Travel Nursing Pay – Considerations for Guaranteed Hours

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“Guaranteed hours” is an often misunderstood concept in travel nursing. Some travel nurses assume that it means they’re going to get paid for the contracted hours no matter what. Some assume that it means they’re going to get paid for the contracted hours as long as they don’t call in sick or otherwise miss a scheduled day of work. Some assume that guaranteed hours are a benefit provided by the company. In fact, guaranteed hours are determined by the contract between the hospital and travel nursing company and exist to protect both the company and the travel nurse.

Guaranteed hours protect the travel nurse and agency

The contract between the hospital and company will spell out the hospital’s guaranteed hours policy. On one hand, these policies serve to protect the company. You see, the company is providing a service to the hospital that relies on hours being worked so that money can be collected to cover all of the costs involved with the entire process. For example, the company may have paid for the travel expenses, housing, and rental car. The company’s ability to cover these costs depends on their ability to bill the hospital for hours worked. And remember, if the company isn’t able to bill 100% of the hours they’re anticipating to bill, then their calculations are going to be thrown off at best, and they’ll lose money at worst. If the hours aren’t worked, then there’s no money for the company, plain and simple.

At the same time, guaranteed hours policies serve to protect the travel nurse. The nurse traveled for the main purpose of working and getting paid. They undoubtedly have bills to pay, and they may even be paying for their own housing and other costs while on the assignment. If they don’t work, then they don’t get paid.

To a certain degree, guaranteed hours policies are in place to ensure that hospitals aren’t gaming the system. You see, hospitals attempt to optimally staff their facilities at all times. They don’t want too many workers, or too few workers, at any time given the workload in the facility. This approach is an effort to keep costs down. However, managing this approach is very difficult. It’s difficult to forecast hospital census, employee sick calls, and other variables that might affect staffing levels and/or patient population.

When hospitals are short-staffed, their first lines of defense should be agency PRN and the hospital’s own PRN and regular staff. If those resources are exhausted and hospitals are still having trouble finding enough staff, then they may consider bringing in a traveler. But if they bring one in and hospital census suddenly returns to normal, or employee sick calls cease, then the hospital will be tempted to start cancelling shifts to save money. This is just one example, and it’s important to remember that hospital’s need travelers for many other reasons that don’t fit this description. However, to a certain degree, guaranteed hours policies are in place to ensure that hospitals don’t call for travel nurses unless there is a real need.

Travel nursing guaranteed hours policies differ: What travel nurses need to know:

It’s very important to understand that these policies vary from hospital to hospital. Some policies guarantee every hour. Some policies allow the hospital to cancel up to 3 shifts within a 13 week period. I’ve even seen some that allow the hospital to cancel one shift a week. As a result, you must determine what the policy is for each contract. You shouldn’t assume that the policy is going to be the same at different hospitals just because you’re working with the same company.

There are some standard issues to be aware of when evaluating these policies. First, I’ve never seen a policy that guarantees hours if the traveler volunteers to leave. For example, the supervisor may ask if you would like to leave a shift early because the census is low. I’m fairly confident I can guarantee that any hours missed as the result of volunteering to leave in such a scenario will not qualify as guaranteed hours.

Second, sometimes the policies will give the hospital the option of cancelling a scheduled shift and offering a future shift to make up for it. If the you declines the future offer, then the cancelled shift doesn’t count against guaranteed hours. Third, guaranteed hours are often times a trade-off between the guarantee and the requirement to float to other units. In other words, you must be willing to float to other units within your scope of practice in order to get the guarantee. Fourth, sometimes hospitals require travelers to float between various hospitals as needed in order to get their guaranteed hours. For example, there may be four hospitals within one metropolitan area that are all part of the same hospital organization. If they don’t need you at one of the hospitals, then they can schedule you at another to make sure you get the guaranteed hours.

As you can see, guaranteed hours policies aren’t as cut and dry as many make them out to be. If this issue is important to you, then you’ll want to find out as much as possible about the hospital’s policy AND the the company’s policy. The two policies may differ and the differences may have an impact on you. For example, the hospital may not guarantee any hours at all but despite this the company still offers guaranteed hours with a clause that says you’ll need to float to other hospitals in the area as a PRN nurse.

Ultimately, you must discuss this issue in detail with your recruiter, and attempt to discuss it during your interview with the manager at the hospital in question. Discussing it with the recruiter is easy enough. You just need to ask them for their policy. The hospital manager you speak with may not be familiar with the policy. Instead of pushing them to find out or saying that your acceptance of the job is contingent on finding out, you should ask other probing questions to get at the heart of the issue. What’s the float policy within and between hospitals? Why are you looking for a traveler? How often do shifts get cancelled?

In any case, the final word on guaranteed hours rests with the company. Remember, you’re signing a contract with the travel nursing company, not with the hospital. As a result, you’ll want to make sure that the company’s policy is clearly stated in the contract you sign.

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4 replies
  1. ashley says:

    I have been traveling for 4.5 years. Most hospitals I feel have the 24 hr rule. In the past, if the hospital wants to cancel or put on call for anything over 24 hours then they have paid those hours at full rate. The company I am with now says on call doesn’t count in the 24 hr rule because you are technically still getting paid, as if 2.50/hr adds up to anything. This makes no sense to me, because if that’s the case why would a hospital ever have this rule? They could just, instead, put their travelers on call every shift, and never have to worry about a max. What’s your experience?

    Reply
    • Kyle Schmidt says:

      Thanks for the inquiry, Ashley. My sincerest apologies, but I’m confused as to exactly what is happening in the situation you’ve described. Travel contracts should have scheduled hours in all cases. For example, if the contract is for 36 hours per week, then the hospital is expected to put the traveler on the schedule for 3 12 hour shifts. In addition, there could be some “call”. For example, the hospital might put the traveler “on-call” for a period of 12 to 24 hours in addition to the scheduled contracted shifts. While the traveler is on-call, the agency is able to bill the “on-call rate” which is typically pretty low. This is most likely the $2.50 in the scenario you’ve described. If the traveler gets called in to work during the on-call hours, then the agency is able to bill the “call-back” or “called-in” rate, which is typically the full bill rate for the contracted hours or the overtime rate for the contracted hours if there is one. In this case, the agency should be paying the traveler as much or more than they’re paying for the contracted hours. In the situation I’ve just described, I’ve never dealt with a scenario where the hospital keeps the traveler on-call for more than 24 hours. My apologies.

      That said, I’m wondering if you’re not being scheduled for shifts and, instead, the hospital is just keeping you on-call for extended periods of time just to get you scheduled for shifts as they need you. If so, this isn’t a travel contract; it’s PRN with the added benefit of on-call pay. My apologies, but I’m not certain what the rules would be in a scenario like this. And, in any case, the hospital and agency could, unfortunately, make up whatever rules they want to make up if the issue is not clearly stated in your contract.

      I hope this helps. Please let me know if I’ve missed the point of the specific scenario you’re dealing with.

      Reply
  2. Amber Hawkins says:

    I was called off and paid the “on call” $2 an hour but also charged for a missed shift. While I see in my contract I can be placed on call up to 24 hours, I had never been on call on previous assignments so should have asked more questions to my recruiter. The issue and lesson I’m facing is that this happened in Dec and it is now March and I just left that assignment. Will I still be able to recoup my missed shift costs or is it too late?

    Reply
    • Kyle Schmidt says:

      Sorry to hear about this, Amber. Chances are that it is too late. Recouping those costs is typically only allowed while working the same contract. Of course, your agency can do whatever they’d like, so it wouldn’t hurt to ask!

      Reply

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