A Career Update…

I think the last time I shared a career update I was still commuting about an hour and a half to work in the “bigger hospital” near us. It’s time to catch you up to speed.

Since February 2022, I’ve been considered a “travel nurse” in some form or fashion. The first contract I took was through “agency” meaning that there was a nursing recruiter of sorts that was coordinating my assignment. I had to go through mandatory trainings, vaccinations, drug screens etc. It was a very formal process. It was during the tail end of COVID so I was making pretty decent money.

The perk of travel nursing is that because you live so far away from your assignment, you get some tax free stipends to accommodate your living expenses while you are away from your tax home on assignment. That’s where travel nurses really “make the money.” You have to live 50 miles away from the facility you are traveling to. I lived 51 miles away so I qualified for the stipends. This arrangement however, is very expensive for the hiring facility.

For example, rates in Iowa right now are on average of $2,000 per week for three 12 hour shifts. That’s what the travel nurse gets paid. The hospital has to pay that $2,000 per week but they also have to pay the agency for arranging the contract. They pay about 30% more than the rate the travel nurse is getting.

So in total, the hospital is paying $2,600 per week for the travel nurse, $600 of that going to the agency. These are all rough numbers and guesstimates so don’t quote me on this. These nurses are also guaranteed pay for 36 hours whether the hospital needs them or not. This was an example of the first contract I took.

For a time period, the hospital I worked PRN at was hiring what was called PRN contracts. This would be for an already established employee that wouldn’t need any benefits. I don’t need insurance because Craig gets insurance through the farm. The hospital offers an hourly rate and then I also received a 10% shift differential from that hourly rate. I took a total of 5 of these 13 week contracts at two different facilities. These did NOT have guaranteed pay/hours like they do with agency. Each time I signed a new contract the rate would decrease as they eventually were getting rid of these contracts and moving the PRN contracted staff to permanent staff. They do not offer these contracts anymore.

Hospitals are now getting smarter. They don’t want to pay agency rates so they are creating their own internal “agency staffing” to save money. I have not taken this kind of contract yet so I’m not sure exactly how they work as far as benefits.

My current contract is just an hourly rate paid directly to me as an independent nurse contractor. I have an arrangement directly with the hospital. I am not guaranteed any hours, I am not guaranteed long term employment. I have no benefits. No taxes are taken out of my check. They might need me, they might not need me. I’ve been at my current facility since June and this is the second time I’ve been here helping cover medical and maternity leaves. It’s in my top 3 favorite hospitals that I’ve been to.

Because my hours are not guaranteed, I have minimal job security. That’s the downside and the upside of this arrangement.

I say that there is an upside because I love not being permanently “stuck” at one facility. I love meeting new people, traveling to new facilities, and working with new providers. I’m only on the schedule through December at my current facility so the world is my oyster.

Part of me would like to stay where I am, working the ER night shift at a critical access hospital. I love the people here, I love the facility, it feels like “home” to me.

Part of me would like to get back to teaching. I taught nursing students in the hospital for 4 semesters back before COVID hit and I loved it.

Part of me would like to go back to the ICU to get more critical care experience. This is beneficial if I want to continue my journey towards becoming a flight nurse. Many bases require 3 years of ICU experience and I only have 2.

Part of me wants to try something totally new like taking a nursing house supervisor position at a bigger hospital.

Part of me wants to work in the medical ICU at Mayo in Rochester.

Part of me just really wants to be a flight nurse.

Part of me wants to go back to the first facility I was a travel nurse at and be hired on as agency staff again.

As you can see, there’s a lot of moving parts. There’s a lot to try and explore and think about. That’s the beauty of nursing, you’re never stuck and opportunities are endless.

I found these two quotes the other day and it was so comforting and reminded me that there really isn’t a wrong decision to make and maybe taking just a little bit more time is just what the doctor ordered.

Anyway, if you have any ideas or suggestions or guidance on what I should do with my life, drop a comment below. I’m open to suggestions because clearly I have no idea what I’m doing. (other than working night shift…I’m for sure going to be staying on nights) #nightshiftforlife

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7 responses to “A Career Update…”

  1. carolyn sullivan Avatar
    carolyn sullivan

    Sometimes the place you need to be is just there, w no other options…. Those tend to be the best places, I’ve found.

  2. Susan V Avatar
    Susan V

    My gut reaction is to go get the last year of ICU experience you need to provide an opportunity you might want to pursue a little later. Speaking as a retired HR generalist, I think any job you take provides either valuable experience or contacts that will help you as you develop in the work place. But, the flight nurse has a requirement that you are really close to fulfilling. Good luck.

  3. Kate Avatar
    Kate

    You definitely have many options and interests. Like you said, a nurse does not need to stay in one area indefinitely. Maybe as suggested by reader above, get that one more year in ICU and then go from there.

  4. Kathy Wilson Avatar
    Kathy Wilson

    ICU for the experience! Flight nurse sounds exciting

  5. Carolyn Avatar

    I would list the pros and cons of each option, consider the age of your youngest and look at where you will be in a couple of years. To me, it makes sense (and I am not a nurse) to get your ICU qualifications because not only will it help if you become a flight nurse, it will also help in all the other options you mentioned. I think it is good that you know yourself well enough to know that you like working in tense and critical situations, you like change and moving around and you get along with where you are working. As long as your kids are young, that probably has to be your first consideration as they still need a lot of your time. But, taking care of you and working towards your future goals is so good… and good to consider how to get yourself to where you want to be. In my case as a teacher, I always wished I had taken the time to get my masters degree. Crazy as it sounds, doing the same job but with an MEd gets you way more pay and therefore better retirement funds than just having a bachelor’s degree. Lots of teachers started their masters when it became available as online learning and I envied them… but, I was in my last 5 years of teaching and by then, wasn’t interested. The more education you can have, the more units you can get experience in will be in your favor so do what you love and what inspires you. Change is as good as a rest.

  6. Becky Gilliam Avatar
    Becky Gilliam

    Get that ICU experience under your belt and then step back and view your options. Daughter worked at local hospital for 13 years, 6 surgical and 7 ICU. She then shadowed a CRNA. She went back to school for that training and it opened a whole new world. She purchased her dream vacation home – near beach (not oceanfront). She is doing like you, trying to pay off ALL debt. She loves what she does now, and really enjoys time at home and traveling with 7 weeks paid vacations per year.

  7. Mary Philllips Avatar
    Mary Philllips

    Never give up on your dreams. Work in the ICU to gain experience and you may move forward to being a flight nurse at that time or turn a different direction.

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