picknenders

Medefis is like ebay. Hospitals post orders through them and the agencies bid on the order with a specified bill rate. Generally speaking, it helps drive down the cost per traveler for the hospital - not in all cases - but in many. A traditional VM posts orders at a universal bill rate - that's why Medefis bid system is unique.

What do you find to be the most frustrating aspect of travel nursing? What is the most rewarding aspect?

Definitely less medsurg right now. LD/MB/PP have spiked drastically over the last few weeks. So frustrating to have medsurg nurses who want to work, but not jobs for them! Flu season usually helps increase medsurg and er though, so hopefully we'll see an increase soon!

Try other areas and keep your mind open. usually the first one is the toughest to get, but having that one on your resume will help you with future travels. Hang in there!

Ned is right. Not affiliated with AMN (aside from staffing some of their direct accounts). Now that the market is transitioning to a vendor managed business, we as a company had to adapt and work with more vm's and less direct clients. It pushes bill rates down and in turn the pay to you. If you are able to land a gig with an agency who is a direct filler for the hospital, chances are the pay will be significantly higher, as there isn't a "middle man" taking a cut.

Yes I am - but I'm not on here to solicit. Just put my two sense in and keep my eyes and ears on the industry. I also do Public Relations, am a current Big Brother for BBS of Cincinnati and a season ticket holder for the University of Cincinnati Bearcat's Football Program! So I'm not just a recruiter. :)

Ned - You are exactly right in what you say. I had never recruited prior to working for On Assignment, so it was a whole new ballgame for me. Yes, unfortunately there are negotiations that do occur. However, all of our jobs are put in to our system at our required margin - Many agencies are contracted with the same hospital - however, the majority of those are contracted through vendor managers who charge universal bill rates - on the flip side, there are still hospitals out there who have direct agencies and they do not work with other travel companies. The other aspect not being considered by your point above is the commission structure of the recruiter. Some agencies pay their recruiters exactly like car salesmen - the greater the gross margin on the particular nurse, the greater the commission. We pay recruiters based on full time RNs working. This means there is no reason to withold money from the RN. Of course I've had to negotiate and of course I feel that the compensation should be higher based on the experience and specialty of the RN. Unfortunately, we don't bill the hospital differently if we send them a RN of 25 years or an RN of 2 years. That's why I say if you set your standards appropriately in the beginning, there should be no need for negotiating. There's no doubt that you are well in-tune with the travel industry - I'd say probably more so than I am. However, I thought it would be nice to lend a different perspective to some of the questions on here. I definitely respect all of your knowledge!

Ned - you sound like you're well informed. You are correct that the IRS does not see your direct hourly wages - however, as you mentioned, they do have access to overall taxable earnings. While you may have not experienced an audit due to wage swings, I have personally worked with numerous travel RNs who have. While there is no exact formula that triggers an audit, you are much more at risk by taking an extremely low rate with high per-diems. Especially if your per-diems exceed your hourly gross.

Find someone you trust and have a connection with. That will make or break it. When you face adversity (which you will at some point during an assignment) your recruiters response/actions will be what keeps/pushes you away from the company.

A lot of it depends on the area - but $1000 per week without housing should be do-able with about 90% of the contracts you see out there. Typically housing is about $6-10 per hour (depending on area). So if a job pays $30 with housing, it would be $36-40 without.

Travel agencies can give tax free money for Housing and M&I because they are viewed as "double expenses", meaning that you already have that expense back home - therefore they can give you money for it. The problem which you will run in to is that some agencies take advantage of this (agencies don't pay tax on that money either), so they'll drop your pay rate to $10 per hour and pay the rest in per-diems. The lowest standard by IRS is $22.50 per hour - if someone tries to pay less than that, you are in jeopardy. It is true that each city dictates the amount of perdiems allowed. Overall, the tax advantage program is a good idea if you have the opporunity to go with it. Just be careful on the hourly rate.

ha! You shouldn't have to negotiate if the recruiter is being honest! They pay is set by the bill rate at which the travel agency charges the hospital to provide the nurse. It sucks that people treat this like a used car deal. Unfortunately it's the name of the game at this point. Set clear standards and a good recruiter will fulfill them.

we (on assignment) require at least one year of experience in the specialty that you would be traveling in. I would say, though, that most of the hospitals that would be willing to take you with just one year of experience would make you never want to travel again... bunny is right - better to wait and hone your skills than to jump in head first and have a horrible experience.

Any hospital chain can "blacklist" you - it happens with HCA quite often...lots of people don't like working for their hospitals. However, definitely do your research before making any kind of commitment. Remember that the recruiter is always trying to sell the job to you. Check out AHD.com and ALWAYS look to see if the hospital is operating at a loss of revenue (shown at the very bottom) - if they are, that tells you that it's a bit of a mess from top to bottom. 9 times out of 10, it will be a bad environment.

I would call a few that you think sound like a good fit for you - most of them have job postings on their websites. Talk to a recruiter and see which one jives the best with your personality. I'm a recruiter, and have found that the relationship that I build with each nurse directly dictates the success or failure of the assignment. Of course there are other factors that go in to it, but if you have a great, honest relationship with your recruiter, it can do wonders!