For most hospitals, employing travel nurses isn’t new: before the COVID-19 pandemic, Kent County Memorial Hospital in Warwick typically had eight to 10 travel nurses – health care workers who travel from place to place to work temporarily at certain locations – in its workforce.
Today, that figure is around 50.
While not a huge portion of the hospital’s overall nursing staff, which includes about 430 full-time and part-time staff nurses, it’s a significant increase from Kent’s pre-pandemic levels and comes with significantly higher expenses.
“Our costs are higher, so in order for us to fulfill our mission and care for our community, you do need a stable financial environment,” said Judy Thorpe, chief nursing officer at Kent, which is operated by Care New England Health System. “We want to be able to care for the community, and it’s a struggle now until our labor costs stabilize.”
In addition to paying extra for travel nurses, Kent has also had to increase its compensation for its staff nurses to attract and retain staff. All in all, the hospital now pays double to triple the expenses in nurse staffing compared with before the pandemic.
Lifespan Corp., the state’s largest hospital system, is in a similar situation: about 118 travel nurses work across Lifespan facilities as of early April, alongside 2,500 to 3,000 staff nurses. But this level of travel nurses on staff is “probably twice than what we’ve had pre-COVID,” said Cathy Duquette, chief nursing executive at Lifespan.
While travel nurses provide essential care amid widespread staffing shortages, which have become particularly pronounced due to the COVID-19 pandemic, agencies require higher payment that hospitals say they can’t match for their own staff, even as they increase wages and compensation.
The need for additional travel nurses at Kent arose from the same issues familiar to hospitals around the country and throughout the world, Thorpe said: an influx of patients during the pandemic, as well as staff nurses being out sick with COVID-19.
And with travel nursing becoming more common, hospitals have another competitor when trying to attract full-time staff.
Multiple factors are drawing nurses to leave their staff positions for a travel assignment, according to observers.
For one, the positions offer higher compensation. One agency, Nebraska-based Triage Staffing, in mid-April had job postings in Rhode Island with weekly gross pay packages of up to $4,314.
Not all of this money goes into the nurse’s paycheck – the package also includes a housing and food stipend – but hourly pay still works out to wages around 20% to 25% higher than a staff nurse’s wages on average, according to Triage Staffing CEO John Maaske.
But Maaske suspects the primary spike in travel nursing among nurses – at Triage, this interest has tripled compared with pre-pandemic rates – is “the opportunity to experience different kinds of work settings,” especially as more health care workers experience burnout.
And as many office workers enjoy benefits such as flexible schedules and remote or hybrid roles, nurses are looking for more opportunities to take control of their work schedules, Maaske said.
While some nurses appreciate the opportunities offered by travel nursing agencies, Triage and companies like it have also been accused of profiting off the pandemic at the expense of hospitals and staff nurses.
When the state leaders allocated Coronavirus Aid, Relief, and Economic Security Act funding for health care, “I’m pretty sure they weren’t voting so a couple of nurse staffing agencies can make a lot of money,” said Patrick J. Quinn, vice president of Service Employees International Union 1199 New England, which represents about 2,500 Care New England workers, including nurses at Women & Infants Hospital and Butler Hospital.
“Workers in health care – nurses in particular – should be paid well, but there’s no room for profiteering off the COVID crisis,” Quinn said. “That’s really repugnant.”
Expenses charged by agencies have created a “huge budget issue,” he said, and most expenses are “going to the agencies that are booking the nurses – not to the nurse.”
Despite criticisms, Maaske said he sees travel nursing as “part of a really positive solution for how health care is delivered as we move forward.
“It allows hospitals to make sure that they’re able to provide good patient care during different peaks and volumes that they may experience throughout the year,” he said. “Without a contingent workforce, it’s hard to execute that.”
Health care leaders in Rhode Island expect this contingent workforce – and the higher costs associated with it – won’t be changing anytime soon.
“We are certainly committed for the foreseeable future to sign-on bonuses and those types of costs,” Thorpe said.
The reliance on contract workers in health care also extends beyond hospitals, and even to higher education, Duquette said.
“It’s not just hospitals, not just nurses,” she noted. “It’s also primary, outpatient, ambulatory [care]. The shortages are impacting the entirety of the health care delivery system right now, even nursing school faculty.”
At Salve Regina University, spokesperson Matt Boxler said the university has “lost adjunct instructors to travel nursing because they can be paid more for working than they can for teaching.”
Like Kent, Lifespan has also added bonuses, benefits and when possible, flexibility, in an attempt to attract and retain staff, and expects to keep these in place for the foreseeable future.
“We saw an exodus from nursing and other health care professions,” Duquette said. “It’s going to take a little time to catch up, so we’ll be relying on our travel nurses for a while and recruiting.”
Jacquelyn Voghel is a PBN staff writer. Contact her at Voghel@PBN.com.
