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$4.5TAnnual US Healthcare Spend (18% of GDP)
6,100+Registered Hospitals Across the US
4M+Registered Nurses � Largest Workforce
$20B+US Travel Nursing Market Size
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How to Use This Document
First read, revision guide, and quick reference
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?? Before Your Trainer Session

Read each module section top to bottom. Focus on the What & Why before you worry about memorising. The goal is familiarity � so your trainer's explanations click faster.

?? During Revision

Use the accordion sections to test yourself � can you recall the detail before expanding? Use the Quiz tab to simulate real scenarios before your first desk call.

? On the Job

Bookmark this file. Use Ctrl+F to search any term instantly. The pay table, certification map, and compliance checklist are all here for quick reference mid-call.

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What You Will Know After All 3 Modules
Your learning outcomes
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Module 1 � The System

  • ? Distinguish hospital types (CAH, LTAC, SNF, Specialty)
  • ? Explain hospital ownership models
  • ? Name key clinical departments & what each recruits for
  • ? Understand care tiers (Primary ? Quaternary)

Module 2 � The People

  • ? Navigate the CNA ? CRNA career ladder
  • ? Distinguish licence vs certification
  • ? Explain travel nurse pay packages
  • ? Recognise allied health roles and their certs

Module 3 � Operations

  • ? Explain HMO, PPO, Medicare, Medicaid
  • ? Navigate the MSP ? VMS ? Agency chain
  • ? Verify a licence on Nursys in under 2 minutes
  • ? Screen for compliance: work auth, drug test, health docs
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Why Recruiters Must Know Healthcare
Domain knowledge is your competitive edge on every call
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Healthcare recruiting is not like IT recruiting. You cannot fake your way through a screening call with a nurse. Candidates will use terms like ICU, Magnet hospital, compact licence, CCRN � and they will know immediately whether you understand their world.

Your domain knowledge creates four practical advantages:

??? You Speak the Language

Knowing terms like "ICU," "Magnet hospital," and "compact licence" builds instant credibility on your first call.

?? Settings ? Same Needs

A Level I Trauma Centre hires very differently from a rural Critical Access Hospital. Setting dictates the right candidate profile.

?? Qualifications Are Gatekeepers

One missing credential can kill a placement. You need to know what to verify � and when to walk away from a submission.

?? Pay Varies Widely

A nurse at a teaching hospital earns differently from a travel nurse at a rural facility. Setting correct expectations prevents falloffs.

Recruiter Insight
Healthcare staffing is a $20B+ industry in the US. The demand for nurses and allied health professionals far outpaces supply � which is exactly why staffing agencies exist. The nursing shortage is structural (aging baby boomers needing care + retiring nurses). This is a long-term opportunity, not a cycle.
$4.5THealthcare spend per year
6,100+Registered hospitals
18M+Healthcare workers
4M+Registered Nurses
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The US Care Tier System
Primary ? Secondary ? Tertiary ? Quaternary � how complexity escalates
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Think of US healthcare as a pyramid. Every patient enters at the bottom and gets escalated upward based on how complex their condition is. Each tier employs different nurses, requires different credentials, and represents different placement opportunities.

L4 Quaternary Care Highly experimental/ultra-specialised � organ transplants, rare cancer protocols, limb reattachment. Mayo Clinic, Johns Hopkins, Cleveland Clinic, NIH affiliates. Mostly permanent staff, not agency placed. Elite research centres
L3 Tertiary Care Large academic medical centres & Level I/II Trauma Centres. Cardiac surgery, neurosurgery, transplant, high-risk OB. Nurses carry heavier certs (CCRN, CNOR). Higher bill rates. Premium placements
L2 Secondary Care General and community hospitals. Surgeries, emergency admissions, specialist consultations, inpatient stays. This is where the bulk of your nursing placements live � Med/Surg, ER, OB, tele units. Most placements here
L1 Primary Care Front door to healthcare � annual checkups, chronic disease mgmt, referrals. FMDs, FNPs, Internists, Pediatricians. 80%+ of patient interactions happen here. Hospitals don't employ them directly � private practices & FQHCs. Rare agency placements
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Types of Healthcare Facilities
Not all hospitals are the same � each type hires differently
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Critical Distinction
A SNF is NOT a nursing home. An LTAC is NOT a SNF. An urgent care is NOT an ER. These are four entirely different levels of care with different staffing needs, certifications required, and pay scales. Never confuse them in client calls.
?? General Acute Care Hospital
Most placements

Most common type. Treats wide range of conditions including emergencies, surgeries, maternity. Open 24/7. Think of a typical community hospital. This is where the majority of your travel nurse placements will land.

Med/Surg RNER RNICU RNL&D RN
?? Teaching / Academic Medical Centre
Premium roles

Affiliated with a university. Has residents & fellows. High acuity cases, cutting-edge treatments. High volume hiring. BSN typically required. Higher certification standards � CCRN, CNOR common requirements.

BSN RequiredHigh certs
?? Critical Access Hospital (CAH)
Agency-friendly

Rural hospitals with =25 beds, certified by CMS. Often struggle to recruit locally and rely heavily on staffing agencies. This is your bread and butter � CAHs cannot attract enough nurses locally, so they HAVE to use agencies like yours.

Meditech EMRRural
?? Specialty Hospital
Niche roles

Focus on one area: Rehab, Psychiatric, Cancer (Oncology), Cardiac, Ortho, Children's. Very specific credential needs. A psychiatric facility will NOT take a general nurse without psych experience � credentials are non-negotiable here.

??? Long-Term Acute Care (LTAC)
LPN heavy

For patients needing extended hospital-level care (avg 25+ days). Skilled nursing needed. Growing market post-COVID as vent-dependent patients increased. LPN/LVNs placed heavily here alongside RNs.

?? Ambulatory / Outpatient Centre
Flexible shifts

Day surgeries, clinics, imaging centres. No overnight stays. Often hire part-time and contract workers. Ask about Athenahealth/NextGen EMR for outpatient. NP/FNP placements common in clinic settings.


Hospital Ownership Types

Non-Profit / Not-for-Profit 58%

Majority of US hospitals. Reinvest surplus into care. Often faith-based (Ascension, Providence). Competitive pay, stable environment. Large agency users for travel nurses.

For-Profit / Investor-Owned 21%

HCA Healthcare, Tenet Health, LifePoint. High efficiency & cost management focus. Largest systems = most standardised hiring. Major staffing agency clients � HCA alone has 185+ hospitals.

Government / Public 21%

Federal (VA Hospitals), State (psychiatric, county, correctional). Hiring is bureaucratic & slower. Government pay scales, union presence. Less agency use, more direct hire. Flag this for freshers � don't waste time pursuing VA placements without the right contacts.

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Key Hospital Departments � Every Recruiter Must Know These
Units you will hear about on every call with a healthcare client
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Critical Nuances
Telemetry ? ICU. Antepartum ? L&D ? Postpartum. A tele nurse cannot fill an ICU role. A pure antepartum nurse cannot walk into an active L&D room. A psych nurse does not do wound care, IV lines, or post-surgical monitoring. Always ask about cross-training before assuming interchangeability.
DepartmentWhat Happens HerePrimary Nurse LevelKey CertificationsRecruiter Watch-Out
ICU / Critical CareIntensive monitoring of life-threatening conditions. Multiple ICU types: MICU (medical), SICU (surgical), CVICU (cardiac), NICU (neonatal), PICU (pediatric), NSICU (neuro)RN-BSN preferredCCRN Often Required, ACLS, BLSNever submit non-ICU RN for ICU role without explicit client approval
ER / EDEmergency department � handles everything from minor injuries to trauma codes. Level I�IV trauma designations matterRN (ADN acceptable, BSN preferred)CEN, ACLS, TNCC (Level I/II trauma)Ask: "How many years of ER experience?" � not just "Do you have ER experience?"
Med/Surg FloorMedical-Surgical � the most common hospital floor. Post-surgical patients, chronic disease management, general admissionsRN (ADN/BSN both common)CMSRN Optional, BLSHighest volume placement; good starting point for travel nurses with 1�2 yrs exp
Telemetry / Step-DownCardiac monitoring for stable but at-risk patients. Between Med/Surg and ICU in acuity levelRNACLS, BLS; cardiac arrhythmia training expectedTele ? ICU. Tele RN cannot substitute for ICU RN � different skill set entirely
L&D (Labour & Delivery)Active labour management, vaginal and C-section deliveries, fetal monitoringRN-BSN preferredNRP Required, ACLS, BLS; AWHONN Fetal MonitoringAsk: "Are you cross-trained in antepartum and postpartum, or L&D only?" Cross-training is key
NICU (Neonatal ICU)Premature and critically ill newborns. Levels II, III, IV � higher level = sicker babiesRN with NICU specialtyNRP Required, PALS, RNC-NIC Preferred at L3/L4Level III/IV NICU requires RNC-NIC. Do not submit without confirming NICU level experience
OR (Operating Room)Surgical suite � circulating nurse manages the room; scrub tech handles instruments. Separate roles � never confuseRN (circulating); CST (scrub tech)CNOR Often Required, BLS, ACLSScrub tech ? Circulating RN. Always ask: "Are you a scrub tech or a circulating nurse?"
OncologyCancer patients � chemotherapy administration, infusion therapy, symptom managementRNOCN Specialty cert, ONS Chemo Cert Required to admin chemoONS chemo cert is a separate, hard requirement to administer chemotherapy � not the same as OCN
Psychiatric UnitMental health � crisis intervention, medication management, therapeutic communication, de-escalation. Completely different skill set from physical medicineRN with psych experienceCPI/PMHCNS, PMHN-BC; BLSNever submit a Med/Surg nurse for psych without explicit client approval. Psych nurses do NOT do wound care or IV lines
Correctional HealthHealthcare inside prisons/jails. Standard clinical skills + security environment. Corizon, NaphCare, Centurion manage these contracts nationallyRN or LPNStandard nursing licence; psych experience helpfulNon-traditional setting but growing market. Agency-friendly. Screen for comfort in security environments
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The Nursing Career Ladder � CNA to CRNA
8 levels, each requiring more education and carrying more responsibility
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Most Critical Facts to Internalize
(1) A CNA is NOT a nurse � they are an assistant and can NEVER administer medication. (2) LPN and LVN are the same role � California and Texas call it LVN. (3) ADN and BSN hold the EXACT SAME RN licence � the difference is education level and Magnet acceptance. (4) NP, CNM, and CRNA are all APRNs. (5) CRNA earns more than most primary care physicians.
L7 CRNA Certified Registered Nurse Anesthetist � Administers all types of anaesthesia (general, regional, monitored sedation). Requires DNP + 1+ yr ICU experience + 3-yr CRNA programme. NBCRNA certification. Independent practice in 40+ states. Highest-paid nursing role in the US. $180K�$230K staff
$250�$350/hr travel
L6 NP / CNM Nurse Practitioner � Diagnoses, treats, prescribes. Specialty-specific (FNP, PMHNP, AGACNP). Full practice authority in 26+ states. DEA number required for controlled substances. ANCC or AANP certification. CNM � Certified Nurse Midwife. Manages pregnancy, labour, delivery, postpartum and gynaecology. AMCB certification. NP: $110K�$180K
CNM: $105K�$135K
L5 MSN / CNS Master of Science in Nursing � Advanced clinical expert, educator or systems leader. NOT a prescriber (unless also NP). CNS (Clinical Nurse Specialist) focuses on a specific patient population or disease process. $85K�$120K
L4 RN-BSN Registered Nurse � Bachelor of Science � Same NCLEX-RN licence as ADN. Required at Magnet hospitals. Higher pay, more career opportunities. Many hospitals now require BSN within 3�5 yrs of hire. The becoming baseline standard for new grads. $38�$68/hr
Higher than ADN
L3 RN-ADN Registered Nurse � Associate Degree � Full nursing scope. NCLEX-RN required (same exam as BSN). Entry point to hospital nursing. 2-year degree from community college. SAME LICENCE as BSN � just not accepted at Magnet hospitals. Often accepts BSN bridge enrolment in lieu. $32�$55/hr
L2 LPN / LVN Licensed Practical/Vocational Nurse � Administers medications, wound care, basic assessments. Works under RN or MD direction. 12�18 month diploma programme. NCLEX-PN exam. LVN = California and Texas name for same role. Common in SNF, LTAC, home health, clinics. $22�$42/hr
L1 CNA Certified Nursing Assistant � Assists with ADLs: bathing, feeding, mobility, vitals. CANNOT give medications � ever. Not a nurse. 4�12 week state-approved programme. Listed on state CNA registry (not a nursing licence). Settings: SNF, assisted living, home health, memory care. $15�$28/hr

NP Specialties � The Full Map

Every NP has a specialty certification. The specialty defines who they can see and where they can work. When you get an NP job order, the first question to the candidate is always: "What is your NP certification and what body issued it?"

FNP � Family NP Most Common

All ages from birth to elderly. Primary care, urgent care, family medicine clinics.

Cert: FNP-BC (ANCC) or FNP-C (AANP)

PMHNP � Psych/Mental Health NP Highest Demand

Mental health diagnoses and prescribing � depression, bipolar, schizophrenia, anxiety. US is in a mental health crisis. PMHNPs command $150K�$180K.

Cert: PMHNP-BC (ANCC)

AGACNP � Adult-Gero Acute Care NP

Adults in hospital/acute care � ICU, stepdown, hospitalist teams. Growing role. An FNP CANNOT replace a PMHNP or AGACNP � these are different certifications.

PNP � Paediatric NP

Children from birth to 21. PNP-PC (primary care) or PNP-AC (acute/hospital). Different certifications � always ask which one.

NNP � Neonatal NP

Premature and critically ill newborns in NICU. Highly specialised. Strong NICU background required. NNP-BC (ANCC via NCC).

ENP � Emergency NP

Emergency department practice. Relatively new specialty. Growing demand in high-volume EDs. ENP-C (ANCC).

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Licences vs Certifications � The Critical Distinction
Getting this wrong on a screening call destroys credibility instantly
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?? LICENCE � MANDATORY. Cannot work without it.
  • Issued by a government body (State Board of Nursing)
  • Required by law before practising nursing
  • Examples: NCLEX-RN, NCLEX-PN, APRN licence, CNA registry
  • Renewed typically every 2 years
  • Verified on the state BON website � public record
  • Submitting without active licence = compliance violation
  • Expired/lapsed licence = candidate cannot work
?? CERTIFICATION � CREDENTIAL. Proves specialty expertise.
  • Issued by a professional organisation or credentialing body
  • Demonstrates mastery in a clinical specialty
  • Examples: CCRN, CEN, BLS, ACLS, PALS, OCN, CNOR
  • NOT issued by the government � voluntary (some become employer-mandatory)
  • BLS is technically a certification but universally required
  • Specialty certs expire � always ask expiry dates
  • A cert without an active licence is meaningless � licence comes first
Your Verification Sequence on EVERY Screening Call
Step 1
Verify active licence on state BON
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Step 2
Ask BLS expiry date
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Step 3
Ask role-specific certs
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Step 4
Get copies before submission

Life Support Certifications � Non-Negotiables

CertFull NameWho Needs ItValidIssuing BodyRecruiter Rule
BLSBasic Life SupportALL clinical roles � no exception2 yearsAHA (preferred), ARCAsk expiry DATE, not "do you have it?" Expired = do NOT submit.
ACLSAdvanced Cardiac Life SupportICU, ER, OR, tele, L&D, PACU, procedure areas2 yearsAHARequired for all critical care and step-down placements
PALSPediatric Advanced Life SupportNICU, PICU, L&D, peds ER, nursery, peds floors2 yearsAHAAny role involving patients under 18 needs this
NRPNeonatal Resuscitation ProgrammeL&D, NICU, nursery, neonatal transport2 yearsAAP + AHAL&D and NICU nurses without NRP cannot work those units
TNCCTrauma Nursing Core CourseLevel I & II trauma ER nurses4 yearsENANot universal � check trauma designation level of specific ER

Specialty Nursing Certifications � Expert-Level Signals

These are earned after clinical experience � they signal mastery, not just training. Ask for expiry dates on all of these.

CCRN � Critical Care RN

ICU specialty. 1,750 hrs direct critical care in last 2 years + RN licence. AACN. Valid 3 years. Highly valued � signals ICU mastery.

CEN � Certified Emergency Nurse

ER specialty. No minimum exp to sit exam. BCEN. Valid 4 years. Signals ER commitment and advanced knowledge.

CNOR � Certified Perioperative Nurse

OR specialty. 2 years periop experience (2,400 hrs). CCI. Valid 5 years. Often required for OR placements at academic centres.

OCN � Oncology Certified Nurse

12 mo RN exp + 1,000 hrs oncology. ONCC. ONS Chemo Cert is a SEPARATE requirement to administer chemo � not the same as OCN. Both may be needed.

PMHN-BC � Psych-Mental Health BC

Psych specialty. 2 years psych nursing + 2,000 hrs. ANCC. Valid 5 years.

RNC-NIC � NICU RN Certified

2 years NICU experience. NCC. Valid 3 years. Level III/IV NICUs often prefer or require this.


NCLEX � The Gateway Licensing Exam

Every nurse must pass NCLEX before they can legally work. There is no workaround. NCLEX-RN is for all Registered Nurses (ADN and BSN). NCLEX-PN is for all LPN/LVNs � a separate, different exam.

How NCLEX Works ?
Computer Adaptive Test (CAT) � adjusts question difficulty as you answer. NCLEX-RN: minimum 75 questions, maximum 145. NCLEX-PN: minimum 85, maximum 205. Pass/fail only � no score or percentage given. Must finish within 5 hours. Administered by Pearson VUE. Results in 48 hours via "Quick Results" ($8 fee).
Recruiter's NCLEX Checklist ?
Ask: "Have you passed your boards?" ("boards" = informal for NCLEX). Never assume a new grad has passed � always verify on state BON. A new grad who has not yet passed NCLEX CANNOT work as an RN in any clinical setting. CGFNS certificate (for international nurses) is NOT the same as passing NCLEX.

Compact Licence (NLC) � Your Daily Tool

??? Compact Licence (NLC)

Valid in ALL 41 NLC member states � ONE licence. Nurse must live (primary residence) in a compact state. Can work in any compact state immediately � no waiting, no extra cost. Game-changer for travel nursing: instant deployment capability.

TXFLTNAZNCGAOHVAPA+32 more
?? Single-State Licence

Valid in ONE state only. Processing for a new state: 4�12 weeks + $100�$300 fee. California: 8�14 weeks (slowest). New York: 6�10 weeks. CA and NY are NOT in the NLC compact � nurses living there cannot hold a compact licence.

Ask on EVERY first call: "Is your licence a compact licence?"
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Travel Nursing � The $20B Market
Pay package structure, the 13-week contract lifecycle, and what makes a great travel candidate
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$20B+US travel nursing market
500K+Active travel nurses
13 wksStandard contract length
$200KTop annual travel nurse earnings

Why Nurses Choose to Travel

  • Significantly higher pay than staff positions
  • Tax-free housing and meal stipends boost take-home
  • Flexibility to choose assignments, locations, and timing
  • Variety of clinical experience across different hospital systems
  • Often used by nurses saving for a house or paying off student loans
  • Adventure, geography, and personal growth

Travel Nurse Pay Package � How It Works

Travel nursing pay is NOT just an hourly rate. It is a package with multiple components. The IRS allows tax-free housing and meal stipends for workers who: (1) maintain a permanent tax home at their primary residence, and (2) are working away from that home on a temporary basis.

Taxable base pay$22�$30/hrCounts for benefits, OT, tax
Housing stipend$900�$1,800/wkTax-free. Covers accommodation
Meal & incidentals$200�$450/wkTax-free per diem
Travel reimbursement$500 one-timeDrive or flight to assignment
Completion bonus$500�$2,000Some contracts offer this
Math reality check: A travel ICU nurse at $3,000/wk total: $1,500 taxable + $1,500 tax-free. vs a staff ICU nurse at $45/hr � 36 hrs = $1,620/wk � all taxable. The travel nurse earns nearly double take-home.

Weekly Gross Package by Specialty (2024�25 Reference)

$1,800�$2,400Med/Surg RN / week
$2,000�$2,800Tele RN / week
$2,400�$3,500ICU / Critical Care RN / week
$2,600�$3,800OR / L&D / NICU RN / week

The 13-Week Contract Lifecycle � Your Recruiter Workflow

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Source the Candidate
Job boards: Vivian Health (largest travel nurse board), Highway Hypodermics, Indeed, LinkedIn. Facebook Groups (Travel Nursing Central � 100K+ members). Referrals from placed nurses (convert 3� faster than cold leads). Passive candidates via Instagram DM: "Have you ever considered travel nursing?"
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Screen & Qualify
Full screening checklist: licence status + compact vs single-state, BLS/ACLS expiry, specialty + years of experience, availability date, pay expectations, work authorisation, EMR experience (Epic/Cerner/Meditech).
3
Submit the Profile
Send to client: skills checklist, references, verified licence copy, certifications. Client typically responds within 24�72 hours. Speed of submission is a key differentiator � don't delay.
4
Client Interview
Most hospitals do a 15�20 min phone or video interview. Brief your candidate on the unit type, patient population, manager name, and what to emphasise from their experience.
5
Offer & Contract
Client extends offer. Agency builds the compensation package (base rate + stipends). Nurse reviews and signs agency contract. Counter-offers are common � handle professionally and know your margin limits.
6
Compliance & Onboarding (1�3 weeks)
Agency compliance team verifies: all credentials, drug screen, background check, health records (TB, immunisations, COVID, titres). Start this immediately at offer stage � never wait until contract start. Health clearance takes 1�3 weeks.
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On Assignment (Weeks 1�13)
Check in at assignment start, week 4, and week 8. Identify issues early. Build relationship. A happy nurse is your best referral source. "Ghosting" after placement is the #1 reason nurses don't extend or refer others.
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Extension or Redeploy � Week 10: Most Valuable Call
At week 10: Ask the client "Would you like to extend?" AND ask the nurse "Where would you like to go next?" Extension = revenue with zero sourcing cost. Redeploy = second placement commission. Do NOT wait for them to bring it up.

What Makes a Great Travel Nurse Candidate

? Compact licence holder

Instant deployment across 41 states � no licence processing delays

? CCRN, CEN, or specialty cert

Commands higher bill rate from client; faster acceptances

? Epic or Cerner experience

Most hospitals use these systems � EMR match = faster onboarding

? Flexible on shift

Days, nights, rotating � flexibility opens more options and clients

? 1�2+ years recent bedside

Most agencies require minimum 1�2 years in specialty. Some clients require 2+.

? Willing to extend

Saves sourcing costs on next contract � identify this willingness early

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Allied Health & Administrative Roles
The non-nursing clinical and operational workforce � roles you'll see on job orders
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Key Distinction
Allied health roles (phlebotomist, rad tech, surgical tech, RT) are clinical � they touch patients and require licences or certifications. Administrative roles (prior auth, billing, HEDIS, HIM) are non-clinical � they work with data, records, and systems. Build separate qualification checklists for each category.
?? Clinical Lab � Phlebotomist, MLT, MLS ?
Phlebotomist

What they do: Draw blood for laboratory testing. Hospitals, labs, blood banks, clinics, home health.
Education: 2�6 week certificate. Some employers train on the job.
Cert: CPT via NHA, ASCP, or AMT.
Pay: $16�$22/hr staff.
Ask: "How many successful venipunctures per day in your current role?"

MLT � Medical Lab Technician

What they do: Routine lab tests under MLS supervision � haematology, urinalysis, basic chemistry, microbiology cultures.
Education: 2-year AAS. NAACLS-accredited.
Cert: MLT(ASCP) via ASCP Board of Certification. NHA also offers MLT exam.
Pay: $22�$32/hr staff.

MLS / CLS � Medical Lab Scientist

What they do: Full-scope lab testing including blood banking (transfusion medicine), microbiology, haematology, immunology. Blood bank (SBB) certified are the rarest and highest-value lab placement.
Education: 4-year Bachelor's degree.
Cert: MLS(ASCP) or CLS(ASCP). SBB(ASCP) for blood bank.
Pay: $30�$55/hr. Critical shortage.

?? Radiology & Imaging � RT(R), MRI, CT, Sonography ?

ARRT (American Registry of Radiologic Technologists) is the gold standard credentialing body for ALL imaging roles. The base credential is RT(R) (radiographer). From there, technologists add specialty post-primary credentials: MR, CT, mammography, etc. Think of RT(R) as the "BSN" of imaging � you must have it before specialising.

RT(R) � Radiologic Technologist

X-ray, fluoroscopy, general imaging. 2-year AAS (JRCERT-accredited). ARRT RT(R) cert. Most states require state radiography licence in addition. $28�$42/hr staff; $35�$55/hr travel.

RT(MR) � MRI Tech

Must first be ARRT-certified RT(R). ARRT MR specialty: RT(MR)(ARRT). Some states require separate MRI licence. $35�$55/hr staff; $45�$65/hr travel. Strong demand.

RT(CT) � CT Tech

Must first be ARRT-certified RT(R). ARRT CT specialty: RT(CT)(ARRT). High ER demand � CT scanners run 24/7 in acute settings. $32�$50/hr staff; $40�$58/hr travel.

RDMS � Sonographer

Ultrasound � OB, cardiac echo, vascular. From ARDMS (separate from ARRT pathway � a sonographer doesn't necessarily have RT(R)). Specialties: AB, OB/GYN, RCS (cardiac echo), RVT (vascular). Cardiac echo techs command highest rates. $35�$55/hr.

RT(M) � Mammography Tech

Must be RT(R) + ARRT mammography specialty. Required by federal law (MQSA). Women's imaging centres, mobile mammography units. $30�$45/hr.

RT(N) � Nuclear Medicine Tech

Administers radioactive tracers for imaging. ARRT RT(N) or NMTCB. Specialised � fewer facilities. $38�$55/hr.

?? Surgical Tech (CST) & Respiratory Therapist (RT/RRT) ?

Surgical Technologist (CST / Scrub Tech)

Prepares the OR, sets up the sterile field, passes instruments to surgeons. Works INSIDE the sterile field. Different from the OR circulating nurse � always ask which one the candidate is. 1�2 year certificate/degree. CST via NBSTSA. Cardiac, neuro, and ortho scrub techs command premium rates.

Pay: $22�$38/hr staff | $35�$55/hr travel

Respiratory Therapist (CRT / RRT)

Manages patients with breathing difficulties � mechanical ventilator management, oxygen therapy, ABG collection and analysis. ICU, ER, NICU, PICU, LTAC, pulmonary rehab. 2-year AAS (COARC-accredited). NBRC issues CRT (entry) and RRT (advanced). ECMO-trained RTs and neonatal RTs are the most scarce � elevate their priority immediately.

Pay: $28�$48/hr staff | $38�$60/hr travel. Critical shortage nationally � some facilities wait 6+ months.

?? Healthcare Operations & Administrative Roles (Remote-Friendly) ?
?? HEDIS Nurse / Quality Abstractor � Seasonal Goldmine

HEDIS = Healthcare Effectiveness Data and Information Set. Health plans use it to measure care quality (90+ clinical measures for NCQA). HEDIS nurses review medical records to extract data � did the diabetic patient get an eye exam? Did children receive immunisations?

Active RN licence required. Fully remote. Seasonal peak: January through May each year.
Pay: $35�$55/hr. Build pipeline in Nov�Dec. Place Jan�May. 8�16 week contracts.

Prior Authorization Specialist

Reviews and submits prior auth requests to insurance companies before procedures, meds, or referrals. Clinical background (RN/LPN/MA) increasingly preferred. Cert: CPMA via AAPC.
Pay: $18�$30/hr. Largely remote. Year-round demand.

Occupational / Employee Health Nurse

Manages health and safety of employees. Pre-employment physicals, workers' comp, OSHA compliance. RN licence required. Cert: COHN or COHN-S via ABOHN.
Pay: $35�$55/hr.

Medical Coder / Billing Specialist

Translates clinical documentation into ICD-10 diagnosis codes and CPT procedure codes. Cert: CPC (AAPC) or CCS (AHIMA). Highly remote-friendly.
Pay: $18�$32/hr.

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Managed Care & Insurance � Why Recruiters Must Understand This
Staffing levels are driven by payer contracts
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A hospital's payer mix � the proportion of patients on each plan type � directly affects how much revenue it collects per patient, and therefore how much budget it has for agency staffing. This affects your bill rate negotiations.

HMO � Health Maintenance Organisation

Patients must use in-network providers only. Requires a Primary Care Physician (PCP) as gatekeeper. PCP must issue referrals to see specialists. Lowest premiums � strictest network control.

Example: Kaiser Permanente (fully integrated HMO � is both insurer AND provider)

Recruiter: HMO hospitals have tighter budgets and more regulatory oversight.
PPO � Preferred Provider Organisation

Most flexible � in-network or out-of-network coverage. No referral needed to see a specialist. Higher premiums than HMO. Most common commercial insurance type in the US.

Examples: Blue Cross Blue Shield PPO, Aetna PPO, Cigna PPO

Recruiter: PPO-heavy hospitals typically have stronger finances and more agency spend.
Medicare � Federal. Adults 65+ and disabled.

Part A: Hospital insurance � inpatient stays, skilled nursing, hospice.
Part B: Outpatient/physician services � monthly premium.
Part C: Medicare Advantage � private managed care approved by CMS (fastest growing).
Part D: Prescription drug coverage.
Hospitals must meet CMS Conditions of Participation (CoPs) to receive Medicare payment.

Medicaid � Federal + State. For low-income populations.

Joint federal/state programme. Eligibility varies by state. Largest single payer for SNF care. Critical for LPN/CNA placements. Medicaid pays hospitals LESS than Medicare or commercial � high Medicaid payer mix = tighter margins. Safety-net hospitals (public, low-income) have high Medicaid mix.

Practical Insight
When a hospital tells you their bill rate is lower than market, it is almost always because they are a safety-net hospital with a high Medicaid payer mix. They earn less per patient so they have less to spend on agency staff. This is not a reason to avoid them � it is context for setting expectations.
2
The MSP Model � Your Position in the Chain
Most large health systems don't manage staffing agencies directly. An MSP sits in between.
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?? Hospital / Health System
Has open nursing positions. Sends job order to MSP.
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MSP
Manages all vendor agencies. Distributes via VMS. Takes management fee from hospital.
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VMS Platform
Technology layer: Shiftwise, Stafferlink, Beeline, Medefis (AMN).
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?? Your Agency
Submits candidates through VMS. Competes on speed & quality.

Bill Rate vs Pay Rate vs Margin

Bill RateWhat the hospital/MSP pays your agency per hour of work
Pay RateWhat your agency pays the nurse per hour (total comp package)
MarginBill rate minus (pay rate + overhead + benefits + compliance costs)
Typical Margin20�35% of bill rate on travel nursing
Real example: HCA ICU job via Trio MSP at $85/hr bill rate. Agency pays nurse $55/hr total comp. Margin: $30/hr � 36 hrs/wk � 13 wks = $14,040 per placement.

Key Healthcare Staffing Clients

Trio Workforce & HWL MSP ?
Healthcare workforce MSPs. Manage staffing programmes for multiple hospital systems. Travel nursing and allied health focus. Confirm the end client hospital name before each requisition � bill rates vary significantly by end client.
Aya Healthcare MSP + Agency ?
One of the largest travel nurse agencies AND MSPs in the US. Dual role: when Aya is the MSP, you are a vendor submitting through their platform. When Aya is a direct agency, different relationship � you may be competing with them. Know which mode you're in per client.
AMN Healthcare MSP + Agency ?
Largest healthcare staffing company in the US. Runs an MSP (clients include Kaiser Permanente). Subsidiary brands: Nursefinders, O'Grady Peyton, Staff Care. Uses Medefis (proprietary VMS) � get trained on it early if you work AMN-managed accounts.
Medical Solutions Direct Agency ?
Travel nursing and allied health staffing agency. NOT an MSP � works directly with hospital clients. No MSP layer � faster decision-making but fewer orders. Speed and quality of submission are key differentiators.
3
EMR & Charting Software � Why It's a Screening Priority
An EMR is how nurses document everything. The wrong match creates real problems.
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~35%US hospitals use Epic
~25%US hospitals use Cerner
$29BAnnual EMR market size
2 weeksTypical EMR onboarding time
SystemMarket ShareTypical SettingWhat to Ask CandidateRecruiter Tip
Epic ~35% Large academic & hospital systems: Mayo, Cleveland Clinic, Kaiser, NYU, Johns Hopkins "Have you used Epic? Which modules � Hyperspace, Stork (OB), Beacon (oncology)?" "Are you a superuser?" Epic superuser = premium candidate. Note it prominently in submission profiles.
Cerner / Oracle Health ~25% Large community hospitals, VA/DOD facilities. Rebranded Oracle Health 2022. "Have you used Cerner or Oracle Health?" (both names used). "Cerner Millennium or older version?" "FirstNet for ER?" Dominant in VA hospitals. If client is VA/government, Cerner experience is first thing to verify.
Meditech Tier 2 Community & rural hospitals, Critical Access Hospitals "Have you used Meditech? Which version � Expanse, 6.1, or Magic?" Version matters hugely � Magic and Expanse are almost different skills. CAH placements frequently require Meditech. Expanse experience is most transferable to newer installations.
PointClickCare Dominant in SNF Skilled nursing facilities (SNF) and long-term post-acute care (LTPAC) "Have you used PointClickCare or PCC?" Every LPN or CNA placed in a SNF will be asked about PCC. Make it a reflex question for any long-term care placement.
Athenahealth Outpatient Outpatient clinics, small practices, urgent care, specialty clinics "Have you worked with Athenahealth?" Ask for FNP/NP or clinic RN placements in outpatient settings. Cloud-based � increasingly common in physician practice and clinic settings where NPs are placed.
MatrixCare Home health dominant Home health agencies, hospice, LTPAC "Have you used MatrixCare in your home health or hospice role?" Key system for home health and hospice nurse placements. Ask for any home health placement.
Setting ? System Shortcut
Hospital = ask Epic/Cerner/Meditech � SNF = ask PointClickCare � Home health = ask MatrixCare � Outpatient clinic = ask Athenahealth or NextGen � Physician practice = ask Allscripts/Veradigm
4
Compliance & Pre-Screening Requirements
The non-negotiables. Getting these wrong is not an option.
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?? Work Authorisation � W2 Only

Healthcare staffing is almost exclusively W2 (not 1099 or Corp-to-Corp). Ask on call #1 � never at offer stage.

  • ? Accepted: US Citizen (USC), Green Card/Permanent Resident (GC)
  • ? TN Visa: Some clients (Canadians under USMCA) � confirm per job order
  • ? NOT Accepted: H-1B, J-1, OPT, CPT, EAD, H-4 EAD
?? Background Check
  • Standard criminal check � 7 or 10-year look-back
  • Some clients: national background check
  • Felony convictions: near-universal disqualifiers
  • Abuse-related misdemeanours: automatic disqualifiers in healthcare
  • Inform candidates upfront � surprises kill placements
?? Drug Testing � Mandatory for All
  • Standard: 9-panel or 10-panel drug test
  • Some clients: 12-panel or expanded opioid panel
  • Marijuana: most healthcare facilities maintain drug-free policy regardless of state law
  • Synthetic opioids (fentanyl, tramadol): require expanded panel
?? Health Clearance Requirements (Start Compliance at Offer Stage � Takes 1�3 Weeks)
TB Test
2-step Mantoux or QuantiFERON blood test. Negative result required. Valid 12 months.
Immunisation Records
MMR (Measles, Mumps, Rubella) � Varicella � Hepatitis B series � Annual flu shot � COVID-19 (policy varies post-2023)
Titres
Many facilities require titre testing to confirm immunity � especially Hep B, MMR, Varicella. Religious exemption documentation handled separately.
Physical Exam
Basic health clearance required by some facilities. Start compliance at offer stage � never at contract start.

Nursys Licence Verification � Step by Step

Non-Negotiable
Submitting a nurse with an unverified or lapsed licence is a compliance violation and a legal liability. This takes 2 minutes. Do it every time, before every submission.
1
Collect from Candidate (First Screening Call)
Full legal name (as it appears on licence) + licence number + issuing state.
2
Go to Nursys.com
The national nurse licensure database managed by NCSBN. Covers most states. Fastest multi-state lookup tool available.
3
Search by Name or Licence Number
Enter the candidate's name or licence number. Results show all licences on file nationally across all states.
4
Verify STATUS = ACTIVE
Status must say ACTIVE. If it says Pending, Inactive, Expired, or Lapsed � do NOT submit. Period.
5
Check Expiry Date
Licence must not expire during the assignment. If expiring within 3 months, flag to the client immediately.
6
Check for Disciplinary Actions ("Dings")
Any pending or past disciplinary actions, restrictions, or conditions will appear. Types: Written reprimand, Probation, Suspension, Restriction, Surrender. NOT all dings are disqualifying � but ALL must be disclosed. Candidate must provide signed written incident report. Non-disclosure is ALWAYS worse than disclosure.
7
Screenshot and File in ATS
Download PDF copy of the verified licence page. Store in the candidate's compliance file in your ATS (Ceipal). Note the verification date.

Resume Standards � The 30-Day Gap Rule

30-Day Rule
Any gap in employment of more than 30 days must be explained and included on the resume. Required for each gap: dates (month/year) + reason + location during the gap. MSP compliance teams will reject unexplained gaps.
Overlapping Dates ?
A nurse who worked at two facilities simultaneously needs to document hours at each. Without this documentation, the compliance team will reject the profile. Include hours per week + number of days per week at each facility during the overlap period.
Education Requirements ?
Must include: Institution name and location � Programme/degree type � Year of completion. Physical copy of diploma must be on file with the agency. International candidates: degree equivalency evaluation required (CGFNS or approved equivalent). For RN-to-BSN bridge: include expected completion date.
Work Experience Standards ?
For each position: Facility name + city + state � Dates (month/year to month/year) � Unit name and floor type � Job title � Full-time/Part-time/Per diem/Travel. Most recent position must be within the last 12�24 months � many clients will not accept candidates who haven't worked clinically recently.

Compliance Document Checklist

BLS card � front and back, expiry date clearly visible
Nursing licence � screenshot from Nursys with verification date
ACLS/PALS/NRP � copies with expiry dates if applicable to role
Specialty certifications � CCRN, CEN, CNOR, etc. with expiry dates
Skills checklist � completed and signed for candidate's specialty
Two professional references � from supervisors/managers in same field within last 24 months
Updated resume � no unexplained gaps, all education and demographics included
Work authorisation confirmed � W2 only, GC or USC preference noted per client
Background check consent � signed
Drug test order � confirmed 9/10/12-panel per client requirement
TB test/QuantiFERON � negative result on file, valid 12 months
Immunisation records � MMR, Varicella, Hep B series, flu shot, COVID records or exemption
5
Top Employers & Pay Scales � 2024�25 Reference
Know who the clients are and what every role earns
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HCA Healthcare

For-profit 185+ hospitals, 21 states. TX, FL, TN, VA, GA. Largest for-profit system. High-volume MSP client. Major travel nurse consumer. Standardised hiring process � your most common client.

CommonSpirit Health

Non-profit 150+ hospitals, 21 states. West and Midwest. Formed from CHI + Dignity merger. Mix of travel and staff hiring.

Ascension Health

Catholic Non-profit 140+ hospitals, 19 states. Largest Catholic non-profit system. Strong Midwest and South presence.

Tenet Healthcare

For-profit 60+ hospitals. TX, CA, FL, AZ. Large MSP client. Subsidiary: USPI (ambulatory surgery centres). High travel nurse usage.

Kaiser Permanente

Integrated HMO 39 hospitals, 700+ offices. Both insurer AND provider. Staffing primarily through AMN MSP. Strong union presence. Hard to access without AMN relationship.

Mayo Clinic / Cleveland Clinic

Academic Non-profit Top-ranked globally. BSN required. High certification standards � CCRN often required at interview stage. Premium placements with premium bill rates.

New York Note
New York is NOT in the NLC compact � a nurse with a compact licence CANNOT practice in New York. Every nurse placed in NY needs a New York single-state licence. New York-Presbyterian and other NYC health systems will reject compact-only candidates.

Complete Pay Scale Reference � Staff vs Travel (2024�25)

RoleStaff PayTravel / Contract PayPrimary Setting
CNA$15�$22/hr$18�$28/hrSNF, hospital, home health
LPN / LVN$22�$32/hr$28�$42/hrSNF, LTAC, clinics, some hospitals
RN � Med/Surg floor$32�$48/hr$1,800�$2,400/wkAll hospital medical floors
RN � Telemetry$34�$52/hr$2,000�$2,800/wkCardiac monitoring/step-down units
RN � ICU / Critical Care$38�$65/hr$2,400�$3,500/wkAll ICU types (MICU/SICU/CVICU)
RN � ER / Trauma$36�$62/hr$2,200�$3,200/wkLevel I�IV Emergency Departments
RN � OR$38�$65/hr$2,500�$3,600/wkHospital ORs, ambulatory surgery centres
RN � L&D$38�$65/hr$2,500�$3,500/wkLabour & Delivery, antepartum, postpartum
RN � NICU$40�$68/hr$2,600�$3,800/wkNeonatal ICU Level II, III, IV
RN � Oncology$36�$58/hr$2,200�$3,000/wkCancer units, infusion centres
RN � Psych / Behavioral$30�$50/hr$1,900�$2,800/wkInpatient psych, behavioral health
NP � PMHNP$130�$180K/yr$90�$140/hrPsychiatric units, mental health clinics
NP � FNP / General$110�$150K/yr$80�$130/hrPrimary care, urgent care, hospitalist
CRNA$180�$230K/yr$250�$350/hrOR, pain mgmt, OB, rural hospitals
Respiratory Therapist (RRT)$28�$48/hr$38�$60/hrICU, ER, NICU, LTAC
Rad Tech RT(R)$28�$42/hr$35�$55/hrHospital imaging, urgent care, ASC
MRI / CT Tech$35�$55/hr$40�$65/hrHospitals, imaging centres
Surgical Tech (CST)$22�$38/hr$35�$55/hrHospital OR, ambulatory surgery centres
Phlebotomist$16�$22/hr$18�$28/hrHospitals, labs, blood banks, home health
HEDIS Nurse (RN)$35�$55/hrRemote � Jan�MayHealth plan quality review teams
Prior Auth Specialist$18�$30/hrRemote � year-roundHospitals, health plans, physician groups
Medical Coder (CPC)$18�$32/hrRemote � year-roundHospitals, physician groups, payers

Gold border = highest-value travel placements � Teal border = remote placements

Candidate Profile � Submission Packet
Rainna Rene Barnett
Profession Type
RN � Registered Nurse
Specialty
Behavioral Health (Psych)
Years in Specialty
10+ years (5 in management)
Travel Experience
>5 assignments
??
Submission Form Data
What the recruiter captured on the submission template
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Full NameRainna Rene Barnett
SSN Last 48087
Permanent Address4043 Primo Rd, Festus, Missouri 63028
Phone(636) 331-9288
Emaildoubler0419@gmail.com
Available Start Date02/23/2026
RTO (Requested Time Off)18/04/2026 � 25/04/2026 ?? Flag to client at submission
Interview Availability8am EST � 1pm EST
Prior Hospital ExperienceNA (first time at this specific facility)
Trauma LevelLevel II � 2 years
Travel Experience>5 assignments ?
??
Certifications on File
What was submitted in this packet
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CertStatusExpiryNotes
BLS? Active04/2026AHA � Emergency Management Resources
ACLS? Active09/2026AHA � Emergency Management Resources
CPI (NCI with APS)?? ExpiredIssued 2/13/25, Expired 2/13/26Crisis Prevention Inst. Non-violent Crisis Intervention � Psych specific. Expired at time of this reference doc review � needs renewal.
COVID-19 Vaccination? On fileN/A (2-dose Moderna, 2021)Booster status not shown � may need to confirm per client policy
??
Licence Verification (Nursys)
Primary source verification � as of Sept 4, 2025
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Licence TypeStateStatusExpiryCompact
RNMissouri ? ACTIVE / UNENCUMBERED 04/30/2027 MULTISTATE ?
PN (LPN)Missouri? EXPIRED05/31/2016None
RNIllinois? EXPIRED09/30/2020N/A
Key Takeaway for Fresher
The active Missouri RN licence with MULTISTATE compact status means Rainna can work in all 41 NLC states immediately � no additional licence applications needed. The expired LPN and expired Illinois RN licences are historical and irrelevant to current placements. Always verify the ACTIVE licence and compact status first.

Rainna's compact licence authorises RN practice in: AL, AZ, AR, CO, DE, FL, GA, Guam, ID, IN, IA, KS, ME, MD, MS, MO, MT, NE, NH, NJ, NM, NC, ND, OH, OK, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY and more.

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Skills Checklist Analysis
Self-assessment score � Psychiatry Skills Checklist
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3.9 / 4.0Overall Competency Score

Scale: 4.0 = Expert (serves as resource) � 3.0 = Proficient (independent) � 2.0 = Novice (needs assistance) � 1.0 = Inexperienced

Expert Level (Score 4) � All Core Psych Competencies ?
All categories scored 4/4: Admit/Orient Voluntary & Involuntary Clients, Initial Comprehensive/Focused/Screening Assessment, Multi-disciplinary Planning, Crisis Intervention, Therapeutic Communication, Full Restraints/Wrist Restraints. All psychiatric disorders (Schizophrenia, Bipolar, Suicidal Ideation, PTSD, Eating Disorders, Substance Abuse, Personality Disorders). All psychotropic agents (Antipsychotics, Antidepressants, Antimanic, Anticonvulsants). All age-specific competencies from Toddler through Older Adults.
Notable Lower Scores (2/4) ?
Assist with Lumbar Puncture (2/4) � less common in pure psych settings. Couple/Family Therapy (2/4) � focuses on individual/group. Newborn & Infant (30 days�1 year) age-specific (2/4) � expected for a psych-focused RN who doesn't work neonatal. Admin of Hyperalimentation and Blood/Blood Products (3/4) � slightly below expert. These gaps are clinically appropriate for a behavioral health specialist and would not affect a psych unit placement.
A 3.9/4.0 skills checklist score from a candidate with 10+ years of psych experience and management background is an excellent submission profile for a behavioral health role.
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Resume Summary � Experience Timeline
Reading a healthcare resume the recruiter way � what to verify
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DatesEmployerRoleSettingRecruiter Note
09/2025�02/2026Our Lady of Fatima Hospital, Providence RIRN Charge Nurse � Psych EDHospital Psych ERMost recent role � high acuity, ER psych experience is premium
07/2025�09/2025Rosebud Sioux Tribe Detox Center, Rosebud SDClinical SupervisorDetox/Substance Use2 months � short assignment. Reference provided (Nicole Cantin, Manager). Would rehire: YES.
02/2025�04/2025Brattleboro Retreat, Brattleboro VTAdolescent Travel Psych RN/Charge RNInpatient Adolescent PsychTravel assignment � adolescent psych specialty on file. Reference provided. Would rehire: YES.
09/2024�02/2025BJC Behavioral Health, St. Louis MORN Psych Nurse � Team LeadOutpatient PsychLeadership role � supervised nursing ops across multiple clinics
06/2024�09/2024MGM Corporation (Multiple SNFs)Traveling Director of NursingSNF / Rehab (MO, IA, OK)DON travel role � demonstrates multi-site management. Medicare/Medicaid facilities.
02/2024�05/2024Rhode Island Hospital, Providence RITravel Psychiatric RNInpatient PsychTravel assignment � inpatient psych at academic-level hospital
08/2023�01/2024Mercy St. Louis HospitalSupervisor, Psychiatric RNInpatient PsychSupervisory role � management experience within psych
11/2022�12/2022Employment GapFestus, MissouriGap documented "Looking for new contract" � dates + location present. Compliant.
04/2021�08/2021Employment GapGap documented "Medical Issue" � reason stated. Compliant.
Recruiter Read � What Makes This a Strong Profile
10+ years of continuous psych/behavioral health experience. Management and supervisory history (DON, Clinical Supervisor, Team Lead, Charge Nurse) distinguishes this candidate. More than 5 travel assignments = experienced traveller = lower onboarding friction. Documented employment gaps (both compliant). Active compact RN licence through 2027. ACLS and BLS current. References on file from 2 most recent supervisors. The only item to address: CPI certification expired Feb 2026 � needs renewal before or during onboarding.
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How You Would Screen This Candidate � Live Practice
If Rainna called your desk tomorrow, here is your question sequence
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1
Work Authorisation
"What is your work authorisation status?" Expected: US Citizen (confirmed by Missouri DL on file). ? Proceed.
2
Licence Status
"Can I get your RN licence number and the state it's issued in?" ? Verify on Nursys: Missouri RN 2014039583, ACTIVE, UNENCUMBERED, Compact/Multistate, expires 04/30/2027. ? No disciplinary actions.
3
Compact Status
"Is your licence a compact licence?" Expected: Yes, Missouri is a compact state, RN licence is Multistate. ? Can be immediately deployed to any NLC state � no licence paperwork delays.
4
BLS Expiry
"Can I get your BLS expiry date?" Expected: April 2026. ? Current. Note: will expire partway through a 13-week contract starting Feb 2026 � flag for renewal before month 3.
5
Specialty & Years of Experience
"What is your primary specialty?" Psych/Behavioral Health, 10+ years including inpatient, adolescent, detox, management roles. ? Strong specialty profile.
6
EMR Experience
"What EMR systems have you worked with?" Check submission: Cerner, Epic, and Meditech are all ticked. ? Strong EMR profile � multiple systems.
7
Availability & RTO
Available start: 02/23/2026. RTO: 18/04/2026�25/04/2026. Flag RTO to client at time of submission � not after offer. Some clients will not accept mid-contract RTO.
8
CPI Cert � Flag for Renewal
CPI (Crisis Prevention Institute) expired Feb 2026. For a psych placement, this is likely required by the client. Advise Rainna to renew before or at the start of the assignment. Include note in submission profile: "CPI renewal in progress."
Question 1 of 10: A client calls requesting an ICU travel nurse for a Level I Trauma Centre in Texas. A candidate calls you � she lives in Tennessee (a compact state) and has an active RN licence. Can she take this assignment without additional licence work?
No � she needs a Texas-specific licence application
Yes � compact licence covers all NLC states including Texas
Yes � but only after she applies for a Texas endorsement
No � Level I Trauma Centres require BSN only
Question 2 of 10: On a screening call, a travel nurse candidate says 'I'm a travel nurse and I've been doing this for 5 years. My NCLEX-RN is from 2018.' What is the first thing you verify?
Confirm she passed NCLEX in 2018
Verify her current RN licence STATUS is ACTIVE on Nursys.com
Ask if she has BLS
Ask for her travel experience details
Question 3 of 10: A job order says 'BSN Required' for an ICU travel nurse position at an academic medical centre. A candidate calls � she has an ADN degree, has been an ICU nurse for 3 years, holds a CCRN, and is enrolled in an RN-to-BSN bridge programme completing in 6 months. What do you do?
Do not submit � ADN means she doesn't qualify at all
Submit her immediately without any notes
Submit her and note in the profile that she is enrolled in an RN-to-BSN bridge with expected completion in 6 months � let client decide
Tell her to wait until BSN is complete before applying for travel
Question 4 of 10: Your candidate says she has Epic experience. She worked at a Meditech hospital for the last 2 years before that. The client job order specifically says 'Epic required.' What is your next best move?
Submit her � Epic experience from before is still valid
Ask: 'What Epic modules did you use and for how long?' before deciding to submit
Do not submit � she has been away from Epic for 2 years
Call the client and ask if they'll waive the requirement
Question 5 of 10: A candidate mentions she had a written reprimand on her Missouri nursing licence 3 years ago for a documentation error. It was resolved with no restrictions. She's hesitant to disclose it. What do you do?
Advise her not to mention it � it was resolved, so it won't show up
Submit the profile without noting the reprimand and hope the client doesn't ask
Tell her the disciplinary action will appear on Nursys and she MUST provide a signed written incident report explaining what happened � full disclosure is required
Cancel the submission � any ding is an automatic disqualifier
Question 6 of 10: A hospital job order comes through an MSP (Trio Workforce). They list a bill rate of $78/hr. Your agency will pay the nurse $52/hr total compensation. What is your gross margin per hour, and what does a 13-week ICU placement at 36 hrs/week generate?
$26/hr margin = $12,168 gross revenue over 13 weeks
$26/hr margin = $36,504 gross revenue over 13 weeks
$26/hr margin = $24,336 gross revenue over 13 weeks
$78/hr revenue means $78 per hour is your margin
Question 7 of 10: A client tells you they need a PMHNP for their outpatient mental health clinic. A candidate calls saying she's an FNP (Family Nurse Practitioner). She says 'I can see mental health patients � it's similar enough.' What is your response?
Submit her with a note explaining she's flexible
An FNP CAN see mental health patients, so this works
Do NOT submit � FNP and PMHNP are completely different certifications with different scope. The client needs a PMHNP specifically.
Ask the client if they'll accept an FNP as a substitution without telling the candidate
Question 8 of 10: You have placed an ICU travel nurse who is now in week 4 of her 13-week assignment. What should you do at this stage?
Wait until week 13 to check in � avoid bothering her during the assignment
Do nothing � once placed, the assignment runs itself until completion
Call to check in: 'How's the assignment going? Anything you need?' � and begin building the week 10 extension conversation
Send a form email asking for references to use for future placements
Question 9 of 10: Your candidate's resume shows she worked at Memorial Hospital until December 2022, then started at St. Luke's in August 2023. The MSP compliance team will review this. What do you need to do?
Nothing � 8 months is not unusual in healthcare
Submit as-is � the gap doesn't affect qualifications
Contact the candidate: get the dates, reason, and location for the Jan�Aug 2023 gap. Update the resume to include this before submission.
Delete the Memorial Hospital entry to close the gap
Question 10 of 10: It is November. You want to build a pipeline for a seasonal placement opportunity that runs January through May. Which role are you targeting, and where do you source these candidates?
ICU travel nurses for the winter surge � source from Vivian Health
HEDIS abstraction nurses (RNs) for health plan quality review contracts � source from experienced bedside RNs looking for remote work
Prior auth specialists for hospital billing departments � source from LinkedIn
New graduate RNs for nursing residency programmes � source from nursing schools