Carlie: Hey there, it’s Carlie with the Expat Focus podcast. We’ve got a new episode dropping every month and a website full of news and information for anyone planning a move to a new country. To get all the latest news and resources, sign up to our newsletter at expatfocus.com/newsletter.
Did you know the USA is probably the most lucrative market for work as a travel nurse? While you can take travel nursing abroad, the role doesn’t actually exist in all countries.
Kylee Nelson is a nurse who is encouraging others in her profession to take a break from the bedside to help prevent burnout and to get out and see the world. Kylee has worked as a travel nurse for seven years, including in Saudi Arabia and all over the USA.
Nothing is off limits with Kylee in this episode: we talk money, how much you can earn as a travel nurse versus being on staff permanently, how to work with recruiters (or not), how you’ll be welcomed by colleagues when you start your latest assignment (or not), and what countries you should look at if you are interested in travel nursing abroad. Kylee, welcome to the Expat Focus Podcast.
Kylee: Thank you for having me, Carlie. I’m really excited to be here.
Carlie: For the uninitiated, can I ask what is a travel nurse?
Kylee: A travel nurse is a nurse that works at different hospitals. They’re contracted workers, and you rotate every 13 weeks. You do have the possibility to stay longer, but that’s the basis of travel nursing. And I think something that’s interesting is that we have it in the United States, Canada, Australia, New Zealand, England, Ireland, but it’s nowhere else.
Carlie: Okay. So it’s kind of an Anglophone invention.
Kylee: Yes. And if you ask me, the United States probably does it best. I think that it’s just a little bit more flexible in the United States.
Carlie: Do you know why travel nursing exists?
Kylee: Actually, I should look up the history of travel nursing, but…
Carlie: Who decided that a travel nurse is a good idea?
Kylee: I think it’s because of when hospitals have a dire need for nurses, right? So if you have an influx of patients because of a pandemic or just a crazy accident. So I work in the neonatal intensive care unit and if a state has a big event… So, if the Chicago Cubs win the world series…
Usually this is true for every big event. Usually more people get pregnant cause they’re celebrating after. So then those NICUs and labor and delivery units know, “oh, maybe in the next six to nine months, we’re going to have an uptick in patients.”
Carlie: Right.
Kylee: And it’s not that they necessarily grab travel nurses specifically for that. But you can know “oh, maybe in Chicago, there’s going to be a need in the next six months or so.”
Carlie: Right. So hospitals can plan ahead for when they know there’s going to be a bit of a busy period and basically find those nurses to contract for those busy periods.
Kylee: Yes, but you still don’t really get an assignment until maybe a month before, so it’s not like they’re like, “oh, in six months, we’re going to need travel nurses, let’s hire people.” It’s a very last minute gig.
Carlie: So does that mean you have to live your life a little bit last minute and not plan so far ahead?
Kylee: I think that was the hardest thing about travel nursing for me. I’m so Type A, I would literally plan a vacation a year in advance. But yes, I had to very much just go with the flow.
Cause you will get your assignment and you have sometimes a week. Then you have a week to move there, to find housing, to…you don’t get a schedule until usually the day before you arrive. And then the next three months, you’re just at the will of the hospital. You know, you can’t really plan in those three months to do anything because you don’t know when you’re going to be working.
Carlie: So if you only have a week’s notice to move, for example, is the hospital helping you out with things like accommodation?
Kylee: So no. So basically you’re the travel nurse and then there’s the company that works directly with the hospital and recruits the travel nurses. So you, as the travel nurse, you really don’t have…you’re not talking to the hospital at all, but the company can help you secure housing. But that’s usually not the best idea because you’ll make less money.
Carlie: Okay, because they sort of take it out of your expected salary or something.
Kylee: Yeah. So as a travel nurse, you get paid from three buckets. You get a housing stipend, a meal stipend, and your hourly rate. And in the United States, your housing and meal stipend are not taxed. So if the company finds housing for you, you don’t get any housing stipend. But if you find it on your own, you can usually get it for less money than what the housing stipend is. So you can pocket more money.
Carlie: Right. Of course. Can I be bold and say how much can you make as a travel nurse?
Kylee: Oh my gosh. So every unit/every specialty is different. I think that the highest paid travel nurses are O. R. Labour and Delivery. And I would say from personal experience, probably the paediatric ICU during Covid, those ICU nurses were making $10,000 a week, but that is not the case anymore. My highest paying contract was I think $3,200 per week and that’s only 3 days of work.
So it’s very lucrative, but average now…the prices are a little bit lower. I think it always kind of ebbs and flows, right? Now we’re kind of at a pit. And I would say the average in the neonatal Intensive Care Unit where I work is probably about $2,000 to $2,500 a week.
But when…so I did it for seven years and when I started, obviously the prices were much lower. My first paycheck was only $1,300 per week, which is still a lot. So that month, you’re making whatever 1,300 times four is. But then at the end, I’m making $3,200 a week, which is triple almost? Double? Yeah.
Carlie: And I guess the amount of money that you can command depends on your years of experience and as you said, what area that you specialise in. But also does it depend, for example, in the United States, do travel nurses get different rates depending on the cities they’re working in?
Kylee: Yes, absolutely. So usually San Francisco pays the best, but you also get paid well in really rural areas where no nurses want to go. So those hospitals do have to pay more. I think another interesting thing… So I told you, you have a company, right? So you get paid out of those three buckets, but essentially the hospital sets what’s called a bill rate.
So the hospital sets your bill rate and then as the travel nurse, you don’t technically know what the bill rate is. So the company knows. And then the company takes a portion of that bill rate, which obviously they have to run their operations and the recruiter needs to be paid. So I understand that. But if you’re working with a recruiter who doesn’t have your best interest at heart, they can take such a larger piece of that bill rate and you would not know.
So if you are one of four travel nurses on a unit, the chances that you’re all getting paid the same are very low, right? Everybody probably has a different recruiter and so every recruiter is taking a different amount of money from every nurse.
Carlie: I’ve worked in workplaces where you’re not allowed to speak about your salary. Is that the same among travel nurses or do you do it anyway?
Kylee: No, yeah, I think that’s changing. I feel like it was really taboo. I honestly feel in the middle about it. I feel like in some situations I feel weird, but in other situations I feel very empowered. I’m like, “no, we should all know because they shouldn’t be able to get away with just taking such a big portion.”
I don’t know. I think another thing that’s interesting though, if you have a good recruiter… So if I was making $1,000 a week and you were making $2,000 and I said to you, “Oh, can you please send me your contract?” And then I could send it to my recruiter and then my recruiter would match that rate.
Carlie: Right. So you can sort of use it as bargaining.
Kylee: Yes. So it is beneficial, but you also have to keep in mind at some point, $100 is not a big deal, you know, because there’s other nuances, like, does this person have health insurance? Do you have your own health insurance? So there’s little nuances. So if somebody is making $200 more or less than me, I really don’t get my panties in a bundle because to me it’s just an inch…
Carlie: It’s not a $1,000 a week difference.
Kylee: Which I haven’t heard of, but I would be livid if that happened to me.
Carlie: So what if you want to cut out the middleman in order to get more money. Is there a way to just be like, “Hey, hospital, let’s not use that agency, but let’s just talk about a position, a travel nursing contract that we could do together.” Is that possible? Or is that really a faux pas?
Kylee: There are platforms now that do that for you. One that comes to mind I believe is called Trusted Health, but I can’t promise that’s the name of it. And yes, basically there’s no recruiter. So I’ve never used the platform, but I assume that when you log in, you’re getting these requirements from the hospital, but I think it’s a little bit more challenging, right? Cause then you have to also do a lot more work that your recruiter would be doing.
Carlie: Yeah, and the negotiation could be a bit confusing, too.
Kylee: I know some people that have used it and they really like it. But I was more in it for the fun of it and I think a bonus was that I was paid well. I was never somebody that did it for the money. But yes, some people do it for the money. And so for them, it’s probably way more beneficial to cut out the recruiter.
Carlie: Is it a case of this being a small industry though? If you decide to go and cut out the recruiter, are you going to get a name for yourself as, “Oh, that one doesn’t give everyone a slice of the cake?”
Kylee: I don’t think so because the platforms that have been designed to do it. And it’s really not…I don’t think that the recruiters are like a dying industry by any means. I think way more travel nurses use recruiters than don’t. But it is a small world and I would say if you make a name for yourself in terms of just bad behaviour that can really get around.
I started to get these coveted travel nurse positions because I did a good job and then managers would help me to the next place versus making a name for myself in a bad way… You definitely don’t get very far.
Carlie: I want to ask about the culture within the hospital between the nurses. You obviously have permanent staff. How welcoming or not are they to travel nurses that are coming in and out?
Kylee: I actually really appreciate this question. So yeah, as you said, some places are very welcoming and some are not. Obviously travel nurses are making much more money than the staff nurses and I think that that can create hostility. I have found that places that have travel nurses often usually do a lot better welcoming them versus places that don’t, obviously.
And I also think that management plays quite a big role in ensuring that your nurses are all getting along. In places where the nurses have been rude to me for being a travel nurse I find that management maybe isn’t as involved – not with the travel nurses – but just as involved on the unit. And the unit just doesn’t have as good of a repertoire. Versus managers that are very involved on the unit and the nurses generally like each other, I feel like they are much more welcoming to travel nurses.
But you have to keep in mind as a staff nurse too, the travel nurses are…there’s downsides, right? Yes, we’re getting paid more, but there’s a lot of downsides. I did travel nursing on and off for seven years. And I went back to staff nursing in 2022, I think. I was working in Chicago and we had travel nurses and they were making $6,000 more per month than I was making, which is a lot of money. And it was very disheartening.
I also had to keep in mind that’s not their fault. It’s just a flaw in the system and they happen to be…I used to benefit from that and now they are, and I need to let them have that. And that’s great. And if I have an issue with that, that’s more between management, that’s not anything to do with them.
Carlie: I suppose 2022 was the tail end of the pandemic. Still probably a bit of surge pricing, if I could use a rideshare analogy.
Kylee: Yeah, that’s a good word. So one of the bad things about the…well, there were a lot of bad things about the pandemic…but everyone found out travel nurses are making $10,000 a week, but then housing for travel nurses started growing, growing, growing.
And so now you see these rates have come back down, but the housing hasn’t. So right now it’s a really challenging time to be a travel nurse because after you’re paying for your housing, you’re really not making a lot of money. And in the United States, you’re also required to pay rent in your home state. So you’re duplicating your expenses: you’re paying rent wherever you’re working, and you’re paying rent in your home state, and that’s so that you’re able to get your stipends tax-free.
Carlie: You have to keep double rentals, is that what you’re saying?
Kylee: Yeah.
Carlie: So how do people work around that? Is that usually you are subletting your place while you are working as a travel nurse, or…?
Kylee: So what I did was I moved into my parents’ house. So I didn’t have my own place, but I had to pay my parents rent and technically you have to pay the market value. You’re not allowed to just be like, “Oh, here’s $50 a month.” You have to research what it would cost for them to actually rent a room in their house and you are required to pay that amount.
Carlie: Wow. That’s crazy.
Kylee: It’s only if you were to get caught by the IRS you’d get in trouble if you’re not doing these things. So yeah, of course I’ve met people that got creative with the rules.
Carlie: There’s always a risk that goes along with that.
Kylee: Yes, exactly.
Carlie: So how do you get that next job? You said you only find out last minute about your next contract. So during your 180 days or however long you’re…13 weeks, I think you said…at what point during that contract do you start thinking about the next move and when are you going to know?
Kylee: So generally I think there’s two ways about this, right? So about halfway through your assignment…usually if there’s still a need, the manager will contact the recruiter or come to you and say, “we’d like for you to stay longer. Are you available?” So that’s one way. If you don’t want to, then you would just tell your recruiter, “I want to move on.”
The great thing about travel nursing is you don’t have to go anywhere you don’t want to go. So you’ll tell your recruiter, “these are the places I’m interested in,” or “I only want to work the night shift,” or “I only want to work the day shift.” And then they’ll look at what they have open. And usually I would say about five weeks out, they really start searching more and more.
Carlie: Cause I guess there’s a point where you can’t search too early, right? You have to leave it to a certain point.
Kylee: Yes. As a new travel nurse, I would not even reach out to a recruiter until four months before you want to leave, and that’s because there’s not going to be jobs for you any sooner than that.
Carlie: I want to talk about taking your travel nurse qualifications abroad. Now you mentioned that travel nursing doesn’t exist in every country, which I’m surprised about. You mentioned the UK, Australia, Canada… So my first question is how easy is it if you’re a US-qualified nurse to decide to pack up and go abroad? Where do you start?
Kylee: That’s a great question. So I think if you are a nurse who wants to move abroad, one thing to keep in mind is the pay abroad is much less than the United States.
US nurses, I would argue, are probably the highest paid in the world, especially as a travel nurse. I’ve worked abroad in Saudi Arabia and that wasn’t as a travel nurse, right? That was for a contracted year. And then I also did some volunteer work in North Macedonia and I interviewed for a job in England, in London.
And for all of those jobs…well, the volunteer job, I didn’t get paid…but my paycheck was significantly lower. And I think that stops a lot of people in their tracks. For instance, in England, the pay is 1/3rd of what you’re getting at home. So that stops a lot of people. But if you’re still somebody that really wants to go abroad, I think your best bet to start is you need to reach out to a recruitment agency that recruits international nurses.
I have a website and on my website, I do have a list of those resources. But just off the top of my head, if you want to go to Australia or New Zealand, cause those are probably the closest in pay to the US, a company called Healthcare Australia does staff for those countries and they recruit American nurses.
So that’s a good place to start. And then the company really helps you out. Like I would not have been able to work in Saudi Arabia if I didn’t have the company that I had. I worked with a company named Helen Ziegler: it’s not a person, it’s a company, and they are based in Canada. So if you are interested in working in the Middle East, then that’s a good company to start with as well.
Carlie: Now surely the Middle East is lucrative in terms of salary though.
Kylee: No!
Carlie: Really?
Kylee: I think it can be if you work there for a few years. But for instance, so I told you I was making my last travel nurse assignment…I made $3,200 per week. And in Saudi Arabia, I was taking home–I can’t remember exactly–but I think I was taking home $5,000 to $6,000 per month.
But in the US I’m working 36 hours a week and in Saudi Arabia, I’m working 48 to 60 hours per week. So sure, the pay isn’t bad. I mean, it’s good. And they pay for your housing and your transportation to get to Saudi Arabia. And it’s tax free. So it’s good money, but you’re working so many more hours that I did the math once, and I think it came out to depending on how many hours that week you’re working, $25 to $30 an hour. And again, in the US, it’s just higher than that for less hours.
Carlie: Am I right in assuming a standard nursing shift is a good 12 hours?
Kylee: Yes, that’s correct. And I don’t know in Australia, but in the US, if you work over 40 hours, it’s overtime. So nurses only work the three 12 hours. And if you need to pick up extra, or if they need you to, you can, but you’re not required. But in Saudi Arabia, no, you’re working four to five 12-hour shifts per week.
Carlie: It’s really interesting that you said the salaries in places like New Zealand, Australia, Canada are lower for travel nurses than the USA, because I’ve spoken to guests on the podcast just recently who are talking about how for immigration, if you’re on that skills list/if you’re an essential worker, such as a doctor, such as a nurse, you’re going to be in a good place to immigrate to countries like Australia, Canada, New Zealand. So why do you think as a travel nurse in those countries, the pay is just ordinary?
Kylee: I wonder if it just has to do with the US has a different healthcare system and I don’t know in Australia, New Zealand… Canada has universal healthcare. Is that the same case for Australia?
Carlie: We have a form of it in Australia and the UK.
Kylee: So that’s what my guess would be. I don’t know for sure, but I would guess that it’s because of that. I don’t know how nurses in the US have got into this…which I don’t want to argue with it…I think we should get paid more. But yes, I think that nursing can be…in the United States…it can be very lucrative.
But again, if you’re somebody that desires to go abroad, it’s not always about money, right? I knew in Saudi Arabia I was going to make less. But I really wanted to explore the Middle East. And I know people that go down to Australia and New Zealand and they love it and it’s not all about the money, right? So I still think if you have that desire, it’s worth it.
Carlie: So let’s talk about that lifestyle because as you said, your motivation to go abroad is not necessarily about the check, though it’s helpful. It can be about the experiences that you’re going to have. So you’re working really long hours, but about three days a week. Does that mean you have four days to yourself to get out and explore the place you’re living in?
Kylee: Yes, that is what that means. But I think any nurse would tell you that after you work, especially if you work three days in a row, you’re pretty beat. And I think it’s a little bit intimidating. I think when I first started travel nursing, I did such a good job at like, “okay, every single week, I’m going to at least dedicate one day to either doing a miniature road trip or, you know, getting out and exploring the city.” Then throughout my seven years, I definitely got worse at that.
But you have the opportunity to travel a lot. I think the better thing to do actually…so I told you in the US you work 13 weeks…what I think is even better to do then is after your 13 weeks to take some time off, whether that’s one week, four weeks, five months, which is something that I used to do.
I think it’s better to plan…I would love to plan a road trip, right? So if I’m living in San Francisco, I just focus my energy in San Francisco for 13 weeks. And then at the end of that, I plan a road trip down the coast of California. Or if I’m in Seattle, maybe I plan to go up to Canada, and just take that time at the end of the contract. That’s how I used to like to do it.
Carlie: So what travel nursing assignment in what city have you enjoyed the most?
Kylee: Definitely Seattle, Washington. So I think that they have a really good community of travel nurses there. And I think that the staff nurses in Seattle…I’ve worked at a couple of different hospitals…are generally very, very kind and welcoming.
Seattle is such a fabulous city, especially in the summer months. But I think the most unique place, and probably the nearest and dearest to my heart, I worked in Santa Barbara, California. Have you heard of Santa Barbara?
Carlie: I’ve heard of the city.
Kylee: We call it the American Riviera and it’s just so beautiful and the perfect weather.You’re right on the beach. I would never live there full time. It’s not for me, it’s very small. But to spend 13 weeks there was like a dream come true.
Carlie: And on the other side of the coin, what destination did you find the least enjoyable?
Kylee: I thought I was going to love Boston and I disliked it so much. The nurses were not very nice. And overall, I just was a little bit underwhelmed with Boston in a way. I thought I would love it there. I honestly thought I would move there. And that’s another great thing about travel nursing is if you don’t know where you want to live, you get 13 weeks and different places to decide. So, I thought I was going to be awesome.
Carlie: Try before you commit.
Kylee: Yes, exactly. It wasn’t for me.
Carlie: I’m curious, when you go abroad as a travel nurse, I assume you can only go to countries where your qualifications are transferable. But once you get on the ground, are you required to do any localised trainings?
Kylee: So in Saudi Arabia, I had to get a nursing licence for Saudi Arabia, but again, my company really guided me through all of that. In places like…this is actually interesting… So in the United States, I also believe…and maybe this is why we’re paid more…I would say in Canada as well, the United States and Canada, nurses have a higher responsibility than nurses in the UK.
In Australia, I actually think maybe nurses have a little bit more responsibility because from what I’ve heard, they’re also required to act as a respiratory therapist. And that’s not the case in the US. So I think that when you go abroad, you have to keep in mind that every place uses nurses in a different way.
And so in Saudi, we were not given any extra training, but again, coming from the United States, I already had all of that. Saudi also hires a lot of nurses from the UK, from the Philippines. So I don’t know what their training is like and if when they come to Saudi it’s a big change. As an American nurse, it’s pretty easy, except I would say if you’re going to Australia and you have to work as an RT as well.
Carlie: When it comes to the practical elements of your job and working between cities and countries, is there anything that stands out to you that was different, like in terms of the tools that you use, or the processes that you had to kind of learn on the spot? Like, “Oh no, we don’t do it that way. We do it this way.”
Kylee: Yes, even in different states, it’s not just abroad. It’s also in the United States. Every single hospital has a different policy, different way of doing things. And that’s one of the hardest things about travel nursing. And something else I would tell new travel nurses: Just be adaptable. Do not say, “Oh, well, we do it this way where I came from.” That’s not helpful. You just need to learn, adapt, and do it how they want you to do it. And you will go so much further.
Carlie: Have there been any moments at work where you’ve kind of stepped back and been like, “Oh, wow, I get to do this.”
Kylee: Yeah, a lot. I think especially when I got the job in Saudi Arabia…so I originally got the job in January, 2020, and then the pandemic. And so it was obviously taken away. So when the pandemic was better, I reapplied. And I reapplied and I got the job again and I think just flying over there… It was very stressful, but it was like, “Wow. Exactly. I can’t believe that this is my life.”
And nursing is such a unique career, even if you’re not a travel nurse, simply because you only work three days a week in America. So you have so much time to travel, explore, spend time with friends, family. You can start a podcast, you can start anything. You don’t have to be a travel nurse, but as a travel nurse, just your ability to move around the United States in itself is pretty incredible, I think.
Carlie: Kylee, on your blog, you talk about the things you wish you knew before you jumped into travel nursing. What are some key things that you’ve learned along the way?
Kylee: I think the biggest thing that I wish I knew was travel nursing can be very romanticised. I love it so much, I want everybody to do it. But you will have very lonely days. You will have times where you’re stressed because maybe you don’t know where you’re going next, or it’s hard to find housing.
And I think that that’s one thing people need to do a little bit better job at talking about. Because I’ve gotten messages from travel nurses that will say, “Oh, why am I so lonely? I thought that I would really like this lifestyle.” But you’ll have lonely days. And that’s something that I wish I had realised before I started.
I think another key, key thing to travel nursing is the whole bit about showing up and people liking you or not liking you. My feelings were hurt a lot when I felt like the staff nurses didn’t like me. And at some point you have to realise that that’s not about you. That’s about them. And you just have to do your best and still be kind and show up to do the job that you were hired to do and think to yourself, “Okay, well, that’s their problem. It’s not my problem.”
Carlie: Are there any support networks that exist out there for travel nurses?
Kylee: Okay, so again, when I started in 2016, there was nothing. Now there’s so many good support networks. I would say first off, Facebook. You can find so many travel nurse groups on Facebook. So if I’m moving to San Francisco, I would get on Facebook and search “travel nurse, San Francisco.” So that’s a really good place to start to meet people.
And then my friend started this company called MedVenture and they’re doing a really good job at uniting travel nurses as well. It’s just a free app that anybody can download. So that would be another good resource, but honestly, Facebook has saved me so many times and I used to use…do you know Bumble?
Carlie: Bumble, the dating app? Yeah.
Kylee: You could do the BFF version, which I don’t have the app anymore, so I don’t know if you can still do this, but I used to do Bumble BFF and then look for girls that were in the city I was in.
Carlie: Oh, that’s such a great idea.
Kylee: That only worked out once, but that was a good way to do it as well.
Carlie: I remember I had a friend whose husband did that when they were in a new city so he could find a tennis buddy. He’s like, “I’m going on a dating app, but I’m just looking for a guy to come with me once a week and play some tennis.”
Kylee: Did he find somebody?
Carlie: I think he did, yeah.
Kylee: See, it works.
Carlie: So for anyone with a nursing qualification who wants to follow in your footsteps and be a travel nurse, be it just in the USA or looking at taking the travel nursing abroad, where do you suggest they start?
Kylee: You always need to have two years of experience as a staff nurse. So if you are a brand new nurse, listening to this, just focus on getting two years of experience: take everything you can, take the hardest patients, learn as much as you can, get as much experience as you can. And then I would recommend about four or five months out searching for a recruiter.
I love my recruiter. So if anybody needs a recommendation, let me know. But you can start searching for a recruiter. Ask around. If there’s travel nurses on your floor, ask them. And then once you do that, that’s when you can get the ball rolling. But if you want to go international, I also believe you need two years of experience, and I would argue travel nursing first would probably help you adapt a lot easier to international nursing, but I don’t think it’s a necessity.
Carlie: So travel nurse in your home country first before you look abroad.
Kylee: Yeah, that’s what I would recommend.
Carlie: Kylee, it’s been fantastic to speak to you today on the Expat Focus podcast. Where can listeners find you?
Kylee: Thank you so much. I have a website with a ton of resources on travel and nursing and travel nursing. It’s passportsandpreemies.com. Tthat’s just for my NICU nursing background. Or I’m on Instagram, TikTok at @passportsandpreemies.
Carlie: That’s it for today. Do you have questions for Kylee about travel nurse salaries? The best recruiters? Maybe you want to know what healthcare in the US or Saudi Arabia is really like? Hit the comments section of our YouTube channel and ask away – just search for Expat Focus. If you enjoy this podcast, please leave us a review on Apple Podcasts or wherever you like to listen. And I’ll catch you next time.