Traveling nurses – a double-edged sword for desperate hospitals

Higher wages are forcing full-time nurses to take up work as mobile nurses, leaving their former employers even more understaffed, creating tension between nurses and raising questions about the impact on quality of care.

While nursing contracts often do not include the same benefits as paid nurses, higher hourly wages are an attractive trade-off for many, especially as COVID-19 overwhelms hospitals in some states and heightens the need for nurses. and increases compensation. expenses.

Financially sound hospitals can pay nurses between $ 6,000 and $ 10,000 a week, often along with a stipend to cover housing and travel expenses.

“The nursing situation has essentially led to a betting war between hospitals,” said Dr. Philip Cool, vice president and chief physician of the health system at Augusta University in Augusta, Georgia. “A nurse can leave the facility, sign a ‘travel contract’ to the facility across the street, and earn more than double what they made while staying at home.”

The growing demand and limited labor supply, in turn, has led to rapid wage increases, said Kathy Konke, senior vice president of customer service at Fastaff Travel Nursing.

But when hospitals offer higher wages, it can exacerbate staffing problems in hospitals with fewer resources that cannot match the compensation available to nurses elsewhere, Kool said.

Since the start of the pandemic, the urgent need for mobile nurses to fill the workforce gap has increased dramatically. According to medical staffing company Aya Healthcare, demand is 284% higher than it was at that time last year.

As the delta option increases the number of COVID-19 cases, Konke said there are over 40,000 travel nursing seats available on any given day.

In 2020, 90% of hospital executives hired traveling nurses to support their teams during the pandemic. Last year, before COVID-19 arrived in the U.S., less than 60% hired nurses, according to Survey 2021 of 100 executives of the recruiting agency Avant Healthcare Professionals.

“The Delta Virus is driving even more competition for scarce talent, and our clients cite retention issues as well as ongoing recruitment,” said Susan Salka, CEO of human resources firm AMN Healthcare, in a statement. “Demand is compounded by vacations, physician fatigue, growing patient numbers and operating room failure – and our clients tell us this is unlikely to change anytime soon.”

In addition to higher wages, travel positions provide nurses with an easier way to support their families, pay off student loan arrears, and avoid excessive burnout through more flexible scheduling, according to a spokesman for the American Nursing Association.

An ANA spokesman said travel nursing was meant to be a short-term solution in critical areas. But in the current circumstances, the need for medical care has overwhelmed the entire medical staff, including both hired and contract nurses.

According to Patricia Pittman, professor of health policy and management at the School of Health Sciences, this pushes staff nurses away from working conditions and employer frustrations due to long-standing labor shortages, layoffs during the pandemic, and pay gaps between staff and nurses involved in travel. Public Health at George Washington University.

“The good thing about nursing travel is that during natural disasters or very irregular levels of demand, hospitals can use nurses to fill the gaps,” Pittman said. “The bad side of travel nurses is that they become an excuse not to invest in regular nurses. This is a double-edged sword. ” This could further cause resentment among the nurses, who have been carrying a heavy burden since the beginning of last year. …

Kelly Rivera-Crane, a business agent for Teamsters Local 332 and a Registered Nurse at Ascension Genesys Hospital in Grand Blanca, Michigan, offers bonuses for recruiting traveling nurses rather than employees – it’s a slap in the face.

Rivera-Crane said salaried nurses should be treated better after they are loyal to their employers, get through the pandemic hard, and face inadequate staff when hospitals violate the nursing-patient ratio rules.

Bringing in traveling nurses can also disrupt workflow and healthcare as they typically don’t receive as much training from their temporary employers as full-time nurses and don’t stay long enough to build relationships with patients, Rivera-Crane said.

According to Cole, a nurse who has worked in a hospital for eight weeks cannot have the same understanding of processes, patients, and problems as a staff nurse working in a hospital. “When you replace team members, it can certainly affect the quality of care,” he said. “The likelihood of error and communication problems is likely to increase.” Forty full-time nurses resigned from the Augusta University health care system last month, attracted by high-paying nursing travel, Cole said. “As soon as we have a traveling nurse, we lose staff due to travel contracts,” he said.

In some hospitals, staff turnover is so high that a large portion of the unit consists of traveling nurses on some shifts, said Matt Calzia, a nursing practice consultant for the Oregon Nurses Association. scarcity in rural and underserved areas that have fewer resources and are home to marginalized communities with poor access to health care, Calzia said. These are the hospitals that least of all can afford to hire workers, he said.

“You are perpetuating inequalities in the health system as a whole,” Calzia said. “We take nurses from areas who really need nurses, but also don’t pay, and move them to areas that can pay better and that really need nurses as well.”

Because of unsustainably high wages for nurses while traveling, the American Hospital Association asked the FTC in February to investigate reports from nurse recruiting agencies. anti-competitive pricing

With the travel nursing industry inaccessible to some hospitals, Pittman said, many are beginning to realize that it was a mistake to fire nurses rather than invest in them and treat them as critical workers.

Employers are reluctant to listen to nurses’ cries for help, Pittman said, and offer near-meaningless bonuses and wellness workshops instead of addressing the systemic problems that make nursing such a challenge.

“The silver lining of this crisis is that it is forcing nursing and hospital leaders to take the nursing staffing situation more seriously,” Pittman said.

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