Nurses leave staff jobs during covid and triple salaries to travel

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The American Hospital Association represents a wide variety of hospitals, including nonprofit, for-profit, government, and others. A previous version of this article stated that the group only represented nonprofit hospitals. The article has been corrected.

Wanderlust and the money to fund it made Alex Stow’s decision easier. After working a few years in an intensive care unit, he signed up to become a travel nurse, tripling his salary to around $95 an hour by agreeing to help understaffed hospitals across the country during 13 weeks at a time.

“Voyage” turned out to be a bit of a misnomer. His current posting is in Traverse City, Michigan, just hours from his old full-time job in Lansing — close enough that he’s still working day shifts at his old hospital.

Now, 25-year-old Stow is buying a truck and an RV and getting ready to hit the road. He will work wherever he pleases and take time to tour the country between nursing assignments.

“As soon as I found out it was something I thought, ‘My name is written all over the place,'” said Stow, who agreed to discuss his new work life if hospitals weren’t named. .

In March and April 2020, The Post asked five nurses across the United States to describe what life is like working on the front lines of the coronavirus pandemic. (Video: Drea Cornejo/The Washington Post)

If 2020 was the year travel nursing took off, with growth of 35% compared to the pre-pandemic year of 2019, this year took it to new heights, with an additional growth of 40 % expected, according to an independent healthcare industry analyst. Workforce.

The pandemic continues; an aging, exhausted and retiring nursing workforce; the return of hospital services that were closed last year; and shortages of foreign recruits and nursing students have combined to make itinerant nursing one of the most critical and sensitive issues in health care.

“Of all the things that keep hospital CEOs awake at night, this is key,” said Chip Kahn, president and CEO of the Federation of American Hospitals, which represents about 1,000 for-profit facilities.

Hospitals accuse tour operators of inflating prices. Companies say they are responding to the laws of supply and demand in an increasingly mobile work environment. Nurses’ unions say there would be no shortages if nurses were paid properly and had better working conditions.

The only area of ​​agreement is that health staffing suffers from fundamental problems that need to be addressed for some balance and effectiveness to return.

“We need a better way to think about how we oversee, distribute, and monitor the supply of our healthcare workforce,” said Bianca K. Frogner, director of the medical school’s Center for Health Workforce Studies. from the University of Washington. “We don’t have any sort of centralized labor commission in this country.”

Stow’s hourly wage is currently near the median of $99 per hour for critical care travel nurses, according to Barry Asin, president of Staffing Industry Analysts, a research firm that focuses on the workforce. occasional work.

But a quick search brings up ads for even higher pay: $9,486 per week for critical care nurses, published by industry leader Aya Healthcare; nurses with cardiovascular experience can earn even more. Travel agencies may also offer a full range of benefits, and some pay nurses a bonus for referring other nurses.

The highest salary goes to nurses with experience in specialized hospital units such as different types of intensive care units, those willing to travel to remote locations for weeks or months, and those who are ready to respond immediately to emergency needs, industry people said. The demand for other healthcare workers, such as respiratory technicians, also continues unabated.

In contrast, a full-time registered nurse earns an average of just under $74,000 a year, according to a 2018 report from the Department of Health and Human Services. About 2.6 million nurses worked in hospitals in 2018, according to the government.

The market for traveling nurses, which Asin said could accommodate more than 100,000 such staff this year, had more than 40,000 vacancies in October, according to its data. Companies continue to recruit caregiver nurses to become travelers. Especially for younger and older nurses who are not tied to home or family, money and travel can be an attractive proposition.

“If people can go somewhere else and earn a year’s salary in three or four months, they will,” said Karen Donelan, a health policy professor at Brandeis University who tracks nursing staffing issues. “But they are walking in high covid areas. It is therefore a risk-reward scenario.

U.S. hospitals have faced periodic shortages of nurses for years, and demand was high even before the pandemic, fueled by aging patients and more insured people, said Bart Valdez, chief executive of Ingenovis Health, which has 6,000 traveling nurses, including Stow, in hospitals. Across the country. The arrival of the omicron variant could put more people in US hospitals with covid-19.

The average age of a nurse is 50 and critical care nurses are older – an aging workforce nearing retirement. The number of nurses needed to replace them has been limited by a shortage of faculty in nursing schools, said Akin Demehin, director of policy for the American Hospital Association, which represents a wide variety of hospitals. .

Hospitals are again offering elective surgeries and procedures that were canceled in the first year of the pandemic, putting more pressure on nursing staff. The flow of foreign nurses to the United States has been virtually halted by the pandemic and is not close to normal, said Kahn of the American Hospital Federation.

Then came the pandemic-fueled “Great Resignation” that created labor shortages in the United States. In health care alone, 534,000 people quit their jobs in August, according to the Bureau of Labor Statistics. Some left for other jobs, but others simply quit or retired. In long-term care facilities such as nursing homes and assisted living facilities, 400,000 health care workers have left since the pandemic began, said Frogner of the University of Washington.

Asin said that “2020 has been the year of ‘Everyone to the Barricades – let’s solve this national problem.’ ” ”

Exhausted by the pandemic, 3 in 10 healthcare workers plan to leave the profession

As coronavirus cases rose in their areas, hospitals also hired day nurses and retired nurses. In some particularly serious cases, the government sent military and public health personnel. Massachusetts announced last month that hospitals would reduce elective procedures due to rising covid-19 cases and staffing shortages.

The nation’s largest nurses’ union says hospitals are bearing the brunt of the just-in-time staffing model they created to cut costs by keeping the number of full-time nurses as small as possible.

“This current staffing crisis is one of the decisions of the hospital industry,” Deborah Burger, president of National Nurses United, said in a written statement. “They need to look closely at how their treatment of permanent staff and exploitation of the nursing ethos has inevitably led to this unsustainable pattern of hospital staffing.”

In the current crisis, these conditions have led to accusations that travel companies are abusing hospitals. In the event of a staff shortage, hospitals must close beds. Last month, four members of Congress asked Jeff Zients, the White House coronavirus coordinator, to look into the matter, and in February the American Hospital Association filed a complaint with the Federal Trade Commission.

“The rates that are paid and the amounts that nurses earn are often out of step with doctors,” Kahn said. “Companies that have these nurses are able to abuse and take advantage. I don’t think it can last forever.

Hospitals have been able to use government coronavirus relief funds to pay for some of their expenses, but that may not always be the case, the American Hospital Association’s Demehin said.

Valdez, of Ingenovis Health, said that “if you need nurses to support patients and you need them immediately, you will have to pay to get them there because they have so many different opportunities. It’s a high number — I admit it. But it’s a higher cost of not providing the services to the patients.

Stow said he sometimes sees the conflict first-hand when working side-by-side with staff nurses, performing the same tasks for much higher pay.

“With any population of people, you will have a few here and there. . . . They might show it a little bit and they might treat you a little bit differently,” he said. “I think most of the nurses you work with realize that we didn’t cause this. We are, for the moment, a kind of band-aid for the situation.

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