Agencies 101 for Nursing Practice: How to Choose, Negotiate, and Avoid Getting Lowballed
If you’ve ever finished a chat with a recruiter and thought, “Did I just get lowballed?”—you’re not alone. For nurses moving from an employed staff nurse role to building their own nursing practice, agencies are more than just a contract source. They’re a relationship, and your approach to agencies can make or break your pay, schedule, and sanity.
Why Agencies Matter for Your Nursing Practice Structure
Agencies are your pipeline. An employed staff nurse relies on one employer. A nursing practice builds options. The mistake? Treating agencies like a one-time transaction. Instead, think relationship: compare offers, negotiate clearly, and protect your interests.
How to Choose the Right Agencies
- Don’t rely on one agency: Even if you love them, have 2–3 options for stability.
- Match your goals: Do they place in your provinces, units, and preferred schedules? Is their reputation solid when things get tough?
- Watch recruiter behavior: Green flags—direct answers, clear process, no rush. Red flags—vague pay answers, pressure, dodging questions. If they’re unorganized now, it won’t improve later.
Understanding Pay: Rate, Stipend, and Accommodations
When reviewing offers, break down:
- Hourly rate: Regular, overtime, and stat holiday rates—ask for all.
- Stipend: Is there one? Is it taxed? What makes it change?
- Accommodations: Provided or allowance? Where, what, how much, and when paid?
- Travel reimbursement: How much, when, and what receipts are needed?
Questions to Ask So You Don’t Get Lowballed
- “What’s the bill rate for this contract?”
- “Can you send the full pay package breakdown in writing?”
- “What’s the cancellation policy?”
- “What are the expectations on floating?”
- “What’s the schedule and how locked is it?”
- “What’s the fastest way to increase my rate?”
Simple Negotiation Scripts for Nurses
- “Can you walk me through the pay package? I’m comparing two other options.”
- “I’m interested, but at that rate it doesn’t make sense for my nursing practice. If we can get to $X/hour, I can commit today.”
- “If the hourly rate can’t move, what can we adjust—stipend, travel reimbursement, completion bonus, or schedule?”
- “I’m not comfortable signing until I have the full breakdown in writing.”
- “I appreciate it. I’m going to pass on this one. If something comes up closer to $X, let’s revisit.”
The Mindset Shift: You’re Not Begging, You’re Building
Operating as a nursing practice means you’re doing due diligence—not asking permission. You’re protecting your time, license, and pay structure. That’s professionalism.
Recap
- Choose 2–3 agencies
- Get everything in writing
- Ask about bill rate, pay breakdown, cancellation, floating, schedule
- Negotiate calmly and professionally
If you do these things, you’ll avoid most lowball situations.
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