Agencies. Doesnt it just make you sick??????

Nurses Activism

Published

How interesting that the entire article is all about how lucrative travel agencies are...... for the owners of the travel agencies! And what great timing the owners had to be cashing in on "the shortage". Not a word about any benefit to the nurses whom they stable.

Im sure the NURSES who work for these agencies arent being paid a SIXFOLD increase in wages or benefits while the agency owners are raking those hundreds of millions of $$$ on our backs.

How interesting that the owner is a former state legislator. I wonder what he knew. Good thing he's not STILL a legislator. He might not want to see the nursing "shortage" solved. Hmmm.... thats a thought. I wonder if any of these agencies are trying to make sure the nursing "shortage" ISNT solved. Might just put them out of business. This guy's travel company managed to earn $518 MILLION for him just last year!! $518 MILLION $$$$ for passing nurses around to hospitals every few weeks. And what % of those hundreds of millions did the NURSES who did the work get?

It makes me sick........

March 2, 2002

Tony Fong

San Diego Union Tribune

"Filling the need for nurses

Companies profit as they respond to shortage

As hospitals and health-care administrators scramble to deal with a widespread shortage of nurses, a number of companies have emerged to capitalize on the deficiency.

Companies such as San Diego-based AMN Healthcare Services have built a strong business out of supplying temporary nurses to hospitals suffering from a shortage of qualified staffers.By bolstering its roster of nurses and their number of assignments, AMN has seen its revenue grow nearly SIXFOLD during the past three years.

The demand for nursing services has been so strong that AMN and a competitor, Cross Country Inc. of Boca Raton, Fla., were able to buck the weak market for public stock offerings last year.

AMN went public Nov. 13, raising $175 MILLION. Its shares closed yesterday at $25.95, up more than 52 percent from the $17 offering price. Cross Country, which went public Oct. 25, closed yesterday at $26.64, up more than 56 percent from its IPO.

Riding the current bullish wave surrounding the industry, Medical Staffing Network, also in Boca Raton, filed for a public offering in early February.

Since the late 1990s, Wall Street had viewed health care skeptically, but lately the industry has shown signs of life. And for nurse staffing companies, the time has been ripe for investors.

"Right now, AMN is positioned in one of the hottest sectors," said Robert Mains, a health-care analyst at Advest Group in Saratoga Springs, N.Y., a minority underwriter in AMN's public offering.

Fueling such sentiments is a nationwide nursing shortage that experts say is going to get worse because of a shrinking supply of nurses and an expanding need for them.

Unlike some of its competitors, AMN deals only with travel nurses, not per-diem nurses. A per-diem nurse's assignments can last as little as one shift, but travel nurses typically work on 13-week contracts. They can also crisscross the country, going from one assignment to another.

Travel nurses are not a long-term solution for the nursing shortage, but the demand is so great that hospitals have no choice but to use them, said Ann Davis, a vice president with the Sharp HealthCare hospital system.

Sharp typically uses about 100 travel nurses at any time, including 80 from AMN, Davis said.

"The thing that works nicely is they're here for a 13-week contract . . . and if you need supplemental staff, it's better to have them in, have them oriented and have them stay for a length of time," Davis said.

Founded in 1985 by Steven C. Francis and his wife, Gayle, AMN was headquartered in Las Vegas before the couple moved it to San Diego two years later. Steven Francis is a former Nevada state assemblyman.

The company now operates five brands: American Mobile Healthcare, Medical Express, Preferred Healthcare Staffing, Nurses Rx and O'Grady-Peyton International.

During 2001, AMN had revenue of $517.8 MILLION, a nearly SIXFOLD increase from $87.7 million in 1998. AMN has 25,000 nurses in its database, of whom 6,883 were on assignment during the fourth quarter of 2001, up from 4,048 in the year-before period. AMN has 800 corporate employees, including 550 locally.

Haas Wheat & Partners, an equity fund based in Dallas, has a 65 percent ownership stake in the company.

The company contracts with 2,500 hospitals in 50 states, constituting 40 percent of all acute-care hospitals and half of all acute-care beds in the country, making it the biggest travel-nurse company in the nation, AMN officials said.

Although Francis said that "the health of our industry isn't just reliant on the nursing shortage," the shortage obviously was a major factor in the company's decision to go public when it did.

During the fall, when AMN and Cross Country went public, Wall Street was enduring one of its worst years for IPOs. Just 87 IPOs were completed in 2001, the fewest since 1979. In September, there were no public offerings, as the effects of terrorist attacks and a deteriorating economy rattled the markets.

While hospitals have always had to deal with staffing shortages, what makes the current shortage opportune for companies like AMN is its magnitude and the fact that no short-term solutions are in sight, analysts said.

The dilemma is this: There has been an exodus of nurses from the profession, and fewer students are choosing the field. At the same time, as baby boomers grow older, there is an increasing need for nurses.

"In the past, there was a feeling the industry would right itself," but that is no longer true, said Mains of Advest.

This year, the Federation of American Hospitals and the American Hospital Association said one out of seven hospitals nationwide reported having more than 20 percent of their registered-nursing positions unfilled.

While hospitals have offered significant bonuses and recruited nurses from outside the United States, those measures have shown only marginal benefits.

Similarly, the effects of the recent nurse-to-patient ratio requirements established by California are unclear. While nursing officials hail it as a major step toward easing staffing problems, hospital administrators warn that there isn't a large-enough pool of nurses from which to hire. As a result, hospitals may have to mothball beds to meet the requirements.

In the meantime, hospitals have increasingly relied on nurse staffing companies to fill the holes.

Hospitals spent $7.2 billion in 2000 for temporary employees, the majority of whom were nurses, according to the Staffing Industry Report, an industry newsletter. For 2002, it estimated that spending will increase to $10.6 billion.

The current shortage has resulted in more nurses going into the travel-nurse sector, Francis said.

"They're able to get higher pay rates because there's a demand . . . but there's also more opportunity for them," he said. "When you think about it, you can go anywhere in the country and work."

AMN charges hospitals an average of about $45 an hour for its nurses and pays the nurses about $29. AMN also pays for its nurses' housing and health insurance and offers 401(k) benefits.>>>

http://www.uniontrib.com/news/uniontrib/sat/business/news_1b2amn.html

so lets see if we have it right - this one travel company made $518 MILLION dollars last year alone & the RN made just $29/hr in California. I know travel nurses who say they are offered less than $18-$25/hr so I suppose they should be happy with the $29/hr this company sometimes pays, huh? Thats not even new grad ADN salary in my city. And we get free healthcare & 401K too. Its a disgrace. What these agencies are doing is a travesty for nurses. These people are becoming millionaires off the backs of nurses. Same as hospital executives.

We should all become independent contractors and cut out the middle man. WE have the skills that are in demand. Why shouldnt WE be the ones earning the big bucks for those skills. Geez..... it never ends.

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Specializes in Home Health.

jt, I hear what you are saying, but if hospitals weren't 1) treating their employees like crap, and 2) willing to pay those travel co exec's those exhorbitant fees, then agencies would not be getting richer.

I work agency every once in a while. I haven't in about the last 5 months. Why? I can't stomach being back in the hospital as opposed to my freedom in home health, despite the misery of the paperwork (for which I blame hcfa/cms entirly, LOL.) My agency is nurse-owned, and from what I can see, the owner has not raked in anywhere near the figures you describe. Unless she keeps her jag garaged at the mansion she didn't tell us about. ???

Many would argue that this is what America is about, capitalism. These people have found a market for what they are selling. Thier employees may not be getting as big a cut of the pie, but they are very happy, and their quality of life is greatly improved. I have taken several pay cuts in my career to improve my quality of life, it is always worth it to me. If their employees are ever unhappy with their salaries, they can always choose to go back to working in the hospitals.

I think jt, if you were to change your job now, you may also find that you are not compensated for your years of experience. There is one facility around here that is paying max of $27.50 for RN with 20 or more years experience. After that, there is no further increase except your 1-3% yearly.

Also, did you see the thread in general forum, which reported hospital CEO's who were making in the millions for salary? I forget who started the thread or the title of it, it was a few months back. I find it just as appaling.

I would consider independent, but then I'd have to do my own taxes, etc, so for me, it was just as easy to have the agency do that for me. I do incur costs such as acls ($175) and bls ($40) q 2 yrs to be able to stay w agency, and I have decided to let that lapse, so I will probably not work agency any more but get my CCM and be an independent CM...maybe. Still not sure what I want to be when I grow up. But I do know, I want to be happy, not work every other holiday or weekends, and be there for my teenagers.

Just my 2 cents.

I occasionally work agency-my agency is nurse run. My home hospital does not employ agency and the number of nurses leaving my emerg due to the poor working conditions and the high expectations of management and clients(can't call them patients because we are a business now, working up patients, not allowing time for teaching and caring). My agency gives me the shifts I need to allow me to spend enough time with my daughter, flexibility in these shifts and encourages me to educate myself and actually pays for courses, unlike my hospital.

>

I know! LOL!! Thats the point! So they should give the nurses a bigger share of the pile! lol.

We're a hot commodity. What theyre selling is us! So why shouldnt we get a larger share of what we're bringing in? Why should we have to choose between salary & sanity? ;)

PS

The article was referring to travel agencies only. I dont know of any other kinds of agencies that are raking in that kind of money either.

Originally posted by -jt

I guess we're just not looking at the same thing. Its a disgrace that as an RN you were in the situation you were in before - earning $10/hr?????? How dare they. No wonder they cant find nurses. Its great that you are now being paid and treated better.... and have found an agency that is responsive!

If you are making $20/hr now you have doubled your income but if I, with almost 20 yrs experience was to take some of the travel jobs I have been offered with that salary, Id be cutting my salary in half.

I know about the housing expenses and benefits but ex-hubby pays the mortgage & I have free health benefits as a staff RN so that wouldnt make a difference for me. Only my salary would be affected & it would be less.

I just think that if those agencies can be giving you what they are giving you now, and STILL be making $518 MILLION a year for themselves, then they can do even better for you and give you even more of a share of the cash pie that you worked to get them.

Why should we settle for the minimum improvement? With the kind of money the agencies are making off supplying nurses, they can afford to pay the nurses better than $20/hr.

Just because what a nurse may have now travelling is better than what she had before shouldnt mean that there cant be even more improvement for her. I understand your point that youre happy because your quality of life is so much better now. But you cant travel with kids forever. It would be nice to be paid enough so we can have some savings set aside for when that time comes.

I think the agencies can do even more for the nurses in actual pay if they are bringing in that kind of money for the agency & getting the owners rich.

:eek: I forgot to mention that I'm an LPN. I haven't seen my current wage offered to LPN's that are not travelers. Still, I make more now than the RN's at my last job made.

also, traveling with kids isn't so bad. I haven't had to move to my second job yet. Most of the hospitals hiring travelers have chronic staffing problems. There are a couple of travelers here that are going on year #2 at the same place. So far, I've renewed my 13 week contract twice (9 months employment) with comments from my supervisor that they would like to keep me longer. (keeps them from having to train another traveler). Sure, they'd like to stop using travelers, but there's not exactly a flood of new-hires pounding down their door.

but I do see your point. I see better opportunities in my future and do not plan to travel forever. Thank you for commenting, Kimber

There are a couple of travelers here that are going on year #2 at the same place. So far, I've renewed my 13 week contract twice (9 months employment) with comments from my supervisor that they would like to keep me longer. (keeps them from having to train another traveler). Sure, they'd like to stop using travelers, but there's not exactly a flood of new-hires pounding down their door. >>

They dont seem to get the point that the travelers are there because of what they are getting from the travel agencies. If as a traveler you are earning better than the staff, what reason would people have to be pounding down the hospital doors to be staff? Maybe if the hospital gave what the travelers are getting, there would be new hires to be found. Dont these administrators think??

Originally posted by -jt

There are a couple of travelers here that are going on year #2 at the same place. So far, I've renewed my 13 week contract twice (9 months employment) with comments from my supervisor that they would like to keep me longer. (keeps them from having to train another traveler). Sure, they'd like to stop using travelers, but there's not exactly a flood of new-hires pounding down their door. >>

They dont seem to get the point that the travelers are there because of what they are getting from the travel agencies. If as a traveler you are earning better than the staff, what reason would people have to be pounding down the hospital doors to be staff? Maybe if the hospital gave what the travelers are getting, there would be new hires to be found. Dont these administrators think??

No, they're not thinking. If my last employer treated me well to begin with, I'd never have even considered traveling. I am looking forward to the day when these hospitals DO wise up. I would love to take a permanent position that offers the pay and benefits I'm getting now. Maybe the increased use of travelers will cause some administrators to rethink the way they treat their regular staff and make some big changes.

The place I'm working at now does offer "Premium Pay" for staff nurses. Everything compares to what I make with one exception. The rent. My agency pays an equivalent of $800/mo toward my housing. Multiply that by 12 and you'll see why I remain a traveler. Kimberly

Specializes in Home Health.

I see jt, I thought you meant all agencies. I guess the travelers are making a lot more money. But still, the hospital could do the same exact thing for those nurses, pay them the same, w/o housing of course, and cut out the agencies, but my point is they won't. What baffles me is why the nurses in those hospitals stay when they realize the money that is paid to agencies could be going to them.

I have said this before, I forsee the future as each nurse independently contracting with hospitals, b/c I honestly don't see nurses returning to those conditions any time soon.

Specializes in Community Health Nurse.

I started working as a travel nurse in the Fall of 1988, 1 1/2 years out of college. The only reason I started traveling was to get as far away from my ex-husband and his shinanigans as possible, so I moved with my youngest daughter to Hawaii on a Travel Nurse Assignment to give me time to "heal" on "unknown turf". ;) And, heal I did! I had a great time there! :) I loved traveling so much that I kept traveling for the next 2 1/2 years after Hawaii, and I would do it again today if I ever decide to return to nursing. :o

I, too, always wondered why hospitals would pay out their butts for travel nurses and agency nurses instead of paying their staff nurses just as well in order to keep them from leaving. :confused: The military hospitals have even started using agency and contract nurses, claiming not enough nurses want to work for them anymore, and not enough are joining the military. The military hospital here has boo-coo contract nurses who say they like working here, so they stay on like staff, but get paid the big bucks! If we weren't about ready to leave Texas, I would give it a shot, but we don't have enough time left here (thank God) for me to consider it.

Something should be done to stop this madness so staff nurses receive the pay they deserve. I'm all for it, even if I did enjoy traveling as a nurse once upon a time. ;)

Regarding agency nursing I make anywhere from $35-52 dollars per hour working for various agencies. In my last regular hospital weekend program program job I made $41 an hour plus benefits. I think it would be a great idea if we nurses would develop our own professional , travelling agency. But the neccessary groundwork set up needs to be done. I once spoke with an LPN whose RN sister & herself owned their own agency. The LPN earned $130,000 per year on her nursing wages alone. Pretty amazing, huh! She explained to me that they had to post a $150,000 equity/cash bond in order to insure the business for liability/malpractice insurance. If there are any nurses willing to take the plunge, let me know, because I think we as nurses could undercut the competition & make more agency hourly wages besides. E-mail [email protected], if interested or call (920)788-4242. PJ RN

Originally posted by Pam Johnson

If there are any nurses willing to take the plunge, let me know, because I think we as nurses could undercut the competition & make more agency hourly wages besides. E-mail [email protected], if interested or call (920)788-4242. PJ RN

PJ ... my email was returned. Any typos in the email address you listed?:confused:

gr8nurse,

I corrected the E-mail address had too many c's. Corrected E-mail address: [email protected]. PJ RN Nurse Solidarity.

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