If you're a nurse or a trained technician that works in a hospital or clinic, and you're getting tired or bored because of what you deal with on a daily basis, there's an option you might want to think about considering. There are companies that are known as traveling nurses services that will contract with you to go to hospitals or clinics across the country that need your services.


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It sounds like a good gig, and in some ways it is. But there are some realities that most people don't know about until they get into it that are negative. You're not going to find this information anywhere else online; I know because I checked. So, I'm going to give you the down and dirty of working for organizations like this so that you know how to protect yourself or what's coming if you decide this is something you want to try.

Except for the first three, these aren't in any particular order. We'll get the first three out of the way because these are the most critical things you'll probably deal with that will shock you. That's just the way it is.

1. They aren't organized well

The strangest thing you'll find is that many of these organizations aren't organized all that well. You'll quickly get the feeling that they have no idea what the heck they're doing.

You might get contacted by someone to work at a particular facility somewhere in the country, but they often don't have any real idea about the job or what it entails. The reason is because quite often they're scouring the same kinds of job sites that people search when they're looking for work. Instead of taking time to contact the organization to find out exactly what their needs are, they start prospecting as soon as they can, looking for bodies so that when they do contact a potential client they can recommend people they've already spoken to.

This means your first contact will be something like them telling you what area of the country they have, and the position that's listed, without any other details about it. They're finding out what your interest is, and if you're not interested they move on to try to find someone else who might be interested.

If you're interested, they'll tell you that they'll let you know within a few days, even if you're the last person they've confirmed is interested. This is because most places that need someone wants at least three personnel options to select from.

Just because you've been contacted does not mean you're going to get the job; you'll have to pass the interview and possibly have to take their psychological test. Get used to taking tests; more on this later.

2. Don't know the areas of the country they're pitching to you


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Unless you're talking to someone who lives in the area that needs somebody, you'll find out pretty quickly that the people you talk to have absolutely no idea about the area they're trying to send you to. This can get scary quickly when they're trying to send you to a high cost area they know nothing about, and they're trying to talk you into accepting a certain amount of money to find a place on your own for you to stay at during the course of your contract.

The problem is that they don't know if it's a high cost area, a dangerous area... nothing. They leave it up to you to do the research, which is hard to do early on when they don't want to give you more specifics on where they want to send you. You can look up certain things on the internet to find out a little bit about the area if they tell you, but it should be their job to look this up and tell you what you could be getting yourself into.

I remember advising someone to tell the organization to find a place for them to stay when they wanted to place someone in New Jersey, in an area where the money they were going to allow for the person to find a place to say wasn't close to the amount of money for any apartments or hotels in the area. The company eventually found a place for the person that was 35 minutes away that was still $500 more than what they were going to give this person for accommodations. It was also inconvenient having to drive that many minutes a day for a temporary job; you'll learn why later.

3. Don't know the industry

The people who work for traveling nurses services are recruiters and sales people, which means they have absolutely no idea what health care is all about. This becomes problematic when they pitch you for a position that you're not qualified for, might be overqualified for, or they have no idea about the certain types of certifications that are needed by certain facilities in order to do the job.

Because of this, they could be setting you up for a position that you don't really want because the pay their offering is inconsistent what you believe your worth is. You might be talking to someone who believes a nurse is a nurse no matter what department they're needed for, or someone who believes that an EEG technician is the same thing as a respiratory therapist.

This means you have to be prepared to ask questions about the job and hopefully get to see a written job description so that there are no problems on the back end. Be ready to wait for the job description until they're sure they're a player in the game.

4. Physicals/Shots/Lab Tests

Every agency you go to is going to require you to have a physical, up to date shot records, a lot of lab tests and a drug test. If you end up signing with multiple agencies, each one is going to require you to have all of these things done again, even if they're within six months of each other.


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In my mind this is problematic, especially if you already have copies of the tests that you can share with them. What I've found is that if an agency sends you for testing, they won't share the results with you unless they find something wrong. This is where it's better being an independent consultant, because you can decide to pay for the tests yourself (which is a business write-off) and you get the test results first.

What I recommend is that you pay for at least your drug testing so that you have a record of it you can provide to all these agencies when you're going to new assignments. Drug tests are good for a year, and at least it's one thing you don't have to keep having done if they'll accept it. If you want to pay for lab tests they're good for six months, but it's probably better to let the companies pay for it; the same goes for shots.

Unfortunately, you'll probably have to keep getting physicals with every move unless you stay with the same agency. Sometimes they'll accept your records if you've had a physical with your personal physician but they're under no obligation to do so.

5. Length of contracts

The length of most contracts is normally thirteen weeks. They'll hope that you'll extend as long as possible, but there are caveats you need to know about.

Every state you work in is going to try to claim taxes from you, but if you're there less than six months you'll get all your money back. To get around this, you need to take anywhere from two weeks to a month off an assignment before you go back so that you don't get hit harder because of the state taxes. Every state doesn't have taxes, but most of them do.

If you go to Hawaii, you have to sign a contract for six months because of the costs associated with getting you there and coming back. If you have to leave early, the cost of getting home is totally on you.

6. Terms of contracts

The terms of the contracts are pretty much like the terms of any other contract you'll ever sign. Very little goes your way as far as your rights and your protection. If there's ever a disagreement, you'll have to go through arbitration selected by the employer; you know how that's going to work out. Truthfully, you should probably have a lawyer look at it before you sign it, but you won't. At the very least make sure you read every single sentence and understand it; if not, ask questions.


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For instance, if you're gone eight weeks and you suddenly have to go home because of an illness in the family, quite often you have to pay the remaining weeks that you're not going to be on the assignment. If they have gotten you a hotel and paid in advance, they're going to charge you for that also. If you need to be home for a week but are going to return, they're going to dock you a certain amount of pay even though they didn't pay you for the week you were gone. Also, they'll expect you to find your own way of transportation to get back home and get back to the assignment; I'll address more of this when we get to number eight.

For some of these organizations, if you stay in town during a holiday and the facility you're working at is closed, you don't get paid for that day. They'll cover your hotel, but you're not getting paid unless you're working. If you're working, you might not get double time for your hours like you would if you're a full-time employee. This might be something you can negotiate in the contract, but I don't know anyone who's ever tried it because it's something they don't think about.

7. Hospital Tests

A lot of hospitals across the country now have tests that they require new employees to complete. You might be required to do these tests with this particular hospital before you can go there, even if you already know these things. In a lot of ways this makes sense, but if you've just spent three months at one hospital and you're going to another hospital and they're asking you things like confidentiality or how to treat patients courteously and it's something you've already done it's a waste of time. One of the problems I have with this is that you have to do it on your own time which means you're not going to get paid for it, whereas new employees would do it on the employer's dime.

They don't always give you a lot of time up front to get these tests done. Quite often people have found out only a few days before they were scheduled to leave home that they had to complete a bunch of tests (remember what I said above about some of these companies being disorganized?) and suddenly they're pressed for time between trying to complete tasks, packing, and preparing everything else that needs to be taken care of while they're out of town.

I know someone who was given 12 tests to complete with only two days at home before having to go on the road. This person thought they would be able to complete the test at the hospital, as there was only one test left to do. Instead, the hospital sent the person back to the hotel to complete the test and the traveling nurse company wouldn't pay them for that day. They actually took back some of the money for the hotel room because they weren't at work; how unfair is that? I'll address this last part a little bit more at number 10.

8. Travel/Mileage

This is a biggie. Except for extreme circumstances, they expect you to get to your new assignment by driving everywhere... and I mean everywhere! If you live in Maine and the assignment is in California they expect you to drive that entire distance. Not only that, but almost all traveling nurses services will only pay for the first 400 miles on the way there and the first 400 miles on the way back home. Hawaii and Alaska are the exceptions to this rule, but it's still a ridiculous rule; both of these are ridiculous rules.

This means if you have to drive a long way to get to the client's location on a daily basis, you don't get paid for travel expenses. Your daily meal per diem will give you a little bit of extra money, but that's not what it's supposed to be used for, which is why it's an unfair rule.

The one bit of leverage you might have here is if the facility absolutely needs someone and you're the only person they can get, and you tell them that you're not going to drive that distance. It's the only time where they'll contact the hospital or organization and ask them if they'll pay for you to fly there. Most hospitals actually will, but this takes us back to number one where I said these people don't always seem to know what they're doing. These are the times where I'm glad I'm a consultant, because there's no way I would accept either of the above conditions.

9. Accommodations


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At number two I mentioned that these organizations have absolutely no idea what the places they're sending you are like. This is where you need to be savvy and protect yourself. Many of them will offer you an upfront amount once they learn a little bit more about where you'll be located, and allow you to find a place you want to stay. This gives you the opportunity to find a place to stay and then keep the rest of the money, and in some circumstances this isn't a bad deal. For instance, if they give you $1000 a month to find a place and you can find a nice place for $600 a month, that's $1,200 tax-free for at least three months.

Unfortunately, it doesn't always work out like that. They'll encourage you to get an apartment instead of a hotel room, but you'll probably have to get an unfurnished apartment you can afford. This means you'll probably have to buy everything for it; curtains, towels, etc, unless you have a large enough vehicle to cart it around with you.

However, if you have them do it they may try to find the cheapest option without knowing whether they're putting you in danger or not. The cheapest option might be an unfurnished apartment, which I mentioned above. It might be a "roach motel", where the price is right but you're in a dangerous neighborhood. This is where you have to stand your ground because they'd hate for word to get out that they treat workers badly.

That sounds like the worst part but it's not. If you didn't read the contract to find out if you have a right of refusal where they send you, it could cost you not only time but money to go elsewhere or decide you don't want to do the assignment at all. If the people working at the organization that contracts with you were doing their job properly, they would find out from the people they're contracting with what areas they should be looking at for your accommodations, whether it's an apartment or hotel.

10. Dealing with clients on your behalf

what sometimes happens is that you've agreed to go to a place to work a certain shift and a certain number of hours, only to arrive and find out that's not what the people there had in mind for you. Because you've already gotten to the facility, you don't have a right to change anything, even if you call the traveling nurses services to act on your behalf. You could immediately say you're not going to do it, but that comes with repercussions you might not want to deal with long term.

That's a common bait and switch from employers, which includes being on call after someone has told you that wouldn't be anything you'd have to do, or them putting you on a children's ward when you had mentioned that you didn't want to work with children. The nurses services organizations will always side with the employer, and this can be problematic.

I know someone who was two days within leaving for an assignment when the company called them and said that the hospital would not respect the letter that they from their physician at home indicating that they shouldn't be getting a flu shot. The nursing service had known about the letter, and since this person had worked with his client in the past and never had any issues, thought everything was okay.

The company contacted the person and said the hospital would force the person to both see their own doctor and take the flu shot without trying to protect the person they'd contracted with. This derailed the person from going, luckily before leaving town. This person didn't even get an apology for the disruption that was caused; that's as unprofessional as you can get.

11. Pay

Depending on the job you're qualified for, your certifications and what's expected of you to do, you can make anywhere from $25-$75 an hour. The high end sounds impressive, but don't go in thinking that's what you're going to get most of the time. Like a lot of other places, they're going to try to low ball you as much as they can, and early on in working with one of these organizations you might have to go that route to build some equity.

The thing is, $25 an hour might sound like a good deal to you, as it comes with a daily meal per diem that's tax-free. However, at the end of 13 weeks that's about $13,000, and it might be a while before you get your next assignment. So it's not the greatest amount of money for a contractor to deal with, especially without guarantees of follow up assignments or insurance coverage.

You'll also find that the closer you are to home, the harder these organizations are going to try to get one over on you. They'll want to pay you less money, they won't want to pay for any expenses which includes parking or mileage, and if you're within a two hour distance they'll expect you to go back home every day.

Anything longer than two hours, they expect you to live in the area for the duration of the contract. My belief is that if you're close to where your client is, they should pay you a little bit more money because of all the money they and the client are going to save on expenses, and covering something like parking should be a no-brainer. You should ask for this, but you also need to read your contract as well as be strong in your commitment. Their belief is that you'll jump at the chance to work close to home for more money than you would've received if you were a full-time employee. Like I said before, they're going to try to get you at the cheapest price possible.

12. Insurance

The last thing I'm going to cover is health insurance. This differs from organization to organization, but you'll get health coverage at some point unless you already have it. With some organizations you get it from the day you start an assignment, and it ends on the day you end an assignment. With some other organizations, your insurance doesn't kick in until you've been somewhere 60 days, which means if you're on a three month contract you're only covered for 30 days. That sounds ridiculous, but it's common.

You also need to know that you're paying for your insurance. For organizations that don't give you coverage until after 60 days, this means you are going to pay out more money than coverage you'll get from that insurance. This is why you need to read the contracts so you know what you're up against and can find ways to protect yourself.

In conclusion...

Deciding you want to travel to do your work isn't necessarily a bad thing. You get to go places you might have never thought of, and in some cases you'll like it so much you might decide to stay as a permanent employee. Sometimes you'll be close enough to large cities or sites you want to see that will make the entire trip worthwhile.

However, you need to be cognizant of what you're going to have to deal with and be ready to protect your own interests from the first time contact is made. The companies will make it look like they're doing everything for your benefit, but they're not. It's up to you to make sure you know what's expected of you, what you can expect from the company, and make the best decision possible that's good for you.