Enid Bedford is grateful that her nursing career has given her the opportunity to be closer to her family.
Bedford, a nurse from Memphis, Tenn., entered the field in her 50s after all her children had left home. During the pandemic, she started traveling for better pay and a better schedule.
“I usually work a 13- or 26-week assignment, then I can go home for two months and sit back and relax and spend time with my husband or family,” she said.
Bedford’s youngest son plays football for Indiana University — more than six hours from home. When she tore her ACL in the first game of the season, Bedford was able to get a contract as a travel nurse at a nearby hospital in Bloomington.
“I wasn’t here to enter his 21-year-old student life, but to help him through his injury,” she said. “And now that he’s doing so well, I’ll finish my mission and then be on my way.”
Travel nurses fill temporary positions in hospitals across the country, often signing contracts for a few months at a time before moving on to experience a new city. The travel nurse industry skyrocketed in 2020 as hospitals struggled with staff shortages.
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WFIU/WTIU News
Travel nurse salary varies widely depending on the task. Estimates show that hourly wages can be at least double if not triple the $39 an hour the average nurse makes. But the price hospitals pay for travel nurses is significantly more than the nurses themselves are paid, because nurses work with staffing agencies that contract with hospitals, negotiating prices based on demand.
That’s why about a quarter of hospitals say they’re looking to reduce their reliance on extra staff in the next year, according to 2022 NSI National Health Care Retention and RN Staffing Report.
“For every 20 travel RNs eliminated, a hospital can save an average of $4,203,000,” according to the NSI report.
Weekly pay for travel nurses decreased since the height of the pandemic, but reliance on travel nurses continues to take a financial toll on hospital budgets, forcing many to take a deeper look at employee benefits and other retention efforts.
Higher salary, greater flexibility
Higher wages were cited as the main reason why nurses chose to fulfill travel contracts, conformable a survey conducted by healthcare company Relias. Other main reasons included dissatisfaction with management, interest in exploring new locations and greater flexibility.
Patrick Smith spent two years as a registered nurse in his hometown of Tuscaloosa, Alabama before becoming an ambulatory nurse. He said Bloomington, Indiana, is the third city he’s lived in on a travel contract.
“I like meeting new people. I’m going to experience a new area that I haven’t been to,” Smith said. “And it’s not like, oh, I’ve visited this place. Like I have to live there for a few months.”
Others have even figured out how to get the benefits of being a travel nurse without ever going too far from home. They are known as “local travelers” and – like Brakayla Hillis – tend to take contracts within 90 minutes of home.
Hillis has landed contracts in several Indiana cities, including Fort Wayne and Bloomington, and now works in her hometown of Greenwood. She never expected that travel would be her life. But she said the financial and scheduling benefits are too good to turn down, especially since she’s in school to become a nurse.
Devan Ridgway
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WFIU/WTIU News
One of her recent assignments was at a hospital that was moving to a new location and hoped to reduce its reliance on travel nurses.
“We were very busy with travelers, and then when we moved to the new hospital, they tried to go back to where it was just nursing staff and push the travelers away,” Hillis said. “So they took a major pay cut of about $2,000 a week.”
Pay cuts in future contracts meant it was time for Hillis to move on. Her next contract was with another central Indiana hospital that she said gave its nursing staff triple bonuses to compete with travel pay.
“Hospitals are basically trying to reward staff just so they don’t have to use travelers, but it still seems to be happening,” she said.
Can improving staff morale reduce hospitals’ reliance on travel nurses?
Turnover rates for US nurses varies by geographic location and specialty, but ranges from 9 percent to 37 percent. In 2021, more than 1 in 3 hospitals reported a vacancy rate of more than 10 percent.
Another concern: Burnout appears to contribute to a greater desire to leave the profession entirely. According to the Relias report, 29% of respondents surveyed at the end of 2021 said they were considering leaving nursing, compared to 11% of respondents in 2020.
The issue of understaffing is known to contribute to burnout and is also increasing patient safety concerns. It’s a big part of the reason hospitals continue to contract with nurse staffing agencies to fill gaps.
But the high costs associated with travel health care are prompting many in the industry to take a closer look at the value of contracts between hospitals and staffing agencies, said Rachel Culpepper of the Indiana Nurse Management Association.
Staffing agencies sometimes make double or triple what nurses make, she said.
The “market war” between hospitals and staffing agencies is also forcing hospitals to consider ways to improve job satisfaction—by improving employee culture, increasing paid time off, or even changing standard shift hours.
“We’ve been doing 12-hour shifts for a long time,” Culpepper said. “And we’re hearing from our team members that it may not be what they want anymore.”
Throughout the pandemic, travel nurses have helped fill “critical vacancies,” said Cindy Herrington, chief nursing officer for the South Central region for IU Health, Indiana’s largest hospital system.
“We are very grateful to our temporary nurses for their help during times of increased need for nurses,” she said in an email. “America’s hospitals could not have gotten through the pandemic and this job market without their great work.”
This story comes from Indiana Public Media in association with Side Effects Public Media. Follow Holden on Twitter: @AbshierHolden.