Sarah Komar, Editor-in-Chief
Originally published Jan. 25, 2022, in The Arkansas Traveler
As a years-long national nursing shortage that was accelerated by the COVID-19 pandemic continues, the mass exodus of registered nurses from staff roles to higher-paying travel positions is compounding the problem.
Several factors have contributed to the ongoing and projected shortage, including a large segment of the nursing workforce reaching or nearing retirement age and an insufficient level of nursing school enrollment, according to the American Association of Colleges of Nursing.
Even before the start of the pandemic, the RN shortage was projected to grow between 2016 and 2030 to as many as 175,900 openings per year for RNs, and be most intense in the South and the West, according to Bureau of Labor Statistics numbers and a forecast published in the American Journal of Medical Quality.
But burnout caused by working in dangerous conditions during the pandemic added a new layer to the crisis, with many staff nurses quitting or moving to other healthcare jobs because of stress. These alternative jobs include administrative or non-clinical nursing, and travel nursing, wherein nurses contracted with private companies move between states, cities and hospitals, typically on 13-week contracts.
“Hospital leadership is very concerned about staffing,” said Dr. Amanda Novack, medical director of infection prevention at Baptist Health, Arkansas’ largest healthcare system. “And some of that is because we lost staff to — we had people that were employed here that it was advantageous for them to become travel nurses and make a lot more money going other places in the country during the pandemic. But then there’s also just really an incredible amount of burnout.”
Jordan Ogier, an RN of six years who has been working for a travel agency since October 2020, left her hospital in southern Arkansas, where she had worked on a medical-surgical floor for two years, to travel in Salt Lake City. Ogier, who was also going through a divorce and no longer tethered to her small town, felt overworked, underappreciated and fed up with hospital management she thought did not care about keeping front-line workers safe, she said.
“We didn’t have enough ventilators. We didn’t have enough masks. We didn’t have enough of anything,” Ogier said. “And we didn’t know anything about COVID. We didn’t know was it airborne, was it droplet, what precautions were we supposed to be using? But the thing is that trickles down to the ‘little people’ — being the nurses who actually work with the patients.”
With the shortage continuing to grow across the state, hospitals are pouring resources into recruiting more RNs. Since summer 2021, the University of Arkansas for Medical Sciences has been offering a $25,000 RN sign-on bonus for qualified applicants, and an $18,000 RN referral bonus for current nurses who refer qualified candidates.
Officials are also running extensive social media advertising campaigns featuring positive testimonials from UAMS nurses and touting benefits of working in the system, including specialized training programs, innovations developed at UAMS facilities and UA tuition discounts for employees’ families, Senior Nurse Recruiter Susan Temple Erikson said.
But until hospitals can stem the flow of exiting staff nurses and replace them with new, permanent hires, most are relying on travel or per diem nurses to fill in the gaps. Competition between states and hospital systems for travel nurses during the currently surging pandemic has driven wages to record levels, causing even more to leave traditional staff roles for higher-paying positions.
The introduction of financial incentives and other programs designed to improve the lives of UAMS nurses has helped the system retain staff fairly consistently throughout the past several months, Erickson said. But high travel nurse salaries and the number of other hospital systems headquartered in Little Rock have made it extremely difficult to compete for new employees. UAMS system hospitals and clinics paid nearly $4.2 million to travel nurse vendors in fiscal year 2020 and nearly $5.8 million in fiscal year 2021, compared to just over $806,000 in fiscal year 2019, according to UAMS records.
In fiscal year 2021, UAMS officials paid vendors an average hourly rate of $94.60 for a travel nurse working a 13-week assignment in the system. That average rose more than $26 in one year. The average hourly rate paid to a UAMS staff RN is $34, not including the costs of health, dental, vision and life insurance, retirement contributions and other benefits provided to those eligible, said Leslie Taylor, UAMS vice chancellor for communications and marketing.
Since she left her staff position for Salt Lake City, Ogier has gone from making around $2,000 a month as a staff nurse to an average of $9,000 per month as a travel nurse, she said. During one recent assignment, a government-subsidized 13-week contract in El Paso, Texas, she sometimes made as much as $7,600 per week.
“A lot of people this past year did what I did,” Ogier said. “They weren’t necessarily going through a divorce and decided to start traveling. But what they did discover is, ‘Oh shit, there’s a lot more money because of the shortage now. A lot more money. I could easily make six times more doing travel nursing than working bedside.’”
Kelsee Dyer, an RN who has been based in Memphis, Tennessee, for 10 years, was also feeling exhausted and frustrated with the managers at her hospital, where she was working two staff nursing jobs but “still only living paycheck to paycheck” in March 2020, she said. So when the pandemic began, Dyer signed on with a travel nursing organization and headed to New York City, the hardest-hit locale in the U.S at the time. She has been traveling ever since.
“I was just on autopilot, like I wasn’t really making a difference,” Dyer said. “And so when the pandemic hit, I just thought, you know, ‘There’s like all these people that are in need, and I know I’m a good nurse, and I have great experience. I have more experience than most of the people that I was working with.’ So I just wanted to feel like I was actually doing some good and doing something that I would be appreciated for.”
In addition to substantially higher wages that have allowed her to pay off all debts except her mortgage, travel nursing has provided benefits like making new friends and getting to choose where she works, Dyer said. This has helped her come closer to her goal of visiting all 50 states.
“All of my patients that I take care of, or all these other nurses that I meet — and I’ve met some really wonderful, hard-working people — it’s just been great to get to know them and for them to get to know me and be able to share my story with them,” Dyer said. “And it’s really helped me find myself and realize who I am and who I want to be.”
Ogier would recommend travel nursing to any RNs looking to make changes in their careers, especially those with few familial attachments, she said. She thinks it is a dream job for people living on their own, like her. One of the best benefits of travel nursing is the flexibility it gives her to choose if and when she wants to work, Ogier said.
This flexibility allowed her to move home at the end of October and take the remainder of 2021 off as a mental health break. During her break, she took a cruise, visited family and focused on her well-being. Ogier, who has struggled with depression her whole life, was able to get daily experimental treatments including ketamine infusions and transcranial magnetic stimulation, and pay for them in cash.
“I feel worlds better and I wouldn’t be able to do that if I was holding a full-time job 12 months a year,” Dyer said. “Instead, I came here and I took two months off for the rest of the year, and I’m still sitting on tens of thousands of dollars in savings.”
This story is part of an ongoing series about the U.S. labor shortage and its effects on Arkansans. For more special coverage, select “Where are the Workers?” under the “News” tab at the top of the site.
A previous version of this article, which also appeared in the January print edition, included a photo caption in which the city of Pomona, California, was misspelled and the name of the Pomona Valley Hospital Medical Center was incomplete. The Arkansas Traveler strives for accuracy and clarity in all matters.
Sarah Komar 