Gail Ingram BSN-RN responds:
Hospitals look to fill positions with travel nurses on units with high turn-over. Retention issues are often caused by poor or no management and working conditions can be tough. Depending on the unit’s unique nursing culture and circumstances, support can be limited and it is imperative for travel nurses to be highly competent and proficient in their clinical skill set.
After a couple of years of solid acute bedside experience, travel nursing is a great way for newer nurses to increase their income. It allows them the opportunity to work outside of nursing unions which base pay only on years of experience and not nursing excellence. But once a nurse has been in the field for about 8 years, the pay rate of unionized nurses tends to match that of a travel nurse.
However there are also tax advantages for travel nurses. Travel nurses are paid a low hourly wage ($25-$35) which keeps them in a low tax bracket. The bulk of their income is in the form of a furnished corporate apartment near the hospital. Although when the nurse finds his/her own housing, a housing stipend can be negotiated. Housing stipends are tax-free reimbursements (AKA undocumented income) and are not declared on income tax. Housing stipends range from $1800 to $3000/month in addition to $25-$35 per hour depending on the city/state/institution of employment.
Some disadvantages to being in a lower tax bracket and receiving tax-free stipends (undocumented income) occur when applying for credit, buying a car, or attempting to rent an apartment which requires a certain W-2 income. A letter from the travel nurse agency will usually suffice but some landlords and banks won’t accept anything but official tax documents.
To find work, travel nurses can utilize several agencies at the same time and choose between a multitude of job offers. There are national agencies (Cross Country, American Mobile, etc.) and local agencies (Seattle—HRN, New York—Access, Prime, etc.). Local agencies usually offer higher pay rates but may skimp on the health insurance.
An ICU trained nurse has the largest selection of travel assignments available to them. They can work contracts in an ICU, PACU, IMC, PCU, tele-stepdown, tele/med-surg or other assignments like clinic or occupational health nursing depending on their previous experience and comfort level. A med/surg nurse can only be assigned med/surg or clinic/occupational health positions. It is very hard to change specialties while travel nursing.
When signing up with a new agency, travel nurses must pass tests (pharmacology, cardiac arrhythmias, etc.) and fill out endless skills checklists. Upon arriving at the hospital, the institution will require additional testing and completion of JCAHO compliance paperwork. A classroom orientation is scheduled which includes the hospital’s philosophy, equipment usage, and computer charting. Travel nurses receive two days of orientation on their unit (learning the location of fire extinguishers, finding the medication, supply, and dirty utility rooms, practice charting assessments) and are expected to function independently by their third shift.
From personal experience, pay rates went down during the recession but are on the rise again. In December 2008 to March 2009 I was paid $30/hour (taxed) and a $3000/month housing stipend (un-taxed) to work on a Progressive Care Unit just outside of Seattle. This was with a national agency and included health insurance. I worked several summers on a telemetry unit in the Hamptons and made $40 to $44/hour with shared housing provided (no health insurance). The current rate of pay in Manhattan varies by agency, institution and a nurse’s negotiation power. With no health insurance, $30/hour and $3000/month stipend is on par for local agencies. This works out to approximately $50/hour after it is all broken down. Compared to the cost of living, travel nurses make more working in other markets.
Here is a post I wrote about the first travel assignment I took in NYC: New York City Nursing | East Coast vs. West Coast.
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