The COVID-19 pandemic has created a crisis in the form of a shortage of nurses. This forced many American hospitals to pay a high price for the help they needed to deal with the sheer volume of patients this summer.
There are two problems, say health leaders. Nurses quit their jobs or retire, exhausted or demoralized by this crisis. And many of them leave for more promising temporary jobs with mobile nursing agencies, which can pay $5,000 thousand or more per week.
It was so difficult that the doctors said, “Maybe I should stop being a doctor and be a nurse,” said Dr. Phillip Coule, medical director at Augusta University Medical Center, Georgia. She sometimes faces 20 to 30 resignations a week from nurses taking jobs as itinerant nurses.
“And then we have to pay exorbitant fees to get staff from other states to come to our state,” Coule said.
The average mobile nurse salary has jumped from about $1,000 to $2,000 a week before the pandemic, to $3,000 to $5,000 today, said Sophia Morris, vice president of Aya Healthcare, a San Diego-based healthcare provider. He said Aya had opened 48,000 job opportunities for itinerant nurses.
James Quick, president of SimpliFi, Aya’s competitor, said the hospitals he worked with were now facing an unprecedented level of job vacancies.
“Small to mid-sized hospitals generally have dozens of vacancies for full-time positions, and large health systems have hundreds of vacancies for full-time workers,” he said.
Soaring salaries have made it difficult for hospitals that can’t dig deep into their pockets.
Kansas Governor Laura Kelly recently complained about the risks her state’s hospitals face not competing for nurses from other states who can afford to pay “a great deal.” He said recently that several hospitals, including in Topeka, had provided beds for patients but there were no nurses.
In Kansas City, Missouri, Truman Medical Centers has lost 10 nurses who have switched to mobile work in recent days and are trying to find mobile nurses to replace them, said the hospital’s CEO, Charlie Shields.
She said it was difficult to compete with mobile nurse agencies, which charge $165 to $170 per hour per nurse. He says the nursing agencies get a large share of the rates, but he estimates that nurses still receive $70 to $90 an hour, two or three times what hospitals pay for their nurses.
“I think it’s clear that people are taking advantage of the demand out there,” Shields said. “I hate to use the word ‘exploit’ to describe it, but we are definitely paying a premium fee and allowing people to earn quite a high profit margin.”
In Texas, more than 6,000 mobile nurses have flooded into the state to help deal with a surge in patient numbers through state-backed programs. But on the same day that 19 nurses left to work for a hospital in the north of the state, another 20 in the same area filed notices that they would be leaving their jobs to become contract itinerant nurses, said Carrie Kroll, vice president at the Association. Texas Hospital.
“The nurses who didn’t come out, who stayed in the facility where they worked, they saw the other people who were now coming in and getting paid more. This creates tension in the work environment,” Kroll said.
The pandemic was in its early stages when Kim Davis, 36, decided to quit her job at a hospital in Arkansas and become an itinerant nurse. He says he has roughly doubled his pay in the 14 months after he treated patients in intensive care units in Phoenix; San Bernardino, California; and Tampa, Florida.
“Since I became a traveling nurse, I have paid all my debts. I paid off a college tuition loan of about $50 thousand,” he continued.
Davis says many of his colleagues are following in the same footsteps. “They go to be itinerant nurses because why are we doing the same job for half the pay?,” she said. “If they have to risk their lives, they must be rewarded.”
Health leaders say nurses are extremely tired and frustrated at being asked to work overtime, being shouted at and criticized by members of the public, and for dealing with people who choose not to be vaccinated or not to wear masks.
“Imagine going to work every day and working your hardest ever, then coming home and what we see every day is our work not being recognized by society,” said Julie Hoff, chief executive nurse at OU Health in Oklahoma. “The deaths we see every day are not appreciated or recognized.”
Meanwhile, hospitals were increasingly squeezed by the entry and exit of nurses and new employees from mobile nurse agencies.
Coule cites a recent example of his hospital in Georgia recruiting a respiratory therapist through an agency to replace staff who decided to become mobile workers. His replacement turned out to be from the same hospital where the respiratory therapist moved to work. “Basically we swap personnel but at double the cost,” he said.
Patricia Pittman, director of the Fitzhugh Mullan Institute for Health Workforce Equity at George Washington University, said many nurses were still resentful of their employers from the early days of the pandemic, partly because they were forced to work without adequate personal protective equipment (PPE).
“Nurses say, ‘Hey, if I’m not treated with respect, I might as well move into a traveling nurse,’ she says. “That way I can work in a very unpleasant place for 13 weeks, but then I can take two or three months off and do whatever.” [uh/ab]