Finding nurses willing to work at rural hospitals — a problem even before the pandemic — has been partially solved by the use of temporary “traveling” nurses, experts said. But that solution comes with a cost.
Hiring traveling nurses through a staffing agency can cost many times what hospitals pay local nurses. And some people worry that the traveling-nurse system may be creating another problem by luring staff nurses away to more lucrative temporary positions. But an industry expert said this claim is overblown.
According to ZipRecruiter, the pay for nurses in small towns ranges from $36,000 to $94,000. Some jobs offer signing bonuses, as well.
In comparison, traveling nurses make anywhere from $5,000 a week to up to $9,500 a week, although nursing specialty can have a big impact on pay. Sites like Aya Healthcare list traveling-nurse jobs that last from a few weeks to a few months, with full benefits, housing, healthcare, and sick days.
During the pandemic, traveling nurses helped out in areas seeing the most patients – urban areas like New York and California. During the surge of the Delta variant, traveling nurses helped out in more rural areas.
Brock Slabach, chief operations officer with the National Rural Health Association, said the pandemic has forced hospitals to rely more and more on traveling nurses.
“Hospitals are having difficult times in recruiting/retaining workforce, and agency nurses, or traveling nurses, have historically filled temporary gaps in staffing.,” he said.
“The pandemic has caused excessive turnover in rural hospital staffing with a very limited supply of agency nurses, thus creating high prices to hire these nurses – as much as or over $200 per hour. This is unsustainable. It also causes morale issues when agency nurses share what they’re making with staff nurses and it creates real morale issues.”
For some nurses, he said, the lure of more money leads them to become traveling nurses.
Another factor driving the increase in demand for traveling nurses at rural hospitals is vaccine mandates, Slabach said.
“I’m hearing from hospital CEOs that the vaccine mandate for health care workers being promulgated by the Biden administration will cause further attrition of staffing in rural hospitals,” he said. “These CEOs support allowing weekly testing for Covid infection as an alternative to a vaccine mandate.”
But Dr. Nicole Rouhana with the Rural Nurse Organization, a nurse/midwife with a 40-year career in health care and program director at the State University of New York in Binghamton, said media reports of rural nurses becoming traveling nurses seem overblown.
“I think it’s gotten a lot of press, but I don’t think it’s as prevalent as everybody thinks it is,” she said. “I mean, there are people who might have small children or they might want to go somewhere for two weeks and make a lot of cash and then come home to take care of their kids. We are seeing it, but it’s not lasting long.”
Rouhana said she felt the use of traveling nurses would begin to wane a bit when the country gets Covid-19 under control, over the next two or three years.
But by then, she said, the issue facing healthcare will be the increasing numbers of baby boomers aging and putting further strain on the healthcare system. Rural areas, whose residents tend to be older, poorer, and sicker, will need more nurses to care for them as they age.
Already, healthcare organizations like RNO are working to recruit people into the nursing profession. The key to getting nurses to stay long-term in rural areas, she said, was recruiting people who already live there.
“If we develop our Healthcare Workforce from within the communities, where they come from, we’re going to have a long-term provider,” she said. “They raise their kids there. They were born and raised there. They might have land there. So their likelihood of them staying there long-term is much higher than if, for instance, we recruited somebody from an urban setting to come to the rural area. Research shows that they (urban recruits) usually stay in a rural setting for only two to three years.”
Other programs through the U.S. Office of Health Resources and Services Administration provide scholarships for two-year nursing programs in exchange for a two-year commitment to work in a rural area, she said. Federal workforce grants are also available to provide students with tuition, laptops, clinical equipment and specialized training to care for rural populations, she said.
“We can bypass all those recruitment and retention efforts that healthcare organizations are burdened with by, instead, doing focused recruitment from within our rural communities and saying to these nurses ‘Hey, you want to become a nurse practitioner? I’ll pay you, you can do your training right in your community and then when you graduate, the people who trained you are probably going to want to hire you because you live in the community, you’re known and respected in the community and we trained you.’”