Category: Travel NP Advice

I am by no means an accountant, but based off of experience I wanted to list some benefits of being a locum tenens nurse practitioner for tax purposes.

As I have recommended before, it is usually best to mix up your locum tenens assignments by working with some W2 agencies and some 1099 agencies. The reason is because you can have some of your income deducted for federal taxes, while also having a job that considers you to be self-employed.

In my case, since I am single, do not have children, and make more than the ‘deductions cut off income ‘for W2 employees – I am unable to deduct many expenses as a W2 employee.

On the other side, by being a sole proprietor (1099)/self-employed, I am able to deduct many expenses related to my job.

 

This tax season I was able to deduct the following items from my income:

 

• Meals: as a traveler you are able to deduct $250/week on meals since you are away from home.
• Travel: Travel not reimbursed by agency. For instance if you were given mileage to drive to another state, you can still deduct hotel costs that were paid while making the expedition. Or if you needed to fly back home during an assignment you can deduct the cost of your flight etc.
  I also include costs of luggage fees, shipping/storage costs, rental car fees (if not reimbursed) etc.
• Mileage: If you have to drive in between different clinics or are not compensated for mileage commuting from home to a new assignment.
• Car costs: If you decide to use your own car for the assignment you can deduct car payments, gas, tolls, car insurance, maintenance costs, and tag fees.
• Licenses: Sometimes you may obtain a license on your own and the agency does not technically “reimburse” you – they may give you a stipend or bonus instead. In this case you can deduct the cost of the state license or DEA certificate.
• Home: If you own your house at your state home you can deduct a percentage of the house used for your office.

 

Some other miscellaneous items you can deduct:

• Uniforms and laundry
• Office supplies and books
• Technology (including computer and phone if used for work – can be deducted if you ever chart at home or take after hours call)
• Health insurance
• Malpractice insurance
• Conferences and continuing education
• Professional Membership organizations
• Business credit card fees
• Donations
• IRA/401k contributions
• Student loan interest fees
• House and child deductions

 

Deductions as a locum tenens nurse practitioner quickly accumulate. In the end it brought down my total gross income so my overall tax bracket is lowered and I am able to qualify for deductions I normally wouldn’t be able to.

Doing taxes can be time consuming when you have income from various states and a collection of deductions to claim, but it pays off to be meticulous. Just be sure to keep a record of receipts and expenses!

I have had many questions about creating a locum tenens CV. What should be on there? Should we include nursing experience before work as a nurse practitioner? Do we need to have references?

Here are some tips when creating and organizing your locum tenens CV.

• Include at 3-4 references at the end of your CV. These references should be other nurse practitioner co-workers or supervising physicians. Your agency and job assignment will request to have references they can contact prior to your start date. It makes it easier to have these on your CV for them to refer to.

 

• Do not include work experience as a RN. Most employers will only really care about your work as a nurse practitioner. This will also become tedious when completing applications for hire because you will have to document every work experience that is on your CV (including addresses, contact information, dates etc).

 

• List languages you are fluent in or can communicate with medically. This is often the first thing employers will look at when selecting a locum tenens nurse practitioner. For instance, we know that a Spanish-speaking provider can be a high commodity.

 

• Under job description for previous work experiences, be sure to include special skills and procedures done. Employers like to see that you have done plenty of well woman exams, incision and drainages, suturing and splinting, etc. Just stating that you diagnose and treat is redundant and obvious.

 

• Be sure to list all of your licenses and certifications. These include state licenses, national certifications, and your DEA. When reviewing your CV compared to other traveling nurse practitioners, employers may quickly cast yours aside if it is not clear that you have the necessary state license.

 

• Other categories include: education, professional memberships, community service, and awards. Keep these sections concise with dates. There is no need to provide a detailed explanation on these topics.

 

 

Of course your resume may also vary depending on your situation. For example, you may be looking to work as a locum tenens nurse practitioner in the Emergency Room, but you do not have any nurse practitioner experience working there. In this case, feel free to include your RN work experience if it was in the ER.

 

Please send me any questions you may have regarding your locum tenens CV!

I have had many readers and peers ask me how do they know if locum tenens is right for them? I am a strong believer that locum tenens is for everyone. The most important aspect is just finding the right fit for you.

For instance, if you have been working in a specialty field for the past several years, you may be interested in switching to a different specialty or to primary care. You can definitely do this through locum tenens! Should you accept an assignment in a new field seeing 30 patients per day? Probably not. For sure there are facilities out there that are willing to give you a lighter patient load and training into your new field, because they are in that much need of a provider.

Some people have asked me if locum tenens is only for single nurse practitioners without children. The answer is No. I know mothers that work as travel nurse practitioners. They commute to a city about 1 hour away from home and work 2-3 days per week. This allows them to be flexible if they need to be home with their kids, while also keeping their pockets full. I know other locum tenens providers that have their spouse travel with them on each assignment.

Is locum tenens only for outgoing and social providers? You don’t have to be the friendliest person in the world to be a locum tenens nurse practitioner. But you should have an open mind and be able to quickly adapt to new environments. This doesn’t mean you have to be the loudest or most talkative person. I like to think I am an introvert but have found myself easily adapting to new locum tenens positions and getting along with my new coworkers.

I think most people are afraid to take that first step of starting traveling/locum tenens because it is an unknown. It is definitely worth the risk, and I think after the first two assignments, you will figure out if locum tenens is right for you or not.

I was certainly afraid to begin locum tenens myself. It was something I had always wanted to do, but could not bring myself to take that first giant leap. For the first time in my life I was going to be completely by myself for a long period of time. I thought I would miss my friends and family like crazy. Good thing I have been fortunate that they visit me, I see them in between assignments, and that we keep in touch.

I thought I would get lonely. Luckily, everyone has been friendly both at work and in the community where I have found it easy to meet new people (not to mention I know people in almost every state). I contemplated the notion that maybe I wouldn’t be as competent in a different setting. I have found that healthcare is always a learning and adapting process, that makes you a stronger provider when thrown into new settings

If you are ready for a change, feeling burnt out or unappreciated at your current job, try locum tenens! I always receive questions about the pay rate for traveling nurse practitioners. Even though the pay rate is higher in locum tenens then in full-time positions, there are other unquantifiable benefits of being a locum tenens nurse practitioner. These include: flexibility; not working more than a 40 hour shift for free; unlimited time off; avoiding bureaucracy and the complications that come with it; of course traveling for free; and my favorite – challenging yourself!

One of the best things in locum tenens is having an end date. Instead of getting lost in the motions of everyday work life, you can have something to look forward to (the end of your current assignment and the beginning of a new one). I am so glad I took that first step of starting locum tenens, and I haven’t regretted it since!

 

I previously wrote about finally obtaining my California license and being ecstatic about it. It ended up still being a bit of a hassle because the CA furnishing license took another 4 weeks. On top of that, CA board of nursing required me to take a 3 hour continuing education course on scheduled II controlled substances through the California Association of Nurse Practitioners. Luckily, the agency I was working with paid for the course which cost $250.

The course itself was pretty easy and straightforward. It consisted of reading powerpoints and pdf documents at your own pace. Then I had to take a short test on what I had read. Once I passed the test, I submitted the certification to the CA BON. They had provided me with a fax number to submit a copy of the certification.

I was impressed with my licensing coordinator from the agency because as soon as I faxed it over, she already called to make sure her contacts there input the information. Within 1 hour she had called me to tell me the CA BON changed my furnishing license to allow scheduled II’s to be prescribed, and the DEA has already provided her with my new CA DEA.

Those of us that have obtained or are in the process of obtaining a CA license know how slow the CA BON of works, and how difficult it is to get in contact with someone there. If you plan on working in California, make sure you allow an ample amount of time to obtain your license.

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!

I am constantly being asked questions about pay rates for locum tenens nurse practitioners and the difference between W2 and 1099. I decided to write a post about these different pay options.

Everyone’s situation is different so I cannot say one is better than the other regarding W2 vs 1099. I do know that a lot of people automatically think W2 is better because you don’t have to worry about your taxes at the end of the year, and they provide benefits such as health insurance.

Although W2 agencies take out taxes from your paycheck and provide benefits, they tend to pay way lower than 1099 agencies. I have seen the same job being offered by a W2 agency and a 1099 agency with a $10/hour difference. When being offered health insurance, they also tend to deduct another $3/hour from your pay rate to pay for the health insurance. If you choose to pay for health insurance out-of-pocket, you typically are only spending $1/hour of your pay on private insurance, and you get to deduct it at the end of the year when filing your taxes.

Personally, I prefer 1099 because of the higher pay rate. Also, since you are technically self-employed you can deduct a lot of items that will lower your overall taxes. Based off of experience, I think the mixture of working with some W2 agencies and some 1099 agencies is optimal. The reason for this is because the taxes taken out with the W2 position, and owed with the 1099 position will often balance each other out.

I do not choose an agency based off of pay type, instead I choose an agency based off of the job options they can present to me. I usually narrow it down to a handful of agencies, and choose the best job from there, despite them being W2/1099.

I have had several readers ask me questions about the time frame of searching for an assignment. How soon should we start searching? When should we begin getting worried if we haven’t yet found an assignment?

Sites generally are looking for someone to start as soon as possible. Therefore, I recommend beginning your search process 1-2 months before your ideal start date (if you already have the state license). It may take several weeks for something to become available that meets your criteria. As I have mentioned before, I always recommend working with more than one agency so you can increase your chances of finding the right assignment.

If you are 1 month away from your ideal start date, I recommend expanding your focus. This may mean being open-minded about the location; anywhere in the state vs just one city as an option. Or this may mean being open about the time frame; consider a longer time frame than the typical 3 months. You should also start consulting with other agencies you haven’t connected with yet.

Once you find an assignment you do like, the interview process can range from same-day interviews to 2 weeks. Then the site sometimes needs a second interview, or several days to make a decision (if they have other interviews or need to have a staff meeting about budget etc.).

Always inquire about the credentialing time frame. Each site is different and credentialing may vary from 1 day to 3 months. So if you are 1 month outside of your ideal start date, and the sites credentialing can take up to 2 months, you may want to consider other options.

Definitely, do not wait until the last-minute to find a position unless you are open to anything and anywhere. Sometimes recruiters will tell you that credentialing is quick, so in your mind you think you can start right away. I would definitely factor in about 2 weeks for credentialing for the majority of assignments. I would factor in 1-2 weeks for interviews and 2-4 weeks for the searching process. This is why I recommend searching about 2 months before your ideal start date.

• Do your research: Research which places you would like to practice in. Are you willing to travel? Do you only want to practice locally? Are you interested in working in a state with full practice authority? During your initial conversation with a recruiter, they always want to know where you are interested in working.

• Identify agencies you would like to work with: Do you prefer to be paid via W2 or 1099? Do you need benefits? Do you need travel and lodging? I suggest searching the agencies current job availabilities to see if they are similar to your needs. For example, one agency may have an abundance of opportunities in your state, while another agency may have more job opportunities in your specialty.
• Establish a relationship with your recruiter: You should have at least 5 agencies and recruiters that are actively searching for you. A good recruiter will be following up with you and returning your phone calls. It is common for locum tenens providers to bounce back and forth between agencies, depending on what jobs are available.
• Get organized: Gather all of your licenses, certificates, CEU’s, vaccination records, and other documents you may need to submit. I recommend having them scanned to a computer so you can easily email them to your recruiters and credentialing team.

• Have several references available: Most agencies and sites will ask for at least three references. Optimally one reference will be a supervisor or physician, and the other two references should be co-workers (other nurse practitioners or physician assistants). You should always have more than three references available, in case the agency cannot reach someone, to keep the process moving along.