Alternative Pay


When looking for a locum tenens assignment, we frequently only think about hourly pay. From my experiences and talking to other traveling nurse practitioners, there can be other monetary incentives.

Some agencies will provide a sign-on bonus for a very high-need site. The sign on bonus can range from several hundred dollars to several thousands of dollars. For example, I know a nurse practitioner that accepted a locums position in South Dakota with a sign-on bonus of $1000. The reason they provided her with a bonus is because it is challenging recruiting someone for that particular state. Typically, the bonus is provided in divided amounts throughout the length of the assignment, to make sure you don’t just accept the bonus and give your 30 days notice.

Moreover, there are agencies that will provide you with a weekly stipend or a daily per diem to cover extra expenses. For instance, to cover the cost of your license indirectly, they may give you $100 a week as a stipend, which in the long run is more than the cost of the license. Or they may give you a $30 per day per diem, to help cover costs of meals and gas. Keep in mind that per diems are tax-free! Imagine having an extra $600 a month at your disposal.

Finally, I have seen a variety of “holiday pay”. If you elect to work on a holiday workday, you are entitled to time and a half. Government focused locum tenens agencies will pay you for federal holidays even when you do not work because the site is closed. This can be pretty substantial.

Some recruiters may laugh at you when you tell them your expected hourly rate or that you need your DEA cost covered. Do not settle for one “no”. One agencies’ “no”, may be another agencies’ “yes”. If the site really wants you, the agency needs you, and they are willing to do whatever it takes to get you out there!

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