The Flow of Money

To be good at negotiating, the first step is understanding where the money comes from and what happens to all the money before it ends up in the nurse's hands. 

Hospital pays the Agency 

When a hospital has a need for a travel nurse, the hospital typically uses an agency to fill that need. The hospital will pay the agency a previously agreed upon amount. This amount is called the bill rate. The bill rate amount and terms of the contract (guaranteed hours/hours required/holiday, weekend requirements, etc.) are most likely already set by the hospital and written in the master contract. This contract is rarely mentioned but it is usually called the master contract and it is a contract between the hospital and the agency. The master contract is where the hospital lists their expectations for the contract. 

The master contract explains all the details including what the hospital will pay for and how much they will pay for it (bill rate). When the nurse is negotiating a contract, the agency should not have to “go back and talk to the hospital” because most things are written in the master contract. Hospitals typically do not negotiate/change the terms of the master contract (bill rate) when a nurse is demanding more money because in most situations, hospitals know another nurse will accept the contract if one nurse will not. 

Since the hospital pays the agency and the agency pays the nurse, all negotiations regarding pay is done between the nurse and the recruiter.