Your First Travel Nurse Contract (What to Expect)

Congratulations! You’ve accepted your first contract as a travel nurse.  This article will walk through what to expect before you begin, during your first weeks, and throughout the rest of your assignment. 

  *Are you still looking for a contract? If you want to know how to choose a contract or if a particular contract is a good offer, check out one of these hyperlinked posts.*

The Onboarding Process- What to expect

Compliance

After you have found and accepted a contract, there are several tasks that have to be completed before you start working. Most travel nurse agencies have an onboarding/compliance specialist or team that will guide you through this. It is very important to complete these items on time in order to avoid delaying your start date. 

Onboarding or compliance tasks can be divided into two categories- online paperwork and health. Here is what to expect for each of these:

Online paperwork:

• Education modules– the number of these and the time that they will take will vary per hospital. Some hospitals have you do most of this before you start and others have you do it before you start. Make sure you are getting paid for any hospital specific education modules. Other education modules that are not specific to the hospital may also be included, but they should not be excessive and you likely will not be paid for those. 
• Various forms to sign- there isn’t a lot to go into here, but expect to have to sign several forms. One major form is authorization for a background check. Background checks can take a while to return, so be sure to sign your authorization early in order to avoid any delays in your start date.

Health: Your compliance team will set up an appointment for you at an urgent care type of facility. You will have to go in to get various items taken care of. The specific items will vary based on the hospital’s requirements, but here are common ones to expect:

• Urine drug Screen- I’ve had to do this within 30 days of my start date for every assignment so far
• Physical- some places want a new one, but others only require one within the past year
• N95 fit test- sometimes done pre-assignment and sometimes at the hospital during week 1. Many places require you to bring your own N95 (your agency may be able to mail this for you)
• TB skin test or tspot test
• Hep B and varicella vaccine titers or boosters if not up to date

First day instructions

One thing to understand about travel nursing- there will be a lot of things that you will not know until last minute. 

The earliest that I have received first day instructions is the Thursday before my start date (more often the Friday before). 

Other than an interview call (often hospitals don’t even do this!), do not expect to hear anything from the hospital sooner than the thursday or friday of the week before you start. At this point, you should expect to find out 4 things:

1. That you are clear to start
2. Where to show up for day 1
3. What time to show up day 1
4. How to track and report your time for your paycheck

Don’t sweat it if this is all the information you get. Show up for day 1 in scrubs ready to start on your unit or sit in a classroom. First days vary, but they are always a little chaotic. Personally, I think it helps to know to expect this. 

The First Week of a Travel Nurse Assignment

As stated above, first weeks can vary a lot. I’ve had contracts where the entire first week is in a classroom (so boring, but it’s easy pay). I’ve had contracts where I start orienting on my unit immediately. I’ve also had contracts where most of my first week is spent online doing education modules. 

Unit orientation– I’ve had anywhere between 1 and 3 shifts of unit orientation with a preceptor. Coming from the staff job world where you typically get several weeks, this sounds intimidating. Honestly though, it’s not bad, and I’ve come to prefer it.

You’ll start to notice things that do and do not vary from hospital to hospital, so you will get better at asking those questions during your orientation.

Other than that, my best advice is to take over the full patient assignment and ask your preceptor to shadow you (not the other way around) so you can ask questions as they come up. 

Once you are on your own, you will still ask a lot of questions about specific processes and where things are. Don’t worry, that is 100% expected. As far as door codes and other memorization tidbits, I recommend writing them down and creating a badge buddy for yourself. You can find cheap, transparent badge buddy sleeves on amazon. In addition to door codes, I like to write things like the phone numbers for the charge nurse, respiratory and lab on my badge buddy.  

During your Contract

Plan on feeling a little lost and behind for the first 2-3 weeks of your assignment (especially if you are learning an new charting system). This is okay. Know that it will get easier, and you will get your feet back on the ground. 

Once you have your feet, your assignment will start to feel more normal. You’ll start to feel like part of the team and staff will eventually learn to trust you. Don’t worry if they are a little stand-off-ish at first or question your skills. Sometimes you need a little time at a place to prove yourself. It will come, just be the best nurse you can be for your patients, and everything else will follow.

Extending or moving on to the next contract

Around the middle of your contract you need to get an idea of if you want to extend where you are or move on to another assignment. Let your recruiter know which you would like to do. If you are going to extend, they will need to reach out to their hospital contacts for the extension request. If you do not want to extend, you will need to start looking for your next contract 4-6 weeks before your next preferred start date. 

Know that your pay may change with an extension. Before the covid pay boom, it was common to get a slight pay increase with an extension. I started travel nursing in 2022, so my pay for extensions has almost always decreased or stayed the same as hospitals are fighting to drive rates down. By the way, if you are wanting to compare contract rates, check out this calculator to make the process quick and easy.  

I know that starting your first travel contract can be really nerve-wrecking, but knowing what to expect can help. 

I have a few more resources to help you on your travel nursing journey. To see the full list of resources, click here.