What's up with ER traveler pay right now?!

NedRN · May 8, 2017

FB is all well and good, but I'd highly recommend you get your information directly from the source - direct contact with agencies to develop several good relationships with recruiters. Shopping around, right? Only this way can you discover what you are worth in a given market at a given time, not by word of mouth. Most recruiting posts, especially on job boards, are suspect and effectively worthless unless you are already signed up with agencies (the specific assignment will be gone by the time your paperwork is ready to submit to a hospital).

So that is step one to maximize your income. Step two is to go to PanTravelers and sign up for a free account so you can use their Travelers Calculator. Now when you get an assignment quote, you can ask for all the details, including hourly pay, housing stipend, per diem, value of any provided health insurance, completion bonus, and travel pay to assignment. Plug that into the calculator and the results will allow you to directly compare offers from different agencies to learn which one really pays the most.

Step three is to estimate what local housing will cost, a quick trip to the local Craigslist will work - in many markets you will see ads aimed specifically at travel nurses and other healthcare travelers.

Sometimes well paying areas like San Francisco have housing costs so high that you could net more in other places. So now you know how to maximize your pay. Lots of other tricks like negotiating, playing one agency off another et cetera: it indeed can be like buying a car.

But there is more to this game without travel experience than just picking the best pay. I don't care what your experience is, a manager is going to be unlikely to pick you over someone with successful travel experience so you are competing against a large pool of better candidates for good asssignments. You can get lucky your first assignment, but the odds of a high paying assignment being good is much lower and you may discover why the pay was so high and experienced travelers didn't take it (because they had good relationships with their recruiters). Ideally, you should completely ignore total compensation for your first assignment and focus on getting an appropriate assignment that you can complete successfully and get a good evaluation. In fact, I would recommend you look for "easy" which might be a suburban or rural community hospital.

After your first assignment, you can start chasing the money from a position of strength and knowledge about conditions at random hospitals (especially if you have only worked at one hospital). Being a hired gun is nothing like working staff, no get out of jail free card. As a traveler, one wrong word to a patient, doc, or staff can get you terminated at some hospitals. You have to be uber professional and not play the experience card when they want you to do things their way.

I've heard nothing about fewer job orders in the travel industry. There is a good bit of uncertainty among hospitals about Trump and what is coming and like any other business that suffers uncertainty, investment is down, and hiring is slowed down. The last usually helps the travel job orders but hurts those looking for staff jobs.

I have worked in California many times over the last 22 years, and I've never made what staff makes there. It can be possible to find a travel assignment that pays over $70 an hour, but the housing may knock your effective pay back to $40 an hour. If you want to make what staff makes in high paying areas of the West Coast, NYC, NJ, unionized areas of the NE or even parts of the midwest, you need to go staff.

One more word of warning. Travel may not pay as much as you think. If you live in an area not mentioned above, you will make more as a traveler than staff. But the benefits will suck big. It is very similar to per diem at a hospital versus regular staff, more per hour in lieu of benefits. However, if you are relatively well paid now, it wil be difficult to pencil out without trying it. One big catch to travel is that to receive those tax free stipends, you have to maintain a home base residency (your post does imply you know this). They can only be labeled as business expenses if you are working away from home. If no home, you cannot be working away from home. No, you can't just use a relative or friends mailing address. Won't fly if you are audited by the IRS. If you do it right, you have two complete sets of housing costs reducing your pay (worth it generally). If not, all your compensation is taxable, also reducing the "net pay" you may see some talk about.

Don't trust any recruiters, agency sites, random people on FB and here (including me) or even most tax preparers on this topic. We won't be present at your audit (good tax professionals will be, but you will still owe personally your back taxes, interest, and penalties). To understand this topic more, read unbiased information on PanTravelers or TravelTax.

Long post, but short tutorial about travel. You can spend hours reading more about travel on PanTravelers.

offlabel · May 8, 2017

Posts are too long to actually read all the way through, but it sounds like schools are graduating more nurses so demand for and therefore pay to travelers is falling. More of a lifestyle thing than for the money now.

NedRN · May 8, 2017

Posts are too long to actually read all the way through, but it sounds like schools are graduating more nurses so demand for and therefore pay to travelers is falling. More of a lifestyle thing than for the money now.

Amen to picking travel for lifestyle over money. That said, when I started traveling in 1995 after three years of staff in the South, the difference was hard to describe. But as staff, I lived a fairly frugal lifestyle but had only saved enough after three years to buy a decent used car ($3,000) not having a car at all. As a traveler, I saved 80 percent of my pay. Money just seem to pour in. Mind you, the situation 22 years ago is not directly comparable to now, Cross Country had just "invented" Tax Advantage and no other agency used it because of the lack of clarity with IRS rules. Happened to be the one I picked. I did not maintain a tax home, but I did later when the rules were clarified. Agencies were also allowed to provide housing then for the "convenience of the employer" - think lumber camp. That is not allowed any more.

Do you have a citation for increasing rates of graduating nurses that exceed existing demand? As I understand it, it will be many years before supply will catch up with demand. Healthcare jobs, including nursing, are increasing faster than any other industry in an environment of full employment. Contingent labor like travelers thrive under such conditions.

Wolf at the Door, BSN · May 11, 2017

I've been researching travel nursing for over a year now and keep seeing people mention how low the current pay is. I'm so close to taking an assignment, or would be if I could just find one that pays well. Some recruiters recommend that I just take "whatever" to get an assignment under my belt, but honestly, I don't want to take just anything. I have a few years in at a large teaching hospital (level 1) and I'll be honest, I'm cool with going to a small community hospital if needed. I want a reasonable paycheck though. It has to be a lucrative situation if I am going to be paying bills in two locations. I recently applied for my CA license and realize it will take awhile to actually be approved. That's okay, no issues there. I am, however, a bit confused with the pay there. I'm in a few of the Facebook groups for travel nurses and when I see recruiters post new contracts, some of the net weekly checks are under $1500 in CA (some way under). It's so bad that I'm actually considering just applying for a staff job instead of a travel contract once I get my license. A quick Google search will bring up the union contracts and pay scale. UCSF legit pays over $73/hr base at my experience level...and I'm only a few years in. Recruiters are a whole different ballgame as well. I've been talking to a few and even went as far as to complete all the paperwork, skills checklists, references, etc. One recruiter specifically was trying to push me to take a position in MA where my net weekly pay would be less than $1200 a week. I was pretty clear from the beginning regarding income requirements. It's insulting and I feel like I'm dealing with a car salesman. What is everyone's take on those FB groups? Is that where bottom of the barrel recruiters and positions are posted? Am I coming at this from the wrong angle? Is this the wrong time to get into travel nursing? I've seen a lot of experienced travel nurses express that the pay packages go up and down based on needs, which makes sense. A lot say we are at a low point and that it will eventually go back up, but I have been watching for over a year and do not see any improvement. How long do these low points typically last for and is there a light at the end of the tunnel?

Go with a perm job if you can get it. It will take a few months. UCSF does not offer relocation. San Fran apt studio 2800-3100k. ER nursing is not going to get you 3-4k weekly gross for 36 hours (L&D, OR, PICU get that kind of money year round). You will be less stressed with a California ER job than anything on the East Coast. I love the East Coast as that is where I grew up. Since everyone wants to be on the East Coast the pay and RN duties are crap.

Make sure to read my Thread about travel nurse licensing. Once you have a California RN license it is going to suck your pockets going forward. https://allnurses.com/travel-nursing/travel-nurse-licensing-1090206.html

EastCoastLiving · May 13, 2017

Go with a perm job if you can get it. It will take a few months. UCSF does not offer relocation. San Fran apt studio 2800-3100k. ER nursing is not going to get you 3-4k weekly gross for 36 hours (L&D, OR, PICU get that kind of money year round). You will be less stressed with a California ER job than anything on the East Coast. I love the East Coast as that is where I grew up. Since everyone wants to be on the East Coast the pay and RN duties are crap.
Make sure to read my Thread about travel nurse licensing. Once you have a California RN license it is going to suck your pockets going forward. https://allnurses.com/travel-nursing/travel-nurse-licensing-1090206.html

Why do those other specialties pay so much more than the ER? I've actually been curious about that for awhile. Would you mind comparing and contrasting East and West Coast ER jobs? I only know the Massachusetts way. :)

NedRN · May 14, 2017

Why do those other specialties pay so much more than the ER? I've actually been curious about that for awhile.

Simple supply and demand market forces at work. The underlying basis is also very simple, those other specialties take more training then ED. In most professions, specialties that require higher training pay better. Staff nursing pay is not really fair market, and admins make a conscious decision to constrain pay so all nurses despite specialty make about the same. Unions, despite raising all boats, also focus more on experience than training and contribute to the same distortions.

Specialties also have constrained supply which contributes to higher pay. Simply put, there are a lot of ED nurses (second only to med surg I believe) which means greater supply and lower pay. It is much harder to find an OR or L&D nurses. These specialties also have a higher burnout rate which lowers supply.

Unlike staff nursing, travel nursing is not constrained to a local market, and more closely follows supply and demand indicative of a free market. Thus you can have these wild pay differences between specialties.

ED is kind of entry level like med surg, in that a community hospital may give you only a few weeks before they take you off the leash. Nevertheless, ED does require more training or experience than med surg and does pay better (for travelers). The upside of ED for travel is good pay and the ability to travel to more locations than even med surg in my opinion. It also serves as a really nice stepping stone to ICU or PACU if you get bored, overworked, or need a new challenge.

Argo · May 14, 2017

I am working in SF now, I work OR. The pay here is in the $65-90/hr range for staff. After taxes (cali and sf have pretty significant taxes) their biweekly pay is about $3500. I take home $3000 a week on 36 hours. I stay in my RV which costs me about $500/month. I have found roomate situations in the city for under $1000, studios for $2000. Even with $2500 rent I would be ahead of the staff pay.

Ned is right about certain specialty areas. My current hospital has something like 10 openings for OR RN staff. That is huge since either you get an experienced one, which are becoming increasingly difficult to find, or you train new ones which is a 12-24 month process.

They keep trying to get me to work staff but the pay is not enough compared to traveler pay for me. I also get contracted time off and dont have to take call as a traveller. SF law also makes the agency give me ETO/sick time after 30 days. I didnt know that until after 2 assignments but I have 2 weeks accrued already.

Is it worth it for you to travel, I dont know. It is for me though. I keep a detailed income and expense report and calculate everything before, during and after an assignment.

NedRN · May 14, 2017

What happens to ETO after an assignment?

Argo · May 14, 2017

It stays in the company bank for you. I had a 3 month break between 2 assignments with the same company and the accrual was still there. My recruiter said it will stay as long as I am with the company per SF/CA law.... I plan to use it though since it is full pay with stipends, I found that odd but it is.

NedRN · May 14, 2017

Well, it your money. No doubt the agency adjusted your gross pay to account for the extra expense. Be better if you could just cash it out so you are not tied to one employer. I don't think it is particularly odd that your stipends are included. They are part of your compensation and play into a number of other legal possibilities like workers compensation claims and child support. Clearly a well done law for the benefit of workers.

EastCoastLiving · May 15, 2017

It's so hard for me to imagine anything more difficult than learning how to manage the ED. I went straight from nursing school to a large level 1 teaching hospital in MA. It involved a cross country move and I knew no one. It's one of the most difficult things I have ever done. I realize I don't know much about anything regarding other departments, but the idea of only having one patient at a time seems like a breath of fresh air compared to multiple unit players, confused nana with explosive diarrhea, the super chill patient with the overbearing family member, and the psych patient that needs a 5 and 2 and some restraints stat. I've actually thought about going to the OR. Do you think it's harder than the ED or just more technical?