As travel nurses fill the acute shortage, higher wages create challenges for health systems

While working alongside a temporary nurse who makes double or triple your salary could cause stress, Erickson says she hasn’t had problems with her co-workers. “They might ask how much I earn, and I’ve been open with them,” Erickson says. “Honestly, they have a small number of employees, so they are more than willing to help as it takes some load from them.”

With four years of experience as a medical and surgical nurse in Sioux Falls, South Dakota, and then three years as an intensive care nurse in Kansas City, Missouri, Erickson transitioned to travel nursing in 2019.

“I was 30 at the time, and I thought, ‘If I don’t do it now, I never will,'” Erickson recalls. Since then, she has worked in Missouri, Florida, Louisiana, Pennsylvania, Maryland, and North Carolina. After completing her contract in Wilmington, Erickson returned to Maryland in November 2021 under contract, where she worked in the surgical intensive care unit at the University of Maryland Medical Center.

Like staff nurses, the vast majority – 78 percent – of travel nurses are women, with an average age of 44. Many travel with a pet or family member, while others choose local contracts that allow them to more easily spend time with family during their days off .

While the largest US travel agencies such as Aya Healthcare only place nurses within the US, agencies such as Worldwide Travel Staffing specialize in placing nurses in roles outside the US, or nurses can find employment through staffing agencies located in the host country. Overseas travel nurses with advanced degrees may work in the United States on an H-1B visa, which allows employers to petition for a temporary worker in a specialized profession.

“I wanted more financial freedom,” says Erickson, who earned more than double her salary as a nurse after signing with Aya Healthcare. “But more than money, it was the experiences I would gain – traveling to new locations and getting paid to do it. I could explore the food, the sights and the people.”

Seeing new places, gaining more experience, and making more money are some of the major “push and pull” factors influencing nurses to move from a staff position to travel, according to NDMU’s Davies.

“Payment factors are those things that push an individual out of their current workplace, whether it’s because of a lower wage, an increased workload, or if they feel it’s an unsafe work environment, perhaps because of employment ratios, and things like that,” Davis explains.

For the “pull” factors, “this becomes a conversation about fairness and fairness,” says Davis. “For some people, the pull factor is, ‘Well, if I’m going to do the same work, why shouldn’t I get the increased compensation? “

In addition to the jump in pay, other benefits of being a travel nurse include increased flexibility, with the option to spend time between contracts, and the opportunity to live in different parts of the country — Davis says her former colleagues have taken jobs in Hawaii and the US Virgin Islands. Additionally, travel nurses can gain experience in different hospital settings.

But for many, the pandemic has been the catalyst to move into travel nursing not just for better pay, but for the opportunity to bring their skills where they are most needed.

“Nurses have been able to go to those places of greatest need and give up themselves, their time, resources, and knowledge to support these healthcare systems,” Davis says. For many nurses, this kind of service instinct is simply part of their calling. “I’ve definitely seen a slight increase in that and know colleagues who have responded to the call amid this pandemic,” Davis says.

Hospitals struggle to pay high fees to make up for the nursing shortfall, but in many cases, they have no other choice. LifeBridge Health, which operates five hospitals and its affiliated care centers in the greater Baltimore area, has been hit by a nursing shortage like most health care groups across the country.

“He made COVID [the shortage] the worst; Leslie Simmons, Executive Vice President and COO of LifeBridge Health explains. Some of the nurses retired early, part of that was the fear and the length of the pandemic. It was exhausting.”

Travel nurses play an important role in increasing the recruitment matrix, Simmons says. In general, she says, LifeBridge Health brings nurses in for eight to 12-week assignments when employees are abroad for maternity leave or summer vacations, or during peak flu season.

During the height of the COVID-19 pandemic, LifeBridge Health employed approximately 200 travel nurses through the system. But paying for it became a challenge when the hourly rates the hospital pays to recruitment agencies for critical care nurses jumped from $100 to $225 an hour.

“It was a challenge because the agencies were paying very high rates, and despite what we were doing to retain staff, we couldn’t keep up,” Simmons says, noting that LifeBridge Health is expected to spend $58 million on travel nurses across all facilities for the year. fiscal 2022, which ends in June, compared to just $13 million in fiscal year 2020. “It’s a 445 percent increase over the last two years. We just can’t afford it.”

Simmons, who comes from a family of nurses and her daughter was considering a travel job, doesn’t blame the nurses for wanting to make more money. “We are grateful that we have travel nurses to help us with this,” she says. “It was hard to pay their prices, but I don’t know we could have done without them.”

But travel nurses are not a sustainable long-term solution to staff shortages. In fact, several groups led by the American Hospital Association, including 200 bipartisan members of Congress, have called for an investigation by the White House into the pricing practices of staffing agencies that hire travel nurses across the country. They cited rapid price inflation with profit margins of 40 percent and the consolidation of recruitment agencies by private equity firms since 2021.

To retain and grow its workforce, LifeBridge Health spent $14.5 million in salary increases and $26 million in sign-up and retention bonuses. “[But] Simmons says. “The agencies will hire our employees and pay retention bonuses.”

For a long-term solution to the shortage, LifeBridge Health has recruited more than 100 foreign-educated nurses, many of whom are starting this spring at Sinai Hospital in Baltimore. The recruitment of doctors, nurses, and other healthcare professionals from abroad has occurred for more than 70 years and is part of addressing the current nursing shortage, according to the American Association for International Healthcare Employment.

“We think it’s a more sustainable way to get more nurses into the state,” Simmons says. They also focus on training recent graduate nurses for residency programs and ensuring that staff salaries remain competitive. Veteran Nurse and Nurse Brian Liquido traveled to Nursing in February to help support his extended family financially after they suffered unexpected losses due to COVID-19.

“I like feeling uncomfortable. If I don’t feel like I’m learning something, it’s time to move on. I used to be able to adapt and that’s just another test of that.”

Liquido, whose comprehensive resume includes seven years on the Lifeline Critical Care Transportation Team with Johns Hopkins Hospital—two of whom have been as a flight nurse for a STAT MedEvac helicopter—has the personality and skills that enable him to excel in an unknown and ever-changing environment. Travel Nursing.

“I’m an adrenaline junkie,” he says. “I like feeling uncomfortable. If I don’t feel like I’m learning something, it’s time to move on. I’m used to being adaptable and that’s just another test of that.”

During the pandemic, Liquido frequently worked more than 50 hours per week on his crew site, often alongside the travel nurses. “There was a noticeable change,” he says of the long-term fatigue a year after the pandemic. “Initially, it was infuriating for someone to make double and triple — at its height, four times — what I made as a nurse,” he says.

But over time, he says, general “desensitization” led to a reluctant acceptance among the nursing staff. “Now, most people say, ‘That’s how it is,’ and I don’t see that hostility anymore if the traveler is good, and most of my experiences with travelers as a staff nurse is that they’ve all been super efficient.”

He says he has no regrets about moving to a travel nurse with Aya Healthcare. He is now working on his first assignment in the Open Heart Intensive Care Unit at York Hospital. “Now I can just do my three shifts, give good care, and then keep something in the tank to take back to my family,” says a father of two.

“Everyone has their own reasons for traveling,” Liquido says. “For me it is not just about money. This is a plus, but it is about family and having a better work-life balance.”