Agency Nursing vs Staff Nursing - page 5

Hi All! I am preparing to do a debate in my Nursing 510 course about agency vs staff nursing. It is a formal debate complete with PowerPoint presentation, etc. My team and I will be arguing... Read More

  1. by   prn nurse
    The infrastructure I was referring to is not someone sitting in your hospital's offices checking to see if your CPR, etc. is current. The infrastructure is in other buildings and cities. Staff nurses and agency nurses make the same salaries. Any staff nurse can add 40% of her hourly salary and that should be what the agency nurse is costing the staff nurses' corporation. The value of the staff nurses' benefits is 40 % of her salary. It has been calculated this way for twenty years , who knows? Maybe longer. That 40 % pays for your benefits and the cost of administering them. We do all make the same salaries in our respective cities. So, IMHO, it is kinda chicken---- to shaft temps with the worst patients.....on the basis they "are making the big bucks". I am always appreciative of them and welcome them and treat them with hospitality and as professional equals. I love my benefits. It is my choice to work on staff. And I am GRATEFUL for a temp, not resentful or envious.
  2. by   Q.
    Prn Nurse-

    As far as infrastructure, do agencies not also provide these types of benefits to their employees? Something is not adding up.

    You have a staff nurse, who is making $20 an hour, with all the "infrastructure" expenses you mentioned as well.

    You have an agency nurse, who is making $50 an hour, with all the agency's infrastructure expenses. How is it that the agency is able to administer these expenses AND pay the nurse more, but the hospital is not?

    Something is not adding up for me here.
  3. by   imakidnurse
    I believe there is a viewpoint that may not be addressed here in this forum so far, and that is the viewpoint of the nurse manager and or director of the units. I believe that if some of you were put in a position of actually having to staff a unit, you may sing a different song. I am not a manager myself, but I have seen some of what they go through.

    The point was mentioned that the agency nurses can pose a safely issue due to the fact that they are not familiar with policies and procedures. That is the falt of the institution. I can't begin to tell you how many times I have walked onto a unit and gotten absolutely no orientation. They only care about a warm body. You are left on you own, often with a very heavy assignment.
  4. by   Teshiee


  5. by   montroyal
    Originally posted by Susy K

    Perhaps you need to read the entire thread before commenting. This was a thread started to give me insight about a debate I am doing.

    I DID take control of my nursing career; thank you. I work in a clinic setting now and am in school for my MSN - hence, the project this thread is about. I left the hospital because as a nurse with a mere 4 years experience, I was in charge of a bunch of agency nurses who couldn't do C-sections, couldn't start amnioinfusions and docs were unhappy. I was stressed and so I left. Now another agency nurse is there in my place.

    Please don't make assumptions about my state of mind or my degree of happiness. And please read an entire discussion, not just the bits and pieces that you care to, if you are going to comment.
    Thanks for your post.
    Were the nurses not doing performing these duties because of hospital policies or because they had no knowledge of how to do them. If it was hospital policy, then the hospital is to blame for your situation, not the nurses. If the nurses could not perform these duties because of lack of knowledge, they and the hospital should be held accountable to the board of nursing. I can't believe any state board of nursing would allow nurses to work in a position that they are not able to perform their duties. If a nurse is counted as staff, then they must be able to perform all the duties required by a staff nurse in that postion. If they cannot perform all the duties, they cannot be counted. That why , at all the hospitals I have worked, orienties were not counted on the staff sheet as filling a staff position for the shift.
  6. by   Kathy8716
    I've just finished a 3 year!! 'temporary' assignment with a local hospital. I've seen both sides of the agency nursing issue. I believe that agency nursing fills a real need. But more often (at least in the hospital I just left) the agency nursing is needed because of mismanagement of current staff. "Rent a nurses" are very costly to hospitals. If the hospital were to pay their own staff more $/hr, they could have better staff at a lower price to them. They could also increase their own staff @ a higher $/hr. Both of these steps would ease the budget crunch, increase staffing & do a lot to help morale of current staff. I believe that there will always be a place for temp. nurses because of illnesses, leaves & vacations, but from what I've seen, this hospital would rather pay out more $ than actually address the issues & concerns of staff who've already committed to them.
  7. by   bestblondRN
    Our hospital took a good, long look at what was contributing to the enormous vacancy rates on our units. Our agency bill for RN staff for 2001 was almost $4 million (all unbudgeted dollars), and our CNA billing was an additional $1.5 million (again, unbudgeted dollars)--a huge hit for our 330 bed hospital.

    The administration realized that this couldn't go on any longer, so they invested $3.5 million dollars and did an across-the-board pay raise for all RNs. First, they brought us up to scale by region (comparing us to all other "city" hospitals, including the unionized ones, in Chicago). Second, they adjusted the pay scale based on years of RN experience in the U.S. For a number of nurses, the increases were upwards of $10,000 a year. Since the first of the year, we have reduced our vacancies significantly, retained nurses who had been looking at moving to agencies as their primary job, and recruited a lot of new nurses. I really half-expected our staffing ratios to be cut in all of this, but the administration is holding true to their word to keep staffing levels as they were (which are very good, comparably speaking). Benefits were also left intact. Yes, we are still using agency nurses, however in far fewer numbers, and really as a bridge until positions are filled and new people are oriented.

    I think hospital administrators, being primarily business people, look toward the bottom line way too often. In this case, they realized that they would have to invest money in their staff in order to save or make money, retain nurses, and provide quality care--and their strategy is working, so far.
  8. by   fadingyouth
    i have been an agency nurse and traveler for some 15 years.
    While it is true that we only seem to stop gap the problem and not fix it(hospital staffing shortage), it is the hospitals that need to awaken. In this city staff shortages are often created by the dollar amount. I was recently offerred a full time position for 1/2 of what I earn working agency. As a LVN of 35 years experience that would have given me an increase of $6.50 since I first stepped foot in any hospital. The certifications that I strove to obtain mean little today.
    In some areas we are contracted for 8 to 13 week periods and those often continue for a long course--several years for some. Over a period of time we become as knowledgeable as a staff nurse and with most contracts here it is mandated that we accept 5 on-calls a month. We are scheduled by the nurse manager and abide by the protocols and rules set by the hospital.
    A few "old-timers" recently discussed this problem and concluded that: 1) hospitals need to learn how to take care of their staff; 2) enticing benefits and bonuses need to be offerred;
    3) Pay is an issue in that sometimes a nurse needs the pay right then; and 4) they would like to have some measure of control over their schedule--their life.
    As for having "bad, inexperienced nurses" it is not always the trademark of an agency nurse. I have met staff nurses who did assessments w/o the use of a stethoscope, attempted 5 times to start an IV then asked for help, and became mesmerized by the activity on the monitor. Please remember that there is good and bad in all areas--the title or degree means nothing!
  9. by   Brita01
    Originally posted by Susy K
    Prn Nurse-

    As far as infrastructure, do agencies not also provide these types of benefits to their employees? Something is not adding up.

    You have a staff nurse, who is making $20 an hour, with all the "infrastructure" expenses you mentioned as well.

    You have an agency nurse, who is making $50 an hour, with all the agency's infrastructure expenses. How is it that the agency is able to administer these expenses AND pay the nurse more, but the hospital is not?

    Something is not adding up for me here.

    Just speaking for myself and my agency, and strictly talking about benefits so that we may have some kind of comparison; the benefits my agency offers are definitely not as good as the benefits that I received while working as a staff nurse. Health insurance as a staff nurse for single coverage costed me $40 a month. Health insurance as an agency nurse for single coverage costs me $200 a month. As a staff nurse, my hospital equalled my 401K plan contributions. My agency does not equal my contributions. As a staff nurse I had sick days available. As an agency nurse I do not. The above 2 benefits are the only benefits my agency offers while the hospital I used to work for offered others in addition to the ones I mentioned. Why do I choose agency nursing over staff nursing? I work the days that I want, the shift that I want, and make more money despite the expense of health insurance. I walk in, take care of my patients, and leave without having to stay over for the mandatory meetings where more bull**** and empty promises are doled out by management. I believe that if hospitals increase pay, let nurses work the days and shifts that they prefer, and take some of the hats off the heads of nurses, they would be able to retain them.
  10. by   SavageWist
    i have worked agency over 2 years and would not do it any other way. i have only walked into a hostile inveroment a couple of times. i am not to work in a area that i am not properly trained. our agency gives test in areas and your scores reflect where you will work. i always offer to help my fellow nurses with difficult patients. and each shift i work i give at least 110%. any nurse out there has the same apportunity to work agency just as i do. i was tired of getting taken advatage of as most facilities are. i do get paid a little more money, i dont have to work overtime, and i can sch. the hours i work and not feel guilty to take a week or two off of work when the mood strikes. there are other reasons that i could go into but i dont want to bore others. hope this will help in your debate. good luck
  11. by   lanalpn
    I am an agency nurse and actually i enjoy it. I have worked in a LTC facility for years and find this less stressful for me. As a good agency nurse, or just a good nurse if u do not know the "normal condition or routine" u ask. I have no problem asking a staff member about one of my patients. If i am unsure about something i ask.
    With agency u don't have to go the the company bs that staff does. Out of all the facilities i have been to staff nurse complain about how the company is making them do this or that. As agency nurse you go in and do what u have to with out having to worry about getting your nurse's notes done so you can go to the manatory meeting at the end of your shift.
    I look at every place i go as a job, i do what i took an oath to do. Some agency nurses are just pill pushers but a lot of us are real nurses who love what we do.
  12. by   YukonSean
    I am now a staff RN at a hospital (inpatient mental health), but I was a "moonlighting" registry RN for many years. Why? The answer is simple: as the other nurses have described, the money and autonomy are both very appealing. There are other (professional) benefits for the clinician as well. For example, I was at a nursing agency in a large city (Toronto, Canada, pop. = 5 million), and so I was able to work at loads and loads of different hospitals, in various patient care areas. As you would expect, this is a wonderful way to keep one's med-surg skills current. (Although, I confess that I have no interest whatsoever in doing med-surg anymore! I would never leave psychiatric nursing.) Certainly, there is down side to all of this: guess who gets the backbreaking patients, the placement-problem clients, and the dubious pleasure of scooping up the myriad "code browns" on any given medical floor! The poor sucker from the staffing agency, who just walked in to the ward with his or her "one hour orientation", that's who! RNs are notorious for "eating our young"; this is even a discussion topic on one of the chat lists. To accuse registry nurses of having inferior skills is just a red herring, a way of laterally displacing disgruntlement and burnout. Of course not every nurse can work in each unit. I could no more do ICU than could a paediatric RN take on adult forensics. This is why many of us choose to specialise. Yet in an economy of supply and demand, there is an obvious need for registry staff. Just take a look at the hundreds of American "travel nursing" companies who so aggressively compete for even grad nurses.
  13. by   MHN
    agency nursing also offers the flexibility to nurses who for reasons such as family commitments, ongoing studies can not gain permanent employment that will allow for there requirements.We ahve shortages too our hospitals have a casual pool of nurses that can be called in when there are shortages.