Archive for July, 2008

Working with Multiple Agencies: The more the merrier or the more the messier?

Tuesday, July 29th, 2008

 

So you’re a travel nurse or perhaps an aspiring travel nurse looking for an assignment amongst the many open nursing jobs across the USA.  Human nature often drives us to want more of everything but is that really the best way to go in the travel nursing field?  Maybe you should consider being very selective in the number of agencies you choose to partner with.

Let’s face it, it’s a real pain keeping all of your documents and credentials current with a bunch of agencies.  More serious though, perhaps the biggest drawback in working with multiple agencies is the potential of being submitted for the same position by several agencies.  This is a definite turn-off to the facility and a red flag that you are not a sincere candidate and are only shopping around.  This is especially unfortunate considering you may have even been submitted without your knowledge or consent by one or more agencies.  Sadly, that does happen since some agencies are trying to look “productive” to the facility but you could be the one that loses your ideal assignment.

Working consistently with one agency will allow you to build a trust-based relationship with your recruiter and will also allow a greater continuity of your benefits.  You’ll also have peace of mind that you will consistently have top-notch housing accommodations and no “roach motels”.

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There Is No 50 Mile Rule

Sunday, July 20th, 2008

  The Myth Of The Travel Nursing 50 Mile Rule

If you are a travel nurse you have probably heard some recruiter, somewhere mention a “50 Mile” Rule.  The so called 50 mile rule is the imaginary logistical line that magically turns a nursing job into a travel nursing job that might offer tax free money.  First, let me tell you that there is no 50 mile rule when it comes to legally qualifying for tax free reimbursements.  Secondly, let me say that while I believe the recruiters that quote the 50 mile rule are misinformed, I don’t think their misguided information comes from malice. Rather, the confusion lies with a misunderstanding between IRS Code and hospital policy. Across the country, many hospitals consider a traveler any professional that lives farther than 50 miles away from their hospital. This has nothing to do with the IRS at all.  This is strictly hospital policy. Many recruiters confuse hospital policy with IRS rules and set up a traveler to receive tax free reimbursements that they do not legally qualify for. 

IRS rules can be confusing because some are based on the subjective data as it relates to the specific individual.  For example:  If the travel distance requires the nurse to stay overnight to be refreshed to perform her job, then this qualifies.  If the nurse travels home after every shift, then tax free reimbursements don’t apply. This distance is different based on the nurse.  This is called the Sleep & Rest Test.

Example 1: Hadley Sleepover, RN travels to work at a hospital 60 miles from her house.  The drive takes 1.5 hours each way.  Hadley knows that this commute would make her too tired to effectively do her job.  She has a tax home and accepts housing from her travel company.  She is compliant because she does not return home during her assignment.

Example 2:  Shana Comehome, RN travels 70 miles to work at a hospital.  The drive takes about 1.75 hours.  She drives home at the end of her shift and uses the drive time to unwind and talk to her friends & family on her cell phone.  Shana has a tax home and does not qualify for tax free reimbursements because she is returning home at the end of each shift. 

Example 3:  Kerri Hotel, RN accepts an assignment that’s about 75 miles from her tax home.  She works 12 hour shifts and blocks them together so she works 3 days in a row.  During these shifts, she stays in a hotel.  On her “off days” she returns home. Kerri has accepted a housing allowance from her travel company. However, because Kerri returns home, 4 days per week- 4/7ths of this housing allowance is taxable.  This is because when she returns home she doesn’t have duplication of expenses. 

Example 4: Gabby Apartment, RN accepts an assignment that is 100 miles from her home.  She has a tax home and accepts the package provided by her travel company.  Like Kerri above, Gabby returns home on her off days.  The housing allowance qualifies for tax free reimbursements; however, the meal allowance must either be returned or added as taxable income.  This is because the recurring expense of the apartment remains even while Gabby is at home.  There is duplication of expenses.

I truly hope these examples help you gain a better understanding about the  myths of the 50 mile rule.  Happy travels!

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The Mind Of A Nurse - A Story From The Field

Wednesday, July 16th, 2008

During my nursing career, I have worked in several specialties. I worked Medical / Surgical, Step Down, Intensive Care (ICU) and Emergency Room (ER). The ER is where I feel most at home. I like the action, the varying degrees of acuity, and just simply not knowing what is going to come through those doors next. In the ER, I see things that have went horribly wrong. From broken necks, impaling injuries, abuse, motor vehicle accidents, burns, boating accidents, failed suicide attempts, stabbings, gun shot wounds, rape victims, drunks and bar fights, and the list goes on. What has having seen these worst case scenarios done to my mind? One case has been plaguing me since it happened. I am going to give you the scenario and I am reaching out to other nurses for their comments. Here goes: I was working the 3:00p.m. to 3:30a.m shift in a level I trauma center. It was about 1:00a.m. and I get notified that the “choppers” are bringing in a young man with a self inflicted gun shot wound (GSW). He apparently had a dispute with his girlfriend, got drunk and then got a gun. He was going to be my patient when he arrived. He would occupy my time until my shift ended. At approximately 1:27a.m. my patient arrived and came in via stretcher right off of the chopper. We moved him to an ER gurney. The hospital trauma team was there with me. We began our assessment. The patient, in his attempt to end his life, placed a loaded shotgun under his chin aiming up. He pulled the trigger. The result was an incredibly disfigured and bloody face. The eyes…gone. What was once his face, resembled raw hamburger with pieces of flesh and blood mixed in. Mouth…unidentifiable. Nose…gone. Once the vital signs were checked, the patient was hooked up to the monitors, and the IV’s established by the flight nurses checked, we began our head to toe assessment. The command was given while holding his hands. “If you can hear me, squeeze your right hand.” He did. “Squeeze your left hand.” He did. Oh my lord, this poor soul. In his attempt to end his life, just managed to remove his face, mouth, nose and eyes. His brain was fully intact. My thoughts went to this young man’s future. This one event, in a moment of sadness, rage and drunkenness has altered this person for the rest of his life. I stayed focused, doing my job. I couldn’t allow this to “rattle me”. It didn’t. I did my job to my full ability, trying to keep my patient alive and comfortable. Once stabilized, I took him off to the operating room. My shift was over. My drive home was about 45 minutes and it allowed me to “decompress.” Once home, my wife was in bed, but a nice note was written on the kitchen counter. “Dinner is in the fridge, I love you.” Dinner was spaghetti. I heated it up and was eating it. Then it hit me. “What is wrong with you?” I said to myself. “How can you go from seeing what you just seen to eating spaghetti”. I rationalize it like this: As nurses, we have to stay focused. If emotion enters our job, it may impact our ability to function in the best interest of the patient. I believe, as nurses, we create defense mechanisms to allow us to deal with these types of scenarios. We are not insensitive or “warped”. We have emotions just like everyone else, we just have to control ours. What do you think…?

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Nurse Recruiting in the Philippines Part 2 of a 3 part Series - The US Immigration System

Saturday, July 12th, 2008

The Problem

The harsh reality of the impending nursing shortage has been well chronicled. It is expected that in 12 years, the USA will be 800,000 nurses short nationwide. That is an average of 16,000 open nursing jobs per State. As of this writing, the USA is reported to have the most expensive, least effective healthcare system in the industrialized world. The shortage has the potential to cripple US healthcare in the next 10-15 years.

This shortage is due to multiple factors. First, the aging baby boomer population will intensify the need for qualified healthcare workers.

Second, the nursing education infrastructure in the USA is at maximum capacity presently. Plans for expansion appear to be challenged by lack of qualified clinical instructors. Some people theorize that the nursing and academic bureaucracies are much more limiting than lacking instructors.

The need to find and employ nurses from outside the USA is glaringly apparent and yet, here we sit. At present, we don’t even have an available non-immigrant visa classification for nurses. Immigrant visas (aka green cards) have slowed to a snail’s pace due to “retrogression”. The current green card process for a nurse would take 5 years if a qualified international nurse were petitioned today. Hardly a fast track.

 

So why don’t we fix it?

The USCIS (formerly the BCIS - formerly the INS) can only play the cards they are dealt. They take their direction from our President, Congress and Senate and the Department of Homeland Security.

If you put those four entities in a boat, they would be rowing in 4 different directions - all for different reasons. The reason we can’t resolve the healthcare worker immigration issue is because it is part of a bigger issue which is currently under immense scrutiny in a post 9/11 world - comprehensive immigration reform.

Because President Bush lacked the necessary political capital in the summer of 2007, the sweeping changes in immigration he advocated were doomed to failure. Comprehensive Immigration Reform died an agonizing death. Many people feel we have little chance for any meaningful immigration changes until late 2009 or early 2010 - after the new administration is fully entrenched. There may be one or two quick fix solutions in the interim, but nothing meaningful will happen in the near term.

The problem is that our legislators serve too many masters and entertain far too many secondary agendas related to this issue. I read a proposal a few months ago for “expedited” green cards which would be made available for an additional $1,500.00 fee. That $1,500.00 would be earmarked for educating children in Africa?

I believe in education. I believe in charity. I also believe that the plight of most of Africa is tragic. That said, I know for certain that secondary agendas are pure detriment to any meaningful initiatives. No matter how noble the idea may be - tying it up to an immigration fee has a polarizing effect.

Another problem is that politics in general are a barrier to fixing this situation. “Immigration reform” means many different things to many people. A lot of the controversy relates to border security and hence, national security. It could be a political mis-step to get caught on the wrong side of an issue this important.

Get Out of Our Own Way

Much of the challenge with our legislators is that they get their information from multiple sources - all of whom have their own agendas. The American Hospital Association has been advocating expanded healthcare worker immigration. Some factions of the American Nurses Association have reportedly lobbied against increased nursing immigration quotas - as they feel all long term solutions should come from increased wages and expanded nursing education programs right here at home.

Memo to the AHA - you’re on the right track, keep up the good work.

Memo to the ANA - organic can’t happen fast enough. In a perfect world - we would be able to expand nursing organically and quickly. In theory, by 2020, the supply would have caught up with the demand. Those of us who have worked in the nursing trenches realize there is a big divide between theoretical and practical nursing. The same level of chasm exists here. By the time we realize the net effect of our inaction, it will be too late to do anything meaningful enough to fix it.

Time For Some Action

If you’re a nurse living in the USA, please click on the following link: http://capwiz.com/sjhs/issues/alert/?alertid=11498866 and tell your legislator that it is time to do something about healthcare immigration reform. If you plan on accessing healthcare anytime around 2020, your life could depend on it.

For more information, email info@expedientmedstaff.com or call 877.367.8770 and ask for the Foreign Recruitment Department.

Next Month: The International Nurse

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Press Release - Expedient Medstaff Awarded Travel Nursing Contract In New Mexico

Friday, July 11th, 2008

  Expedient Medstaff, a leading travel nursing agency, proudly announces it has been selected to provide travel nursing services to a select group of hospitals in the state of New Mexico.

Expedient Medstaff CEO, Mike Emery commented “I am pleased Expedient Medstaff has been awarded this opportunity.  Furthermore, I am excited about enhancing our strong footprint in the Southwest and providing more career choices for our travel nurses.  We look forward to providing talented traveling nurses to these great hospitals in New Mexico.”

Under the terms of this award, Expedient Medstaff will provide travel nurses to multiple hospitals in New Mexico.  The award is for a two-year term with the option to renew at the end of the term.  Expedient Medstaff believes this is an excellent opportunity for their travel nurses.  Expedient Medstaff President, Matt Cahillane noted “We are confident that we can supply the high-caliber nurses that these hospitals need and welcome.”

About Expedient Medstaff

Expedient Medstaff is national provider of healthcare staffing services.  Expedient Medstaff specializes in travel nursing and offers rewarding nursing jobs, in beautiful locations, throughout the United States. Expedient Medstaff also offers direct placement services for healthcare professionals striving to secure a long term career opportunity. Expedient Medstaff serves hospitals, health systems, and Fortune 500 companies throughout the United States.  Expedient Medstaff is Joint Commission Certified.

For those interested in learning more, please visit us by clicking on: Travel Nursing Jobs With Expedient Medstaff, Your Travel Nursing Agency, or

Expedient Medstaff

One Heritage Place

Suite 250

Southgate, MI 48195

877-367-8770

info@expedientmedstaff.com

http://www.expedientmedstaff.com/

 

 

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The Pro’s & Cons Of Travel Nursing

Tuesday, July 8th, 2008

 

Many nurses think about travel nursing or working for a nursing agency.  The cold reality is that while this is great for some, it is definitely NOT for others.  All recruiters will tell you the positive aspects, but very few will tell you the negatives.  This article will address both.

Let’s discuss some of the positives first:

  • 1) Travel Nurses as well as agency nurses avoid the politics that come in so many facilities. I don’t think there is an experienced nurse anywhere that doesn’t understand the frustrations associated with the negative dynamics that can take place between fellow nurses, managers, administration and physicians. Travel nurses have no obligation to stick around and deal with these dynamics.
  • 2) Travel Nurses can truly see the country. If a nurse is tired of snow, cold and sleet then how about Florida, Arizona, California or Hawaii? On the other side if the nurse doesn’t care to work in the blazing summer heat in Arizona then how about Alaska or Maine? Local agency nurses too can flip from multiple hospitals in the area if they are sick of working at a particular hospital system.
  • 3) The money can be good. From contract completion bonuses to tax breaks both travel and agency nursing can be very lucrative. Many times hospitals are willing to pay out bonuses in exchange for hard to fill nursing assignments.

Now let’s address some of the downsides:

  • 1) If a nurse is tired of working in their area of practice (ICU, ER, etc.) they will be unable to receive orientation to new areas. Hospitals will not pay to train or orient an agency or travel nurse. Additionally, most hospitals require 1-2 years of experience in the area the nurse practices. Therefore even if you orient to a new area as a staff nurse there can be a 1-2 year delay before you can travel in the area you have just been oriented to.
  • 2) Travel nursing can be lonely. Most travel nurses bring along pets just for this reason. Face it, if a nurse has never been to Arizona before and accepts a travel assignment there who will they know? Nurses that are outgoing, or are ok with being loners do well. This downside does not apply to local agency nursing.
  • 3) Upward mobility is limited. If nurse is looking for a promotion to a unit manager or Chief Nursing Officer travel or agency nursing is not recommended. Almost always a travel or agency nurse will remain practicing in there area of expertise throughout the duration of their travel/agency employment.

 

Travel and agency nursing has both upsides as well as downsides.  Both should be considered before a nurse determines if travel or agency is right for them.

 

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Press Release - Expedient Medstaff Chosen By Over 100 Ohio Hospitals

Saturday, July 5th, 2008

 

Expedient Medstaff, a leading travel nursing agency, proudly announces it has been selected to provide travel nursing services to over 100 hospitals in the state of Ohio.

Expedient Medstaff CEO, Mike Emery commented “I am pleased Expedient Medstaff has been awarded this opportunity.  Furthermore, I am excited about enhancing our strong footprint in the Midwest and providing more career choices for our travel nurses.  We look forward to providing talented traveling nurses to these great hospitals in Ohio.”

Under the terms of this award, Expedient Medstaff will provide travel nurses to multiple hospitals in Ohio.  The award is for a one-year term with the option to renew at the end of the term.  Expedient Medstaff believes this is an excellent opportunity for their travel nurses.  Expedient Medstaff President, Matt Cahillane noted “We are confident that we can supply the high-caliber nurses that these hospitals need and welcome.”

About Expedient Medstaff

Expedient Medstaff is national provider of healthcare staffing services.  Expedient Medstaff specializes in travel nursing and offers rewarding nursing jobs, in beautiful locations, throughout the United States. Expedient Medstaff also offers direct placement services for healthcare professionals striving to secure a long term career opportunity. Expedient Medstaff serves hospitals, health systems, and Fortune 500 companies throughout the United States.  Expedient Medstaff is Joint Commission Certified.

For those interested in learning more, please visit us by clicking on: Travel Nursing Jobs With Expedient Medstaff, Your Travel Nursing Agency, or

 

Expedient Medstaff

One Heritage Place

Suite 250

Southgate, MI 48195

877-367-8770

info@expedientmedstaff.com

http://www.expedientmedstaff.com/

 

 

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Press Release - Expedient Medstaff Brings Travel Nurses To Maryland & DC

Thursday, July 3rd, 2008

 

Expedient Medstaff Brings Quality Nurses To Maryland & DC

Expedient Medstaff, a leading travel nursing agency, proudly announces it has been selected by an area hospital association to provide nurse staffing services to 28 hospitals in Maryland and the District of Columbia. 

Expedient Medstaff CEO, Mike Emery commented that “We are pleased to open up this relationship with the hospitals of Maryland and the District of Columbia.  Geographically, this area offers the travel nursing jobs that many travel nurses seek.  With our database of over 10,000 Registered Nurses, we are well positioned to bring quality nurses to the hospitals of Maryland and the District of Columbia.”

Under the terms of this award, Expedient Medstaff will provide travel nurses to the hospitals of Maryland and the District of Columbia.  The award is for a one-year term with the option to renew at the end of the term.  Expedient Medstaff believes this is an excellent opportunity for their travel nurses.  Expedient Medstaff President, Matt Cahillane noted “We are confident that we can supply the high-caliber nurses that the hospitals need and welcome.”

About Expedient Medstaff

Expedient Medstaff is national provider of healthcare staffing services.  Expedient Medstaff specializes in travel nursing and offers rewarding nursing jobs in beautiful locations throughout the United States. Expedient Medstaff also offers direct placement services for healthcare professionals striving to secure a long term career opportunity. Expedient Medstaff serves hospitals, health systems, and Fortune 500 companies throughout the United States.  Expedient Medstaff is Joint Commission Certified.

For those interested in learning more, please visit us by clicking on: Travel Nursing Jobs With Expedient Medstaff, Your Travel Nursing Agency, or

 

Expedient Medstaff

One Heritage Place

Suite 250

Southgate, MI 48195

877-367-8770

info@expedientmedstaff.com

http://www.expedientmedstaff.com/

 

 

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The Travel Nursing Paradox

Tuesday, July 1st, 2008

 PART 2: What you can do to increase your chances of landing the ideal travel job

Refresher From Last Month

Last month we spoke about the magnitude of the present nursing shortage and the number of open nursing jobs currently unfilled. According to the experts, this situation will only worsen in the coming years.  We also addressed the impact (actually non-impact!) of the nursing shortage on the travel nursing industry - simply put there is no shortage of travel nurse candidates for the choice openings.  This seems like an illogical situation but it is reality in the travel nursing world.

What Can a Travel Nurse Do To Maximize the Odds of Getting the Desired Position?

The travel nurse that wants to increase the odds of winning the ideal travel position can do a number of things to better their chances.  Simply understanding the situation and being prepared will go a long way. 

In order to be submitted for a travel opening, your recruiter will need some basic minimum information:

  • 1) Resume with work history. Be sure your resume “sells” you and your skills. Be as specific as you can and highlight any particular skills, experience, procedures, certifications, or equipment usage that demonstrates your competence. Also be sure to explain any time lapses in your nursing career such as taking time off for motherhood or additional schooling.
  • 2) Current detailed skills checklist specific to your specialty. Many hospitals will also want to see the result of a medical challenge exam but at a minimum, the self administered skills checklist will be required.
  • 3) Current Supervisory References. Typically 2 references are required and they need to be from supervisors’, not just coworkers or friends. These are better if obtained from your current or most recent employer.

 

The key to all of this is to make sure that your recruiter has all of this information ahead of time.  You can’t afford to wait until a position opens up and then start gathering this information.  By that time, your profile will be late and the position will likely be filled already.  Your profile needs to be current and ready to go at a moment’s notice.  All things equal, the early and complete profile has a better chance of being favorably reviewed by the facility.  I know we all like to put off and procrastinate, but getting a well thought out resume and profile together is really a great investment in your future.  The neat thing is that once you’ve got it together, it’s really easy to keep it updated and current.

 

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