It depends. Often when traveling, expenses and overhead cost outweigh the increase in salary. If you can find assignments close to home, you can greatly reduce travel and living expenses. You also can reduce overhead by, not using a staffing agency, to obtain a position. Even if the staffing agency does not provide travel expenses, they still take a portion of your salary. Depending on the agency this can be anywhere between 10% to 30%. Additional costs include; liability insurance, licensing and credentialing charges, financing your own benefit plans (health insurance, retirement…), and then there is accounting and taxes to consider. Just like when considering residence position, I encourage you to consider all the pros, and cons, of an assignment including, but not exclusive, to financial.
Yes, this is more common than not. However, if this is your intention, make sure to review your contract for non-compete clauses. Frequently, staffing agencies require a “buy out” fee. This entails a cost for you, as well as, for the facility. This can be problematic if you find a position, through a staffing agency, close to where you want to live permanently. You may be prevented from getting employed there for two years or more! Be leery and read your contract fully.
As with all positions, the credentialing process can be arduous and time consuming. The good news is, as a traveler, due to the staffing needs, credentialing is usually streamlined. Depending on how long your assignments are, you could be credentialing two or more times per year. The accumulation of multiple sites can potentially slow down the credentialing process, since every site requires verification. Knowing how and who this process is done can be highly beneficial. I recommend keeping contact information on everyone you come into contact with when starting an assignment, you will need that information later on. This is also true for references. I can remember as a new CRNA, a traveling CRNA told me, “the hardest thing about travel, is keeping up with references.” It’s taken me years to realize what he meant. As a traveling, you only have a limited amount of time to make a lasting impression. References are very important for your own job security. I recommend getting at least one reference from every facility. Also, some jobs prefer references from CRNAs others from Anesthesiologist. I even been asked for supervisor references, (when working solo, this may or may not be an anesthesia provider). Keep in mind, there are two types of references. The one that the anesthesiologist calls (acquire prior to accepting you as a candidate) and one that the credentialing office puts in their files (I pretty sure no one looks at). It’s a lot to ask of people, especially when they don’t know you that well.
There are advantages and disadvantages to staffing agencies. I’ve mentioned some of the disadvantages in previous questions. A key component to using a staffing agency, is that they work directly, with the hiring facility, to get you your job. Once you and the facility sign a contract with the staffing agency, all parties are beholden to get you working by your start date.
However, your recruiter (your contact person at the staffing agency) has completed their work. So, at this point you will be dealing with other people/departments, both in the staffing agency and in the assignment. This quickly multiplies and the more people involved the more likely mistakes happen. Although, some agencies are better than others, ultimately, it is up to you to have all your “ducks in order” before your start date.
As I mentioned in a previous question, a great deal of cost can be saved by providing your own travel and living expenses. However, careful planning and calculating of expenses prior to taking on the assignment are necessary. A good friend of mine once told me, in reference to travel cost, “everything is negotiable”. If you want higher hourly wages, a car, an apartment, all you need do, is ask. However, keep in mind, it is also possible to bid yourself out of a job. For new travelers this is where the staffing agency comes in handy. They can cover your costs until you figure out whether or not an assignment is worth it. Early in my traveling career, I went per diem (paid all my own cost) and lost a great deal of money to overhead. I thought, never again! But now, after years of traveling I realize I’m doing a good portion of what an agency dose (ie booking plane tickets, finding housing, credentialing). So, why not go per diem and make the money in wages. It’s a tradeoff. It is my goal, with this website, to get you to think about these things prior to getting started, to avoid making mistakes. Or, at least, the same mistakes I made.
As mentioned, when working with a staffing agency, “everything is negotiable”. When working per diem, traveling with family, can be difficult, and costly. I have a dog I travel with. Flying with him is expensive and finding accommodations difficult. Ironically, however, he is the reason I choose per diem. Staffing agencies are more than willing to accommodate you, however, family, not so much. My husband doesn’t travel with me, but he frequently flies down for visits. The cost of these visits are not covered (although, FYI, they are tax deductible). These costs can quickly add up. The important thing is knowing what is right for you. Identifying your priorities prior to taking on an assignment, will improve the chances of, making your travel experience, rewarding.
Staffing agencies can be very helpful in the credentialing process. However, ultimately you are responsible for your own credentialing. My first travel assignment, I relied heavily on my staffing agency for advice and direction. Without my knowledge, they put me with a first time “credentialing specialist”. I was unable to start for three weeks after my scheduled start date. This is not only bad, for the obvious reasons, of loss of wages and practice time, it can be detrimental to an otherwise clean record. Remember, staffing agencies (recruiters especially) are sales people and although they may be nice people, their interests are different from yours.
Stress is something we all deal with every day. Traveling has its own type of stress, however, the more you do it, the easier it gets. I believe most of the anxiety come from not knowing what’s going to happen next. Remember your first complicated trauma case? Shear adrenaline pumping through your veins, right? Then the next case you pulled from your previous experience. After several cases you feel more comfortable and at ease with your practice. With travel, your first day at a new site, the stress comes from meeting a whole new set of anesthesiologists, nurses, surgeons, OR, equipment, and EMR. At first, this can be overwhelming. However, remember, the basics of anesthesia are the same, no matter where you practice. Even though the faces may change, the challenges and personable skills needed to overcome those challenges, are the same. Surgeons complain about turnover times, nurses complain about “procedure and protocol”, anesthesiologist… well, it’s their way or the highway. Of course, not everyone is the same, but, if you're going to have problems, most likely they will fit into a category you have dealt with before.