Healthcare Staffing Network: Loyal Travel Nurses a Key to Stability and Success

Posted By Travel Nurse Source on Dec 10, 2008 | 2 comments

The following article was contributed by Janet Fikany, senior recruiter for Healthcare Staffing Network (HSN), a member of the Travel Nurse Source network of agencies.

It’s clear that nursing is still one of the biggest growth industries today, and there are now forecasted projections saying that the shortage of nurses could very well approach 29% by the year 2020. If, in fact, our nation intends to achieve measurable, affordable, high-quality health care during this next administration, then the nurse shortage needs to be addressed, and soon. One primary problem is that Nurse Educators often are paid much less than nurses who are actively practicing; therefore, the real shortage exists because that pay disparity has not been addressed. There aren’t enough teachers.

Travel nursing, however, is and always has been its’ own niche- it’s a different story entirely. Where, with staff positions, there are plenty of jobs, and not enough nurses, lately the trend for travel RN’s seems to be completely inverse—we have lots of nurses, but not enough jobs. This is actually shocking to many people, because when they hear numerous agencies saying that there’s a dearth of travel assignments available, the obvious question is, HOW can this be happening in the middle of a nurse shortage? It seems impossible.

There are several answers. I wish I had a crystal ball to see which ones were going to be impactful in the short or long run- but in these crushing economic times, who can say? First off, you have large agencies that have, in their attempts to be all-encompassing, significantly driven down hospital bill rates, hence, nurse pay rates.

Then, we also see that there have been massive closures of Emergency Room Services, because of the growing numbers of uninsured people who have no choice but to use the ER as their “doctor’s office”- and the hospitals can’t afford to keep them open. Therefore, I’ve seen a huge shift in available ER positions during the past year. Travelers who used to command an easy $35-40+ per hour are now working with several agencies, and still it can take months; and their pay rates are not what they once were. We used to have TONS of ICU assignments, but even those are a scarcity lately.

Now, we’re also in the middle of a recession, and, though no one wants to use the “D”-word, it’s out there. That being said, it’s a fact, that hospitals pay higher bill rates for travel nurses. With facilities being driven to cut costs in every possible way, the trend seems to be aggressively for hiring staff or using more per diem nurses, as opposed to travelers.

It’s true, hospital census is down, because fewer people are opting for elective surgeries; we’re doing the “have-to-have’s” instead of the “want-to-have’s”; and it’s also that time of year when hospital budgets are maxed out, so again, no budget for travelers.

Then, the idea is to have a few agencies that have been in business for a while, and who have a consistent reputation of having their clients’ best interests in mind. As a recruiter, I’m well aware that it would be naïve to think that we’re the only agency with whom our travelers talk. But I recently wrote an article where I said, agencies come and go— mostly go. Longevity and loyalty do go hand in hand. There have been many compromises made, along the way, by agencies that seem to equate low bidding for being competitive. If you read their staffing reviews, the proof is in the pudding: because they don’t have loyalty from their travelers- they won’t have longevity either.

Agencies that are confident about their performance and relationships with hospitals are seldom influenced by underbidding an assignment. Remember, we have a nursing shortage. In this market, we have confidence in our travelers, as they have confidence in us. For that reason, I’ve always been willing to represent and even overbid an assignment when I know I have the right person and the right relationship with a hospital. Unlike many of the large companies who devalue their employees by making everything about “the lowest price”, HSN has stayed in business because we don’t foster that mentality. If the right job is there, for the right traveler, it will happen, and it is meant to be, and the planets “align”. Still, there remains the key component of being flexible, when possible, especially when opportunities are fewer than previously, in light of this economic downturn.

My opinion is also that there seems to have been a big shift, lately, in administrative staff turnover. Very often, when you have someone new, the first place in which they want to be effective is in tightening the purse strings. Cutting travel RN budget is often priority one in these cases.

There probably will be an increase of travel assignments once the new Administration takes its’ place in the White House, due to a focus on providing more and better healthcare resources, and as consumer confidence begins to rise again. Also, new budgets will be in place after the first of the year, so I would anticipate that the ebb and flow we’ve seen in the past will provide new opportunities for travelers.

I don’t think that we can expect the kinds of pay rates we’ve seen in the past; at least not for a while. There will most certainly have to be some give-and-take, and I’ve also noticed that quite a few travelers with whom I’ve worked in the past have decided to go with full-time staff assignments and hold off on travel plans for a while. The nice thing about travel nursing is, it’s still going to be there when you’re ready. If anything, this economic impact is going to “separate the men from the boys”.

As I mentioned, we’ve stayed in business for six years with a strong core of nurses and a referral base who continue to work with us year after year. Travel nursing is a very expensive profession to staff, coming from an agency perspective; it’s not just the housing and travel pay, but insurance galore, and many costs are up front. Like many agencies, with fewer travel assignments opening up this time of year, we’ve had to skinny-up a little bit, and just sit tight. But we can confidently say that we’ll still be here when all is said and done; things will most certainly get better. But they probably will never be the same.