Travel Nursing at California Kaiser Hospitals

Kaiser Permanente is one of the largest healthcare employers in the state of California if not the largest. Kaiser is also one of the biggest users of travel nurses in California. In this blog post, we’ll provide some detailed information about travel nursing with Kaiser so that travel nurses know what to expect.

Kaiser Permanente is one of the largest healthcare organizations in America. In addition to their massive footprint in California, they also have operations in Colorado, Georgia, Hawaii, Maryland, Ohio, Oregon, Virginia, Washington, and Washington DC. Like many large organizations, Kaiser is broken up into regional subdivisions. While each subdivision is certainly accountable to the larger organization, they also have a certain level of autonomy with respect to operations.

We’ll be focusing on the California market in this blog post. There are two divisions of Kaiser in California, Northern and Southern. This fact only affects travelers on rare occasions. We’ll point out the differences where applicable throughout this article.

Is Kaiser a good place for travel nurses?

Of course, the first question every nurse considering a travel job with Kaiser wants answered is whether or not Kaiser is a good place for travel nurses. Are Kaisers “travel nurse friendly?” Unfortunately, this question is too general to provide an an all encompassing answer.

Workplace culture plays a big role in whether or not a job will be travel nurse friendly. And culture has a lot to do with the specific people you work with. Therefore, you will find differences between hospitals, differences between Units in the same hospital, and even differences between shifts on the same unit.

In an effort to lock down an answer, many nurses turn to message boards and social media groups to ask for feedback about a specific unit at a specific hospital. Be careful with this approach. Like everyone else, nurses have varying opinions on what constitutes a good work environment. So if you choose to go this route, we recommend asking for specific details and discard general answers like, “It was great!” or “Don’t do it!”

Having placed more than 50 travelers at Kaiser facilities throughout California, I can offer the following anecdotal observations. I worked with more nurses who took permanent jobs with Kaiser than said they’d never work there again because it was so horrible. A strong majority of my Kaiser nurses accepted an extension or took an assignment at another Kaiser hospital.

Kaiser is also great at making sure travelers get their hours and they cancel shifts far less than other organizations. Moreover, Kaisers are really good about making sure that nurses receive their breaks. Sure, you’ll find some Kaisers that drop the ball in both cases, but as an organization, Kaiser is really good about breaks and hours.

Despite these positive indicators, the negative perception of traveling with Kaiser is quite pervasive. There are a couple of reasons for this. First, Kaiser’s system, HealthConnect,  is quite tedious. As a result, I received regular complaints of micro-managing and overbearing paperwork. However, these complaints almost always subsided once the nurse got the hang of things.

Second, many Kaiser hospitals run on 8 hour shifts but bring travel nurses in on 12 hour shifts because it’s so hard to find travelers that will work eights. This means travel nurses are always there during shift changes. This can disrupt the continuity of care. It also increases the likelihood of floating. Travelers may be floated to another unit or may be transferred to a new set of patients as the shifts change. This doesn’t mean that every traveler floats all the time but it does increase the likelihood. Moreover, some specialties are affected more than others.

Travel nursing companies that work with Kaiser

Kaiser hospitals in California consistently have needs for travelers. However, some Kaisers have more needs than others. The most consistent needs are at the facilities in Oakland, Santa Clara, Walnut Creek, Sacramento, Los Angeles, and San Diego.

Perhaps the most important thing to know about landing an assignment with Kaiser in California is that American Mobile Network (AMN) is the Managed Service Provider for all Kaisers in California. This means that AMN has an exclusive contract with Kaiser to staff all their supplemental staffing needs. However, AMN has agreements with a large number of “Sub-vendors” who help fill Kaiser’s supplemental job openings. To be clear, sub-vendors are agencies that have a contract with AMN to provide staff for Kaiser hospitals. However, everything goes through AMN.

This is an important relationship for nurses to understand. By and large, AMN has first crack at filling Kaiser’s supplemental jobs. If they are unable to fill the jobs on their own, then they’ll release the job openings to their sub-vendors. As a result, jobs in the most desirable locations, like San Diego, tend to get filled by AMN because it’s easier to find candidates interested in such locations. Therefore, nurses working with AMN will have the inside track on Kaiser’s jobs.

In addition, AMN charges sub-vendors a service fee that effectively reduces the bill rate for sub-vendors. The fee is approximately 2% of the bill rate. However, this doesn’t mean that sub-vendors always pay less than AMN. In fact, many sub-vendors are able to pay quite a bit more than their larger competitor.

Unfortunately, many nurses do not like working with AMN. The company routinely receives poor reviews on all the major travel nurse agency rating services. And we regularly hear that AMN pays very poorly for the extra hours. Again, AMN uses many sub-vendors for the Kaiser account including some of the top rated staffing agencies, so it’s not absolutely necessary to work with AMN to land a job at Kaiser.

The travel nursing submission process with Kaiser

Upon agreeing to be submitted for a job with Kaiser, your submission profile will first be sent to the AMN Account Manager responsible for managing the specific Kaiser hospital in question. You will be contacted by the Account Manager or another representative, typically within 24-48 hours, who will ask a standard set of basic questions. They will typically ask if you have ever participated in a Code Blue and if you are proficient with IVs. They will also ask if you have all the licenses, certifications, and experience required for the position.

Kaiser Travel Nursing Interviews

If everything checks out, they will schedule a time for your clinical interview. You should attempt to schedule the interview at soon as possible. AMN works hard to fill the positions quickly. So they routinely schedule people for interviews as they are available. This means that someone could sneak in before you and land the job if you wait too long.

Computer Interview

Currently, interviews for Kaiser travel nursing jobs are conducted via the computer. The process is pretty basic. A time will be scheduled and the computer access information will be provided to the traveler.

The interview has two main parts. First, there will be a series of questions that deal with your specific unit. These questions may include medication calculations and other unit specific inquiries. For this series of questions, your answers will be entered into the computer.

The second part of the interview is a series of standard interview questions that will be voice recorded. The questions will address issues like:

• What makes you a good employee?
• How often do you miss work?
• Describe a situation in which you used cultural diversity training to provide patient care.
• Describe an instance in which you had to care for a difficult patient or deal with a difficult family member.

For some great advice on how to handle a computer interview, check out this great article on Highway Hypodermics.

Of course, the computer won’t be able to answer specific questions you have about the job. This means that questions about float policies, support staff, and shift-report will not be answered during this interview. If you receive a job offer, then you can always request to speak with a unit manager or have your recruiter get your questions answered.

Interview With Clinical Interviewer

In the past, the clinical interview was always with a qualified Registered Nurse who worked for AMN. In rare occurrences, you may still encounter a live interview a so it’s beneficial to know how they work.

In this case, a time would be scheduled for the interviewer to call you. It’s best to be available a half an hour before to a half an hour after the scheduled interview time just in case the interviewer calls early or late.

The clinical interviewers typically operate off of a standard interview template that can be modified a little to fit the needs of the particular unit in question. They routinely asked situational questions and medication calculation questions very similar to what is asked on the computer interview.

Unfortunately, the AMN interviewers do not work directly with the unit so they tend to know very little about the way the unit operates. Here again, you may have difficulty getting your travel nursing interview questions answered. Therefore, it’s important to communicate all questions and concerns to your recruiter. This includes questions about scheduling, time off, and other issues.  Your agency will contact the AMN Account Manager who will communicate with the hospital to get answers.

The AMN clinical interviewer will typically let you know immediately whether or not you passed the interview. If you did not pass, then you’ll need to wait 6 months before interviewing for another Kaiser assignment. If you pass, your profile will be forwarded along with the results of your interview to the Unit Manager. Additionally, passing an interview with Kaiser is good for 6 months. Therefore, you can be submitted to any other Kaiser jobs for the same unit during the 6 month period.

Regardless of the type of interview you receive, time-frames vary for the Unit Manager to get back to AMN and your agency as to whether or not you landed the job in question. I’ve had weeks go by without an answer and sometimes the job offer comes back within the hour. On rare occasions, you may receive a call from the unit manager who may ask some additional questions or tie off any loose ends.

Travel nurse onboarding with Kaiser

The onboarding process is a bit more tedious with Kaiser than it is with many hospitals. This is due in large part to the fact that they require their travelers to complete a set or four online training modules on Kaiser’s HealthConnect system prior to orientation. These modules can take up to 12 hours to complete but most nurses finish them in far less time.

Of course, you’ll also have to go through all of the standard testing and submit all the standard medical, license, and certification documentation. It’s important to note that Kaiser typically requires an AWHONN Advanced Fetal Heart Monitoring Certification for L&D nurses. And they typically require a “Telemetry Certification” for Tele, SDU, PCU, and ICU nurses. The telemetry certification can be completed as a CEU course on the same website where the HealthConnect training is completed.

While we’re on the subject, the HealthConnect modules and Telemetry Certification course will be found on RN.com. This is AMN’s CEU and training website. You will need to register for an account. If you don’t want AMN to contact you, then you should be sure to un-check the box that gives them permission to do so during the registration process.

If your contract is with a Kaiser in the Southern California Division, then you’ll need to schedule and attend an onboarding orientation prior to your contract start date. This onboarding orientation typically lasts 3 to 4 hours and there are multiple locations and times available for scheduling. It’s most common for nurses to schedule this onboarding orientation the Saturday before their contract starts.

The onboarding orientation is conducted by an AMN representative. They will answer basic questions about reporting for your assignment. You will be required to complete some standard paperwork and take some standard tests. This is also an opportunity for AMN to pitch you on their services. They may even offer to schedule PRN shifts for you should you choose to take them.

If your contract is with a Kaiser in the Northern California Division, then you’ll be able to complete all the onboarding orientation requirements online. Northern California used to require attendance so the online option is a new addition. They may revert to requiring attendance in the future, or perhaps the Southern California Kaisers will adopt the online method.

As mentioned previously, Kaiser requires nurses to complete a large number of steps prior to starting their assignments. The HealthConnect modules were added to the onboarding process when AMN took over the Kaiser contract from NurseFinders. There was no reimbursement offered to nurses and agencies were unable to bill for the time. Needless to say, there were tons of complaints. Recently, Kaiser began providing agencies with reimbursement for the onboarding process. Nurses will undoubtedly find that reimbursement amounts vary from agency to agency. However, the figure we here most is $200.

Pay expectations for travel nurses at Kaiser

Of course, pay is one of the main considerations when deciding whether or not to accept a job. Kaiser used to be the highest paying option for travel nurses in California. That’s because their contract with NurseFinders had the highest bill rates in the state. The bill rate for Specialty RNs was approximately $72 per hour in Northern California and $66 per hour in Southern California. The non-specialty bill rate was approximately $67 per hour in Northern California and $62 per hour in Southern California.

When the contract came to it’s scheduled end, there was a bidding war between some the industry’s top agencies and the bill rates were reduced significantly. In fact, they dropped by approximately 8% to 12%. As a result, the pay at Kaiser is now on the mid to lower end of the pay scale for California contracts. The fully blended pay rate for a standard assignment with Kaiser can be anywhere from $38 per our to $48 per hour, give-or-take, and depending on the specialty in question.

That said, Kaiser still has the potential to pay the best rates in California. That’s because their “Crisis Rates” are really high. Kaiser approves crisis rates when they have an urgent need or a need that is difficult to fill. The fully blended pay rate for a Kaiser crisis assignment can be anywhere from $55 per hour to $63 per hour, give-or-take, and depending on the specialty in question.

Kaiser also has the potential to pay among the lowest rates in California. That’s because their bill rates for 8 hour shifts are really low. As mentioned previously, many Kaisers operate on 8 hour shifts. Therefore, they sometimes have assignments with 8 hour shifts. The fully blended pay rate for an assignment with 8 hour shifts at Kaiser can be anywhere from $33 per hour to $41 per hour.

Travel nurse time reporting at Kaiser

Of course, a nurse’s hours must be reported to the agency in order for the nurse get paid. Typically, Kaisers require travelers to submit a weekly time sheet to the hospital’s staffing office. The staffing office obtains the appropriate signatures and submits the time sheet to the Vendor Management System, FieldGlass, that AMN uses to manage the account. That time sheet is then sent to your agency if you are going through someone other than AMN.

It’s always a good idea to maintain your own time sheet and submit it weekly to your agency. In fact, some agencies require this. Doing so helps ensure that you are paid properly. It gives the agency a record to compare with Kaiser’s report. They can also use this record to help ensure that hours are reported in a timely fashion.

Travel nursing disciplinary actions with Kaiser

Kaiser contracts are completed without a hitch in the vast majority of cases. However, there is always potential for disciplinary action. In such cases, it’s important for nurses to understand the potential impact. For example, disciplinary actions can be recognized by all of Kaiser California,  just one of the divisions, or just the hospital that levied disciplinary action. This is particularly important when a nurse is flagged as “Do Not Return” or “Do Not Use.”

Moreover, the nurse could potentially be marked as DNU by AMN. This is important even if you do not wish to ever work with AMN. Unfortunately, AMN is the Managed Service Provider for many hospitals and hospital organizations throughout the country. Therefore, if a nurse is DNU’d by AMN they could lose access to all the hospitals where AMN is the Managed Service Provider.

Again, these instances are rare. Be sure to communicate with your recruiter to determine the impact should you find yourself in such a situation.

As always, we’d love to here about your experience with this topic. Please post your questions and comments in the comments sections below!