LPN/new traveling nurse

Home Health Columnist / Guide · Feb 1, 2015

Moved to Travel Nursing forum for best chance member advice.

NedRN · Feb 1, 2015

All lists have underlying criteria. Knowing the criteria helps you determine the usefulness to you. In the case of the HH list, the primary criteria are benefits, not compensation, or traveler satisfaction/service. Additionally, these benefits are self reported by the agency on a questionnaire sent out by Epstein. Agencies that don't reply obviously are not on the list. Epstein says she has made an effort to incorporate traveler feedback on agencies, but the methodology is murky as is the number of reports. The criteria favors large agencies, so that is who is on the list. Yes, there are some agencies with very bad reputations on that list.

Smaller agencies tend to both pay better, and have better service. Large agencies have benefits as well, like superior job choice, and as an LPN, they represent your best choice probably for the relatively few LPN assignments out there (compared to RN assignments).

Yes, any online comments are subject to gaming by agencies. But it is usually easy to spot the recruiters posing as happy travelers with outrageously good agency reviews and often no examples of hospitals or cities or actual pay.

Any list represents a starting point, even just a simple Google. The best predictor of success as a traveler is their relationship with their recruiter, not the agency brand. Even the agencies with bad reputations have happy long term travelers. There is no way to tell who will work for you. Your best chance lies with a lot of footwork, calling lots of agencies and seeing which recruiters you click with. Sign up with them, up to about 5 agencies is manageable. It is good to sign up with several because, well you need a plan B! It will also give you a good handle on who pays the best.

Yes, switching recruiters is possible at any agency, at least any good agency. I started my travel career doing just that. I picked the largest agency at the time for several reasons, and got a recruiter I loathed. I called the manager and was switched so someone I stayed with four years.

Agencies know that housing is half or more of the satisfaction that travelers report with an assignment. So they try to do a good job but nothing is ever 100 percent, especially in housing they haven't used before, or areas they haven't placed many nurses. Many also outsource the job to third party companies that specialize in traveling medical worker housing. You also have the option to take a cash housing stipend and find your own housing.

Yes, some agencies use a lot of extended stays and many travelers like them. I would never use them myself, I think they are overpriced, even the cheap ones with paper thin walls. For the same money, you can get a nice apartment for three months with money left over and a better standard of living. Especially if you are taking kids, I wouldn't think you would want new neighbors daily.

mom_e_bizcut, LPN · Feb 2, 2015

Thank you much, your advice is great, at this point my highest priority is housing that meets all of my needs, followed closely by health insurance then pay, (which I hope to gain a little more leverage on through performance) so the info on top rated vs unrated and larger vs smaller agencies is really valuable for me. I suppose I know that I could prowl the travel sites for weeks and realistically I'm not going to know all details for sure until I've had some assignments (it's the planner in me that's dragging her feet). We've discussed starting with local travelâ€ for my first assignments, I think I may go this route to get a feel for who I'm working with and, to build their confidence in me.

I'll be looking to establish a relationship with a couple more agencies, so maybe I'll allow for a little more diversity in my choices. I realize as an LPN it's probably even more necessary for me to do so to ensure as many opportunities for work as is possible. I assume most agencies are OK with this so I have been upfront with it so far, do you find that to be true in your experience?

Also, you touched on something else I had questions about but, had not posted yet and, that being the health insurance. From what I understand the insurance usually ends when the assignment ends-then picks back up when another begins..is this correct? And, if its not too personal, would anyone know the approximate cost of employee + children?

I'll make this the last of my questions for now and again it's appreciated.

NedRN · Feb 2, 2015

You do understand that recruiters are paid on commission, right? They are in sales. So sure, they would like to have an exclusive. But who works harder, the car salesman who knows you don't shop around, or the one who does?

Insurance coverage varies by the agency. However the large agencies will be covered by COBRA. You should Google COBRA so you understand the implications. When you leave employment, you are covered for up to 90 days or so (there is an article on PanTravelers, and presumably other sites that will tell you how it works). Yes, you will have to pay the full premium backwards to your end date (depending on the agency), but in effect, you already are paying the full costs while working. Insurance costs are part of compensation but most employers hide the full cost.

With travel nursing and every bit of your compensation coming out of a fixed hourly bill rate the agency charges the facility, it is more difficult to hide the true costs of insurance - which is typically between $400 and $800 a month for a single person.

The COBRA legislation also allows you to extend your current insurance for up to 18 months after you leave employment. So you can keep your current insurance (assuming your employer has 50 FTEs). But again, you have to pay the full premium to do so.

You can also buy private insurance, or through the healthcare exchange. Check to make sure that any insurance will cover you for more than just emergency services when you are away from your home area.

Given that insurance is so important to you, the larger or at least midsized agencies may be a better transition for you after a benefited staff job. As such, the HH list may be a particularly good starting place for your search. But the reality is that you will be paying for insurance regardless and at some point you will have to learn that there is no Santa Claus.

mom_e_bizcut, LPN · Feb 2, 2015

Yes you confirmed what my fears have been with the health insurance side of things, I have dealt with COBRA before and I'll just say...YUK. Again all of this info and some of your other thoughts on the insurance is very helpful. thanks a bunch

NedRN · Feb 2, 2015

Seriously? COBRA is great, especially for travelers. Insurance companies hate it and with good reason. After you leave a job, effectively coverage continues. Unless you have an incident where your medical costs are higher than your premium, your insurance cost is zero. That is called self-selection and is an insurance company nightmare. Amazing that the law passed.

mom_e_bizcut, LPN · Feb 2, 2015

It is nice to keep the insurance, but at least in my case, it's the cost that scares me. The times I've had the opportunity to use cobra the premiums were so high that I couldn't make it work financially.

NedRN · Feb 2, 2015

Those COBRA premiums are the real cost of insurance. Now it could have been a premium group health plan and you can do better, but you are going to have to get over the sticker shock. You are paying for it one way or another. When you talk to agencies about assignments, always ask what the COBRA cost would be. You don't know what your real compensation is without knowing that amount. I would recommend using PanTravelers calculator to compare offers as you will be quoted some wild numbers! It is the best way to make sense of things, but you need to know all your compensation including insurance if any portion is paid by the agency to compare accurately.

mom_e_bizcut, LPN · Feb 2, 2015

I'll be sure and do that. The PanTravelers calculator seems like a great resource for better understanding the full pay package. You've been a big help, thanks a million.

MsConstrued · Feb 4, 2015

My first assignment was in an LTC and it was the standard 8 hour shifts but the bad part was they made the schedule ahead of time so I worked all 3 shifts (not in one week but over the course of the assignment) to equal 40 hours a week.

I learned my lesson from my last assignment to always take the housing stipend and then get your own housing whether you want an apartment, extended stay or craigslist houseshare, etc. I had to terminate my contract before it ended and am sure because I was in their housing the costs are going to be much higher than if i I had my own housing. Plus I had to scramble to get out within 2 days. Not that you will ever be in that position but it's better to have more control over the situation if possible.

mom_e_bizcut, LPN · Feb 4, 2015

thank you, very helpful!