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

  1. 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.>>>

    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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    About -jt

    Joined: Oct '00; Posts: 2,662; Likes: 46


  3. by   Jenny P
    So THIS explains all of the "opportunities" to experience travel nursing I get; first in the magazines I read; then my mailbox and my email; and just this las week, 2!!! telephone calls from different traveling nurse companies!
  4. by   nurseleigh
    You should really do the math here. At $29.oo/hour your talking 60,320/year/nurse. in just one quarter he had 6883 nurses working for him. That means he is spending 415,182,560 JUST on wages for these nurses. Don't get me wrong, 102,817,440 is quite a profit for one year. But he also pays housing, health insurance, 401k and some travel nurses are even given a car while they are away from home. Plus you need to add in the round trip plane ticket every 13 weeks per nurse.

    I say if you think he has it so great, do his job!!!!! But quit whining cuz someone else is making money off of you. I dont see anyone complaining because Wal-Mart is making money off the fact that people need toilet paper. You don't REALLY believe it costs that much to make, do you?

  5. by   montroyal
    -jt, as an agency nurse I feel I must respond to your post. Four years ago I stopped working for hospitals. I was sick of being treated like a second class citizen. With the agency, I choose my shifts and my days. I pick were I want to work and with whom. The worst year I've had for income is 50,000 and that was with THREE MONTHS off. I take vacation whenever I want and for how long I want. My company offers health, life and dental insurance. Don't blame the agencies for the nursing shortage, blame the hospitals and the nurses. If the hospitals treated nurses as professionals and nurses(for the most part) refused to be treated as second class citizens, there would not be the need for agency nurses. From what I see and read, this won't happen anytime soon.
  6. by   Charles S. Smith, RN, MS
    The difference between AMN and Cross Country and the vast majority of nurses is that they view nursing and healthcare like a business....and I have to agree. And, JT, I certainly agree with you that any RN can move into independent practice and make a wonderful career/life worth having/living. As you know, I did just that 2 years ago and we are still here and still moving forward.

    It is high time all RNs learned some business skills, learned to negotiate contracts, learned to run their work lives like much of the rest of the healthcare world. When we rise up and let administrators, execs and the business world know that we can compete on an even playing field with them, they will take notice. We can lower costs to hospitals thru independent practice and get more nurses to stay at the bedside. We can capitalize on our own demand right now for the betterment of all. And don't be fooled folks into thinking that these travel companies are charging around $49 (even tho the article said average). They charge at least 2-3 times the rate of the nurse if they are responsible for everything. (some hospitals put the nurse on their own payroll and pay the agencies fees per week).

    So, all you seasoned, expert clinical nurses out there...wise up..nursing is a business too, and we should all have some business skills to be able to compete openly with integrity.

    my best
  7. by   135ctv
    I agree. Like it or not, healthcare is a business. You can compete a lot more effectively if you understand the rules of the game.
  8. by   -jt
    I notice that some of you took my post all wrong. Sorry if I wasnt clear. I wasnt blaming travel nurses for anything. I was advocating for them.

    We all have a highly-demanded service to SELL. Agency owners cut into our profit. Who needs the middle man - especially when hes the one getting the BULK of what is paid for our services while we're the ones doing the actual work???????

    I just think that if the owners are becoming millionaires off the work these nurses do, then the the nurses deserve a lot more than what they are giving them. Id like to throw the owners out of the equation & have the nurses be independents - charging directly & getting to keep every red cent that is paid for them.

    And dont think the company is paying for housing & benefits, etc. It all comes out of the nurses salary. The NURSE is paying for it. The agency owners are still getting their cut.

    I have nothing against travel nursing. I did it myself twice. My issue is with the owners pocketing most of what is paid for the RNs skills.
    Last edit by -jt on Mar 5, '02
  9. by   Charles S. Smith, RN, MS
    Hi again JT...the owners of the travel companies are doing business and they are doing business well because nurses allow it. More nurses need to understand that we all can do business, reap better financial rewards and still reduce nursing service costs...I traveled too, but did it as an independent. The hospitals were grateful and appreciative of not only my skill and expertise, but also the cost savings

  10. by   teeituptom
    Howdy yall
    From deep in the heart of texas

    Nothing wrong with agencies doing your work for you if that is what you want. Ive contracted individually for myself and have done very well, compared to what others are doing. I like being independent

    Keep it in the short grass yalll
  11. by   gr8nurse4u
    My two cents on agency nursing:
    I started being a traveler 9 months ago. What a DIFFERENCE it has made in my life, and the lives of my husband and children.

    NOW: I make $7 MORE an hour PLUS double overtime PLUS a $2,000 bonus every 3 months PLUS most of my rent paid (we upgraded apartment size to accomodate our family size, so we pay a SMALL amount)
    BEFORE: I made $10/h ... time and a half for overtime, no bonus, and meager wage increases yearly. We lived on such a tight budget that anytime something extra was needed (like a new tire for our only car) it was a major financial crisis.

    NOW: We live in an apartment building that's 2 years old. We have a LARGE 3 bedroom, furnished, fireplace, W/D, pool, etc, etc, etc. It's immaculate and VERY nice. My company calls me to make sure the apartment is satisfactory. If something isn't right, they fix it.
    BEFORE: We rented whatever we could afford ... which wasn't much. Our last rental, prior to traveling, was a beat-up, old, disgusting trailer house. Half the time the furnace didn't work. It smelled like the previous tennants cats. Pool? What pool? Nobody ever called me to see if my rental was adequate.

    NOW: I work the shift I want to work. My hours are gauranteed.
    BEFORE: "we all HAVE to take our turn being cut when the census is low", "You HAVE to work all shifts .... (usually in the same week) AND do your fair share of being on-call on your days off." "we're ONLY going to pay you a dollar an hour when your on-call and you HAVE to be able to get to the hospital within 20 minutes of being called"

    NOW: I get an OPTION for a week vacation every 3 months. I don't get paid for it but my rent is free for that week. With the money I earn, a week off without pay is no big deal. They'll pay my travel expenses to and from anywhere I want to go on my week off. I'm going to go someplace fun with my family in April.
    BEFORE: I had to work a full year before I got any paid vacation. 10 days of PTO. 5 days of that were for sick time. The rest of the hours I usually had to use to cover the days I was cut D/T low census. We were never actually able to take a vacation.

    The list goes on. The change from "regular" nursing to travel nursing has made such an impact on my/our quality of life that I wonder why I didn't do this a long time ago.
    It's okay with me if my agency makes a big profit.... they go far beyond what any employer in my past ever has!

  12. by   Teshiee
    Even if the agencies are raking in the bucks. I see nurses are happier with the fact they can spend more time with family and have great accomodations. Charles S. Smith, RN Ms I agree with you we should treat nursing like a business after all we don't nurse we don't eat!

    I currently work for registry with 2 perdiem jobs only because I am getting my experience w/o comitting to a full time position. I make between 32.50-38.00 an hour. I love the flexibility and the lack of political crap you must endure when you are staff. I can't player hate the agencies they are in it for the profits. I agree totally with being independant no middle man is the best. :-)
  13. by   -jt
    <It's okay with me if my agency makes a big profit.... they go far beyond what any employer in my past ever has!>

    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.
  14. by   hoolahan
    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.