under your belt will not only point the way forward (you will know your own capabilities better) but also make you more marketable giving you a better choice of assignments: type, location, and compensation.