Whether you’re a brand new RN or are a seasoned traveler, there is one thing you can never escape—nurse staffing agencies. Staffing agencies are a very integral part of the travel nursing industry. It doesn’t matter if you hate them or love them, they are a necessary part of travel nursing. It might be that the only way to land your dream job is through one agency, or maybe several agencies. It is important to understand that navigating this landscape is critical to your success as a travel nurse.

There are roughly over 300 travel nursing agencies in the U.S. alone with at least 100+ that are Joint Commission Certified. Sometimes it can be hard to identify exactly who to work with or if you should work with an agency at all. This article will examine the various scenarios that staffing agencies affect. Some companies can be great to work with, while others may leave you wanting more. The biggest thing to remember is that no situation is the same. There are plenty of staffing agencies that are great for one traveler and terrible for another. Let’s take a look at the good, the bad, and the ugly of the nurse staffing agency industry.

The Good Things About Nurse Staffing Agencies

Many travelers would describe staffing agencies as a necessary evil. I feel this is an unfair criticism of staffing agencies. While they can make things more complicated and they do make money for work that YOU are doing, they serve a very helpful purpose.

First, let’s outline exactly how a staffing agency works. The concept is extremely simple. Staffing Agencies take a certain dollar amount that a facility is offering nurses and find qualified candidates to fill that role. One of the great things about staffing agencies is that they can provide a traveler with a multitude of options that would take them a lot of time to find themselves. For example, if you want a job in Seattle, how long would it take you to call every hospital in Seattle, find the correct person to speak with, and ask them if they have any openings? I can tell you it’s a looooong time. Also, you may not get the real answer from whoever you speak with since not all hospitals are forthcoming with this information. Just think if you wanted to know all of the available options in Seattle, Denver, and San Francisco; you have now multiplied the amount of time you have to spend looking for a job by three. This consolidation of job opportunities is an incredibly valuable asset that staffing agencies provide for all of their travelers.

Second, staffing agencies provide a multitude of helpful resources for any traveler. Most larger travel agencies have departments dedicated to helping obtain licensure, housing, valuable industry knowledge, and a host of other resources that you would never be privy to on your own. For example, one of the worst hospitals in the United States is Sunrise Hospital in Las Vegas. Now if I was a new traveler and I heard about an opportunity in Las Vegas I would be excited for an opportunity to work just off the strip. However, if you’re working with a relatively knowledgeable agency they would be able to let you know that this is a challenging facility to work at, to say the least.

A staffing agency would be able to tell you that maybe your first assignment should be somewhere else. Really challenging cases, extremely high nurse to patient ratios, and many other things make this a very tough assignment. I’m not saying that no traveler should work at Sunrise Hospital in Las Vegas, but I wouldn’t recommend it to a nurse for their first travel assignment. Knowledge like this makes travel nursing agencies an incredibly helpful tool.

Third, a staffing agency takes care of much of the overhead involved with travel nursing that you may not think about. Most of them offer things like insurance, PTO, 401K, and many other benefits that would be astronomically expensive for any traveler to take care of themselves. For a travel nurse, malpractice insurance itself is almost always covered by the agency, NOT THE HOSPITAL. This is one of the most expensive parts of hiring travelers. It would be impossible for each traveler to cover these extra costs themselves.

While staffing agencies can get a bad rap from travelers who have been mistreated, neglected, and flat out screwed over, they do provide several key things that you would not be able to accomplish on your own. They can provide you with a consolidated list of all the job opportunities in any specific area that you’re interested in. Staffing agencies also provide a lot of resources like industry knowledge, help with licensing, housing, and tons of other things that would be incredibly hard to accomplish by yourself. Finally, they take care of really expensive overhead costs that you would never be able to afford. Combined, these costs can easily range in the millions (seriously!).

The Bad Things About Nurse Staffing Agencies

Warm and fuzzy time is over. It’s time to get to the nitty gritty about exactly what is bad with travel agencies. Now don’t take this the wrong way, most travel nursing agencies are trying to create a win-win scenario. If you think about it at face value, it should be really simple. The hospital has a travel nursing need and sends that information to a staffing agency. You call the agency and are a perfect fit for the position. They send your information to the facility and before you know it, you have landed a fantastic paying job at a great facility. While this is the basis for travel nursing agencies, it is rarely this simple.

First and foremost, remember the almighty dollar is king. One of the most unfortunate things about travel nursing agencies is that they are a business and are looking to make as much money as possible. It does not matter who you work with or what they tell you, every staffing agency is the same. If they can get you to work at a lower rate, it means more money in their pocket. For example, if a hospital is paying a staffing agency $60/hr and they are paying you $40/hr, the agency will take all of their expenses out of the additional $20/hr and keep what is left. This scenario is not necessarily a terrible, thing since the agency has all the overhead that I talked about earlier to pay for. It’s simply providing a service for a small fee like any other business in America.

However, if an agency has two candidates for one position and the rate is $60/hr. they might quote both of them $25/hr. in order to see what candidate will take the job at the lower rate. If they can staff an RN for $25/hr instead of $40/hr., they get to keep the difference and substantially increase their profits. This is a very simple model for how every staffing agency works. It’s unfortunate because the RN is the one doing all of the work yet the staffing agency is the one who makes the most money. One other thing to keep in mind is that the larger the company, the more overhead they have. If you are working with a travel agency that has multiple offices, host tons of fancy events, and has thousands of RN’s across the country, you can almost guarantee they have to cover higher overhead.

At the end of the day, it’s all coming out of YOUR check. This can be a hard thing to understand, but believe me when I tell you that no matter what perks a staffing agency offers you, it is coming out of your paycheck one way or another. When staffing agencies tell you about things like “discounted flights”, “free housing”, “free car rentals”, etc. this is one of the oldest tricks in the travel nursing book. There is about a million ways to do this and the better the recruiter the easier it will be to sell it to you.

I’ll give you one very common example of this that happens in the industry all the time. You get a job in Hawaii and your staffing agency tells you they will ship your car for free, pay for your flight, and give you a $1,000 bonus to take the assignment. This sound almost too good to be true.  The sad reality is that if something sounds too good to be true it’s because it is. Here is exactly what the travel agency is doing. They factor in how much it will cost to ship your car, pay for your flight, and give you that bonus. Let’s just say it costs them $5,000. Next, they take the amount of money they are going to pay you over the course of your entire assignment (Let’s say 10 weeks) and they take $5,000 off of that. So take that $5,000/10 weeks and it means they will just pay you $500 less per week. It gives the illusion that all of these things are free, but really if you just paid for them yourself it would cost exactly the same. This is just one of the many ways staffing agencies make travelers think they are getting a great deal when really they are just looking to fill a job opening.

One major thing to remember is that the better you understand how pay works the better off you will be. As with any industry, knowledge is power. Pay can be incredibly confusing, but understanding the signs of an agency trying to pull one over on you is always key. Look for key words like “free” or “bonus.” While these are nice to hear, they are rarely true.

Pro Tip: Talk to other travelers wherever you are. Ask them who they are traveling with and what the name of their recruiter is. Call recruiters and ask them to quote you pay for that facility. If they don’t want to quote you a number or they quote you waaaay less than other travelers working at the same facility, these are huge indicators that there might be something shady going on.

The Ugly Things About Nurse Staffing Agencies

This is where the travel nursing industry gets really dicey. Travel nursing agencies will ALWAYS do what is in their best interests. If you feel like you have a recruiter that is pushing you into a specific job or into specific housing that is because they are. Travel nursing agencies have vested interests like any other company. From certain facilities they work with more regularly, to housing they support more frequently. Staffing agencies will always try to get you to take a job with a hospital that is the most advantageous for them if they can. Make sure you are aware if you are being pushed or persuaded to take a contract that you don’t want. As always, the better the recruiter the harder it is to tell when this is actually happening.

Subcontracting: This is probably the ugliest part of the travel nursing industry. For those of you who don’t know what subcontracting is, it’s very simple. Certain companies have exclusive agreements with hospitals to provide all of their travel nursing staff. They then contract with staffing agencies to provide them with additional staff to help fill all of the open needs the facility has that they cannot fill themselves.

The main problem with subcontracting is that it can significantly impact your pay. Here’s how. Let’s say that company A has an exclusive agreement to provide Hospital A with travel nurses. Company A has the best rate since they are getting it directly from the facility. Company A then takes these needs and provides them to company B. Company B then pays company A a percentage for the ability to staff these needs and where do you think that money comes from? You guessed it, directly out of your paycheck. Sometimes you will be working with company C who pays company B who then pays company A. In this case, company A, B, and C are all paying a fee to the others to staff these needs and they take that money directly out of your pay.

In a scenario like this, you would make significantly more money to just take the job through company A rather than company C. You are essentially cutting out the middleman. One really good way to recognize this is to ask whoever you are working with if they work with the facility directly and if they subcontract through anyone. If you have a newer recruiter they will have a very hard time answering this question, or in some cases, will not be able to give you an answer at all.

Unfortunately, some staffing agencies flat out lie. This can range from inaccurate pay to telling you that a job is open or closed when it really isn’t. Keep in mind that everything an agency is telling you is always going to be in their best interests. Be strong. If you want a high paying job in Denver don’t settle for something mediocre in New Mexico. You have all the power in this scenario. Good staffing agencies will always try to accommodate you if they can. At the end of the day, it is in their best interests to find any traveler a great paying job in an ideal area.