Doing away with agency nurses. Interesting article.

SmilingBluEyes · Dec 22, 2003

The one hospital I worked at never used agency/travelers. They kept a HUGE perdiem staff, never demanding anything of them other than maintaining currency in their certs/training, attending at least 50% of all staff meetings.....and when they came in, the pay was worth it.

The list of perdiem staff names was as large as that of "regulars"....so there was always someone to fill holes in the schedule or come in. I loved working there. I worked ONLY when I chose and liked NOT having to do any "mandatory" shifts. It fit my lifestyle and needs perfectly ....wish I could have stayed but moving was not my choice...anyhow-------

It's not rocket science. Treat your regular and perdiem staff well, pay them well and agencies/travelers would not be needed in so many situations.

Too bad so few hospitals have this figured out.......

oramar · Dec 22, 2003

Just remember to take these "Happy Happy, Joy Joy" press releases that CEOs hand out to the media with a grain of salt.

Tweety, BSN, RN · Dec 22, 2003

I understand the ultimate goal is not to use outsiders, but right now our hospital can't. This past year however, they started their own contracts where they pay high wages and bonuses and a 13-week assignment and cut out the agency.

We have to get director approval for per diem agency, but in a pinch we get it. With literally a dozen hospitals and even more LTF's in the area competition is fierce and the labor pool smaller.

HomeNurse4kids, LPN · Dec 22, 2003

In an article by The Associated Press printed in our local newspaper this month, it talked of hospitals along the east coast which allow their staff nurses to bid on work shifts over the Internet (their own hospital website) and pick their own hours and pay. According to the article, the average bids were about 30% higher than the base rate paid to RN's but about $12/hr LESS than what they would pay agency nurses. It DID also mention that they may only use this method as a "short-term" way to fill their slots. Interesting, to say the least.

[email protected] · Dec 24, 2003

I wish somebody would stop agencies from staffing the ER I just left. Then they would have to treat staff decently. My bosses were too busy kissing the pool nurses' behinds to treat me as anything more than cheap day labor. "Yassum Boss, Ise jus' doin' de best I can!" I should have suspected something was wrong when I found out they had PERMANANT openings for full time day positions. That place was at least 50% agency in '95 and it still is. Busiest place in town with the crappiest pay. I don't know who was stupider; administration for paying twice as much for agency people, or me for working in that hell hole for such idiots for all those years.

Oh, things'll be better in twenty-oh-four,

Cause I won't be workin' in Hell no more!

:roll :chuckle

ScarlettRN · Dec 24, 2003

I wonder how something like bidding works in practice. It has always been my opinion that flexable hours (more than just the 7-7 grind) and doing higher pay for certain critical times at the hospital would encourage more nurses to work.

Agency nurses wouldn't be in such demand if regular staff knew they could make more money in, say, a one time bonanza when extra help is needed the most.

mattsmom81 · Dec 24, 2003

There are 3 fulltimers and one permanent part time in my ICU nights. The rest is covered by agency contract and we currently have 6. We are HCA and use the HCA agency. These nurses make excellent pay ($43 hr ) and travel around in 13 week stays within the corporation. Sounds like a nice deal for someone who doesn't mind different environments. I haven't figured the economics of lodging, vehicle expenses, etc...but it seems these nurses are doing pretty well when all is said and done.

As a PRN pool RN I make 28 hr base. Sometimes it gets on my nerves...the pay discrepancy for the same work. Ah well, just another possible option in my future...LOL!

Regarding the original question...in my HCA facility it seems they are trying to do away with PRN staff for All About Staffing contracts. I'm the one getting canceled while agency works.

luv2yoga · Dec 24, 2003

Could someone point me to some threads or maybe explain the difference between Agency, PRN and regular? I think I sort-of get it: agency is the travelling nurses (right?), PRN is a deal where they have open shifts and you sign up to work them but no benefits and no guarantee of getting hours (right?) and regular is when you work a specific schedule as a hospital employee with benefits (right?).

Did I miss anything? Sounds like the pay scale is agency top, PRN middle (except for the benefits) and regular last (maybe same as PRN or more if you count benefits). I can understand the relative advantages if I have this right.

mattsmom81 · Dec 27, 2003

If one needs benefits, fulltime is the way to go. I do not and don't need FT hours so prefer PRN or perdiem work. I've done agency fulltime in the past but as I get older a prefer a 'home'...it's all about what we are comfortable with at a point in our life.

Part of the reason our corporate agencynurses/contracts get used is the $$ stays in the coorporation that way.

ratchit · Dec 27, 2003

Originally posted by mattsmom81
We are HCA and use the HCA agency. These nurses make excellent pay ($43 hr ) and travel around in 13 week stays within the corporation. Sounds like a nice deal for someone who doesn't mind different environments. I haven't figured the economics of lodging, vehicle expenses, etc...but it seems these nurses are doing pretty well when all is said and done.

As a PRN pool RN I make 28 hr base. Sometimes it gets on my nerves...the pay discrepancy for the same work. Ah well, just another possible option in my future...LOL!

Regarding the original question...in my HCA facility it seems they are trying to do away with PRN staff for All About Staffing contracts. I'm the one getting canceled while agency works.

All About Staffing is HCA's in-house travel agency. They were created because HCA uses a lot of travelers and wanted it to be cheaper. I can see why they do that.

But I really doubt those AAS nurses are getting paid $43 an hour. Regular travel nurses make about $26-$32 an hour. Some contracts are a little lower, some are a little higher. But that's typical. And that's without sick time, vacation time, tuition reimbursement, and usually without any shift/weekend differentials.

So... If AAS was created to keep more money in HCA's pocket, I doubt they are paying travelers $11-$17 an hour above the typical traveler salary.

Many travelers won't work for AAS/HCA because their contracts are very pro-hospital and don't support the nurse at all. They are actually known for offering a bonus and then cancelling the nurse a week or 2 early to avoid paying it. And from what I read on the travel nurses forum on Delphi, their contracts allow them to cancel you for any reason at any time. (To be fair, lots of hospitals are trying to put that clause in their contracts now.)

I suspect that $43 an hour is the bill rate, not the pay rate. The bill rate is what the hospital pays the agency for the nurse. The agency then pays the nurse, their benefits, the company's overhead, and their own profit. A typical bill rate, depending on region, is about $55 - $70 an hour. If the nurse sees 75% of that money total (housing, insurance, salary) she's doing well. To support a $43 an hour pay rate, they would have to have a bill rate of about $65- that doesn't save HCA anything.

Not slamming you here- but I have traveled for years and know that HCA/AAS pays poorly. If you'd like, I'd be happy to call a couple agencies that I work with and get pay quotes. (AAS has some nurses that work directly through them, but many more nurses that are subcontracted through other agencies.) Just PM me the name or city of the hospital you work in. I'll be VERY surprised if the nurse is actually making above $26 an hour.

They are getting their housing on location paid for- but unless they are paying for their own housing back home, too, the housing money will be treated as taxable income. So they are getting free rent where you are, but if they aren't paying rent somewhere else, they are setting themselves up for a big tax bill later.

Don't feel badly about travelers making more than you- I doubt they are.

T

cannoli · Dec 27, 2003

I work agency but I go to an HCA hospital. The rate is $26.00 an hour. There is no shift differential, so evenings and nights makes the same as days, $26.00 an hour. The pay is one dollar an hour more for the weekend. This is for the med-surg floors.