Travel nurses provide critical staffing to hospitals during nursing shortages
From filling temporary vacancies to accommodating seasonal census swings, travel nurses allow hospitals to provide quality patient care when they are struggling to find enough permanent staff to fill the need.
“It’s for when we have critical shortages, and we keep them until we hire permanent nurses and have them trained,” said Barbara Fetters, RN-BC, nurse manager at Mercy Hospital Springfield in Springfield, Mo., which relies on travel nurses to cover temporary vacancies, primarily on inpatient units but also in the ED or endoscopy. “We do not want to burn out [our regular nurses].”
Travel nurses help cover hard-to-fill positions, particularly in areas that hospitals have difficulty staffing with permanent nurses, according to Vincent Batza, director of Travel Nursing and Allied Health Services for CoreMedical Group in Manchester, N.H., a healthcare staffing and recruiting agency for travel and permanent nurses. He said it’s often difficult to find nurses in specialty areas such as critical care and the ED.
Wendi Dusseault, executive vice president of Travel Nursing for Cross Country Healthcare in Boca Raton, Fla., a leading provider of healthcare staffing and workforce solutions, said hospitals also use travel nurses to meet seasonal needs, such as during the busy winter months in Arizona and Florida, or to fill in for a nurse on a leave of absence. Cross Country assists hospitals with travel, per diem and permanent nurse staffing placements. Dusseault said most hospitals have at least occasional needs for travel nurses.
Sometimes concerns associated with patient-nurse ratios or other issues lead to the need for hospitals to bring in travel nurses, Batza said. He said travel nurses make up a significant percentage of the staff in some facilities.
Most nurses understand the importance of good staffing for quality outcomes and therefore accept the need for travel nurses, according to Dusseault.
“Travel nurses understand [they] have to earn the respect of the people they are working with,” she said. “No one wants to hear on your first or second day how you did it in the last place you worked.”
Ensuring quality care
In 2013, Linda Aiken, PhD, RN, FAAN, FRCN, nursing professor and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania in Philadelphia, and colleagues published a paper indicating that agency-employed supplemental nurses did not adversely affect patient mortality and helped avoid nurse staffing issues associated with higher mortality.
To ensure high quality patient care is maintained, agencies such as CoreMedical and Cross Country ask about travel nurses’ skills and conduct competency testing and try to match the nurse’s skills to the position being filled. The agencies check references and licensure. Cross Country’s clinical team also talks to applicants to help to ferret out skill levels.
Mercy Hospital Springfield requests nurses with certain competencies from the travel agency it uses. Fetters seeks nurses who can do the job and interviews them before agreeing to the agency’s assigning the nurse to Mercy Hospital. During orientation, hospital staff assess competencies before the nurse starts on a specific unit. Mercy provides travel nurses with a welcome packet with contacts and phone numbers for different concerns. The hospital typically assigns lower-acuity patients to travel nurses, Fetters said.
“We want them to be successful while they are here,” she said. “We are here to help them.”
Cross Country follows up with the hiring hospital soon after the nurse starts, mid-assignment and when the assignment ends. The agency will help intervene if a placement is not going well.
Batza encourages hospitals to be totally honest with the prospective travel nurse about the situation at the hospital, whether it’s a shortage of staff, record-keeping challenges because the facility hasn’t upgraded to digital medical records, or other issues.
“You want to have all issues covered up front,” Batza said. “Do not oversell. Be completely honest.”
So how do agencies find enough travel nurses who are willing to go on the road for short-term assignments that typically may last only about 13 weeks?
Dusseault said nurses choose to travel for a number of reasons, including to build their skill level and resume, for the adventure and opportunity to see different parts of the country, and to potentially make more money or look for a new place to live.
Nurses may leave a low-paying area and head to a higher-paying region, such as California, Dusseault said. Both travel companies provide housing or pay these nurses a housing allowance, which helps them to defray expenses during their stay. Some travel nurses will take more difficult to fill positions to earn more to pay off student debts.
“The less attractive [the] place, the higher the pay,” Batza said. Travel nurses are often needed in rural areas that face regional nursing shortages.
CoreMedical reports its applicants are interested in travel nursing for a variety of reasons, including wanting to see different parts of the country, gain experience in a variety of healthcare settings, not have to deal with hospital politics, or try out different areas before settling down. The pay rate, which tends to be higher than for a permanent position, also attracts nurses.
Many nurses approach Cross Country after learning about travel nursing because they want to explore the option of traveling, according to Dusseault.
Cross Country and CoreMedical also advertise online for travel nurses and allied staff. Both staffing agencies provide health and other benefits to healthcare professionals. CoreMedical also offers pet health insurance and a matching 401(k), free continuing education units, and an opportunity to earn a free all-inclusive paid vacation.
Dusseault said Cross Country is constantly looking for nurses who are looking for a different practice experience, noting that traveling is not for everyone.
“Our nurses are looking for the opportunity to see the country and explore new areas,” said Cassandra Viau, marketing manager for CoreMedical. “Travel nursing draws an adventurous crowd.”
Freelance writer Debra Anscombe Wood, RN, contributed to the writing and research of this article.