By AMN Healthcare

August 18, 2023

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How to Land a Travel Nurse Contract Extension

AMN Healthcare provided this article.

One of the best parts about travel nursing is the chance to temporarily live and work in a new location, with your housing and travel expenses covered and plenty of time to explore.

This career option also allows you to choose when and where you work, with contract terms ranging from four weeks for a crisis assignment up to 13 weeks for a more typical travel nurse assignment. But what happens at the end of that assignment period?

contract extension

Nurses can choose to move on to another location, or their assignment facility may ask the traveler to extend their contract and stay a while longer. Usually, organizations will broach the subject about halfway through an initial assignment, but that timeline can vary.

Extending a travel nurse assignment is very common, reports Michele S., a recruitment and placement specialist with Onward Healthcare, adding that extensions are a “win–win” situation for all parties. Many nurses like the chance to stay put a little longer—to work in a place where they’ve gotten to know the people, the culture, and the electronic health record system. They also don’t have to worry about going through the credentialing process again or relocating. At the same time, the facility managers don’t have to worry about finding, onboarding, and training a new travel nurse.

If you’re interested in extending a travel nurse assignment now or in the future, here’s what you need to know.

How to Land a Travel Nurse Contract Extension

According to Michele, site managers will often initiate the extension process, but the nurse traveler can initiate the process, too. She offers the following tips to boost your chances of landing a travel nurse contract extension:

  1. Be the best nurse you can be. You want to create a good impression at work. Give the managers and staff multiple reasons to want you to extend with them. Be reliable. Use good clinical judgment. Make an effort to get to know your new colleagues and to get along with everyone.
  2. Consider extending as early as possible. If you think that you might be interested in staying at your current assignment a while longer, start planning as soon as possible. Know what you want to do and be ready to discuss how to make it work.
  3. Talk to your recruiter. Once you’ve decided you would like to extend your travel nurse assignment, talk to your recruiter right away. Your recruiter will know if your facility tends to offer extension opportunities so that they can give you a better understanding of the likelihood. They can also initiate contact with the organization to discuss options and get the paperwork started if an offer is made. Your recruiter can also discuss other options with you, just in case the extension doesn’t work out.
  4. Feel out your manager. “If you have a good relationship with your manager, talk to them and put the idea in their ear,” suggests Michele. This can get the ball rolling, and you will be at the top of their mind if they decide they need a travel nurse for an additional period.

3 Things to Consider When Planning a Contract Extension

If you and the staffing manager at your assignment facility are both interested in a travel nurse contract extension, there are still some things to consider before you sign on the dotted line:

  1. Time off. Many nurses prefer to take some time off in between travel nursing assignments. Scheduling a vacation, especially a longer vacation, can be a little trickier if you’re planning to extend your travel nurse contract and remain with the same healthcare facility. But that doesn’t mean you have to give up on the idea. Instead, Michele strongly suggests speaking up and making arrangements for vacation or time off as soon as you possibly can. She encourages nurses to be upfront and address the issue before agreeing to an extension. Nurses should also clarify with their recruiter if all of their traveler benefits will remain in effect if they are taking a break from a regular work schedule.
  2. You’ll also want to verify the availability of your travel nurse housing when planning an assignment extension. If you arranged your own housing, check to make sure it’s available during the period of the extension. Otherwise, talk to your recruiter or the agency’s housing staff as soon as possible about making arrangements for you to stay in your company-arranged housing.
  3. The fine print. Finally, be sure to read your contract extension offer carefully and pay attention to all the details. Sometimes the details can change from an original contract to an extension contract. If you have any questions, ask your recruiter.

Are you looking for your next travel nurse assignment? Click here to view our job board. Do you need housing for an upcoming assignment? Click here to search our housing page.

If you are a new travel nurse or looking into becoming a travel nurse:

Travel Nurse Guide: Step-by-Step (now offered in a PDF Downloadable version!)

By Medical Solutions

March 15, 2023

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How to Get Out of a Travel Nursing Contract the Right Way

Medical Solutions provided this article.

When you sign your contract for a travel nursing assignment, you should do so knowing it’s an important, binding agreement. Travel nursing contracts are there to protect clinicians, facilities, and agencies and to ensure a staffing need is adequately filled, and patient care standards are properly met. That said, there are infrequent circumstances that may merit a contract cancellation.

Who Can Cancel a Travel Nurse Contract?

Both facilities and travelers can cancel contracts, and there are many unique scenarios that could lead to either party doing so.

Hospitals cancel contracts for several reasons. Often, it’s due to an error or unforeseen change in seasonal demand forecasts — either of which could lead to an overstaffing problem. EMR/EHR conversion contracts are sometimes canceled for various reasons, too. The healthcare staffing industry also saw many hospitals cancel contracts throughout the COVID-19 pandemic. For example, as elective surgeries were canceled in droves, travel OR nurse contracts followed suit. However, probably the most common reason a hospital might cancel a travel nurse contract is that a traveler’s performance is unacceptable.

Travelers can also cancel a contract in dire circumstances. A supportive recruiter/agency should help you try to troubleshoot to avoid cancelation, when possible, before guiding you through a last-resort cancelation.

Reasons for Breaking a Travel Nurse Contract

In two words: Life happens. But, of course, it’s always more complex than that!

If a traveler legitimately needs to seek a contract cancelation, it’s usually due to a situation like major personal health problems, a family emergency/serious family illness, an unacceptable work environment that may even endanger a traveler’s license, or other such valid reasons.

In the case of an unacceptable work environment, a traveler should make a good-faith effort to resolve the issue in other ways before going straight to the level of contract cancelation. First, express your concern to your recruiter. Discuss the issue with them and ask to speak to a member of the agency’s internal clinical team — a quality healthcare staffing agency will have one to better support their travelers on clinical issues! Let your agency’s support system work with the facility as necessary to correct any work environment issues you feel may be endangering you personally or putting your nursing license in jeopardy.

When it comes to a serious personal health problem, well, you can’t pour from an empty cup. If you need time to manage and heal from an illness or other personal health emergency, most agencies and facilities will understand. And it’s similar with an unavoidable family emergency.

Depending on your specific circumstance, you might also consider that a total contract cancelation could be avoided, and perhaps the contract could just be amended. For example, you have to go home to help with a family emergency, but you would be able to resume the contract in three weeks. In that case, you might consider discussing all possibilities with your recruiter and potentially avoiding an outright cancelation.

Bad reasons for breaking a travel nurse contract? You found a better assignment with higher pay and decided to bail on this one. You’re just not feeling it. You don’t love (fill-in-the-blank location) like you thought you would. If you find yourself wanting to cancel for these or other such frivolous reasons, just don’t!

Remember, it’s not just about a contract. Your patients, colleagues, facility, and agency are all depending on you, so you should just bide your time and meet your commitment in these types of situations. The contract will be over before you know it, and you can move on then — with your professional reputation and integrity intact.

Canceling a Travel Nurse Contract the Right Way

The first thing to ask yourself is, “What does the contract say?” Every travel nursing contract should specifically address what happens in the event of a cancellation by either you or the facility. If your contract does not cover this situation, then you might also check any service agreements you signed with your travel nursing agency. Some agencies will have you sign a service agreement that covers the professional conduct travelers are required to maintain while on assignment. These types of agreements can also cover what happens in the event of a cancellation by the facility and/or the traveler. If an agency uses service agreements, they’re usually signed on a yearly basis and cover all assignments a traveler might work during the year.

After you review what your contract stipulates — or, in some cases, what it does not state — you should call your recruiter immediately. Be 100% upfront with them and explain the reason you want to dissolve your contract. As a healthcare professional, you agreed to a contract and should have a good reason for wanting to sever it.

After you fully explain your situation and reasoning to your recruiter, then it’s your turn to listen. A great recruiter is willing to listen and provide helpful feedback and solutions. In fact, in this trying situation, you’ll see just how good your recruiter and agency are. When you come to a recruiter with a legitimate need to cancel, you should never feel threatened or bullied by them or the agency. You might also find that they’re willing to work with you to minimize the damage and provide you with other travel opportunities in the future.

Open communication is key if you ever need to modify or cancel a travel nursing contract. If you intend on traveling again once the situation is resolved, make sure to tell your recruiter that. As previously mentioned, with the blessing of your agency and facility, it might even be possible for you to take off a few weeks and then return to your assignment when you’re able. The point is, don’t just call your recruiter and say, “I need to break my contract.” Explain your situation and work with your recruiter to find a solution that will make you, the facility, and your company as happy as possible.

Also, you should give as much notice as possible. If you foresee a potential contract-canceling issue on the horizon, it’s never too early to bring it up as a possibility to your recruiter. That way, they can help you monitor the situation and plan ahead. If it never ends up happening, they’ll be elated for you and the contract. Depending on your situation, you should also attempt to cover as many of your scheduled shifts as you can. This is a show of good faith and will mean a lot to the other parties involved.

Canceling a contract is never something we’d encourage. However, things do happen that are beyond our control and might require such a drastic decision. If you handle yourself properly, you can minimize any costs and negative outcomes from breaking your contract.

Consequences of Canceling a Travel Nursing Contract

Depending on the terms of your contract, there may be repercussions that fall on you, your recruiter, and/or the agency you’re working with. For example, if your agency provided housing, it’s probably still on the line for that, and you may be required to pay the remainder of the lease. If you secured your own housing, you will have to navigate that situation on your own. Another example: Your health benefits may lapse when your employment ends — something to especially consider if you or a covered family member is facing a health emergency — so you can make a plan to maintain benefits through another channel. Again, much of this should be outlined in your contract.

Canceling contracts can also affect your future contracts and employment opportunities, even for permanent staff positions. It may make it more difficult for you to get good references. You may have to face tough questions during future interviews. Depending on the circumstances, your agency might have your back, or you might not be invited back to work with them again. Travel nursing agencies thrive on having good relationships with facilities and travelers. If the facility is in the wrong, your agency should side with you. However, if you’re in the wrong, you may find that your agency will decline to work with you on future contracts. Some facilities will also move you to a DNU or DNR status and be unwilling to hire you in the future.

Also, finding yourself in a situation where you need to cancel an assignment is often very stressful. First, your reason for wanting to cancel is likely a major stressor. Then on top of that, you have a lot of work to do and hard conversations to have if you’re going to cancel the right way. Throughout this process, don’t forget to take care of yourself to manage these types of consequences to your mental and physical health.

Bottom Line

Contract cancelations should be avoided at all costs. However, certain circumstances can make them necessary. Travelers don’t appreciate having their contracts canceled by a facility, so it’s important to practice a “golden rule” approach here and only move to cancel as a last resort and due to an emergency situation. Remember that your patients and colleagues may be the ones who suffer the most, but that you’re also putting the facility, your recruiter, and the agency in a real pinch.

If you wish to cancel, communicate openly and honestly with your recruiter, work with them on the best solution, give as much notice as possible, and try to work your scheduled shifts. Also, understand that you may face professional, financial, and other consequences. Above all, we hope you never have to face the kind of situation that necessitates a travel nursing contract cancelation, but if you do, please take care of yourself and lean on your recruiter!

Our job board is a great place to search for your next travel nurse assignment. We have you covered with our housing page if housing is an issue. You can search for what you are looking for.

If you are a new travel nurse or looking into becoming a travel nurse:

Travel Nurse Guide: Step-by-Step (now offered in a PDF Downloadable version!)

By Medely

December 23, 2022

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Want To Keep Your Travel Nurse Contract In The New Year?

Medely provided this article.

The New Year is synonymous with new beginnings, but what if you’re nearing the end of your winter travel assignment and aren’t ready to move on?

For a travel nurse or allied professional, a contract extension means:

  • There’s no need to relocate. Sometimes the timing isn’t right for a move—maybe you’re enjoying yourself too much, or you just don’t have the energy right now. Whatever your situation, a longer assignment will allow you to hold off for a bit.
  • Developing deeper relationships. Healthcare is a small world, especially if you tend to look for contracts within the same area. Stronger connections with managers, nurses, and other professionals can be an asset if (and when) you cross paths in the future.
  • Gaining valuable knowledge. Traveling adds a great breadth of experience to your nursing resume, but extending the current assignment can be an opportunity to sharpen your skills. If you think there’s more you can learn in your current job, staying can support your next career move.

There are plenty of advantages for the facility, too. Among the top benefits is the one that brought you there in the first place: Having a professional on hand who’s committed to patient care and their work is an asset, particularly during an unprecedented shortage of nurses.

But is staying with the same facility the right move for you? And, if so, what can you do to help ensure the facility wants you to stay? That’s what we’ll explore in this blog post. Let’s get started!

Five questions to ask before you extend a travel nurse contract

Before asking for an assignment extension, take a moment to reflect on your recent experiences. Staying at a healthcare facility isn’t just about liking the neighborhood or being comfortable. It should also help you advance your career. Consider the following five questions…

1. How well do you fit with the team?

Travelers can feel like outliers, especially when they’re new and finding their footing. But caregiving is a team activity whether the individuals are permanent or not. Do you work well with the staff nurses? Do you feel valued and respected by the team—and is the feeling mutual? You may still be learning people and processes, but if you aren’t asked for your help or input, it may not be the right environment for you.

2. Is the pay commensurate with your duties?

While typical rates for travelers are still quite high, it’s important that you feel you’re being paid an appropriate amount considering the work that’s being asked of you in this travel nursing job.

3. How do you feel before and after your shifts?

Consider your typical shifts at this facility and how they make you feel. Nursing has its highs and lows, but that means it’s even more important for you to protect yourself. If you enjoy some aspects of an assignment but are left feeling mentally and physically drained, it might be better to prioritize your well-being with a change of scenery.

4. Can you continue to contribute here?

Introspection is often about what you get out of a travel nursing assignment, but it’s as important to consider the facility and its patients. Are you able to create the impact you want? Through your relationships, experiences, and commitment to care, it’s important for you to feel you can add something to the team.

5. How do you feel about staying—or going home?

Maybe you love your new community but are also struggling so far from family and friends. What will you miss at home if you extend your travel nurse contract? You can always negotiate if you need time off. But if a longer stay will leave you feeling lonely or even resentful, you may want to reconsider.

If you feel confident about your desire to stay put, let’s look at what you can do to put yourself in an optimum position before you make your request.

How to position yourself to extend your travel assignment

From day one, you prove yourself as an asset to an organization through your professionalism and approach to day-to-day activities. Here are seven things you can do proactively to position yourself for the extension you’re looking for.

1. Be an active part of the team

As someone who may be seen as an outsider, it can take extra effort—and pushing out of your comfort zone—to connect with other nurses and allied pros. If you’re invited to attend staff meetings, educational opportunities, and other activities, do what you can to show up and participate.

2. Be dependable

From sick days to family emergencies, call-outs happen. When they do, be accountable for the disruption and communicate with the facility as quickly as possible so they can address the impact as quickly as possible. And for your other shifts, be there on time and ready to go.

3. Flex your nursing muscles

Dedicate your attention to your work and push your nursing abilities by going above and beyond when the team needs the support. For example:

  • Offer to work longer if the next nurse is running late
  • Lend a hand when you see another nurse struggling
  • Ask for help if you need it to ensure you’re providing the best care
  • Go above and beyond for patients when it’s appropriate to do so

In short, be the nurse you would want to hire!

4. Find ways to be present with your colleagues

Building relationships at work doesn’t always come naturally, but sometimes it takes just a small step to break the ice. If the facility shares the team’s birthdays, drop off a card for the celebrant. Write a brief handwritten thank you note when another nurse goes out of their way to help you out. Ask a colleague how their day is going and pause to listen to their answer.

5. Get to know the decision-makers

You don’t need to go overboard, but familiarize yourself with the people in charge. Check-in regularly with the hiring manager during your current assignment. Learn the names of the management team. Introduce yourself to the human resources folks, the person in charge of scheduling, and the nursing management team, so you aren’t a stranger to them.

6. Don’t be shy to share your reasons for staying

Once you’ve decided to pursue a travel contract extension, don’t be afraid to tell the decision-makers why you’re enjoying your work at the facility. If you aren’t able to tell them in person, consider leaving a handwritten note or sending an email.

7. Be open about your expectations

As you start to discuss a possible extension, don’t hesitate to ask questions about the contract and be transparent about your needs and expectations, including dates, any pre-existing commitments, your hourly rate, and your schedule. These important details should be clearly communicated ahead of time so that any requests and adjustments can be addressed before the extension occurs.

Let your travel nursing agency know you’re interested in an extension!

Practically speaking, a conversation about extending your contract can be initiated by you and your recruiter or by your manager. Once you’ve decided you would like to stay, let your recruiter know in writing and in person (or by phone) as soon as possible. That way, they’ll have time to connect with the facility to negotiate and confirm details on your behalf.

What are your go-to tips for keeping your travel nurse contract or extending a travel nurse assignment? Tell us about them in the comments!

Our job board is a great place to search for your next travel nurse assignment. If housing is an issue, we have you covered with our housing page. You can search for what you are looking for.

By TNAA- Travel Nurse Across America

June 22, 2022

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Agency Support During Mid-Contract Pay Changes

TNAA Healthcare provided this article.

Your recruiter calls to inform you about a mid-contract pay change. Last year, these were exciting calls to get because it likely meant your pay rate was about to rise. In the current market, it’s not a call you look forward to receiving.

Every agency has to deal with mid-contract pay changes, but how they handle them can be a game-changer for a travel nurse. Before diving into the specifics, let’s talk about bill rates, who sets them, and why changes might occur mid-contract.

Who Sets the Bill Rate?

Who sets the bill rate, and what factors go into a travel nurse’s pay? The bill rate is not set by travel nurse agencies or recruiters. Instead, healthcare facilities set travel nurse bill rates based on market demand and budgets. A healthcare facility works with its managed service provider (MSP) and/or vendor management system (VMS), which help track the facility’s workforce spending. Consulting with the MSP or VMS, the healthcare facility determines the bill rate it wants to set for a particular position. Once that is set, the bill rate for that position goes to hundreds of agencies.

Each agency has different ways it splits that bill rate. The bill rate will include the traveler’s pay, per diems, benefits coverage, agency support and expenses, and more. The agency determines what will be paid hourly and uses the U.S. General Services Administration’s guidelines to establish what will be paid through per diems if the traveler qualifies for them. Your agency and recruiter should help you understand your complete compensation package.

Who Makes Mid-Contract Changes?

Changes start with the healthcare facility’s bill rate and trickle down. The bill rate drop affects all sections of the traveler’s package, from hourly pay to per diems. These have to be adjusted to work with the new bill rate and follow IRS rules.

An important thing to note is the nurse manager on the unit isn’t involved in determining the bill rate, and likely doesn’t know when changes occur.

How Your Agency Should Support You

When a facility drops rates and notifies agencies, your recruiter should contact you promptly to let you know. An action-oriented recruiter will specifically explain what has happened, provide details of the new package, educate you on the market, tell you about other opportunities in the area, and let you make the best choice for yourself.

You can either accept the new rate or decide to end the contract (after hopefully giving a professional notice). Unfortunately, this decision must occur as soon as possible so the agency can redo the contract with the correct rates and avoid any pay or tax discrepancies.

If you opt to end the contract, each agency is different in how it responds. Ideally, you’ll want an agency that doesn’t penalize travelers for leaving due to a mid-contract bill rate decrease. However, some agencies may charge the nurse for terminating the contract or blacklist them. To understand your agency’s response in these situations, read your contract and contact your recruiter for any questions. It’s your career and your right to know!

Decisions, Decisions

There are several decisions to make when becoming a travel nurse. They likely start with putting your trust in an agency and a recruiter to guide your career.

You’re a healthcare traveler who has uprooted life to help patients in areas where your expertise and care are most needed. When life presents you with a difficult situation, is your agency there to support you and navigate you through it? Hopefully, your answer is a resounding, “Yes!”

We hope you found this article on agency support during mid-contract pay changes helpful. Have you had any pay changes mid-contract? If you would like to share your experience please comment below.

Our job board is a great place to search for your next travel nurse assignment. If housing is an issue, we have you covered with our housing page. You can search for what you are looking for.

By TheraEx

May 19, 2022

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Adjusting to a New Environment as a Travel Nurse

PRN Healthcare provided this article.

A new contract means a new facility with new coworkers and policies. With 13-week contracts being a limited amount of time, nurses have to adjust to new policies and cultures quickly. This process can be stressful and a little bit overwhelming. With the proper knowledge of how to adjust, you can focus on your main job, advocating for patients. Do not worry; it gets easier the more contracts you take. Let’s go over some ways to make this process much easier!

Adjusting to your new environment:

Come Prepared

The best way to prepare for your new assignment is to research the facility. It goes a long way to take the time to find out more about the culture your facility has before going there. This can be as simple as reading their overview on the facility website. Once you have some base knowledge on the values of the facility, talk to your recruiter about some additional information they may be able to give. To take it a step further, you can even reach out to nurses and managers that work at the facility to get a better idea of what to expect.

Another way to prepare is to tour the facility before you start. This is a great way to meet some people within the facility, so you have some familiar faces on your first day. In addition to possibly meeting some new people, you will better understand the facility layout. Understanding where everything is can make your transition to the new facility much smoother. Making sure you come prepared is an essential way to help you adjust faster to the new environment.

Constantly Communicate

Another way to make sure your transition is smooth is to communicate effectively with your coworkers and recruiter. As in all things in life, communication is a vital part of success. Not only in your success as a travel nurse but also for your patients. Nursing is a difficult profession, and even the smallest details are important for you, your coworkers, and your patients.

Depending on the facility, patient information and hospital policy can be communicated differently. In a new environment, it may be stressful to keep track of everything, so don’t be afraid to ask another nurse or floor manager for help. Remember, your patient comes first, so making sure you’re doing everything correctly is essential. In addition, make sure you’re also updating the patients’ physician of any changes to make sure everyone is on the same page.

Lastly, make sure you keep your recruiter updated. This is important for your future with the agency as well as your enjoyment with travel nursing. Letting them know what is working well and what needs to change can help them understand where to place you in the future to make sure you’re providing the best care possible.

Dealing with Unfamiliar Situations

As a travel nurse, you have to be able to think and adapt quickly. The best way to do this is to familiarize yourself with the hospital policies. Each facility has different procedures; it is helpful to understand these policies at your current facility. Remember, your primary job is being a patient advocate. Understanding how each hospital operates is a great start to providing great patient care.

There may be a time when you find yourself in a situation, and you are not sure how to deal with it. The best way to overcome this is to ask coworkers, managers, or other staff to make sure you are dealing with the situation in the correct manner. The best way to minimize unfamiliar situations is to learn the hospital codes, watch how other nurses handle situations, and understand the layout of the floor and facility. It all comes back to communication, and if you’re not sure, just ask!

Understanding Your Contract

As a travel nurse, understanding your contract is important. To start, read everything. Make sure you understand what you are bound to do in the hospital and also the expectations of the agency you work for.

An important thing to review in your contract is to make sure your contract dates and times are correct. If any changes need to be made, they should be done before you sign the contract. In addition to checking your times and dates, make sure everything you discussed with your recruiter is in the contract and clearly stated. Making sure your contract is structured correctly will help you with some of the nerves you may have when starting at a new facility. Another important part of your contract to understand is the requirements for floating. Make sure all floating requirements in the contract make sense, and you are comfortable with them. At some point in your assignment, you may be required to float to another unit. Make sure the floating requirements make sense, and you’re floating to a unit you are qualified to handle.

Reaching out to your recruiter for help in understanding your contract is very important. No one wants to be taken by surprise when on a travel assignment. Being knowledgeable about your contract will give you the confidence to perform your best in every assignment!

Travel nursing requires agility to adapt to new locations, coworkers, and facilities. This adds excitement to each new contract. If you are nervous about the changing environment, make sure to fully understand your contract, communicate with your recruiter, come prepared on your first day, and ask questions! After the first few days, you will get into the swing of things and rock your contract!

We hope you found this article on adjusting to new environments helpful. Are there ways you have found to make adjusting easier? Comment them below.

Are you looking for your next travel nurse assignment? Click here to view our jobs page. Do you need housing for an upcoming travel nurse assignment? Click here to search our travel nurse housing page.

If you are a new travel nurse or looking into becoming a travel nurse:

Travel Nurse Guide: Step-by-Step (now offered in a PDF Downloadable version!)

By The Gypsy Nurse

February 7, 2021

45541 Views

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Understanding Travel Nurse Bill Rates

All of your compensation and the company’s expenses/profits will come from one thing; The Bill Rate.  A bill rate is the amount contracted for the hospital to pay the agency based on hours worked for each nurse contracted.  You, as the travel nurse, may never know your bill rate between the agency and the hospital.  You need to know how it’s broken down and why you only have a certain amount to negotiate with.

Bill Rate

Bill Rate Broken Down

Please note: The actual numbers in this calculation are strictly for example purposes. Bill rates fluctuate continuously, so this in no way is a statement on what a current bill rate might be.

Bill Rate: $65/hr
Nurse pay rate: $35/hr (~53%)
Social Security and unemployment,
workers’ compensation, liability,
malpractice, recruitment and
other administrative costs (including profit or GPM): $30

Think of it as a huge pie

The best way that I can think to break down the bill rate is by thinking of the Bill Rate as a huge pie.  Each separate component is a slice of the pie.  Each individual contract has its own pie….some are large, and some are small.  This is dependent on many factors, including location, hospital size, company relationship with the hospital, level of hospital need, etc.   Ultimately, the size of the pie is beyond your negotiation.  There is a separate contract between the hospitals and the nursing agencies that defines this.

The travel company gets their slice

The travel company is going to take a percentage of the pie right off the top.  It’s important to remember that your recruiter does not have a say in this.  This is generally corporate-mandated and covers such things as overhead for the company, employee salary/benefits, and a defined profit margin.  The amount of the pie that the company will lock out of negotiations varies from company to company.

The standard GPM (gross profit margin) is 20-22%. Some agencies, the larger agencies, maintain a 25% GPM for most contracts.   Smaller companies tend to maintain a lower GPM, as low as 15%.

– Crystal Lovato, Placement Specialist at Freedom Healthcare Staffing

The last part of the pie belongs to the traveler (you).  

Several items will come out of your part of the pie.  These may include:

– Travel reimbursements
– Licensing reimbursements
– Any benefits offered, i.e., 401K, health insurance, etc
Housing

And last but not least…..Salary.

How these items come together in your contract is discussed in Preliminary Contract Negotiations. Check out the TOP 10 Questions for Travel Nurses on Taxes

If you are a new travel nurse or looking into becoming a travel nurse:

Travel Nurse Guide: Step-by-Step (now offered in a PDF Downloadable version!)

By The Gypsy Nurse

June 17, 2020

50712 Views

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My Travel Nurse Contract was Canceled. Now What?

There are a multitude of reasons that a travel nurse contract can/will be canceled. This is a scenario that you must prepare for as a Travel Nurse. It happens.  Most agencies have an ‘at will’ employment clause.  If you don’t know what this means, I suggest that you do some research.  In a nutshell, it means that the contract can be canceled at any time for any reason with no recompenses on the Travel Nurse side.

The unfortunate part of a contract cancellation is that the hospital will, many times, give a bogus reason for firing you: a missed med, an insignificant charting error, etc.  It’s usually a ‘clinical’ related reason given.  Realistically though, you probably got canceled for reasons other than your nursing skills and performance. Don’t let this bring you down.  Your reputation is not going to be slaughtered by this, and you will find another travel position.  It’s the nature of the business.

contract was canceled

Unfair? YES.   Realistic? Unfortunately, YES.

It’s not fair, but it’s the ugly side of travel nursing.  If your contract is canceled, you will have two choices in how to handle it.

#1 Let it go and try to get an immediate placement with your agency somewhere else.

This is the option that I most recommend.  Talk to your agency and have them find you something else.  Most of the time, our contracts are canceled for reasons beyond our control (regardless of the reason the hospital gave).  The administration may have decided too late that you were too expensive to keep and was just looking for any reason to fire you, the hospital may have hired enough core staff, and now they don’t need a traveler.

Unless the cancellation reason was a life-threatening issue or something that will be followed up with the Board of Nursing (drug abuse is a good example of this), a good Staffing Agency understands that this happens from time to time and will work with you to find another suitable contract quickly.

#2 Take it to court.

contract was canceled

It’s important to understand first that you are an employee of the agency, not the hospital.  Your agency is not going to support you in your lawsuit.  The agency’s customer is the hospital, not you.  I don’t personally recommend that you take these issues to court. There is an exception to this; if you are reported to the Board of Nursing for a violation that you feel is unfounded.  If this is the case, you will first have to clear yourself through the Board, and then you could pursue a lawsuit with the Agency/Hospital.

*Disclaimer: I do not give legal advice and recommend that you consult a legal professional for these issues.

What expenses will I be responsible for now?

If your contract has been canceled, the first thing that you need to do is consult your contract.  What does the contract say regarding cancellations? There may be fees incurred for housing, travel, etc. Did the hospital give a ’cause’ for termination? If you don’t know, find out from your Travel Agency before moving forward.

Your responsibility for any expenses will depend on your company and your contract. Some travel companies have it written into their contract that the traveler could be responsible for “fees or expenses” when the contract is canceled “with cause”, but some offer no protection and can leave the traveler on the line for expenses even if the facility does not show cause.

The possibility of a Contract cancellation should emphasize the importance of reading the entire contract and understanding what can happen in the instance of cancellation. If you are taking an assignment thousands of miles from home and the contract states that you will be charged housing and other fees in any event of a cancellation (where no cause is needed), perhaps you should either decline the contract or negotiate with the company on this point.

What can I do ahead of time to ‘lessen’ the impact of a canceled contract?

1.  Maintain a Savings – This is something you should consider before ever starting an assignment. Do not put yourself in a position where a week or two without pay could totally cripple you financially. Contracts do get canceled, and if you are not prepared financially, it can have serious consequences.

2.  Make sure you are with a company you can trust – Having a company that knows your reputation and is easy to contact can be a lifesaver in a contract cancellation. Is your recruiter quick to respond and fix the ‘little issues’? Easy to reach during ‘off-hours’?  These are important factors that will assist you in a smooth transition if you should experience a contract cancellation.

contract was canceled

3.  Work with More than one Company – I’ve recommended this before and will re-iterate it here. Have your profile on file with several companies.  Should you need a ‘quick’ response due to a canceled contract, not having to go through the application process with make things move much smoother?

4. References – When it comes to contract cancellations with reasons of clinical insufficiencies, it’s important to have previous good references in order to keep your reputation intact.  I was actually ‘fired’ from a contract once just days after obtaining a glowing reference from my charge nurse.  Showing this to my staffing agency proved to them that the reasons for termination were just bogus, and they were willing to work with me to find me another contract quickly.

5. Use your support Network – I can’t emphasize this enough. No matter what the reason for contract cancellation, it’s going to leave you with a myriad of feelings. Frustration, defeat, incompetence, etc.  NOW is the time to reach out to your support system.  If this is family, friends, travel nursing groups, etc. Reach out and share the experience and use your support network to help you get through this difficult time.

If you are a new travel nurse or looking into becoming a travel nurse:

Travel Nurse Guide: Step-by-Step (now offered in a PDF Downloadable version!)

By Kayla Reynolds

October 20, 2019

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8 Things I Wish I Knew Before I Became a Travel Nurse

Guest Post by The Gypsy Nurse Ambassador Kayla:

8 Things I Wish I Knew Before I Became a Travel Nurse

One of the great things about travel nursing is the variety of experiences that it provides for those that choose this path.  As a ICU travel nurse for the past  5+ years, I’ve learned a lot through trial and error.  If you have interest in becoming a “Gypsy”, or are new to travel nursing, here are 8 things I wish I know before I became a travel nurse that I hope helps you in your journey.

1.)  Have A Safety Net!

Traveling is a risky business and it may sound like a no-brainer but do not start traveling without some kind of savings. You have to be ready for the unexpected like when you car breaks down in the middle of nowhere or contract gets cancelled. You may have to live without working for a few weeks. SO, be prepared for it.

2.) Trust your gut!

I had a pretty lucrative contract in CA but I sold my soul for it. It was a pretty rough assignment using the most outdated charting system and floated from one end of that hospital to other. Yes I got paid well but I certainly worked for it. My gut was right when it said “this is too good to be true”. If you feel after an interview uneasy about anything ask more questions and don’t be afraid to pass on it.

3.) Read your contract!

You have to go over your contract with a fine toothed comb. Make sure you understand everything in your contract and that it includes all the things you have asked for. Some of the top things I make sure is in my contract are pay rates for the first 36 hours, hours from 36-40, and hours from 40+ (the exception is California), requested days off, cancellation policy or guaranteed hours, cancelled contract policy, travel and any other reimbursements, per diems, shift times, specific unit I will be working, and floating policy. Also make sure you understand things like non compete clauses in your contract or any other terms you are agreeing to.

4.) Educate yourself on taxes regarding travel nursing and what is meant by maintaining a tax home.

I spent hours researching articles related to travel nursing and taxes before becoming a travel nurse. This can be very complicated.

 5.) Before starting to apply to companies have all your documents ready.

This will include a resume, certifications, copy of your diploma, vaccination records, copy of your identification card, nursing licenses, and references. Also, every company will request that you do a skills checklist before being submitted to hospitals.

6.) Learn from the experienced travel nurses.

All of us have made mistakes going in but if you know before you start what to look out for this may save you a lot of heartache.

7.) Travel nursing can be uncomfortable at times.

If you were to meet me now you would probably never guess I was not the most social and certainly not as confident as I am today. That I owe to travel nursing pushing me out of my comfort zone. I have learned to go at it on my own and not wait for anyone to tag along with me to have an adventure. I like to call it dating myself or solo explorations.

8.) Be ready for whatever is thrown your way.

Finally, your reaction to situations will make or break your travel nursing career. You can choose to throw in the towel or you can handle it. Travel nursing will test your limits sometimes but you have the power to run it or let it run you.

I hope you found these tips to be helpful. One of the keys to being a successful Gypsy nurse is the willingness to help your help your colleagues. Feel free to let me know if they do by leaving a comment here.

Want to share your own travel nursing tips with fellow Gypsies?  Leave a comment here or (for the budding travel nursing writers out there!) email content@thegypsynurse.com with your ideas and we may be able to turn it in to an article and share it with the thousands of Gypsies in our network!

By The Gypsy Nurse

July 5, 2019

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Ask a Travel Nurse About Travel Nurse Health Insurance

Gypsy,

I’ll end my travel nurse contract soon and plan to take time off between contracts.  What do you do for insurance between contracts?  COBRA is so expensive.

Thanks!
Jackie, RN

health insurance

Jackie,

Insurance worries are a common issue among travel nurses. Most travel nurse contracts will include insurance, but there is always the worry about insurance between contracts. Personally, I choose to carry private insurance.  I tend to work with multiple different travel nursing agencies and prefer not to have to worry about switching insurances with employment.

COBRA

COBRA is certainly an option for insurance coverage between contracts, but it can be expensive. PANTravelers.org offers the following advice for maintaining health insurance coverage between contracts.

  • You then have 60 days from the end of your contract (or 60 days from the letter’s date) to positively select COBRA coverage.
  • After you elect coverage (no reason not to), you have 45 days to pay the premium.
  • This gives you an effective minimum of 105 days (three and a half months) of insurance coverage without paying a cent.
health insurace

So what does this mean? It means that you are covered by your agency’s insurance for well over three months after the contract ends if you select COBRA coverage at the last moment. And there are no consequences for not paying the premium three months later other than your insurance coverage will be canceled retroactively back to when your contract ended. If you had no events during this period that required insurance, you have just received a free ride! And if any events do occur, they would have to add up to more than $1,000 (your minimum likely premium during this period) to be worth paying the premium. This is an insurance company’s nightmare.  Clients are fully covered but electing to pay only if the insurance benefits are more than the cost of premiums.

There is one possible glitch – you want to ensure this strategy works in the worst possible scenario. If you are incapacitated (think unconscious or major trauma) during this period, you may not be able to make the COBRA election or pay the premium. So you should give clear instructions to a family member on what to do just in case with the appropriate forms. Otherwise, your medical bills will not be covered, and that would be a real catastrophe!

– PANTravelers.org

Insurance Recommendations

There are always new discussions on our Travel Nurse Network Facebook group. Here is one discussing private health insurance that might be helpful. Another post of interest is one discussing gaps in employment between contracts. I hope that this has addressed your question.


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