You submitted all your documents, your references checked out, and your license is verified. Then the compliance department tells you your background check is "pending" and your start date might need to be pushed back. Or worse, something showed up on a search that you forgot about or did not think was relevant.
Background checks and drug screens are the compliance items that travel nurses have the least control over and the most anxiety about. They are also the items that can most quickly derail an assignment if something goes wrong. Here is what you need to know.
Types of Background Checks
Travel nursing agencies do not run a single, simple background check. They typically run multiple searches as part of a comprehensive screening package.
National criminal database search. This searches federal and state criminal databases for felony and misdemeanor convictions. It covers your entire history, not just recent years.
County criminal search. Some agencies run additional searches in specific counties where you have lived or worked. County-level searches can turn up records that do not appear in national databases.
Sex offender registry check. A search of the national sex offender registry is standard.
OIG exclusion check. The Office of Inspector General maintains a list of individuals excluded from participation in federal healthcare programs. Being on this list means you cannot work at any facility that accepts Medicare or Medicaid, which is virtually every hospital.
SAM exclusion check. The System for Award Management is another federal exclusion database that agencies check.
Social Security number trace. This verifies your identity and may reveal addresses and aliases associated with your SSN.
Employment verification. Your work history for the past three to five years is verified with previous employers. This confirms job titles, dates of employment, and eligibility for rehire.
Education verification. Your nursing degree is confirmed with your educational institution.
Some facilities also require fingerprint-based background checks, which are processed through the FBI. These are more thorough than name-based searches and are required by certain states as part of the licensing process.
How Long Background Checks Take
The timeline for background checks depends on the type and scope of screening your agency and facility require.
A standard national criminal database search typically returns within one to three business days. County-level searches take longer, especially if records have to be retrieved manually from courthouses. These can take five to ten business days.
OIG and SAM checks are instant. Employment and education verification depends entirely on how quickly your previous employers and school respond. Some HR departments respond within a day. Others take two weeks.
Fingerprint-based FBI checks can take two to six weeks depending on the state and the current processing backlog.
The total timeline for a complete background screening package is typically five to fourteen business days, assuming no issues arise. If a county search has to be done manually, or if a previous employer is slow to respond, it can take longer.
You cannot speed up the background check itself, but you can speed up the parts you control. Submitting accurate personal information, providing correct addresses for everywhere you have lived, and making sure your employment history matches your resume all prevent delays caused by discrepancies.
What Shows Up and What Does Not
The question every travel nurse with any history wants answered is: will this show up?
Felony convictions will show up on a background check. Depending on the nature of the offense and how long ago it occurred, this may or may not prevent you from getting an assignment. Violent offenses, theft, fraud, and drug-related felonies are the most likely to be disqualifying.
Misdemeanor convictions will also show up. Minor misdemeanors from years ago may not be an issue, but it depends on the facility's policies. DUI convictions, for instance, appear on background checks and are evaluated on a case-by-case basis.
Arrests without convictions may or may not show up, depending on the jurisdiction and the type of search. Some states prohibit employers from considering arrests that did not lead to convictions.
Expunged or sealed records. In most cases, expunged records do not appear on standard background checks. However, they may appear on FBI fingerprint checks, depending on state law.
Traffic violations. Standard traffic tickets do not typically appear on criminal background checks. However, serious traffic offenses like DUI or reckless driving do.
Civil matters. Lawsuits, divorces, and other civil court matters generally do not appear on criminal background checks.
If you have something on your record, the worst thing you can do is hide it. Most agencies have a process for reviewing records with issues, and many facilities will still accept nurses with minor or old offenses. But if you fail to disclose something and it comes up during the check, the lack of disclosure is often worse than the offense itself.
Drug Screening Requirements
Drug screens are required for every travel nursing assignment. The standard is a 10-panel urine drug screen, which tests for amphetamines, barbiturates, benzodiazepines, cocaine, marijuana, methadone, methaqualone, opiates, phencyclidine, and propoxyphene.
Some facilities use expanded panels that test for additional substances, and a few facilities have moved to hair follicle testing, which detects substance use over a longer window (typically 90 days compared to a few days for urine).
Drug screens are typically completed within 30 days of your start date. Your agency will tell you where to go for testing. Most use national lab networks like Quest Diagnostics or LabCorp.
Prescription medications. If you take a prescription medication that may trigger a positive result on a drug screen, bring documentation from your prescribing provider. This includes the prescription itself, the date it was prescribed, and a letter from the provider confirming the medication is prescribed to you. The Medical Review Officer who reviews the results will consider prescription documentation before reporting a positive result.
Marijuana. Despite changing state laws around marijuana, most healthcare facilities maintain a zero-tolerance policy for marijuana use. A positive marijuana result will disqualify you from an assignment at the vast majority of hospitals, regardless of whether marijuana is legal in that state.
Preparing for Success
The best approach to background checks and drug screens is simple. Know your own history, disclose anything relevant upfront, and stay clean.
Before you start applying for travel assignments, consider running your own background check. Several consumer background check services are available for a small fee. This lets you see exactly what will show up when an agency runs their check, so there are no surprises.
Keep documentation of any prescription medications that could affect drug screen results. Have provider letters ready before you need them.
If you have something on your record that might be an issue, talk to your recruiter before the background check is run. They have dealt with these situations before and can advise you on how to proceed and which facilities are most likely to work with your situation.
Background checks and drug screens are a routine part of travel nursing compliance. For the vast majority of nurses, they are a minor inconvenience that is completed and forgotten. But for those who are caught off guard, they can derail an assignment and damage a professional relationship. A little preparation goes a long way.
