Top Travel Nursing Challenges and How Staffing Firms Can Help

Travel Nurse Pay Issues

During COVID-19, demand for travel nursing surged due to unprecedented care needs, government emergency contracts, and fierce bill rate competition among agencies. This led to doubled—or even tripled—pay rates. However, as the immediate crisis waned, demand dropped and hospitals initiated cost controls, causing pay rates to normalize.

There’s now ongoing debate around proposals to cap travel nurse wages, as some argue high rates destabilize healthcare finances, while advocacy groups warn it could worsen nursing shortages.

Other emerging trends in the pay landscape:

• Pay transparency between agencies remains inconsistent—Nurses may see varying rates for identical assignments.
• Facilities now offer completion bonuses or retention incentives instead of higher base pay.
• Housing stipends play a bigger role in overall compensation, with increasing focus on competitive housing allowances.

Travel Nurse Tax Issues

Travel nurses continue to face complex tax regulations, especially when working across multiple states with differing tax laws. Each new assignment can trigger unique requirements, and mishandling taxes can result in costly errors.

Multi-State Taxation Challenges

Travel nurses typically file non-resident tax returns for each state where they work, while also managing residency status in their “tax home.” The IRS has strict rules around tax homes and how stipends are treated.

Common mistakes made by travel nurses include:

• Not keeping documentation of housing or rent payments.
• Misunderstanding the difference between taxable wages and tax-free stipends.
• Assuming their agency handles all tax complexity (agencies rarely are responsible for personal tax compliance).

Determining a Tax Home

To determine their tax home, travel nurses have two options. They can either establish a tax home in the area where they have worked the most, or they can return home for at least 30 days out of the year and provide evidence of paying expenses such as mortgage, rent, and utilities. Properly establishing a tax home is essential for travel nurses to ensure compliance with tax laws and maximize their tax benefits.

There are two common ways travel nurses establish their tax home:

1. Maintain ties and expenses in a primary residence (rent receipts, utility bills, mortgage)
2. Return to a permanent residence for at least 30 days per year

Properly establishing a tax home is vital—if not done correctly, all stipends received may become taxable income, increasing tax liability and reducing take-home pay.

Meeting Stipend Rules

Another tax-related challenge for travel nurses is the treatment of stipends. Unlike staff nurses, travel nurses receive tax-free stipends to cover expenses such as travel and housing. However, to qualify for tax-free treatment, travel nurses must adhere to strict IRS rules. It’s important for travel nurses to consult with certified tax professionals who specialize in the healthcare industry to ensure their stipends are properly accounted for and to avoid potential issues when securing loans or disability payments.

IRS compliance is essential for travel nurses benefiting from tax-free stipends.

• Must maintain duplicate expenses (housing at permanent home and at travel assignment).
• Avoid pitfalls related to “permanent traveler” status, a red flag for audit risk.
• Consulting a healthcare-specialized tax professional is strongly recommended to ensure everything is handled correctly.

Top Concerns for Travel Nurses

Travel nurses face more than just tax and pay issues. Their unique career path comes with a wide range of challenges that can impact satisfaction and well-being.

Job Security

Short-term contracts mean constant uncertainty. Last-minute assignment cancellations or abrupt end-dates are common, leaving nurses scrambling for new placements.

Adapting to Different Work Settings

Every facility has its own protocols, charting systems, and team dynamics. Travel nurses must quickly adapt, building rapport and effectiveness in unfamiliar environments.

Licensing and Credentialing

Keeping multiple nursing licenses active is time consuming. While the Nurse Licensure Compact (NLC) helps nurses practice in many states without separate applications, not all states participate—adding layers of credentialing complexity.

Housing and Accommodations

Travel nurse housing challenges are growing as cost-of-living increases outpace stipends in many areas. Nurses relocating every 13 weeks or less struggle to find safe, affordable short-term rentals in competitive markets.

Work-Life Balance

Irregular shifts, long hours, and frequent travel create stress and can chip away at work-life balance. Travel nurse burnout is real, making wellness support crucial.

Workforce Issues

Facilities are still chronically understaffed post-pandemic. High patient loads, resource shortages and lessened administrative support contribute to stress and potential burnout.