It has now been over nine months since we embarked on this journey of travel nursing. We are finishing a contract and an extension in Southern California and soon headed back to our tax home for the next contract.We have learned so much that we figured out the hard way. No matter how much reading we did we did not discover details until they blindsided us. I will answer some of these questions for you know and share our thoughts. Keep in mind, our experiences, of course, are our own and we can't speak for every travel nurse. We just want to describe our real life challenges as a husband/wife team as travel nurses living and learning in our first year around the country.
Will I get orientation for each new hospital I contract with?
While this sounds like an obvious answer, the answer is NO. Although hospitals you contract with WANT to give you 8-12 hours of orientation on your first day on the floor, keep in mind that most hospitals who hire travelers are in somewhat of a state of distress. That is why they are hiring a traveler in the first place. My husband's first day was to include an orientation, however, 2 union nurses called in sick his first day so he was thrown into the workload with 2 critical care patients WITHOUT ANY orientation whatsoever. No walkthrough where to locate equipment, no direction as to what policies and procedure are or where to locate them, no computer sign-on, not even a finger-point to where the restroom was located... nothing! He was NEVER given the orientation, not even after months ticked by.
Long story short, get it written into your contract that an 8 hour orientation on the floor, in the unit, will be given on the first day. If you don't have this in writing, you are setting yourself up for policy infractions and documentation problems when charting.
Los Angeles sounds fun. Should I take a contract there?
Unless you plan to stay for 6 months or more, skip Los Angeles for your job opportunity. Housing is not only highly overinflated, but also not offered for short term stays. Communes are common with everyone paying a fortune, no privacy, and lots of mental health and/or employment issues is what we found.
We took the housing stipend and finding housing in Los Angeles, a very transient town by nature, was nearly IMPOSSIBLE to find housing. No month-to-month leases or 3 month leases are either 1) offered or 2) if they are, they are not affordable. That leaves nurses to craigslist. Nutjobs and depressed or drug-dependent people are offering to gouge you on craigslist. Those are your options. Extended Stay hotels are $89.99/night, even for 30-days or more. Who can afford $2500 a month or more when housing stipends range from $1700 to $2000 per month? An Extended Stay rep was even present at the 2013 Travel Nurse Conference held in Las Vegas and admitted that he had not realized that nurses aren't before the conference! Still, nothing has changed and Extended Stay Hotels are simply not an option for long-term contract stays.
The other option is to take the Agency Housing. Other travelers we work with have done so. The result.... long commutes to work and living with unsavory characters hovering in an extremely overpriced apartment in some cases. The San Fernando Valley is mostly like a ghetto if you are East of the Hwy 101. Densely populated with low-income earners, garbage overflowing everywhere, sirens, and plenty of domestic violence can be heard. Now... the City of Los Angeles actually seems to be better. The Valley stinks... literally.
There are several other routes for finding your own housing, but each attempt has been met with equal shock and disappointment. Airbnb we found a place for $54/night that required no security deposit in Woodland Hills. It was a mid-century modern, 3 bedroom home... it looked like a nice, quiet neighborhood. While we stayed there we learned that the owner rented out her "room" and back yard/pool for live porn film shootings while we were renting. She hid 2 extra roommates, 3 extra cats and a dog from us when we showed up to inspect the place. Moral of the story... the people on craigslist are preying on Travel Nurses. STAY away.
My pay-package has a low taxable rate and makes up for it with housing stipend and M&I. Is this legal?
With the economic downturn of 2010, Agencies realized profit losses as the medical/travel nursing work dried up. Agencies now in are restructuring paypackages for travel nurses with such low taxable rates and paying the rest as housing stipends, which are untaxed. We confirmed this by finding and reading the Corporate Report for one of the industries leaders. Right there in black and white we read how the company is getting more profitable on the backs of the 26,000+ nurses this one company employs. They specifically list in their own corporate reports to investors that this is solely to lessen the tax burden of the Agency. The IRS has now caught on to this throughout the industry and have amped up the auditing of the Agencies AND of the employees who work for those Agencies. It is NOT ok to take ultra-low table income and make up the difference with the stipend. Here are some reasons why.
1) No one wants the IRS auditing them and charging back taxes plus penalties for income that was evading taxes. This is happening every day!
2) Someday you will want to buy a new car, a home, or some other type of large purchase that you will need a loan for. Only TAXABLE income qualifies for your loan consideration. The look-back period of time for a mortgage is 2 years or more, so if you are working for $18/hr taxable now, then in 2 years from now you will only qualify for a small loan instead of reflecting your "real" cashflow income.
3) The less tax you (and your employer) pay, the less money you are contributing to your Social Security Fund. It is in your best interest to pay your fair share of taxes so that later in life you aren't caught with an under-funded lifetime earning shortage.
4) There are many travel companies out there. The big companies have stock-holders and they are those who first took advantage of this creative paypackage and are the first to get audited. There are reputable companies out there who are not skirting the law. Choose those when looking who to bet your working future on.
If we forward our mail through the post office will we be covered for the duration of our contract?
Simply put, NO.
Forwarding through the USPS is
1) slow. You will see a 10 day or more delay with receiving your mail.
2) If you have different last names you must complete multiple change of addresses including a new one for each name.
3) You can not edit the change of address to be shorter, only longer.
4) Not all mail transfers. Our bank checks, our driver's license, car title, and license plate renewals all had a "do not forward" on them and were returned (without telling us) to the DMV and bank. It was murder getting them to be send to us at our temporary, out-of-state address. The bank checks never did reach us. We had to go to a branch office to get counter checks (for a fee).
5) Most but not all magazines will not forward to new address.
6) In order to transfer from your temporary address BACK to your permanent address, there is a 10 day lag-time for the "verification" to go through at the post office PLUS another 10 days for the mail to forward. This is the post office's way of trying to insure that the credit card used with the permanent address is valid.
Your best bet for mail during your traveling is: 1) Paperless billing and 2) Forward all mail to a reliable source such as a family member or friend who will mail a pre-paid shipment to you once a week. This is about the only way to get around the gruesome inconveniences we have found.
What cellphone service is most reliable for someone traveling in the United States?
We found that AT&T was HORRIBLE nearly everywhere we went. Wisconsin, Kansas, Missouri, California, North Carolina, South Caroline, Ohio, Tennessee, Illinois, Texas, Arizona, and everywhere in between, it was terrible coverage. US Cellular (a midwest predominantly) was best for upper mid-west, but Verizon appears to be winning the National Map for best coverage, least dropped calls, and by far the best data coverage.
Will I work holidays and weekends?
Probably. Even if it is in a hospital's policy to schedule nurses for every OTHER weekend and every OTHER holiday, often they schedule travelers for each and every weekend and every holiday or holiday-eve.
If you want or need specific days/holidays/weekends off, specify it in your contract in writing. While you may get part of a weekend off, the only way to insure it is to ask for it in advance of starting your contract. In the three contracts my husband has worked so far, the first he was scheduled every-other weekend and the 1 one holiday. In the second contract (and extension) he worked part of nearly every weekend and he was scheduled to work every holiday day or holiday weekend.
I'm moving my family across the country. Will I get low censused?
Low census is very possible irregardless how far you came for the assignment. While it is true that travelers are brought on because a hospital is short staffed and busy, it is also like any other hospital with natural lull-times in census. If beds are not filled, then someone goes home. That's it. According to each contract we've seen, Agencies agree to allow this. You will not be compensated if you are low censused.
In most hospitals they are busy enough over the duration of your contract that you may request additional an additional shift(s) to make up for the lost hours. It is in your interest to complete the agree hours of your contract, particularly if you have a written completion bonus at the end of your contract.
We recommend getting guaranteed hours written into your contract to avoid missing out on paychecks after you move.
If I extend a contract can I request to go home to visit in between?
Yes. In fact, most agencies provide travel pay specifically for that. Travel pay is only for the travel nurse to go back to the tax-home location though, not any other vacation location.
There are more questions and circumstances that popped up that I will explore here... I will continue this session when I think of the impromptu circumstances that cropped up over the months that weren't covered anywhere else that I read about.
If I travel alone will I meet a lot of other travelers to hang out with?
Some hospitals hire many travelers and others only have you. If you are a solo female traveler in her 20's, then likely you will make some friends at your hospital. If you are an older traveler then expect that others in your age group prefer to be left alone and do their own thing.
We have met other travelers and found that our invitations to meet out for a beer, dinner, or a sightseeing expedition are always politely declined. There was a single 20-something female traveler who lived in the same complex who worked the same schedule as my husband and she was not at all interested in spending time with us, even by the pool! I have concluded that travelers seem to fit into 2 categories; partiers and loners. We are in the middle and, therefore, appear to be alone there!
The bottom line, being a travel nurse can be lonely so before you embark, be sure you are comfortable sightseeing and dining on your own as you may or may not meet people in the location you are assigned.
Will getting what I want into my contract guarantee that it is honored?
No. You must scrutinze your contract before you sign it to insure that what you THINK is in it is actually there. Secondly, your hospital may overlook the details. For example, if you have a provision for a certain day off, your hospital might schedule you anyway. Be sure to bring it to their attention as soon as your schedule comes out.
Just because you discuss it with your recruiter does not mean it is certainly in the contract. A contract is a stock document that is modified for each assignment. Make sure your requests are in it.
If I take the housing stipend, how can I find out what apartment the Agency uses for housing?
Ask your recruiter! Agencies do not mind sharing the information. They prefer for travelers to arrange housing for themselves as the lease and associated expenses (ie. risk) is then on the traveler. Agencies are happy to share the info they have on housing.
What if I fail a Performance Based Developmental System (PBDS) Test that the employer requires?
Avoid these contracts and confirm with your recruiter that this test is not a condition or requirement of employment BEFORE you verbally agree to a contract. I am of the opinion that nurses are licensed for a reason. In order to get licensed a nurse must pass a rigorous state test. Those credentials are in place for a reason. I feel it is excessive for a hospital to then demand an additional test on the spot, and well after a contract has already been signed and a traveler has spent time and money to get to the location.
If a traveler agrees to one of these tests and moves, then fails a test... tough luck! You are on your own! If you opted for company housing then YOU must pay your agency back. If you opted for the stipend AND signed a lease, YOU are on the hook for the full financial term of the apartment lease and your agency will NOT typically stand behind you.
If nurses stick together and demand of their agencies to disallow performance based testing for contracts, then hospitals will be forced to acknowledge and recognize a nurses license as all that is needed to perform the job professionally.
