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Rising cost of traveling nurses having ripple effect on area hospitals

Travel nurses have always been a resource for hospitals, but what used to be a short-term solution has become more common and costly.

ATLANTA — Travel nurses were a lifeline for hospitals during the height of the COVID-19 pandemic for overwhelmed hospitals around the country, but two years into it, the rising cost is having a ripple effect.  

“I often wonder where have all the nurses gone?” Jody Leonard, a nurse with nearly 25 years of experience, said. “Most hospitals are doing what they have to do to get staff in place. Because without nurses, the hospital can't function.”

Leonard, most recently a charge nurse in the metro Atlanta area, has watched as the model for hospital staffing has evolved during the course of the pandemic. 

There have been times, Leonard said, she has been the only permanent, staff nurse on her shift, supported by contracted, temporary positions known as traveling nurses.

“It does seem to be the trend, unfortunately,” Leonard said. “I don't feel it's the best thing for hospitals, especially as a whole, but being brutally honest, the money is tempting.”

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Travel nurses have always been a resource for hospitals, Pat Horton, CEO of the Georgia Center for Nursing Excellence, explained. These positions have historically been contracted out to hospitals to fill gaps where needed. But during the pandemic, more nurses picked up their lives to support what was an already existing shortage in the nursing industry.

Amid burnout, turnover, and nurses retiring in the wake of COVD-19, the need for available nurses increased as did the need for travelers.

“The challenge with that is the cost of travel nurses,” Horton explained. “That has become exorbitant to our organizations who use those, our hospitals, hospital systems, and it's not sustainable.”

The average pay for a traveling nurse has risen from roughly $1,000 to $2,000 per week before the pandemic to $3,000 to $5,000 since before the pandemic, the Associated Press reports.  

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Recent job postings from staffing agencies serving Georgia show a travel nurse contract could pay more than $4,000 a week, and the growing gap in salary between travel and staff nurses can be disheartening to those who’ve committed to a healthcare facility, Leonard explained.

“A lot of what's happening is staff nurses are seeing nurses around them are making 2 to 3 [times] what they're making,” Leonard said. “It's frustrating.”

A recent letter from the American Hospital Association laid out concerns over staffing and cost to Congress, reporting hospitals have been forced to use more expensive travel nurses due to staff shortages caused by the pandemic.

11Alive reached out to local healthcare systems in the metro for further perspective.

Piedmont Healthcare echoed that such a model is “unsustainable” as it relates to nurse staffing.

“We are currently paying rates to contract agencies that represent an increase of more than 200 percent over what we were paying to agencies prior to the pandemic. Much of this increase is not going into the pockets of front-line nurses, without whom we would not have been able to weather this crisis,” a statement reads in part. “These unparalleled cost increases make it difficult for us to sustain the progress we had made in reducing healthcare costs.”

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Meanwhile, Emory Healthcare confirmed the hospital system is using travel nurses five times more often than pre-pandemic, also citing both the essential role of travel nurses and the rising costs.

“Emory Healthcare’s primary focus remains our patients, and providing the best, most-comprehensive care by our excellent care teams,” the statement reads in part. “We have continued to pay increased premiums for our Emory Healthcare nurses and traveler nurses, even as pay has risen throughout the pandemic.”

Grady Health System is experiencing similar issues, now asking Fulton and DeKalb counties for emergency funding to help support increases in staff costs.

“Grady, like almost every hospital in the country, is facing a workforce crisis,” according to a statement from hospital administration. “We have been forced to hire expensive temporary staff to maintain operations. But unlike most hospitals, Grady is a safety net institution, providing care for all who need it. The high cost of recruiting and retaining enough nurses to staff the hospital is leading to budget shortfalls.

As a result, Grady is expected to spend an extra $80 million on staffing this year. If unable to secure enough nurses, the hospital may have to reduce available bed numbers.  

While the AHA went so far as to go to the Federal Trade Commission to ask for a closer look into anti-competitive pricing of certain staffing agencies,  the American Staffing Association, a group that includes healthcare staffing agencies, told 11Alive it comes down to supply and demand.

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“Staffing agencies are offering higher wages to nurses in order to retain their services during this historic labor shortage,” Tony Malara, vice president of government affairs for the American Staffing Association said. “These are nurses who’ve spent two years working on the front lines of the pandemic, and have faced overwork, stress, and even physical danger. Many nurses are suffering from burnout, taken long leaves of absences, or even left the profession entirely. There simply aren’t enough available nurses to meet the demands caused by the pandemic, which is leading to a surge in nurse wages.”

Such pay and flexibility not only impacts current travelling nurses but can also entice permanent nursing staff, who may not have previously traveled, to also explore travel gigs.

“Because the pay has risen so high, many nurses have also chosen to go and travel and take advantage of that opportunity, which you can't blame them,” Horton said.

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Now after six years at her permanent position at a local hospital, Leonard, too, is hitting the road, to explore other opportunities. She plans to take on contracts in other areas of Georgia while awaiting licensing in other states.  

“It was a tough, tough decision for me because I’ve been there for six years,” Leonard said. “And [the hospital] has been my second home.”

Georgia Nursing Workforce Summit is planned for March, according to Pat Horton with the Georgia Center for Nursing Excellence, to bring together industry leaders, workforce partners, academic leaders and those in business to figure out both short and long-term solutions to the staffing crisis. Such strategies may include added flexibility in scheduling and addressing the increased patient care workload, both of which Horton said can have a positive impact on both patient care and nursing retention. 

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