‘There are few core staff left’: Dozens of nurses accept high-paying travel jobs

ARLINGTON — After nine years at Providence Regional Medical Center Everett, Cecillia Hoglund said she was finally joining the “waving bandwagon.” The intensive care nurse leaves her post to become a traveling nurse.

On travel contracts, Hoglund expects to earn $4,500 a week. That’s about four times what she earned in Providence. Despite the title, she will likely remain in state, at another facility in western Washington.

And she hopes it will help her “emotionally endure.” Before the pandemic, Hoglund felt like her job in intensive care meant the difference between a patient dying — what she calls a “heavenly dump” — or a patient getting better. Now, she says, fewer and fewer of her patients are recovering.

“To be frank, I’m shoveling people into body bags faster than they can keep them stocked,” she told the Daily Herald. “You’re holding an iPad in all your gear and you’re crying because there’s a crying family member on an iPad crying and saying goodbye to you while you’re holding the patient’s hand.”

Traveling nursing is a field that has exploded in the past couple of years, with a growing demand for short-term positions and those who fill them enjoy significantly higher salaries.

More nurses are making the same choice. Hoglund estimated her Providence unit had about 80% travel nurses when she left this month.

“There are very few core staff left,” she said. “Since COVID, we’ve been getting loads and loads and loads of travellers.”

“Not sustainable”

The situation worsened this winter, when omicron flooded hospitals with a record number of COVID hospitalizations. In Snohomish County, the figure peaked at around 200, prompting the deployment of the National Guard from Washington to Providence.

Everett Hospital confirmed this month that more temporary positions have been created amid the pandemic. But staff and managers say they can’t always rely on travel nurses.

This is “not a desirable or sustainable approach,” Providence spokesman Casey Calamusa wrote in an email to the Herald.

Last November, hospitals across the state were using nearly 3,000 travel nurses, according to the Washington State Hospital Association, which also called the approach “unsustainable.” The time it takes to fill a registered nurse position has increased by 54% from 2019 to 2021, with well-documented burnout precipitating what officials called a “big quit.”

In some ways, the use of travel nurses has created a feedback loop within hospitals. The presence of so many short-term, highly paid nurses can frustrate in-house staff, exacerbating the burnout that has led to a high demand for traveling nurses.

Everett emergency department nurse Matthew Deitz, for example, said he wanted to keep his job. But it’s hard to see so many of his colleagues leaving and being replaced by traveling nurses. There are “key people” he enjoys working with. If they left the hospital for travel positions, he would also consider that.

“I keep an open mind,” he said. “I’ve been with Providence for 11 years, so I feel loyalty to this hospital.”

For Hoglund, spending his shifts answering “a million questions from a traveler who earns four times what I earn – it’s frustrating.”

It’s hard to make meaningful connections with colleagues who only stay for a few weeks or months. After performing back-to-back CPR on patients, she says, it’s good if a longtime colleague asks how she’s doing, emotionally.

“Those dynamics are kind of missing now,” she said. “That’s why I finally decided to leave.”

“Headhunters”

An analysis of 2021 exit interviews by the Washington State Hospital Association found that 15% of nurses were pursuing travel nursing gigs. This was the third most cited reason for leaving, behind moving spouse (16%) and other unspecified reasons (27%).

This means booming business for agencies working to fill the gaps.

This month, AMN Healthcare Services, the nation’s largest temporary staffing company, said last quarter revenue exceeded previous estimates by $70 million, with demand at “record highs”. An investor presentation cited “significant opportunity with a large and fragmented market,” highlighting a projected shortage of doctors to reach 139,000 by 2033 as the pandemic accelerates turnover. Revenue this quarter is expected to exceed $1.1 billion.

Michael Colosi, an executive at NSI Nursing Solutions, said the “incredible” increase in demand for travel nurses cannot be sustained for long as hospitals shell out big bucks for short contracts. He described hospitals spending hundreds of thousands of dollars a year for the equivalent of a full-time employee.

“I mean, that’s what you pay a surgeon for,” Colosi said.

This is where NSI Nursing Solutions comes in. The company finds and places permanent staff in hospitals. They are generally paid less than traveling nurses, but still more than their new colleagues.

“We are, for lack of a better term, headhunters,” Colosi said.

As for the tension that arises from pay differentials, he said, “it’s inherent in any business. It’s just more polarized right now.

For Deitz, the trend is worrying. What was meant to be a short-term fix now seems to be the norm.

“I saw this happen over a year ago as people slowly started to leave. Eventually everyone will want to travel,” he said. “It will eventually come to a head. .”

“Always in the Air”

Some states have already taken steps to restrict the amount that registered nurses could be paid in certain situations. In Pennsylvania, Republican lawmakers are backing a bill that would regulate contracted health care agencies and prohibit them from charging more than 150% of the average nursing home rate.

Massachusetts and Minnesota also have some restrictions on how much agencies can charge nursing homes for temporary staff.

In Washington, Governor Jay Inslee said this week that salary caps are not the solution.

“We need more nurses. It’s pretty simple,” he said. “…We are at both ends of this challenge. So we use traveling nurses and therefore compete with ourselves.

Inslee cited his proposal to invest millions in residency programs, expanding them in an effort to strengthen the workforce.

Meanwhile, young resident nurses enter a realm of low morale, with no end in sight.

A recent nursing school graduate told the Daily Herald that she noticed the general mood in Providence was, “I don’t know how long I can do this.”

“It’s like it’s still up in the air,” said the nurse, who asked to remain anonymous out of concern for her new job. “…Especially on a really bad night, even with mentors I really admire who have been in Providence for 10 years or more.”

The employee said there is a definite stigma around travel nurses and how much they are paid.

But since she takes care of five to six patients each night, she appreciates – and needs – the help.

“I would just be happy,” she said, “to have more staff and less pressure on me.”

Claudia Yaw: 425-339-3449; claudia.yaw@heraldnet.com. Twitter: @yawclaudia.

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