Travel Nursing Podcast

TTATN 37: Travel Nursing Guaranteed Hours

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Hey everyone. Welcome to The Truth About Travel Nursing Podcast. My name Is Kyle Schmidt and I’m your host. Thank you so much for joining me for episode 37 of the podcast!

In this episode, we’re going to take a detailed look at Guaranteed Hours in travel nursing. Now, I know what you’re thinking. How we could we possibly spend an entire episode discussing guaranteed hours. I mean, it’s cut and dry. The hours are guaranteed! [Please note that this is a transcript of a podcast episode. As such, grammar and spelling are not optimized for written content.]

Not so fast. Unfortunately, it’s not that simple. Like many things in travel nursing, there are nuances and various scenarios that can make this a convoluted topic. So, we’re going to cover Guaranteed Hours in detail so you don’t get caught off guard and you can approach this issue with confidence.

Now, before we get started I want to cover a couple of unrelated topics really quick. First, it’s been nearly 2 years since our last episode! That’s a long freaking time. If you’re like me, then you hate it when podcasts just suddenly go dark on you. I always told myself I would never do that. And then I did it!

Now I know why or how it happens. That is no excuse though. So, my sincerest apologies for going dark. Moving forward, we’re probably not going to produce podcasts on a routine basis. I simply don’t have the time to produce them regularly. However, I promise to produce them more than once every 2 years! I should be able to clear that bar.

The second thing I wanted to let you know about is an amazing offer from Valley Healthcare Staffing to get your California RN License by endorsement. They are currently running a program through November 30 2017 where they will pay for your roundtrip flight out to California, lodge you if necessary, and provide you with a concierge service to help you turn in all the required documentation to obtain Your California RN License.

Oh, and they’ll pay for the license too! Now, there are terms and conditions of course, but even those terms and conditions could be viewed as an amazing benefit to you! We’ll take a look at this amazing deal a little later in this podcast.

What Are Travel Nursing Guaranteed Hours?

But now, let’s dive into to Guaranteed hours. First, what are guaranteed hours? On the surface, the obvious answer is that a certain number of hours are being guaranteed for the travel nurse to work during the course of a contract.

For example, recall that the standard travel nursing contract is for 13 weeks at 36 hours per week for a total of 468 hours. If the recruiter tells you the staffing company offers guaranteed hours, then you would expect the hospital to schedule you exactly in this fashion, right? You’d be scheduled for 36 hours each week for 13 weeks. And if the hospital scheduled you for fewer hours, then you’d get paid for the shortfall anyway.

Why Do Guaranteed Hours Exist in Travel Nursing?

That’s the gist of guaranteed hours and sort of the surface level expectation. As we’ll see a little later, it doesn’t always work that way. But first, it’s important to understand why guaranteed hours exist.

Here again, the fundamental answer is obvious. Guaranteed hours exist to ensure that the travel nurse can count on a certain number of hours on this contract. More importantly, they exist to ensure that the travel nurse can count on earning a certain amount of money on this contract.

I mean, the travel nurse is leaving their permanent job, and leaving their home. And the expectation is that the travel nurse is incurring duplicate expenses to maintain their tax-home. Therefore, the travel nurse needs a guarantee that this contract isn’t going to be a financial disaster for them. They need a way to evaluate that in advance.

The less obvious reason is that the healthcare staffing agency needs a guarantee too. It’s really expensive to recruit travel healthcare professionals. Honestly, it really is like finding a needle in a haystack. Agencies can easily spend over $1,000 on simply recruiting a candidate to submit for the position. So, agencies really don’t even want to take the initial steps if there isn’t a guarantee.

And then, once they’ve placed the candidate in a position, the agency is on the hook for a lot more. They need to credential the candidate, pay for travel expenses, potentially pay for housing, and a bunch of other fixed and variable costs.

So, at the end of the day, the guaranteed hours actually protect both the agency and the traveler against the possibility that the hospital games the system. It’s supposed to prevent the hospital from getting travelers out there and treating them like a PRN, registry, or on-call nurse.

The bottom line here is that both the agency and the traveler lose when shifts get cancelled. That said, I think it’s fair to say that the agency is in a better position than the traveler when it comes to their ability to avoid the cost of cancelled shifts. So, let’s take a look at how the whole guaranteed hours system works.

Guaranteed Hours in the Travel Nursing Contract

So, everything sort of starts with the contract between the agency and the hospital. As we’ve mentioned on this podcast before, agencies and hospitals enter into contracts that govern the terms of service between the two parties. One of those terms is the guaranteed hours policy.

These policies take several forms and there are a couple of layers to them as well. At the highest level, the guaranteed hours clause is going to cover exactly what’s being guaranteed. For example, some hospitals are willing to guarantee all the hours in a contract. Other hospitals are able to cancel up to three shifts during the course of a contract. Still others are able to cancel up to one shift per week. That’s a lot! The point is that there are many variations of what exactly is guaranteed.

The next layer deals with the guidelines for what actually qualifies as a breach of the guaranteed hours clause. For example, some hospitals have clauses that require travelers to float to another unit in order to qualify for the guaranteed hours. So, they may tell you that they don’t have a need in ICU and ask that you float to a StepDown unit or even to a MedSurg floor. If you don’t agree and they cancel your ICU shift, well then that doesn’t qualify as guaranteed hours according to the contract between the agency and hospital.

Another example is when the hospital is able to cancel a shift, but then offer you the option of making it up at a later date. Typically, the later date needs to during the same work week. However, sometimes is can be made up any time during the contract.

Hospitals sometimes have clauses that allow them to schedule or float you to one of the hospital system’s other hospitals. For example, I recall that Dignity Health hear in California had a clause that allowed them to send you to any of their hospitals within a 45 mile radius.

In one case, I worked with a traveler who was getting floated in the middle of his shift from one hospital to another. This poor guy was understandably miserable. It was on the night shift too! We did everything we could to get them to stop it. We ultimately found him a different contract and just bailed on that hospital. They weren’t happy with us, but that’s just not right.

Now, another such stipulation involves leaving shifts voluntarily. If the unit is slow one day and you’re asked if you’d like to leave and you agree, then that’s not going to violate the guaranteed hours policy. I don’t know if that sounds obvious, but I worked with a number of travelers who expected to get paid in that scenario. Unfortunately not.

Finally, guaranteed hours does not mean that the hospital can’t cancel your contract. So, if the hospital cancels the contract six weeks in, they’re not going to pay for the remaining 7 weeks. As I mentioned in episode 16, there is often a cancellation penalty of one to two weeks’ worth of billing, IF, they aren’t cancelling the contract for cause.

How Do Travel Nursing Agencies Handle Guaranteed Hours in the Contract?

Okay, so different hospitals have different policies and there are all these little variables at play, so how do agencies handle it? Because, how the agency handles it is ultimately what’s going to affect you as the travel nurse.

And we have to consider the situation the agency is in. They have all these different contracts with Vendor Management Systems, Managed Service Providers and direct contracts with hospitals. Almost every one of them probably has a different guaranteed hours policy. So, if they want to accurately represent the hospital’s guaranteed hours policy in each contract they send to a travel nurse, then they’ve got their work cut out for them.

Simple Guaranteed Hours in Travel Nursing

So, some agencies will simply guarantee the hours on their own. In other words, the agency will place a straight guarantee for all the hours in their contract between the agency and the nurse. Then, they’ll actually honor that clause no questions asked. If you get called off, they pay you, period.

Now, this sounds amazing on the surface and I honestly believe that it’s among the better ways of handling it. However, it’s pretty much a given that the agency is going to factor the losses they are bound to take on this policy into their pay rates. I mean, shifts are going to get cancelled and those costs can add up super-fast.

So, what does the agency do in this case? Well, they most likely factor a cost to cover this into a standard burden for every single contact. Essentially, it acts as sort of an insurance policy for all of their travelers.

Every traveler the agency works with has a little premium taken out of their pay package. Those who get cancelled are covered. And those who don’t get cancelled are simply paying in the off chance that they will get cancelled. It’s just like an insurance policy only it takes place behind the scenes.

The amount the agency takes out of every pay package is most likely based on their historical experience with cancellations. They’re going to try to hit that number as close to the mark as they can. If they go over the mark, then they run the risk of their pay package being a little less competitive than companies who don’t have this policy.

And once again, we’re back to our most important piece of advice regarding travel nursing contracts and pay packages. In order to accurately compare pay packages, you must consider every variable. In this case, if one agency is offering this type of guarantee, it doesn’t necessarily make it better or worth more. In this case, you’re going to need to decide whether or not this is worth it.

But again, as I mentioned above, I believe this is one of the better approaches for dealing with guaranteed hours. The exact opposite of this solution might be the worst way to deal with guaranteed hours.

Breached Guaranteed Hours for Travel Nursing

You see, some companies will put an iron clad guaranteed hours clause in their contract, but then not live up to it when shifts get cancelled. This sucks because you’ve most likely done your due diligence to make sure the guaranteed hours clause is there. Then, you get cancelled and the company tells you, “Oops, we made a mistake. Actually, the contract with the hospital says they can cancel you…sorry!”

Now, this is really bad form. It really puts you in a bad spot and makes the agency look really bad. At the end of the day, there is really no excuse for this either. I mean, it’s possible that your recruiter doesn’t know this is possible. They may not have experienced it before. However, it’s not like the agency doesn’t know this is possible. They’ve most certainly dealt with the issue numerous times. And even if they’re a new agency, there’s still no excuse. They should know the terms of the contracts they sign and be prepared for dealing with it in a way that delivers good customer service to their travelers.

So, as I mentioned earlier, my personal belief is that the best way to do that is for the agency to offer an across the board guarantee to their travelers and then budget for the losses on the back end. Again, the risk is that their pay packages might be a little lower. Also, they may not budget properly. So, there are some other alternatives.

Matching Guaranteed Hours to Hospital

The first, and maybe most common, alternative is for the agency to match the guaranteed hours clause in the travel nurse’s contract with the guaranteed hours clause in the hospital’s contract. This isn’t exactly easy though. They’re most likely going to need to dig up a hospital contract, review the policy, and enter it into their contract with the travel nurse for every single contract.

Rest assured, if they do it this way, they’re bound to make a mistake or oversite at some point. However, they’ll get it right in the vast majority of cases. And this way, the travel nurse knows what the policy is and can make a decision as to whether or not they want to accept the contract.

Now, another option is for the staffing agency to offer the travel nurse a choice between a higher pay rate without guaranteed hours or a lower pay rate with guaranteed hours. Here again, as the travel nurse, you are essentially paying for an insurance policy to cover losses due to cancelled shifts.

This is a decent solution. The thing that I don’t like about it is that you as the travel nurse have no way of knowing what the guaranteed hours policy is for the hospital in question. If the hospital has a flat out guarantee, then there should be no reason for you to have to pay for anything. The hours are guaranteed. And on the flip side, the fewer hours that are actually guaranteed, the more advantageous this insurance policy could be for you because the hospital could potentially cancel more shifts. Hopefully, agencies that make these offers will let you know these details so you can make an informed decision.

So, you can see how the agency is in a better position to deal with the financial losses of cancelled shifts. They hold the cards in a sense. The have access to the contract between them and the hospital. They’re the ones who have control of the money. And they’re the ones who can choose which approach they’re going to use to deal with any issues that arise.

That’s just the nature of the game. It isn’t a judgment against agencies. As we’ve seen, there are many options that allow them to treat travelers fairly. It’s just a matter of whether or not they actually use those options. And the vast majority of companies will use one of the better options.

BluePipes: Professional Networking and Career Management Tools for Healthcare Professionals

 

How To Get Your California RN License for Free!

So, what can you do as a travel nurse to ensure you’re covering all your bases on this issue? That’s what we want to talk about next. But first, I’m dying to tell you about this offer from Valley Healthcare Staffing to pay for your roundtrip flight to California and pay for your license fees to get your California RN license.

So, just a little background on getting your California RN license by endorsement. Several years ago, California was a walkthrough state. You could have your license the same day as long you submitted all the paperwork. Then, it was found that California had a large number of nurses practicing who had felonies and suspended licenses in other states.

California decided they needed to wait for the results of fingerprints and license checks in order to grant someone a license. You could still get your license pretty quickly if you showed up in person to do the Live-Scan fingerprints because these fingerprint results are received immediately.

But then, California decided to adopt a new software system for managing and tracking the licensing process. This system is called Breeze. Simply put, it was a complete disaster. Some people were waiting over 6 months to get their license. There were public hearings, an official investigation, I mean, it was bad.

And it’s still not very good. It’s not uncommon for it to take 9 to 12 weeks, or even longer, to get your California RN license issued. Showing up in person is still the quicker route. But if something happens to your application, it’s missing something, or there are questions, good freaking luck. They are so log jammed that it takes them weeks to inform you and you’ll have a really difficult time getting a hold of someone.

Now, I’m telling you all this because it’s part of what makes Valley Healthcare’s offer so special. You see, their offices are literally a stone’s throw away from the California Board of Nursing’s Office. They’re in the same business park. And Valley has been walking applications into the Board’s offices for years. They walk in on a weekly basis just to check on the progress of pending applications. They’re able to find out if there are any problems and address them immediately. Essentially your application gets guided through the process by Valley. This way, you should have your license within 6 weeks!

Again, they are going to pay for your round trip flight to Sacramento, pick you up and take you to their office, give you a meal, help you take care of all the paperwork, take you to the board of nursing, get all the paperwork turned in and pay for your license fee.

If your travel time is less than five hours, they’ll take you back to the airport so you can return home the same day. If your travel time is longer than 5 hours, they’ll get you a hotel room and take you to the airport the following day.

As I mentioned earlier, the offer has terms and conditions. I also said that the conditions could be viewed as a bonus. Well, that’s because the offer requires that you let Valley land you one of their over 1200 hot winter needs in California starting before December 31st.

I was able to view a list of these jobs. They’re hiring for over 20 specialties. 19 of the 20 specialties I viewed had pay package over $2,000 per week. Many of them were in excess of $2,300 per week. Plus, Valley has one of the best benefits packages in the business. You get day one United Health coverage, vision and dental coverage. And that’s United’s Silver plan, which is a higher level coverage than most agencies offer. Valley also reimburses your gym membership fees and offers a 401k with 5% match.

Now, it does require a little flexibility on your part but I think it’s well worth it to get this highly desirable RN license under your belt. California has over 10% of the nation’s population. It’s got more travel assignments than any other state and pays the highest rates. So, definitely check out this offer. Go to valleyrocks.com/bluepipes….that’s valleyrocks.com/blupipes. And remember, this deal won’t last forever. The offer expires November 30 2017. Again, go to valleyrocks.com/bluepipes and take advantage of this absolutely amazing program.

Asking the Unit Manager About Travel Nursing Guaranteed Hours

Okay, so let’s look at some of the steps travel nurses can take to protect themselves from issues pertaining to guaranteed hours…or the lack thereof. One of the common recommendations that a lot people make is to check with the manager about guaranteed hours during the interview. I have to tell you, I’m not a big fan of this approach.

It’s one thing to ask the Unit Manager about cancellations in general. Like, how often do travelers get cancelled? Are travelers cancelled first? That kind of stuff. But it’s something different to ask them what the guaranteed hours policy is. Many, if not most, unit managers do not know. It’s generally the purview of some bean-counter or administrator in the staffing office. So, asking the unit manager gives them some work do or forces them to tell you they don’t know. And I don’t think that’s a good thing.

Moreover, at the end of the day it doesn’t matter what the hospital’s policy is. You are going to be governed by the contract between you and the agency. The agency can put whatever they want in that contract.

Perhaps more importantly, it’s your agency’s job to deal with this issue, not yours! I guess at the end of the day, it’s fine to ask the unit manager. But ideally, you’ll already have that information before you go into the interview. The agency should be providing it upfront. So remember, always ask about the guaranteed hours policy for the hospital your recruiter is pitching.

Let your recruiter know that you know these policies can vary from hospital to hospital. That should at least get the recruiter to vocalize what the agency’s policy is. You can then tell them that you will expect them to adhere to that policy moving forward. If something happens and the agency doesn’t abide by the policy, then you’ll be able to reference this conversation.

Check the Travel Nursing Contract for Guaranteed Hours

Next, always check the contract. Never assume the guaranteed hours clause for one contract will be the same as it was for the last contract. As I mentioned earlier, some agencies will match their guaranteed hours clause to the hospital’s.

Moreover, I also recommend that you check for clauses regarding penalties for missed shifts. Now, missed shifts is a topic for another episode, but in general, many agencies have clauses allowing them to make pay deductions for missed shifts in order to cover the cost of things like housing, travel expenses and other fixed costs. You want to make sure that the term “missed shifts” is defined in a way that it cannot be construed to mean “cancelled shifts”.

You see, employers can make deductions from the paychecks of hourly paid employees if they have clearly defined the rules in their employment agreements. So, or goal here is to make sure that they aren’t able to deduct for cancelled shifts.

After doing all of this, you may still find yourself in a situation where you’re not getting paid for cancelled shifts despite the fact that your guaranteed hours clause indicates you should be getting paid. In fact, agencies may even try to deduct for the cost of things like company provided housing, medical insurance and other fixed costs. They’ll argue if you don’t work, then you don’t get paid.

Legal Assistance for Travel Nursing Guaranteed Hours

If this happens to you, then your only course of action is to obtain legal assistance or file a complaint with the state’s labor board. The latter is probably easier and less costly. Unfortunately, it comes to this sometimes, albeit not often.

So, let’s finish up with an example from a travel nursing social media group. The following quote from a travel nurse is actually what inspired me to do this episode. The travel nurse said:

So i need opinions because I’m confused. Signed a contract with guaranteed hours, found out the contract my company signed with the hospital states i can be cancelled twice every two weeks. So my question is do i get paid if i don’t work since my contract says I’m guaranteed my hours? Because, they’re not paying me…

Now, I don’t want you guys to find yourself in this situation. So please, have these conversations with your recruiter in advance. That way, you’ll always be able to reference that conversation. Moreover, always check the contract to make sure At the end of the day, you’ll be able to rely on your contract to ensure you receive what’s been agreed to.

Okay, that’s it for this episode. I hope you found this discussion useful. I hope it saves you from headaches and confusion in the future. Again, please check out that amazing offer from Valley Healthcare and get your California license secured fast and for free…and land high paying job to boot…go to valleyrocks.com/bluepipes that’s valleyrocks.com/bluepipes.

Links

TTATN 016: Travel Nursing Contract Cancellations

Travel Nursing Pay – Choosing Between Guaranteed Hours or a Higher Rate

Travel Nursing Pay – Considerations for Guaranteed Hours

Travel Nursing Pay Video

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