One of the best things about a career in healthcare is having a variety of employment options available. Vivian lets healthcare workers look for jobs in all arenas including permanent staff jobs, travel contracts, local agency, and per diem jobs.
If you’re having a hard time understanding the differences between permanent and travel jobs this guide compares and contrasts the features of both types of employment.
- To work as a staff nurse, you must graduate from an from ADN (Associates) or BSN (Bachelors) accredited nursing program.
- After passing the NCLEX, you can be hired into various staff positions as a new graduate nurse. Some specialties like ICU and ED may require some clinical experience, depending on the facility.
- Nurses must satisfy all licensure requirements only for the state in which they are going to be employed.
- Travel nurses need at least 1-2 years experience, depending on the specialty. New graduates are not eligible for travel nurse positions.
- Having advanced certifications is recommended to be a prime candidate for a travel nurse position.
- Travel nurses must have a compact license, or current license in each state where they plan to practice as a nurse.
- Nurses looking for permanent positions can use Vivian to search jobs across the country and talk directly with recruiters and hiring managers.
- After finding an position, nurses must interview with hiring manager and possibly a panel of peers.
- If you are unsure about a position, it’s possible to ask for a shadow shift to gauge if the unit is a good fit.
- After the interview, there is usually a 2-3 week wait for an official offer from Human Resources. Vivian helps facilitate quicker hiring by maintaining communications between the facilities and our Nurse Concierge team. We are there with you every step of the way during the hiring process.
- Before the start date, the nurse will complete pre-employment screening at the facility employee health and security locations.
- When all pre-employment requirements are fulfilled, there will be a formal facility and hospital orientation for the nurse.
- The best way to view thousands of positions is to use Vivian to search jobs with hundreds of agencies and start chats with recruiters to get submitted to top paying positions.
- Having a complete profile on Vivian will make your applications stand out. When you find a job that meets your requirements, fill out the agency application, skills checklists, and submit all essential documentation via the agency.
- After the agency submits your application with the hospitals, the travel nurse will usually have a telephone interview with someone at the hospital (not always the unit manager).
- The agency will require that the travel nurses signs a contract outlining the specifics of the job after the nurse has been hired.
- After the contract is signed (electronically), you will complete pre-employment screening at a lab/clinic near your current location.
- The last step is traveling to the job site and getting prepared for your first day of work!
- Your first week as a staff nurse is usually a general hospital orientation and facility/unit specific education.
- The unit orientation can be between 2 weeks and 6 months, depending on unit and experience of RN. Higher acuity specialties may have a longer orientation period.
- Staff nurses can expect to fill out orientation binders or online checklists for skills specific to their specialty and unit.
- Units educators will hold serial meetings with new staff to check on orientation process and transition to new role.
- Be prepared to complete 4-15 hours of online pre work including clinical knowledge testing, human resources required paperwork, and parts of general hospital orientation prior to starting. Travel nurses are typically paid around $15 per hour for their time spend doing pre-work.
- Day 1 of a travel nurse assignment is usually a non-clinical day and includes basic paperwork, Joint Commission required education for National Patient Safety Standards, and skills like restraints and glucose monitoring that are checked off prior to the travel nurse working on their assigned unit.
- Clinical orientation can be between 4 hours and 2 days- depending on the facility- time is mostly spent locating items and making sure system sign-ons work. Due to this very short clinical orientation, new graduates aren’t good candidates for travel nursing positions.
- Documentation of travel nurses’ orientation is short and sweet. There will be a quick online checklist, or a few pieces of paper that need to be signed off for the travel nurse to be able to work on the unit
- Full time employees are eligible for health, dental, and vision benefits. Part time and per diem nurses may also be eligible for prorated benefits, depending on the facility.
- Most healthcare institutions off some form of tuition reimbursement for their staff. This can be used to advance you degree in healthcare, and some systems offer reimbursement for advanced certifications, as well.
- Full time nurses are able to save for retirement with 401K or 403b options. After a period of time, the nurse may become ‘vested’ and will be able to take their retirement with them if they choose to change jobs.
- Many facilities have a program designed to help nurses advance their careers and ‘climb the clinical ladder’. Nurses can earn merit raises and further their careers in the nursing profession. Advancement up the ladder is often achieved through specialty certification, engagement in unit and hospital based quality improvement committees, and taking on roles such as charge nurse or preceptor.
- Most agencies provide some form of insurance during the assignment. It is important to ask if these benefits start on day 1, or if there is a delay.
- Some travel nursing benefits may be more expensive that what you would pay as a staff nurse, especially for coverage of more than just an individual.
- If you change agencies between assignments you need to change benefits each time. Another option is to enroll in state provided marketplace insurance to provide consistent coverage.
- Nurses may need to supplement their insurance with additional carriers during time off between jobs. There are a different options for health insurance as a travel nurse.
- Few agencies offer tuition reimbursement, and it usually only applies to nurses that stays with that agency for a prolonged period of time.
Paid Time Off (PTO)
- PTO is offered for full time and part time employees, but usually per diem, or prn, staff are not eligible to be paid for any missed shifts or vacation time.
- The paid leave time may accrue with hourly deposits in each pay check, or some staff may be frontloaded at the beginning of each year with all of their hours.
- Covers sick days and vacation time
- Very few agencies offer some version of PTO, and most will not cover sick days. Additionally, nurses may only be eligible if they work the same agency for multiple assignments.
- Vacation time during an assignment may need to be made up at the end of the contract as days/weeks added on to ensure work the total amount of hours you are contracted for.
- Travel nurses are not paid for time off in between assignments.
- As staff nurses, the leadership will expect that you be dedicated to and engage in actions for your unit goals and quality improvement initiatives.
- Most staff do not float often if they are not in a float pool position. PRN staff and travelers are usually the first to float to other units if needed.
- Over time, staff nurses are encouraged to engage in the roles of preceptor and/or charge nurse. These roles can also help staff nurses advance through clinical ladder programs.
- Many facilities want their staff to become involved in unit and hospital based committees to improve quality of care and patient safety.
- Most nurses will have yearly reviews by a member of their leadership team that may or may not include a performance based merit raise, depending on the facility.
- Travelers are expected to be highly skilled and active team players. They are hired for their experience and ability to start a job with minimal training.
- Travel nurses often float first. Flexibility and adaptability are important as you may have to float to equal or lesser acuity floors.
- Units managers prefer minimal complaining about scheduling or patient assignment (within reason!). Travel nurses are there to help an already strapped unit and shouldn’t be causing additional stress on the unit.
- As a travel nurse, you can’t gain ‘seniority’ on a unit due to the short length of employment. Travelers must be excellent communicators in order to constantly work with staff that are unfamiliar with your skillset and prior experience.
- Travelers do not get annual reviews by managers, but if you are not performing well on a job, you will most likely be contacted by your agency.
Length of Employment
- Employment as a permanent staff nurses can be indefinite. It’s up to the nurse to decide when they are done working for a healthcare system.
- Some hospitals have sign on bonuses that require a contracted time commitment, usually a year or two, but otherwise there is no signed commitment to the facility.
- A normal full time hourly commitment is 36-40 hours per week, depending on the position and workflow of the unit.
- Staff nurses have the option of using PTO for any shifts that are cancelled due to low census.
- Some nurses may work multiple positions in the same facility over the course of time through lateral or vertical movement in the healthcare hierarchy.
- Traditional travel nurse contracts are 36-48 hours per week for 13 weeks. Nurses can often extend beyond that in shorter increments, or for an additional 13 weeks.
- With the arrival of the coronavirus pandemic, new crisis contracts are offering 2-8 week assignments. These contracts are often requiring 48+ hours per week.
- Travelers cannot stay in one location more than eleven months due to tax laws.
- Travel nurses are not paid for cancelled shifts, unless they have a guaranteed hours clause in their contract.
- There is always the risk of contract cancellation due to low census, or a variety of other reasons. Only a few agencies have a clause in their contracts that requires advance notice to the traveler, and it’s usually 2 weeks or less.
- Full time staff either self schedule or work with unit scheduler, and they usually have their schedules at least 4-6 weeks ahead of time.
- Staff nurses must request any vacation time off in advance and get it approved by leadership.
- Time off can be limited to available PTO hours and cannot conflict with other requests, causing short staffing on the unit.
- Full time staff are not usually allowed to have prolonged time off unless it is due to injury/illness/disability/pregnancy. Many units will limit vacation time to two consecutive weeks or less due to staff nursing shortages.
- Travel nurses usually don’t receive their schedule very far in advance, and are scheduled by the unit scheduler or a central staffing team.
- Travelers should request any necessary time off during assignment in your initial contract for manager approval. You may also want to mention it in the interview to make sure it isn’t a deal-breaker for the facility.
- One of the huge benefits of travel nursing is being able to take unlimited amounts of time off between assignments to explore/spend time at home (just remember it’s not paid!).
- Travel nurses can also arrange to take time off between end of assignment and an extension.
Pay & Taxes
- Pay for staff nurses will typically fall within norms for region where facility is located. Base pay is usually based on experience or is calculated via a tiered system determined by the facility.
- Wages are fully taxed in your paycheck
- Staff nurses can be eligible for hospital bonus pay programs if facility is offering permanent staff incentives to work extra shifts.
- Full time nurses are paid at least 1.5x their hourly rate for holidays and overtime shifts.
- Paychecks are usually bi-weekly.
- Pay packages for travel nurses are often significantly more than average regional and facility wages.
- Travelers have the opportunity to have portions of their pay untaxed, if they can claim a ‘permanent tax home’. This means travel nurses will have a larger ‘net’, or ‘take home’, pay check.
- If the facility where a traveler is working offers incentives for staff to work extra, the travel nurse is not eligible for any of these bonus programs.
- Holiday and OT rates are 1.5x the taxable hourly wage, but these rates may appear low if the traveler is taking a large portion of pay in untaxed stipends. Travel nurses can negotiate with agencies for an appropriate OT rate.
- Paychecks are usually weekly.
- Depending on size and amenities, housing for staff nurses is usually on par with local cost of living.
- Staff nurses usually rent or own a home in the area of their facility. They provide their own furnishing for the home, and do not have to search for short term housing unless something unexpected happens.
- In order to be legally eligible for tax-free housing and per diem stipends, a travel nurse must duplicate expenses, including paying for a cost of living in their ‘home’ state.
- If you aren’t eligible to claim a permanent tax home, you can opt to decline stipend and take wages fully taxed. As a travel nurses, you will still be making more than the staff nurses if you have to fully tax your paycheck.
- Travelers can opt to use agency-provided housing, but that often means a huge pay cut and loss of the housing stipend. It is usually more financially prudent to arrange your own housing.
- Travel nurses can find temporary housing in either the form of an extended stay hotel, or a furnished room/apartment/home.
- Some travel nurses opt to stay in their RV and explore between assignments! This is a great way to see the country, and can be a money-saver if you can find affordable site to park.