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Hello everyone. My name is David Morrison and I am currently in my 15th year as a travel nurse and have completed over 30 separate contracts throughout the U.S. I have also arrived on assignments to trashed housing, had contracts canceled,  and countless other issues that compose the less glamorous side of travel nursing.

However, I have also seen many places and met many wonderful people because of travel nursing. Last year, I penned a how-to book on travel nursing aimed at nurses just starting their travel careers. If you would like more information on the book, it is called "Travel Nurse's Bible" and can be found at travelnursesbible.com. Additionally, I write a monthly column in Healthcare Traveler magazine as well as blogging online at TravelNursingBlogs.com for the past year.

I will now be lending my time to Healthcare Travelbook readers to answer all your questions on travel nursing. 

To submit a question, please "Create a New Topic" in the "Ask A Travel Nurse" category and I will reply with an answer.  I look forward to hearing from you!

Does anybody have comments about three companies i have been researching? The three are :Emerald, west ways staffing, and fastaff? Has anybody taken contracts with these companies?

Hello to you both. I hesitate to comment on companies with which I have personally not traveled, so if anyone out there does have experience with any of these companies, please help out your fellow travelers.

I have not traveled with Fastaff, but am on file with them. They typically have high paying assignments, but from most of the travelers I have talked to who have worked for them say that you do earn your money (meaning they are not the easiest assignments in the world). They also seem to staff places that offer a lot of overtime, so it might give you an opportunity to earn some extra if you wish. For example, they do (or at least they used to) offer many assignments that guarantee 48 hrs (or four 12's) a week. Again, nice money, but hard assignment. I recommend first-time travelers take assignments that are only 36 hrs per week. If they have OT, then you can sign up, but do not commit yourself to 4 days a week on your first assignment. See what travel nursing is about first and then consider some of the more challenging assignments.

American Mobile Healthcare (AMH) is big...real big. I met with the CEO of RN Network a few years ago to relay some company ideas when I traveled with them. At that time, he said they (RN Network) had about 600 some travelers, whereas AMH had around 6000 (see...they are BIG). However, with that size, the left hand does not always know what the right hand is up to. True story: I was on assignment in Florida and an AMH recruiter called me to ask if I was still interested in taking a travel assignment with them. I paused for a moment, somewhat confused, and asked her to repeat herself in case there was some confusion on my part. After she repeated the same question, I politely informed her that I was already on an assignment...with THEM.

Big travel company does not necessarily mean bad experience because I did an assignment with AMH a few years back where they paid about the same as the company I was with before that assignment, RN Network. It was for the EXACT same position in Ohio and despite similar hourly pay, RN Network came back with $800 a month housing stipend. AMH was $1350 and even ended up being a few more dollars an hour than RN Network. Plus, I have a recruiter that I love at AMH because she is strictly no BS and tells it like it is. Not sure I would travel with AMH if I had any other recruiter.

With that said, I do like RN Network and would never hesitate to travel with them and do refer a lot of first-time travelers to them as they are a well rounded company. When you get into trouble on an assignment, you want a company that will respond to your issues. I know firsthand that RN Network does that.  You have to decide whether you want to be paid TOP dollar for every assignment, or want the protection of a seasoned company when the fit hits the shan.

Do NOT join only one or two companies. Join five or six. Why limit yourself to the pool of assignments that a few offer when you can double or triple your assignment offerings. Join the big-uns (American Mobile, Cross Country), and then a few well rounded companies that have good reputations for treating their travelers well (Trinity, Cirrus, RN Network, and Medical Solutions). BTW, I have direct contacts for each of these companies if you want a specific recruiter referral rather than just having the company pull a name out of a hat when you call.

Hope this helps and again, if you have experience with any of the other companies mentioned, please chime in with your thoughts.

David

I am new to traveling, and there were so many companies and it was hard to get my first assignment because of my lack of travel experience, but I was able to and am now in Alaska, which I love. I am wondering what you think about getting a set wage, or doing the split for tax purposes. I dont quite understand all that. I really dont even know if I am getting the wage I should be, since I am new at this.

I'm not entirely sure what you mean by "doing the split". I know that California does a "blended" rate where the first 8 hrs of your shift are regular pay and the last 4 hrs are at an overtime rate. However, it sounds like you are speaking about some sort of split in wages which suggests participation in a tax advantage program. 

If you are asking about a tax advantage program, I personally prefer to take a "set" wage and do the tax deductions myself. I find that for many locations, the standard amount that many companies take out does not fully take advantage of my entitled benefit.


For example, if I take the "meals and incidentials" that my company offers and take a pre-tax deduction of $420, then I must assume that I am working in a part of the country that only qualifies for the standard deduction. However, if I am working in Scottsdale, Arizona, where the price of meals and living can be a bit higher, then I am allowed a greater M&I deduction on my taxes. If I just take the dedction my company offered me that put more money in my pocket each week, I could possibly be throwing away hundreds of dollars versus taking my higher rate deduction come tax time.

Plus, if you are like most travelers, the tax advantage programs only muddy the water. Your recruiter says that you will be getting paid $32 an hour. Ok, then why does the contract I sign say that my base rate is $17.29?

When I have used tax advantage programs on my assignments, it actually does work out that my hourly is what the company said it would be. Like in the aforementioned example, my contract might say $17.29, but my final pay does reflect a rate of $32/hr. However, not all companies are the same in the way they structure the program or the amounts they deduct (because that would be too simple). There are nurses out there that make $32/hr, but their contract might read $8.32/hr. This type of rate should send red flags out to anyone.

Joseph Smith, a member of this site, prepares tax returns for travel professionals. He has a great page on his website that speaks to tax advantage programs and can be found here http://www.traveltax.com/TravelRN/KnowledgeBase/TaxAdvantage.html  

Joseph also evaluates tax advantage programs and he might still be doing that for free (with the hopes that you would use his services if you do use a tax professional for your returns). Even if he now charges a fee, it might be worthwhile to see if you particular company is operating where they need to be with regard to IRS regulations (especially if you earn considerably less on paper as opposed to your real take home wage). 

All the sections on Joseph's website are a good read for the new traveler (he was the one I contacted to look over the section in my book on tax issues before I published). If you are going to participate in any tax advantage programs, then you need to read up on them further and truly understand their benefits and their downside. For example, a loan, or your retirement benefits, may be based on your reported income rates. What do you think a bank might say seeing that on paper you only appear to make $8.32 an hour? What could that rate do to you when social security bases its benefits on 35 years of your highest wages? These are all considerations when participating in tax advantage programs.

And finally, we haven't even touched on whether or not you truly qualify for a tax advantage program (do you really meet all the IRS qualifications of having a "tax home"?) All these things must be addressed when addressing any type of tax program provided by your travel company.

I know this might muddy the water a bit, but the more reading you do on the subject, the more understanding you will gain. Plus, if you just can't figure it out, call or message Joseph Smith and consider putting a tax professional in your corner.

I hope this is what you where speaking to and I hope this helps.

David Morrison
http://www.travelnursesbible.com

How have you survived for 15 yrs traveling. 

Not quite sure I understand that last question. I have never really had any problems "surviving" as a travel nurse. The last year has been rough with the hospitals cutting back, but there are still travel assignments out there and there will always continue to be.

You have to remember that travel nursing, in the way that it operates today, has only been like this for about a year and a half. Prior to that, in the good 'ol days, you could pick wherever you wanted to go and be relatively certain of finding a job. Today, it is beneficial to have more than a year of experience (what used to be the norm for starting travel) and you have to be more flexible than ever for your first contract (possibly taking an assignment that might not be your first choice of locations).

I also extend in many locations and have stayed in some for over a year. It's not a lifestyle for everyone, but one that can be pretty rewarding for those that weather the storm when times get tough.

have you worked in hawaii?  how was it?  is it doable to bring a family there?  any advice?

I have worked in Hawaii on three different assignments and usually try to stay about 10 months each time (any more and I get island fever---restlessness due to be on such an isolated piece of land).

You can read a post on Hawaii on this site in the locvation forum--> http://healthcaretravelbook.com/forums/viewtopic/10/67

I also wrote a blog post on another site regarding shipping your vehicle http://travelnursingblogs.com/travel-nursing/travel-nurse-drive-hawaii/

If you read the post on this site, I saw one traveler that states that assignments there are scarce right now. It is doable to take the family along, but certainly more expensive. If you can find a contract there, you might not be able to do more than one assignment (13 weeks). It would also depend on your current financial situation and what bills you would still have back home (like a mortgage for example). However, if you have a "tax home", you would be able to deduct some of the Hawaii expenses.

Bottom line, it's doable and you may still be able to find contracts there if you are persistant and are signed up with at least a few agencies. However, with a family, you should research it thoroughly before taking any contract there. 

I'm looking to travel again.  I did one assignment, but it was only an hour and a half away so I just commuted and stayed in a hotel for 3 nights.  Afterwards, I ended up having to file for unemployment because they weren't resigning and there weren't any travel assignments around.  I'm looking to travel again for the winter and hoping I won't run into that situation again.  I am looking to go to Durham, NC Charlotte, NC areas or Dayton, OH.  I didn't know if having to move would cut down on my wages a lot...? If you recommended any travel companies.  And if it was costly and took a long time to get licenses in other states.  I have a lot of questions and any information would help a lot. 
Thank you so much,
Hannah

Hey Hannah. I will try to answer the best I can, but I might need some more info specific to your situation.

First, you need to join more than one agency. If I'm on the road and my assignment isn't being extended, I get on the phone with about six different companies and just say, "the one that gets me an assignment in the area first, wins". I was in L.A. for about three years and had to leave one hospital because I was there for more than a year (the hospital had a policy not to extend travelers for more than a year). So, I called my agency and told them to find me another facility in L.A., but no dice; they couldn't find me another contract. I called another agency, with whom I was already on file, and they found me an assignment and even took over my company provided housing from the first travel company (I switched assignments AND travel companies and never had to move). Point being, more agencies=more assignment opportunities.

As far as moving cutting down on your wages, certainly you would earn more taking a stipend (when you have a place to stay), but you should still earn a decent wage taking company provided housing. Plus, if you maintain a "tax home", then you can write off many of your expenses while on assignment or participate in your company's tax advantage program (assuming they have one).

As far as licensure in other states, every state is different with their fees, but most companies reimburse for licenses. Licensure times are also different in every state and some states are compact licensure and some are walk-through states (where you can just go to their board and get your license that day). Your recruiter should be familiar with licensure times and be able to tell you of any specific problems they know of with any particular board.

If you'd like to send me an email (david@travelnursesbible.com) and let me know what company you were with and a little more about your specific housing situation (where you live now, will you maintain a tax home while you're away?), I can answer things a bit better and set you up with a few good companies.

Hope this helps.

David
http://travelnursesbible.com

Have you ever quit a assignment due to working conditions? I just ended my contract early and it cost me money big time. My recruiter was no help to me. I had been on assignments in the past with  this company and had no problem. I was working in a prison to say the least. tks  LPN

I have never "walked" on an assignment, but I have been close. My recruiter was wonderful and encouraged me to do what I needed to do and stated they would stand behind me. I was with them for a long time and I believed her when she said this, but I can't say for sure what the outcome would have been.

There are about a million different factors to consider: what your contract says, why you are leaving, are you going to take another contract, have you been with the company for awhile, etc, etc. I try to stick it out, but if the right situation came along, I would have no problem walking. Money can be earned again, my nursing license can't.

David
http://travelnursesbible.com

David, I could really use your advice.  I think it is wonderful that you have been traveling for 15 years.  I traveled several years ago and like you said in a post earlier, it was a different game.  Assignments were abundant with pay in the ranges of $45 to $50 an hour.  I was prepared for the lower wages when I took my current assignment (only 2 weeks in) due to this webside.  It has been very helpful.  I was so lucky to land this assinment right in the area I was looking for.  I love my recruiter and my company for that matter.  My concern is that when my assignment is up - I am only registered with one company.  This seemed to work great when I traveled in 2003.  I am sensing that is not a good plan now.  I feel like I am betraying my company and my recruiter - but I need to make sure my career is stable and like most I can't afford to be waiting around on an assignment to open up.  I am pretty flexible in where I will go so I am hoping that helps.  My other question is a home base.  I sold my house in anticipation of traveling.  I have an apartment back home for the time being - but would really like to just travel and not worry about a place back home.  My biggest concern is then they tax my  housing and I am basically "homeless".  Can you please give me advice on the best way to go with this and what makes the most sense for someone who really wants to travel for several years.
Thank you so much.
Renee

David,
 I just purchased your book. I am thankful you are here offering advice. I am talking to Cross Country Travel now for my first assignment. So, I am looking forward to reading your book.

Thanks for your order. The book should help you along the way with any questions you might have. However, if there is something specific to any situation you encounter, on which you need advice or insight, feel free to email or post a question here. Thanks again and good luck with your travels.

David
http://travelnursesbible.com

Hi david,
I have a lot of questions..my contract ends april 29th, 2011 have talked to my recruiter and told him that i would like to stay at the facility until the end of may, because I would like to stay in the area.

My recruiter  said he would talk to the facility and he should know something by the end of this week, since its closer to the end of my contract. David Should I be talking to another agency now, or give him an opportunity to see if they will need me. i have talked and kept in touch by email with other agencies (that i have never worked for-but they have my paperwork).How much time do i give him due to i have 4 more weeks left?

and when does a person  start marketing themselves to available to another agency before their contract is up--my contract is normally up at the end of the month.

last question, those agencies that i have spoken too, we have NEVER spoke about money, should i have spoken to them regarding the  amount that I currently make, so their is no surprises when I call regarding work/an assignment?

thanks for your advice

Hey Deb. Have heard good things about Valley and Trinity, but have never personally traveled with them. Not sure how much you know of me, but I authored a book personally for you. Well ok, not YOU personally, but for those just starting out. If you have any interest you can check it out at http://travelnursesbible.com and see what all it contains. If you like my advice pieces, you can also check out past issues of Healthcare Traveler Magazine online where I author a monthly column and also subscribe to receive that publication on a monthly basis (free to travel nurses).

I also blog and answer questions over at http://travelnursingblogs.com, so you can see more of my posts there. I also have helped quite a few travelers get their start with recruiters I trust. If you would like any of those contacts, feel free to email me at david@travelnursesbible.com.

Bottom line, I'm here to help with as much or as little help as you'd like. As far as travel companies, read what you can on online forums like ultimatenurse.com or the group for traveling professionals over at Delphiforums.com (just search travel nurse in their search box). Join more than one company (I am on file with six at last count) and read up what you can on other people's experiences. I am quite proud of my book because it has helped a lot of travelers find their way and know what to expect, but you certainly don't need to get the book to become a traveler.

Again, whatever I can help you with, feel free to ask.

David
http://travelnursesbible.com

I'm just beginning to research traveling.  In fact, I'm just beginning my nursing studies.  What I'm wondering is if there are more jobs for any particular areas of nursing.  What interests me most are ER and Labor and Delivery.  I would potentially choose one based on the travel job market, or maybe try to train in both.  Any suggestions?  Thanks!

My other question is about international placement.  Do the same agencies place nurses here as well as in other countries?  Is there special licensing required to work in other countries?

Hey Wendy. As far as fields that are "hot" in travel nursing, it really seems to go in phases. Sometimes you will see a ton of L&D positions, other times, it will be ICU or ER that seems to pop up frequently. With the baby boomers getting older, I would say that anything in adult care will always continue to have a need, but should you want to work with the younger ones, NICU and PICU might be a good option (as well as L&D).

If you had no preference, I would advise you sticking with adults. The only reason I say this is because adult care should always have available positions no matter which facility you wish to work. However, the same cannot be said of peds positions. For instance, I am currently at a facility with no birthing options or peds units. But have you ever seen a facility without an ER? If you do want to cross-train, that will open you up for more positions, but you will need to do that before you travel because there is little chance for cross-training once you begin traveling.

As for international travel, not many companies who do contracts here stateside will also do international. One of the best places to look is O'Grady-Peyton (http://www.ogradypeyton.com/ ). They do international placement and can help you see what is required where you want to go. They have a lot of information on their website and you might even consider sitting for the NCLEX and any overseas exam at the same time upon graduation (while the material is still fresh).

Hope this helps with your planning and let me know if you have any other questions.

David Morrison
http://www.travelnursesbible.com