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.

For virtually any setting where there are nurses, there are agency nurses. Travel contracts are usually a longer need like persistent staffing shortages, or short term like a pregnancy or personal leave. The number of postings for any specialty or setting depends on how many nurses work in them. You will always see the most postings for acute and long term care simply because more nurses work in those positions. I'd suggest calling a few super large agencies, like American Mobile and Cross Country and ask recruiters about it. Could be hard, as such jobs are entry level. I'm sure you have considered ED? Other than acuity, that is the job you are doing at urgent care. And many large hospitals have more than one stream in their emergency rooms, one of which is basically urgent care, not critical care. Still, they prefer more acute experience because travelers that can flex make staffing easier. If travel is the lifestyle you want, I'd consider ED and upgrading your skills and credentials as necessary. It is the perhaps the best specialty for travel as you can go anywhere from the smallest hospital (I've traveled to a 12 bed hospital) to 400 plus bed major city hospitals.

Just so you know, it is not the agency nor the agency recruiter deciding generally who gets an assignment. They are also competing with other agencies (absent an exclusive facility contract). There is a hospital contract specialist in the agency that may decide which traveler profiles to submit to a hospital, and then the hospital HR (or often outsourced HR called vendor managers), and then finally the unit NM or assistant manager will get a profile or several to interview. Or just decide without an interview based on your work history, education, credentials, and references. Sometimes the vendor manager is the one doing the interview (which sucks). Like any chain of decisions, the outcome can be random at times, but the variables you can control like certs can certainly boost your travel assignment options. Getting a first travel assignment successfully completed is a huge win as many nurses are not really well equipped to adapt to a new facility and EMR. This is so important that many hospitals will not take a first time traveler. So you don't want to step out of your own comfort zone for a first assignment no matter the location and pay if there is any hint (from a trustworthy recruiter or in an interview) that it is a difficult assignment. That is for later assignments. Another thing you can control on an assignment is references. I typically get 3 on every assignment, from as high up the food chain as you can. (I have a ED traveler friend who gets them from physicians - but managers or charge nurses are best in most specialties). Then you can pick the references that best reflect you. While you may not have a choice with a single agency, if you use several agencies (I highly recommend it), then your profile becomes highly weighted with good references and you become more valuable (and easier to get going with a new agency). Your agency will also collect references, but a sign of how valuable they are is that they will not share them with you. So you need to get your own. Written ones. Form references make it easier to collect them. There are some examples available for free download (after signing up for a free membership) on PanTravelers.

In your practice? Near zero. But on your CV? It sends a message that you are a professional, actively working to be the best you can be. Think about your own hiring preference between two candidates for your own unit? Wouldn't you pick the one with the better credentials? Experience first perhaps, but everything else being equal, certifications and achievements, and education will weigh heavily in your choice. Actual good fit personality wise for your unit is far less important as it is just a short term assignment. Although for a staff position, personality might be the biggest factor. But it won't be just for your first assignment. You are competing sight unseen with many other travelers for every position. (Mind you, demand is higher than supply in the PACU so you will always be able to find work, but possibly not at the most competitive assignments, those with choice locations and/or better pay). You need extra pluses on your side, especially when a facility is comparing staff and travel experience between candidates.

In short, yes. One reality is that the traveler is not the agency client, the hospital is. So even if contractually not allowed, such cancelations are tolerated to maintain the client relationship (without which the agency will have no work). Not that what happens in the background really matter much to you. What is important to you is your contract with the agency. I think you will find a lot of loopholes protecting the agency from you suing them for contractual damages. Even if not (super rare), it is a daunting task to file suit against an agency and most travelers will simply move on and switch to Plan B (which is why you should always be signed up fully with more than one agency).

She doesn't want to travel as an NP because the the credentialing process takes too long and by then she will have a real job. @serena: Sorry I missed your post. The issue is not really if the agency allows it, it is really if they will submit you to a hospital and let them make the decision. If they do that, any hospital would love someone with your background. But you are right, the general rule of thumb is experience in the last two years. But there is no actual rule, barring obstruction by some by the book risk manager, or same at an agency insurance company.

Whaaat? Travelers have issues with the largest travel company in the world?

I think it very unlikely to show up on a background check, especially if there were no criminal charges. You can find out yourself by running an online background check on yourself. Get the lowest cost one as that will catch anything that is online (more expensive ones will do courthouse checks at prior addresses). Still, it is possible and easy for an agency to go farther and check license status, even of expired licenses. Look up your licensure status of that expired license and see if you are eligible for renewal without further comment of historical discipline. For good measure, your current license as well.

Travel first for the lifestyle. New friends, sights, and culture. Constant learning new ways to practice and sharing when appropriate. Lack of politics. Apparently you are worried about some threshold of compensation to make a contract "worth it". What would that look like? No doubt it is different for everyone and everyone has to make their own choices about what makes any job worth it. Yes, non unionized hospitals (and states without staffing ratio laws) are working with not enough staff. Seems like more of the same to me, other than the pandemic staffing crisis is over.

Small agencies and strike companies take the shortest amount of time (could be just hours). There are a number of ways to speed the process besides agency choice. Written references (I recommend at least three) are far far better than providing names and phone numbers, are easily verified (some agencies may not even bother) and allow easy shift to new agencies. I also recommend getting your own references on each assignment, early (to protect yourself) and several (to choose the ones that best reflect your performance). Managing your own professional portfolio is much better than depending on any agency, and while agencies also collect references/evaluations on each assignment, they will never share them with you. Having them in hand makes switching agencies much easier, thus no agency will share them. Getting references or/and verifying them is perhaps the most common slow down for agency onboarding processes. A form to hand to a referee is also much faster and easier than getting a formal letter of reference. Samples can be found for download on PanTravelers - sign up for a free membership and go to Downloads. These forms leave space for an agency to insert their letterhead. Getting your own physical clearance annually with up to date vaccination records also cut down on time required. Different agencies have different standards for background checks and how often they have to be performed (usually a new agency will require a new background check) but if you can obtain a copy of a background check in the last year, this can also speed things up (depending on the agency). Background checks run a gamut of just seconds to run online, to several days, and this varies depending on the agency. Again, smaller agencies generally take the faster road. Keeping a record of your work history to submit to agencies reduces your own work in filling out paperwork - no need for resume or CV like detail. Now some (larger) agencies want everything done on their own letterhead - it looks better to facilities receiving your profile, and perhaps to the JC, but many agencies can transfer your submitted work history to their own because you are that valuable to them to do stupid stuff on their own dime. You can find out on your own which agencies are fastest which is not going to help you initially, but may help you find agencies are best at filling fast moving desirable assignments. Putting all your eggs in one agency basket means much more downtime if an assignment cancels. I'd talk to a dozen agencies (yes, a lot of work) and pick 3 to 5 agencies that you communicate best with and have the least BS and go through the full signup. I'd suggest a mix of small, medium, and large agencies for best possibilities of choice, availability, and compensation. Then you have a plan A, B, and C. Keep them all updated with every assignment and be up front about your plan. Ditch recruiters that are not happy with your free agent status. Admittedly, signing up with lots of agencies is a pain, even if you keep your professional profile up to date. So many if not most travelers find sticking with one agency is less work and are willing to take the risks and likely lower pay to avoid the hassles of new to you agency signup. Your choice. While it was in the golden older days of travel, I once had an assignment cancel in the middle, and started two days later at a new hospital in the same city with a new agency and stayed in my housing losing almost nothing. A bit lucky perhaps, as I had worked for only one agency for 4 years (so did not follow advice above except I did have all my references for every job ever worked), but the due diligence required was much less back then.

Well, you didn't express any concern as to your clinical skills and adaptability to a new practice environment yet that is the most common failure point of new travelers. Travelers are expected to hit the floor running with minimal orientation to workflow, policies and procedures, and an EMR you may have never used before (they always have some specific facility customization even if you have used it before). Even the best of staff nurses can fail at travel. This may not be you, but before making a hard to reverse decision, try agency per diem at other hospitals to test how difficult it might be to travel. Or how easy perhaps. As far as finances go, I'd recommend at least two months of living expenses in a cash account. Considering how strapped hospitals are for staffing, this should be sufficient if something falls through and you have to scramble for a new assignment. Here is a scary but true statistic industry wide: 1 out of 10 assignments fail for all reasons. I've never seen a number for first time travelers but it has to be a lot higher. Most agencies won't give you their best assignments until you have proven yourself with successfully completed assignments.