Can we talk about the Travel Nurse Cap?!

JBMmom, MSN, NP · Dec 23, 2021

4 hours ago, morelostthanfound said:

the RN travel market is becoming crowded and there are quite a few nurses with very minimal experience hoping to cash in. These nurses appear way over their heads and don’t realize how dangerous their lack of experience is or what a disservice it is for their patients. Scary

We have seen this first hand in my ICU. We are a small unit in a community hospital and apparently a few travel companies push us as a first assignment for new travelers because we are known to be very traveler friendly. We will also accept people with one year ICU experience. In many cases our travelers have been competent and an asset to the unit. However, we've recently had some that are clearly not prepared. And hospitals don't care that they are not only getting zero return on their investment outside of the 13 week contract, but they are in some cases causing more work for us as regular staff. I know one night recently I easily spent an hour of my time trying to help two travelers when they weren't familiar with our labs/ordering/labeling process. That was in addition to being charge with an assignment with three vented patients, two COVID. I'm happy to help when I can, but I really didn't have an extra hour to do the job other people were hired for. Especially when I know they are bringing home FOUR times my pay right now.

Guest 1152923 · Dec 24, 2021

1 hour ago, JBMmom said:

We have seen this first hand in my ICU. We are a small unit in a community hospital and apparently a few travel companies push us as a first assignment for new travelers because we are known to be very traveler friendly. We will also accept people with one year ICU experience. In many cases our travelers have been competent and an asset to the unit. However, we've recently had some that are clearly not prepared. And hospitals don't care that they are not only getting zero return on their investment outside of the 13 week contract, but they are in some cases causing more work for us as regular staff. I know one night recently I easily spent an hour of my time trying to help two travelers when they weren't familiar with our labs/ordering/labeling process. That was in addition to being charge with an assignment with three vented patients, two COVID. I'm happy to help when I can, but I really didn't have an extra hour to do the job other people were hired for. Especially when I know they are bringing home FOUR times my pay right now.

Yes, this is my experience too. Recently we had a traveler on her first assignment who was not even familiar with our EHR (Epic)-really? Some travelers also think that with their minimal experience at a small, rural hospital (not knocking rural hospitals) that they can fly solo in large, university hospitals with very different patient types and much higher acuities

summertx · Dec 24, 2021

On 12/15/2021 at 9:52 PM, CardiTeleRN said:

Why are some states considering capping travel nurse pay?? What is the purpose? To help with the nursing shortage? I'm not sure if someone informed the decision makers that nurses left staff jobs due to low pay so lowering the travel pay will only make nurses leave the profession entirely. I

On 12/15/2021 at 9:52 PM, CardiTeleRN said:

Why are some states considering capping travel nurse pay?? What is the purpose? To help with the nursing shortage? I'm not sure if someone informed the decision makers that nurses left staff jobs due to low pay so lowering the travel pay will only make nurses leave the profession entirely.

Nurses are mostly women, that is why they think it's easy to control them. They won't do this to police officers, paramedics or firefighters. When firefighters come to our facility for an emergency, they come 5-10 fold with help. They come with their stretchers and there are 10 EMS/firefighters. Most nurses at night work alone. We don't get the help that they get.

If there is this 'cap' on nurse pay and if it results in me not getting paid enough, I'll quit and go to another profession.

Mary Cherry · Dec 24, 2021

First, I’m not saying I agree with capping pay at all. You can’t put a monetary value on nursing- we are worth more than what any organization can afford to pay. I think anyone in healthcare can see healthcare is struggling in many areas. Locally, our hospitals are in a crisis state, especially financially. We have a large number of nurses who are “travel nurses” but don’t actually travel. They may rotate through some of the local hospitals, but majority stay with the same organization they previously worked in on different assignments. Nurses are leaving the organization only to be hired by an agency, and then because hospitals are so short on RNs being hired as a travel RN at the same place, same unit for over double the pay. Our travel nurses are currently making more than the doctors but aren’t actually “traveling” because there is always a need so they just keep renewing their assignment. I’ve seen a few travel nurses in my organization stay for >2 years. Many hospitals throughout the state have made a pact not utilize travel nurses at all in order to stop the local nurses who don’t plan to actually travel but want travel pay/benefits. Currently, the organization is paying their RNs more when they pick up an extra shift than they pay the NPs and PAs. It just isn’t sustainable. I’m sure the salary caps are to prevent this from happening (nurses becoming travel nurses for more money but not traveling). Yes, admin could afford a paycut to help raise nursing salaries- but again, nurses are worth more than any amount the administrators are making.

brandy1017, ASN, RN · Dec 24, 2021

39 minutes ago, Mary Cherry said:

First, I’m not saying I agree with capping pay at all. You can’t put a monetary value on nursing- we are worth more than what any organization can afford to pay. I think anyone in healthcare can see healthcare is struggling in many areas. Locally, our hospitals are in a crisis state, especially financially. We have a large number of nurses who are “travel nurses” but don’t actually travel. They may rotate through some of the local hospitals, but majority stay with the same organization they previously worked in on different assignments. Nurses are leaving the organization only to be hired by an agency, and then because hospitals are so short on RNs being hired as a travel RN at the same place, same unit for over double the pay. Our travel nurses are currently making more than the doctors but aren’t actually “traveling” because there is always a need so they just keep renewing their assignment. I’ve seen a few travel nurses in my organization stay for >2 years. Many hospitals throughout the state have made a pact not utilize travel nurses at all in order to stop the local nurses who don’t plan to actually travel but want travel pay/benefits. Currently, the organization is paying their RNs more when they pick up an extra shift than they pay the NPs and PAs. It just isn’t sustainable. I’m sure the salary caps are to prevent this from happening (nurses becoming travel nurses for more money but not traveling). Yes, admin could afford a paycut to help raise nursing salaries- but again, nurses are worth more than any amount the administrators are making.

Not everyone wants to pick up extra and do OT. Some people have families and a life that takes precedence to jumping at bonus money the hospital would dangle! I never picked up. Besides you knew you'd be working short staffed already and it was hard enough to make it thru the shifts I was scheduled.

When you say travel nurses working for your hospital system are they internal pool? They had internal pool that would float to most of the hospitals in the city and also another pool that was supposed to float to other parts of the state, maybe even bordering states, I don't know for sure. But since the need was so great locally they would work in the city. That's not their fault, rather a failure of management to treat their nurses with respect! Where I worked they starting laying off as soon as they took over and by 2019 it became drastic, increased patient ratios and virtually no support staff so nurses left in droves. Why should you stay when you are being abused and mistreated! I worked thru 2020 but finally had enough and quit.

So if they made a pact not to use travelers what are they doing to fill the holes? Mandatory overtime or short staffing or denying vacations if staff doesn't pick up? That's a recipe for more turnover! I'd rather work with travelers than be mandated or working short or not be able to take time off to relax and destress.

The director tried to save money in 2019 by not renewing the travelers we had right before Thanksgiving so he could pay new travelers less money. Well guess what no one wanted the job so we were short and mandated! This pattern continued thru 2020 where we'd have good travelers but they wouldn't be asked to extend till the last week and most had already made plans. It wasn't like management didn't know they needed the travelers. It was and is an ongoing mess made worse by incompetent management that showed their disrespect to the travelers as well as the staff. They just expected these travel nurses would jump to extend at the last minute. So rude and disrespectful!

Maybe your hospital is losing money, I don't know where you live; but I can assure you many of these large hospital systems are making a profit in spite of covid between the govt bailouts and the national guard.

Guest 1152923 · Dec 24, 2021

Agree with Brandy1017 above. Because my hospital is associated with a state university, hospital employees are therefore state employees and their salaries are posted in a state run database. My hospital's CEO and senior management made obscene salaries in 2020 (CEO-over $1,000,000 in wages and bonuses) and junior managers got a fat covid bonus (rumor has it $80,000 each) on top of their wages. Wait....huh? Not patient facing employees, no risk of contracting Covid, Hepatitis, HIV, MRSA...no weekends/holidays, plush offices, no unreasonable, entitled patients, no dangerous overstaffing.....Wow, just wow!

OUxPhys, BSN, RN · Dec 24, 2021

I don't agree with it but I can see hospital lobbyists pushing states to cap travel pay. What's sad is the media will look at nurses for being greedy instead of holding the hospitals responsible for being greedy and treating their staff like garbage.

JKL33 · Dec 25, 2021

18 hours ago, Mary Cherry said:

I’m sure the salary caps are to prevent this from happening (nurses becoming travel nurses for more money but not traveling).

I mean, that's pretty much a matter of word choice. Hospitals aren't upset because the nurses may be called travel nurses even though they're not traveling far, they're upset because they want to continue their ability to increase nurses' responsibilities while staunchly refusing to offer compensation commensurate with their own demands. And treat people ridiculously poorly. And people quit, predictably.

They don't have to call them travel nurses. They could just call them "people who don't want to put up with our crappy attitudes anymore, especially for the kind of pay we are offering, so they now work for someone else." Or, to simplify: Agency nurses.

If hospitals were actually bent out of shape about the terminology and the unfairness of people calling themselves travel nurses while not traveling far, that would be quite the double standard. They are the king of shenanigans and they call their shenanigans whatever will sound good and bamboozle people.

brandy1017, ASN, RN · Jan 2, 2022

I just want to share an article for nurses considering taking travel assignments. It brings up both the pro's and the con's and potential red flags and apparent bad players to watch out for.

https://inthesetimes.com/article/travel-nursing-deploy-to-new-orleans-with-krucial-staffing

pinkdoves, BSN · Jan 2, 2022

On 12/16/2021 at 7:01 PM, LibraNurse27 said:

Yes, and since I am not a talented athlete or entertainer, living in Silicon Valley has taught me that second best would have been becoming a software engineer, or better yet a venture capitalist! Unfortunately I also don't know how to do coding and huge investments make me nervous. Now that I'm back to clinic nursing I don't feel taken advantage of as I did in the hospital.

It's hard for anyone except those who've experienced it to understand the level of responsibility nurses have. I used to feel upset knowing tech workers who invented phone games like Fruit Ninja (fun game!) make ten times more than me, but I realized I don't HAVE to be a nurse. Now I'm focused on enjoying my work and continuing to advocate for nurses. I think the cap on travel nurse pay is ridiculous, and I hope it leaves a bad taste in the public's mouth knowing fewer and fewer people will want to care for them because nurses are continuously undervalued and disrespected.

I am not kidding when I say this--I am STRONGLY considering going to school for software engineering. There are a couple reputable Master's programs that allow students without a background in CS to complete. Nursing can sometimes be rewarding, but the cons greatly outweigh the pros. At 24, I am excited to start in a new field. And if I want to work per diem as an RN I always can... RN is just shift work

nurse2033, MSN, RN · Feb 9, 2022

My jaw dropped when I heard this. First, the idea to provide nursing to underserved areas by capping pay is the opposite of how it works. Nurses would leave states that cap pay and go to states that pay more. That's how our economy works. Supply and demand. Capitalism! I agree with the OP on why the hospital industry has painted itself in this corner. I was already one foot out the door prior to covid for all the common reasons. I have 25 years in healthcare and 16 as a nurse. I came back for the money.

I feel that nurses are finally being paid what we are worth.

The feds have opened up the green card process for foreign nurses, who presumably will work for less, but I think it will take some time for this effect to be felt.

All I want is to be treated as a valued employee. If you can't pay me $100 per hour- I get that, but make it worth my while in other ways, not grind me down with unsafe ratios and insufficient time off. This article- (Excess Administrative Costs Burden the U.S. Health Care System - Center for American Progress) explains how the US spends twice as much on admin and billing as most of the world. Why don't we start there?

brandy1017, ASN, RN · Feb 11, 2022

On 12/20/2021 at 1:09 PM, Susie2310 said:

A state cap may serve as a disincentive to nurses considering changing their employment to become travel nurses. So nurses may just decide to stay where they are. If enough states do this, it seems it could serve as a disincentive for nurses to work as travel nurses, period.

I suppose some might be dissuaded from traveling, but then they might just quit the bedside entirely, find another job or leave nursing altogether rather than stay at a place with poor pay and bad working conditions. Also travel nursing is not an option for everyone. Many people have family or simply aren't interested in travel in spite of the high pay available due to the many downsides.

For me no amount of money would keep me working bedside. Thankfully I had the option to take early retirement and chose that. But I would have stayed if we had good working conditions, adequate staff both nursing and support staff, essential equipment and respect. Just the disrespect alone from the new corporate management was enough for many to leave. But I support all the nurses who do choose to travel, they deserve to be paid well. It is hypocritical how corporate healthcare is all about capitalism, but when supply and demand affects their bottom line, they don't want to pay the market rate and cry foul!