Your first contract

Are you ready?

Most agencies and hospitals want at least 2 years of recent experience in the specialty you'll travel in. Some will take 1 year for med-surg or telemetry; ICU, ER, L&D, and NICU contracts almost always want 2 or more. "Recent" usually means within the last year or two.

Experience isn't the only test. Ask yourself honestly:

• Can you take a full assignment on a unit you've never seen, with a day or two of orientation and no preceptor?
• Are you comfortable asking for help from people who don't know you yet, and okay being the one who gets floated?
• Can you handle a contract getting cut short, or hours being cancelled, without it wrecking your finances?
• Will being away from family and friends for 13 weeks at a time wear on you?

If those make you nervous, that's normal. If you're still shaky in your own specialty at home, give it another year. A first contract is a bad place to learn the basics.

Licenses and the compact

You need a license that's valid in the state you'll work in. If your home (primary residence) state belongs to the Nurse Licensure Compact, your multistate license lets you work in every other compact state. That's most of the country.

Several big travel markets are not in the compact, including California, New York, Illinois, Nevada, Oregon, Hawaii, and Alaska. To work there you need that state's own license, and some take weeks or months to process. California is known for being slow. Check the compact map before you count on a state, since new states join every year.

• Apply for a license in a non-compact state before you're chasing a job there. Many states offer a temporary license while the permanent one processes.
• Set up Nursys e-Notify so you get reminders before any license expires.
• Your multistate license follows your legal residence. If you change your permanent address to a non-compact state, you lose it.

Get your paperwork together now

Every agency asks for the same pile of documents. Having it ready in one folder (a scanned PDF of each) can save you a week and gets you submitted for jobs faster.

• Nursing license(s) and license verification printouts
• BLS plus ACLS, PALS, NRP, or TNCC as your specialty needs. Most hospitals want American Heart Association cards.
• Specialty certifications (CCRN, CEN, and so on), if you have them
• Resume with exact dates, unit, bed count, typical patient ratio, and charting system (Epic, Cerner, Meditech) for every job
• Two or three references, ideally a charge nurse or manager from the last year
• Immunization records: MMR, varicella, and hepatitis B titers or vaccine dates, Tdap, flu, and any others the hospital asks for
• TB test or chest X-ray from the last year
• Driver's license, Social Security card or passport

Expect skills checklists and online tests (medication math, specialty exams) for every agency. Do them carefully. Hospitals read them.

Picking an agency and recruiter

The recruiter matters more than the agency name. A good one tells you the bad parts of a job before you find them yourself.

Talk to two or three agencies. They often have the same jobs at different rates, and some have jobs the others don't. You can be signed up with several at once; you only sign a contract with one per assignment.

Questions worth asking every recruiter:

• What's the full weekly breakdown: taxable hourly rate, housing stipend, meals and incidentals stipend, and any bonus?
• How many hours are guaranteed, and what happens if the hospital cancels my shift?
• Is this job run through an MSP (a managed service provider)? If so, how many agencies are submitting nurses to it?
• What's the overtime rate, and is there a holiday rate?
• When do I get paid, and when is my first check?
• What's the health insurance, and does it start on day one?

Look the hospital up on our map before you agree to be submitted. Check the CMS ratings and what other nurses have reported for patient ratios.

Reading the offer

Travel pay is usually split into two parts:

• Taxable hourly wage. Often lower than you'd expect. This is what your overtime is figured from.
• Tax-free stipends for housing and for meals and incidentals, paid weekly. They're capped at the federal GSA per diem rates for the area.

The stipends are only tax-free if you have a tax home: a permanent residence you pay to keep up while you're away, in an area where you've earned income. If you don't keep one, the IRS treats the stipends as taxable income, and you could owe money later. This catches a lot of first-time travelers. Talk to a tax preparer who works with travel nurses before your first contract. This guide isn't tax advice. Reading a pay package goes into this in detail.

When comparing offers, don't just compare the weekly total. A higher stipend with a very low hourly rate means lower overtime pay, less toward Social Security, and a bigger hit if a shift gets cancelled.

Get it in writing

If a recruiter says it but it isn't in the contract, assume it won't happen. Before you sign, make sure the contract spells out:

• Start and end dates, and your shift (days, nights, or rotating) with the number of hours per week
• Guaranteed hours, and exactly what happens to your pay if the hospital calls you off
• Any time off you need. Ask now, not after you start.
• Where you can be floated, and whether floating is limited to units you're competent on
• The unit and specialty you're hired for
• The cancellation terms: how much notice either side must give, and any penalty for you
• The overtime, holiday, and on-call rates

Ask the unit manager about patient ratios and orientation during the phone interview. Write down what they say. If you can, find out who your charge nurses will be.

Credentialing: the 2 to 4 weeks before you start

Once you accept, the agency's compliance team works through the hospital's checklist. Expect:

• A physical, drug screen, and sometimes a background check and fingerprints
• Respirator fit testing
• Titers or vaccines the hospital requires that you don't have yet
• Online modules for that hospital and that state, sometimes several hours of them

Do every item as soon as you get it. If credentialing isn't finished, your start date gets pushed and you're not getting paid.

Housing

Most travelers take the housing stipend and find their own place. You keep whatever you don't spend. Agency housing is easier but usually costs you more than the stipend would have.

• See Housing on assignment for the full rundown. Look for furnished rentals of 30 days or more on sites made for travelers, like Furnished Finder.
• Never send a deposit for a place you or someone you trust hasn't seen. Rental scams aimed at travel nurses are common. Do a video tour, check that the owner owns the property, and pay through a platform that protects you.
• Try for a lease that lets you leave early if the contract ends early.
• In remote or rural places, housing can be hard to find. Ask the recruiter what other travelers there have done before you sign.

Your first week

Expect a day or two of hospital orientation, then maybe one or two shifts on the unit with another nurse, and then you're on your own. Some places give you a single shadow shift.

• Get your badge, computer login, and medication dispenser access sorted the first day. If they're not working, push for it. You can't do your job without them.
• Find the code cart, the rapid response number, the supply room, and the charge nurse before you need them.
• Learn who the go-to staff nurses are. Most are glad to help a traveler who asks good questions and pitches in.
• Stay out of unit politics. You're there for 13 weeks.
• If you're given an unsafe assignment, say so to the charge nurse and write it down. Let your recruiter know the same day.

Money cushion

Have at least a month of expenses saved before your first contract, and two if you can. Your first check may take a couple of weeks, you'll pay a deposit and first month's rent up front, and you may need to travel and pay for credentialing items before you're reimbursed. Contracts do get cancelled. A cushion means a cancellation is an annoyance, not a crisis.

Red flags

• A recruiter who won't give you the pay breakdown in writing
• Pressure to accept a job within the hour, or to accept before you've talked with the unit
• A contract with no guaranteed hours, or that lets them cancel your shifts with no pay
• A big penalty for you leaving early, but no penalty for the hospital ending the contract
• Vague answers about floating or about the unit's ratios
• A weekly number far above every other offer for the same area. Ask what's different.