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Most agencies work a little differently from one another when it comes to perm placement. As far as my agency goes, we dont actually charge any fee to either the RN or the facility. What usually happens is that the RN will work a few shifts at various facilities in their home area, once they decide they want to go staff we get them in contact with the proper personel to do so. Its a favor to our clients at both ends, any company overhead is covered when the RN does shifts while their looking for that perfect position. Any agency (unless its strictly a perm position agency) that charges a fee is simply hunting for profit, unfortunatly you may be looked at as nothing more than a money making machine, just make sure you ask plenty of questions when signing on with an agency, and above all, use your better judgement.

Most Nurses that Ive spoken with over the years do carry their own insurance, and it is correct as well that in most cases, lawsuits will be directed twoard the hospital. The problem comes into play when the hospital wins the case, you may run the risk of the the lawyers looking for other avenues..ie; the RNs. If your working for an agency then you really dont need the coverage as you will be covered under their malpractice insurance. I always say better safe than sorry, we unfortunatly live in a society thats gone lawsuit crazy.

The pressure to sign a contract may be either the recruiters ploy to log more hours on their paycheck, or that the facility is trying something different temp to see how it goes. In most cases the rates an agency gets paid by a hospital are about the same per hour regardless if its travel or local, so the facilities really dont save much money in the end. Then as far as the pay rates RNs receive, if you really do the math, the pay you rcv while on travel breaks down to about the same youd rcv hourly working local agency per diem contract. Most facilities will also offer a bonus at the end of the contract. All I can say is dont be afraid to ask for what you want, if your company isnt doing EVERYTHING they can to accomadate you, Then it may be time to look for another company.

Ive read all the posts and there Are alot of Agencies reaping pretty substantial rewards. Its true as well that when running an agency there are alot of outgoing costs for that agency. One way to look at it in most cases is the larger the company/corporation, the more pressure they will be under to increase profits. I worked for a large public staffing firm and eventually choose to leave due to the, shall we say shady, corporate environment. If your looking for a more flexible situation, and a company that will work around your requests, go with something smaller. Feel free to IM anytime, I can give some suggestions on various companies.