You found a company (at long last) that you want to work with and your Recruiter seems eager to help you find that perfect position.  With her urging you along, you’ve completed an application, sent in references, filled out Skills Checklists, tracked down your college transcript and texted pictures of all of your certifications.  You’ve even completed all of these Herculean tasks in less time than it takes to binge watch Game of Thrones, Season 5.  Your Recruiter tells you that you did a great job (and you know you did) and they will get to work sending your profile to facilities anxious to have you working there.

And then nothing the next day.  And nothing the day after that.  What gives?

The short answer is that the facilities have made things move at a glacial pace.  The long answer is a bit more complex.

Let’s say there are two hospitals, Red and Blue.  Red Hospital is desperately seeking an ER nurse to start as soon as possible.  They reach out to TRS and ask for profiles to be sent so they can start interviewing immediately.  Profiles are sent, calls are made, interviews happen and an offer is made and accepted.  That nurse can be on the floor in as little as a few days.

Blue Hospital chooses a different method.  They are approached by a VMS/MSP company that tells them that they are able to staff the most thoroughly vetted, exhaustively credentialed and impressively experienced nurses imaginable for a “modest” fee.  Sounds fishy doesn’t it?

Let’s back up a second and define some terminology for you.  A VMS is a Vendor Management Service and an MSP is a Managed Service Provider.  They are different in scope but the essence is the same as far as how a nurse is affected.  They act as a middleman between the facility and any staffing companies and as anyone can attest, a middleman simply overly complicates the process.

Here is an actual real world example: TRS had a nurse on contract who was having trouble clocking in with the facilities Kronos system and contacted us for help.  She had already spoken to her Supervisor but this was not helping her solve the issue.  So let’s follow the chain of contact here:

-Nurse calls TRS Recruiter

-TRS Recruiter calls TRS Account Manager

-TRS Account Manager calls VMS Representative and is told they will ask.  Hours go by.

-VMS calls facility HR Department

-Facility HR Department calls Unit Supervisor

-Unit Supervisor calls IT Department and gets an answer

-Unit Supervisor calls HR Department

-HR Department calls VMS Representative

-VMS Representative emails TRS Account Manager

TRS Account Manager calls TRS Recruiter

-TRS Recruiter calls nurse and says something to the effect of, “press 2”.

It should be apparent how monstrously inefficient the inclusion of a VMS has made this process.  Not only does the contract they sign with the facility preclude a staffing agency from contacting the facility directly, they get paid to obstruct the process.

So Blue Hospital is desperately seeking an ER nurse to start as soon as possible.  They reach out to their VMS and ask for profiles to be sent so they can start interviewing immediately.  The VMS contacts TRS and does the same.  Profiles are sent to the VMS for review before being sent to the facility.  Sometimes this review requires a pre-interview where the nurse must either have a phone call or respond to an email with a set of questions before the profile gets sent from the VMS to the facility.  Sometimes submissions to the VMS require the Recruiter to fill out forms or get the nurse to sign paperwork.  Let’s point out once again, the facility that is so desperately looking for an ER nurse has a plethora of options available but they don’t even realize this as the VMS has not sent any profiles that haven’t met their own criteria.

The VMS, in order to keep with their promise of sending thoroughly vetted candidates, can request unreasonable tests and procedures that duplicate existing data simply because they want more “recent” data.  How many chest x-rays can one safely undergo within a years’ time, for example?  When these criteria are not met immediately, profiles are rejected to the company to be corrected.  Some are and then resent only to be rejected by the VMS for another reason.  This process can last for days and even weeks before the facility even sees your profile.

Let’s say that the facility finally calls, interviews and offers and the nurse accepts.  After this agonizingly long wait, at last the nurse can get her paperwork in and begin her contract, right?  Not necessarily.  In order to keep with their promise of sending exhaustively credentialed candidates, the VMS can require modules (to be done by the nurse prior to Orientation and therefore without pay), Titers rather than vaccination records, online classes and additional certifications that can delay the contract start an additional 4-6 weeks.  They can also require subjective testing upon arrival whose results can determine if there is even a second day on this contract.

The existence of VMS/MSP’s was probably inevitable given the amount of healthcare providers looking for positions and the vast array of facilities looking to have the staff necessary to provide services to an incalculable amount of patients.  The VMS model keeps the facilities from being on the phone 24/7 talking to a myriad of candidates and agencies and allows them to focus on patient care.  So are they a necessary evil in travel nursing?  Probably.

So what does this mean to a travel nurse?  It means that when choosing a company to work with, you want to select one that has experience in dealing with these companies and knows which contracts will entail a monumental amount of hassle, time and stress and which ones do not.  TRS Healthcare has decades of experience navigating these waters and we will do our best to streamline the processes for you.  But the Hurry up and wait game is very real and our experienced team can prepare you for it with honest answers and realistic expectations.







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