By Ike Swetlitz
In February, a 25-year-old oncology nurse at the University of New Mexico Hospital doubled her $900-a-week salary by leaving her staff position and taking a temporary job in Montana.
She didn’t do it for the money — born and raised in Albuquerque, she wanted to get out of New México for a little while and see other parts of the country. When she arrived in Montana, she found herself working alongside more experienced staff nurses who were getting paid much less.
“It’s definitely been a positive, making more money,” the nurse said. Like every nurse who spoke with Searchlight New Mexico, she did not want to be named for fear of retaliation or damaging future employment prospects. “But there are often times that I feel guilty, especially when I’m doing the same job that my fellow coworkers are doing yet making double what they are.”
Travel nurses have long been a part of the American health care system — before the COVID-19 pandemic, hospitals around the country would typically hire these temporary workers for 13-week stints to address unexpected short-term needs, like a sudden vacancy or a natural disaster. Travel nurses sacrificed long-term stability for a higher paycheck and greater flexibility.
But over the past two years, nurses have left hospitals in droves, leaving vacancies everywhere. The persistence of the pandemic, increasingly unsafe working conditions and physically abusive patients have exacerbated a nationwide nursing shortage. Research published in 2018 predicted the country would soon be short about 150,000 nurses, and a report by New Mexico’s Legislative Finance Committee last year estimated that the state needed between 600 and 3,700 more.
The pandemic has given health care workers further reasons to leave, and hospitals, rushing to fill the gaps, are turning to travel nurses – some of whom are the very same people who just left their hospital staff jobs.
In September, travel nurses made up about 12 percent of all New México hospital nurses, according to Troy Clark, president and CEO of the New Mexico Hospital Association. Their pay has skyrocketed, hitting an average high of $104 an hour this fall, more than twice the pre-pandemic level, according to data from Wanderly, a national online healthcare staffing marketplace.
That’s left many nurses — both travelers and permanent staff — scratching their heads: Why is the health care system set up in such a way that hospitals can pay more than $100 an hour for a temporary nurse, while staff nurses might not even make $40 an hour?
“We’re health care providers saving lives,” said one nurse from Georgia on a travel contract in Albuquerque. “What would the CEO think is a more appropriate rate?”
She’s been making about $97 to $139 an hour at travel jobs, a salary that’s allowed her to pay off her car and a good chunk of her student loans. “I don’t see myself going back to staff nursing,” she said.
Prior to COVID-19, the average pay for a travel nurse in New México hovered between $40 and $50 an hour, according to the Wanderly data. This fall, amid the surge of the Delta variant, the rate peaked at $104, then fell to $87 at the end of November. Hospitals pay even more to the agencies that provide the workers and handle the administrative aspects of their employment — the going rate in New México these days is between $180 and $205, said Clark, the hospital association CEO.
For comparison, the average New México nurse’s hourly wage in 2020 was about $36, according to state data. Clark said that most hospitals have increased pay by 10 percent to 15 percent since the pandemic, and some nurses spoke of small hourly raises for bonuses. But a large gap remains between their pay and what travel nurses earn.
“I think what we’re going to see is a wholesale reassessment of how much nurses get paid,” said Barry Asin, president of Staffing Industry Analysts, a national research firm.
The unpredictability of the virus contributes to hospitals’ reliance on temporary nurses, he explained. If hospitals knew the increased workload would persist for a long time, it would make sense to raise wages and hire more staff nurses. But if hospitals went on a hiring spree, and the number of patients plummeted in a year or two, they’d be in a challenging situation. “Once you raise the wages or hire a lot more nurses, it’s a much more difficult thing,” Asin said. “You’re not going to go back and ask them to adjust their pay rates down.”
Tim Johnsen, senior vice president and chief operating officer of Presbyterian Healthcare Services, said that while nurse salaries will probably rise, it would be “completely unsustainable” to pay all staff nurses the “astronomical” rates that travelers command. The hospital system would probably run out of money in a couple of months, he said.
Johnsen said that Presbyterian has been hiring more nurses, trying to retain current staff while bringing in travelers. Recruiting travel nurses from around the country has allowed the hospital to draw from a bigger pool of applicants, he said.
The number of travel nurses in his health system has tracked closely to the virus. The largest spike in COVID-19 cases happened in the fall of 2020, and by November, 14 percent of Presbyterian nurses were travelers, according to Amanda Schoenberg, a hospital spokesperson. As vaccines rolled out in the beginning of 2021 and cases dropped, so did the number of travel nurses, leveling out at pre-pandemic levels of 4 percent by April. And when cases rose again at the end of the summer, the travel-nursing rate followed suit, rising to 13 percent, where it’s been ever since.
Some hospitals and individual units have seen even higher rates. Monica Leyba, chief nurse executive of Christus St. Vincent, said that travel nurses made up about 20 percent of nursing staff at the end of November. A staff nurse at UNMH’s medical intensive care unit said that about half of the nurses on her unit are travel nurses. A UNMH spokesperson declined to say what percentage of the hospital’s nurses were travel nurses.
Having so many travelers in the hospital can lead to challenging situations. Travel nurses only get a few days of training, much fewer than staff nurses. They might not know where to quickly find certain hospital supplies, and need to ask questions of experienced nurses. When units are staffed with so many travelers, there aren’t as many people to turn to. And they usually leave after 13 weeks, at which point a new travel nurse shows up and needs to be trained all over again.
But though they may know less about the specific hospital, they know more about the business of travel nursing — and they share that information with the staff, according to some nurses. “We’re starting to see more and more of these staff, all of a sudden, start to leave and go travel,” said a UNMH nurse who helps train other nurses. That creates another shortage — which gets filled by travel nurses. “It’s just a vicious cycle.”
But the staff nurse doesn’t blame the travelers. She just wishes that her hospital would do more to keep nurses employed. She got a raise of a few percentage points recently, but still only makes about $37 an hour, well below the travel rate.
“It hurts me to see people leave, but I also understand,” she said. “I would probably do the same if I really needed to.”
Ike Swetlitz is an Investigative Reporter with Searchlight New Mexico, a non-partisan, nonprofit news organization dedicated to investigative reporting in New Mexico.
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