NedRN

This doesn't happen. Totally a risk on the agency side to pay more than GSA rates.. If a traveler gets audited, these "reimbursements" are not reported to the IRS so the agency would have to be audited first to even discover individual payments that exceeded GSA numbers. And auditing all such travelers would be very costly versus just recovering overpayments from the agency. I certainly don't recommend doing things like bogus tax homes to cheat the IRS, that can have financial consequences that are potentially life changing between back taxes, interest, and penalties. That said, it is alway prudent to know what your rights are in an audit. One of them is that you don't have to share your work contract, which is the only place where they can find out about your unreported reimbursements (that you accepted legally because you had a valid tax home and were working away from that area). That is all you have to establish if you are unlucky enough to be audited, usually for some other reason. Audit rates on employees in our tax bracket have been low for at least 30 years, and getting lower every year. Still not a reason to take a chance with cheating, but our risk is very low. And you really should only use an agency that does things correctly (the GSA tip is a good place to start). Because travel companies have been a high risk for an audit for the same period, and such companies usually trigger a few random employee audits to get proof against the agency before a formal audit begins against the agency. But we are talking about a fraction of 1% of all travelers that might experience a random audit. Far more travelers who are audited have another unrelated audit trigger than their job compensation. And state tax agencies are far more scary than the IRS, and one error travel companies often make is failing to withhold state income taxes in your work state, and/or your tax home state.

I don't think you should consider travel nursing at this point. Staff nursing is safer by a good bit, typically you have a family get out of jail free card if you screw up. You have zero safety as a travel nurse so your goal is to be an above average nurse before making such a move. You are expected to hit the ground running on arrival at a travel assignment with minimal orientation which is why you need breadth of experience in your specialty, good technical skills, and great organizational skills. Most travel nurses are from the South where wages are low. Travel allows a pretty big bump in compensation (in lieu of benefits) and allows you to continue your permanent residence but only if you are from a low wage area. Over the course of a career, there is little financial difference between staff and travel. The best reason to travel is (usually) not about money but about lifestyle. 20 years is already a long career. You could consider taking less challenging jobs as many nurses do as they get closer to retirement. You didn't describe your specialty, but there are often related jobs that are less stressful. For example, lots of ED and ICU nurses go to PACU, and in general teaching hospital nurses move to a community hospital. I could name more examples but I'm sure you get the idea. You really don't want to put up with the crap you are getting now whether no matter where the fault lies. I had to bail from my specialty in my first (and only) staff job and it was indeed beyond my abilities right out of school. What they didn't tell me is that two out of three nurses accepted into my program also failed. So at least I knew that it was more likely a failure of their program than me. And the hospital didn't even consider firing me but offered me a choice of a couple other areas. Which turned out great and a 9 month precept program gave me plenty of time to work on my organizational skills which were sad initially. Worked well in school, not so much in real life. And the joke goes that as a guy, I had zero organizational skills as I had never been a housewife or secretary. No offense intended.

One out of ten travel contracts fail to complete. This is an industry aggregate number and some agencies do better, and some do worse. Same thing on the traveler side, I've met some who have such good people skills that in 20 plus years of travel they have completed every assignment. Now me, in 30 years of travel, I'm right there at being terminated one out of ten assignments, and I'd place the blame square on my strong personality (pretty much you need one to work in CVOR). I've never been fired for cause and my evaluations have always been great (remember what I said earlier about getting references early?). So I have some great war stories and each one would result in "you were terminated for that" by readers! But I have one similar to yours and was inspired to share. Arrived at one assignment, and everyone loved me but one fellow traveler. I was completely unaware that she was gossiping and complaining about me just because. Had a meeting with the manager and charge nurse where silly allegations were aired. They were well satisfied with my answers, and everyone (perhaps other than this other traveler) were happy with the air cleared. A week later, I got a call from my agency (which was owned by me) that HR called them with the same issues and requested termination. HR never asked for my side. Turns out that my termination was a surprise to the manager and charge nurse! I didn't fight it, but I likely could have worked a few more days before HR found out I hadn't left. And yes, I have good references from even this hospital, but I'm not going to put a terminated contract on my work history.

Not if you have a good contract. However, most contracts favor and protect the agency (their lawyer wrote it) so travelers may be fired without cause. A decent contract requires termination only for just cause. And a good agency will protect the traveler. A bad hospital or agency may make up a "just cause" - so even with a fair contract you can be terminated and believe me, it is not worth fighting. Generally filing a legal claim is more about emotions than money. I did file suit against a major hospital who terminated me for not having a permanent license in DC. In fact I held a temp license signed by the very director who fired me (they do things very differently there from most state boards). I won (and even collected), but no, it wasn't worth it. Those of you who know TravelTax, perhaps the most famous guy doing traveler tax returns (he also serves in an advisory position for the association who represents agencies), has a similar winning a lawsuit story from when he was a travel RT before getting his accounting degrees. But these stories are rare because travelers seldom win. Too hard to file suit and carry through with it. As an aside, typically allied health and advanced practitioners have better contracts than travel nurses.

Not a clinical complaint so not an immediate danger to your career. If your agency gets similar feedback, or already has from prior contracts, they could decline to use you again, but that is the worst that can happen. There are hundreds of agencies, just move on. Try to put this completely out of your mind. Easier said than done, but you really don't want to be thinking of this daily for years. It would be healthy to reflect on your patient interaction skills and see if you can identify any improvements, but otherwise attempt to put this behind you. I will sound like a broken record for those who have followed my past posts, but taking charge of your career will make it much easier to move on to another agency. You (and all travelers) should maintain a professional portfolio. Besides basics like health documents and a work history, the really important part is a collection of written references, Agencies collect these from each assignment but seldom share as this makes agency switching rather easy, which is not in an agency's business interests. Instead collect your own written references from every assignment you are on. Go up as high on the facility food chain as you can, start after two weeks on a job (for protection against an actual clinical complain), and get several. I personally try for at least 3 from every assignment. Now instead of providing a telephone number for references and being dependent on what a random person says to your recruiter on the phone (it is often hard to find the person who agreed to act as a reference), you have the content under your control. Pick the references that are well written and reflect your skills and abilities. PanTravelers has a very easy one page form reference that will just take a couple minutes (or less) to fill out that you can present in person on the assignment. Have them check a few boxes and ask them to write at least one sentence and you will have a valuable asset for the rest of your career. Sign up with PanTravelers, choose the free tier, and go to Resources>Downloads.

By working with several agencies and comparing compensation. There is a calculator on PanTravelers you may find helpful in comparing the offers bottom line: how much you put in the bank.

If you have only worked at one hospital, check your skills by trying per diem at another hospital. Adaptability and fast transition to new to you policies and computer charting is key to success.

There is no "best" agency. If there was, there would be only one agency.

Sure, a passport is identification. It is what I usually provide. The only real difference is that a passport doesn't have your address. Neither is really valid for ID as a copy. But it meets the agency criteria as not much else is close. It is pretty common for hospitals to ask for actual physical ID at orientation and then they make a copy. None of that will actually stop a good impersonation of a provider. In my long career, I've encountered both travel nurses and a locums that clearly misrepresented themselves (or were laughably incompetent) and was among many that reported them to the facility. In each case, they were eventually terminated by the facility, but it took several weeks while they worked through the legal issues. Not sure if they even suffered any other penalty but that would be confidential in any case. There are some other mechanisms for ID verification. For example, one vendor I use sends me to a third party site and verifies my ID but only up or down info back to the vendor. That sort of solution is just pie in the sky of course as there is no way to get agencies to adopt such systems universally but they are coming. Another secure type of ID just went live for me today on my iPhone. Requests for ID only validates my identity and little else. Only works with 11 state drivers licenses at the moment. I cannot even display the license on my phone, verification is only transmitted to another local device by an authorized vendor such as TSA. More future stuff that will take many years to become common. Very hard to run a background check without a social security number. I have no idea how many travelers fail background checks, but certainly some agencies don't want the risk to their reputation of getting a facility to commit to a traveler before a background check has cleared. More paperwork every year or two. No background checks at all by agencies or BONs when I started traveling in 1995. No one asked for ID either.

It is super easy to impersonate a healthcare worker, a healthcare license is not identification. Anyone can download licensure verification. If no one along the way to starting an assignment checks a valid ID.... I'm not sure I remember when agencies started checking ID, but for many years no one did, not even during hospital orientation. At some point, I started stashing a copy of my ID with the rest of my professional portfolio ready to email to an agency or hospital.

In nearly 30 years of travel starting well before multistate licenses were a thing, I never did anything about keeping track of licenses and certifications (other than stashing them in my memory). All other documents got scanned: I personally always used a flattop portable scanner for best results (especially on professional documents like written references), but scanning documents with phone apps would be just as legal albeit less professional. Then everything got filed into folders on my laptop, and backed up on a portable drive. Important points: a professional portfolio with a one page work history (concise enough to fit on one page), a one page cover with a short summary of strengths and experience, a one page skills checklist from PanTravelers (agencies invariably want their own skills checklist but I often bypassed agencies), and several written references curated specifically for the facility of interest. Having this ready to email (fax in the olden times - very few agencies in 1995 had email when I started to travel, even the largest ones at the time) to go in seconds following an interview with a hospital or agency was often important in securing good assignments. Other credentials such as licenses, certifications, and health records were not usually required immediately (times have changed) before a verbal understanding or even a contract was signed and could be gathered later during the due diligence phase. Still helpful to have all these files organized and ready to send. In any case these days, you have to download the relevant licensure verification from the relevant nursing authority or proxy with a current date showing good standing, and a number of states do not even issue physical licenses anymore. Tax home compliance docs certainly could be useful to collect should you ever face an audit, but I was too lazy to organize rental, ownership, property tax, utility bills, and physician visit records and would have had to scramble if audited. But I had them. Sometimes my scanned drivers license or passport was needed, because of possible identity theft by those without credentials. Which is easier than one might think when anyone can randomly get a valid license verification with someone else's name. Per diems, and reimbursements are not required to keep track of with a valid tax home (and certainly would raise the eyebrows of a first line auditor without travel industry experience). In any case, they are detailed in the contracts you have file away, as well as payroll records (which I save diligently as they can be very useful in a number of potential scenarios) none of which you should show to an auditor unless pushed hard. Housing expenses at the remote work area should be kept as they can prove that you were working remotely and eligible for those per diems and reimbursements. Again, for an audit situation (very rare in our income class). The major reason for travelers to get audited is an audit attempt aimed at an agency we worked for to check on their internal tax practices, not because of our tax returns.

It is easiest to call your agency for a breakdown of your pay stub. Every agency does it differently depending on what their accountant and lawyer wants to see. But looking at it I think your housing/per diem allowance added there as a negative deduction, adding that number to your net pay. I don't see a deduction for 401, only a description of hours eligible for 401 (probably just part of their pay stub template, included even without a deduction). No agency pay stubs are straight forward as they all account for non taxable "reimbursements" differently. Staff nurses seldom have such large reimbursements (perhaps college tuition), something on the order of scrubs irregularly.

No change in any rules, but depending on your specific plans, it may become a bigger hassle this year to cross the border.

I know a lot of mellow ER nurses. Calm is good in chaos. Your choice of course, but one last plug as I mentioned is that many EDs are streamed between acute and urgent. Doesn't hurt to check with agencies about possibly working urgent only. You won't be able really to trust a recruiter, but if it sounds promising, you can go through with the signup process and see how the manager interview goes. Project confidence, but be clear you are not ready for acute care. An agency may have several such assignments, so you can practice your interview technique and see if you find a fit as well. I might mention that organizational and prioritization skills are super important. I sucked as a new grad in the OR because even though I did great in prior careers, none of them required these skills. It took a while, but I finally acquired them and did well. Not sure everyone can, but it can definitely be learned maybe by most. I've hung out in the ED at a number of assignments and the typical environment and typical personnel seems to be super relaxed and chill excepting perhaps a room with an active code or major trauma. Inner city hospitals can get crazy of course.

I'm truly sorry for your experience. However, it was up to you, not your agency. Your license and health, not theirs. You have a licensure and personal duty to remove yourself from unsafe practice environments. (As long as it is not middle of a shift with active patient assignments.) Find yourself a good workers comp lawyer, and fight for disability. You are owed at least that much from your service to the country. I'd also talk to a personal injury lawyer - I don't think worker's comp relieves the hospital from liability, nor does the fact you were not their direct employee.