‘Nurses have finally learned what they are worth’

For at least three decades, hospitals in the United States have followed a model that aims to tailor nurses precisely to the number of beds occupied. It’s a guessing game where nurses do the daily counts and hospital administrators anticipate the seasonal movements of illness and people – winter flu and migrating retirees. Many hospitals do not offer nurses clear paths to career advancement or pay increases. Depending on demand, they can swap nurses between units. If there are shortages throughout the hospital, they send emails and text messages asking nurses to come in and take an extra 12-hour shift. And when the shortages are too great, hospitals turn to travelers.

Even before the pandemic, there were many reasons to hire travelers. Nurses would be deployed for a season, maternity leave or the opening of a new ward. This kind of DIY job became more common, and according to data from Staffing Industry Analysts, sales in the travel industry tripled from 2009 to 2019, reflecting a workforce that was already on the move. There are hundreds of staffing agencies in the United States: national agencies, regional agencies, agencies that specialize in bringing in nurses from other countries, agencies that send US nurses abroad. By mid-March 2020, there were more than 12,000 traveling nurse vacancies, more than double the number in 2019.

As the coronavirus spread, demand came from all quarters. In December 2020, there were more than 30,000 traveler vacancies. And with the help of federal dollars — from the CARES Act Provider-Relief Funds and the American Rescue Plan — their salaries started to rise. Jobs in Fargo, ND, advertised job openings for $8,000 a week. In New York, travelers could earn $10,000 or more. The median salary of a nurse in Texas is about $75,000; a traveler could make that in months.

Nurses often refer to their work as a calling – a calling that is essentially not about money. At the same time, nurses have protested for years against their long hours and the nurse-patient ratio. In 2018 alone, there were protests in California, Michigan, New York, Pennsylvania and several other states. When the pandemic hit and travel positions opened up in hospitals across the country, nurses suddenly had more options than ever. They could continue to serve patients, work grueling hours in appalling conditions, but they would be well paid. Travelers were appreciated. Their work was in high demand. The money would be enough to work, go home and recover after a few weeks or months.

Hospital associations were already beginning to see the high costs of these workers, but they had little choice. The shortages were too great and would only get worse. In July 2020, Texas established a statewide staffed emergency response system, coordinated by selected regional advisory councils. The state has invested $7 billion in emergency resources to replenish staff, allowing hospitals like Northwest to attract travel nurses without incurring the full cost. “The problem is, their salaries were so much higher than our employees,” said Brian Weis, the chief medical officer at Northwest. “Our working nurses did the same job, but they say, ‘Why are we getting paid a fraction of what these nurses are?'”

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The following year, demand for travel nursing broke loose from Covid. In April and May 2021, when the number of cases fell, the number of hospital applications for travel nurses only grew exponentially. “They now know what pent-up demand is doing to a healthcare system, and it’s not healthy,” said April Hansen, group president at Aya Healthcare, one of the largest providers of travel nurses in the country. “If you look at our question today, it’s similar to our pre-Covid question in terms of specialties: med-surge, telemetry, ICU, emergency room, surgical. It’s just the volume that every specialty is asking for.”

It’s not just the boom of traveling nurses that has transformed the market. There are also more job opportunities out of bed than ever. Nurses treat patients in doctors’ offices; insurance companies employ thousands of nurses; Microsoft and Amazon have hundreds of job openings in healthcare. Today, only 54 percent of registered nurses in the country work in hospitals. “Before the pandemic, there was competition for talent,” Hansen said. “But the pandemic took a small tear and made it as wide as the Grand Canyon.”

This post ‘Nurses have finally learned what they are worth’

was original published at “https://www.nytimes.com/2022/02/15/magazine/traveling-nurses.html”