Why do hospitals hire travellers?

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There are millions of unemployed nurses, everywhere. And the pay of nurses is plummeting in many places. They could hire some of those milions, even to just have a pool of staff on call. Yet they pay huge $ for the travellers (salary, big housing allowances from the agency, food, etc., plus I'm sure the agency gets a big fat slice of the cash pie). I don't get it. Not in this economy anyway. The 80's, that makes more sense.

It might also be useful to put total travel nurses into perspective with total employed nurses. There are somewhere between 20,000 and 22,000 travel nurses this year (the number of FTE - full time equivalents) versus 2.6 million employed nurses in the US. That makes travel nurses a very small safety valve indeed at less one percent of the total. As such, any additional costs of travel nurses are negligible in the large picture, and can even reduce costs in many scenarios.

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Specializes in Nursing Professional Development.
True enough, though- but why use not a local agency, unless it IS that the locals know the place suks, and won't go there, and travellers don't have the inside scoop on what places might suk?

There aren't good, reliable agencies everywhere. Local agencies may not be able to provide experienced nurses with specialized skills. The nurses at the local agencies may not be interested in working in a full time schedule, work the unpopular shifts, etc. In short, there may not be a good "fit" between what a local agency can provide -- if there even IS a local agency -- and what the hospital needs.

I work for a children's hospital -- the only children's hospital in my region. When we need experienced PICU nurses or peds OR nurses or Peds ED nurses, etc., we're not going to find them at a local agency. If they had the skills we need, and wanted to work the shifts we have available, we'd hire them. But all the experienced peds specialty nurses in town already work for my hospital. When we need quick replacements while we hire and train local nurses for long term positions (which can take months to orient & a year or two to become truly skilled), we need to use travelers to fill the gap.

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Next, why do hospitals have permanent staff at all? Control, and continuity of a good healthcare culture is the answer. Even when local registry is available, travelers with a contract provide much better continuity of care than a new random nurse every day. Ask your manager which sort of nurse she would prefer and her answer would be staff first, then traveler, then registry. A regular registry or pool nurse is very acceptable of course, but by their very nature, usually not dependable. They seek part time work for a reason.Interesting question. I once worked agency at a 400 bed SNF in the NE, that had no permament nursing staff other than the management. They had nurses from every agency within 100 miles. It sounds like chaos, but they let the agency nurses fill in their own schedules, so a lot of them were there full time for weeks or months. I never found out why such a huge place would not have a 'real' staff. It was bizarre. I wonder if it had to do with wanting to prevent the nurses from organizing?

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Specializes in Pedi.
There are millions of unemployed nurses, everywhere. And the pay of nurses is plummeting in many places. They could hire some of those milions, even to just have a pool of staff on call. Yet they pay huge $ for the travellers (salary, big housing allowances from the agency, food, etc., plus I'm sure the agency gets a big fat slice of the cash pie). I don't get it. Not in this economy anyway. The 80's, that makes more sense.

First, there are not "millions" of unemployed nurses everywhere. There are around 3 million RNs in the United States- if there were "millions" unemployed, nursing would have a 67% unemployment rate. The national unemployment rate for nurses is about 2%. Many of the unemployed are new grads.

Travelers make sense for a lot of reasons, the most obvious of which is to cover maternity leaves. My floor once had seven nurses pregnant at once and they all had their babies over a period of 5 months so their leaves overlapped significantly. Travelers typically take 13 week contracts which is just about perfect to cover a 12 week maternity leave.

Second obvious reason is when there are a lot of resignations at once. When I worked in the hospital, people would leave in waves. You'd have ten people leave over a course of a few months. Even if the hospitals hired replacements right away (which they don't), those nurses have to be fully orientated. Travelers get 1-2 days of orientation and then hit the ground running.

Local agencies don't staff hospitals AT ALL where I live. I've seen an agency CNA once and essentially the only thing my hospital used agencies for was to staff sitters. I've never met an agency nurse in my city.

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Interesting question. I once worked agency at a 400 bed SNF in the NE, that had no permament nursing staff other than the management. They had nurses from every agency within 100 miles. It sounds like chaos, but they let the agency nurses fill in their own schedules, so a lot of them were there full time for weeks or months. I never found out why such a huge place would not have a 'real' staff. It was bizarre. I wonder if it had to do with wanting to prevent the nurses from organizing?

I've never heard of a facility where there are no regular employees. Workers at SNFs may find this offensive, and while continuity of care is quite important at such places in my opinion for good quality of life of the residents, you don't have to have super clinical skills to work in SNFs. Thus a great staff is not as clinically necessary as it would be at an acute care hospital and perhaps can get away with all temps.

I can only guess that agency SNF nurses cost less that fully benefited staff nurses. Nevertheless, that is a bad business model, and a bad healthcare model. I would never place a relative in such an institution. Thus such a place should close with informed consumers unless it is a government run facility of last resort.

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Paid subscription required. Perhaps you could excerpt it?

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Paid subscription required. Perhaps you could excerpt it?

Posted the same on the news forum and it seems to happen there as well. However can find the article easily on Google News, therefore Modern Health News must "lock" link backs.

Go to this Google search and it is the third or fourth story down titled "Always On The Move": Travel nurse - Google Search

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OK, skimmed it. Nothing worth excerpting. Basically it was a catchall of quotes, nothing to add to this particular thread that hasn't already been said.

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First, there are not "millions" of unemployed nurses everywhere. There are around 3 million RNs in the United States- if there were "millions" unemployed, nursing would have a 67% unemployment rate. The national unemployment rate for nurses is about 2%. Many of the unemployed are new grads. Travelers make sense for a lot of reasons, the most obvious of which is to cover maternity leaves. My floor once had seven nurses pregnant at once and they all had their babies over a period of 5 months so their leaves overlapped significantly. Travelers typically take 13 week contracts which is just about perfect to cover a 12 week maternity leave. Second obvious reason is when there are a lot of resignations at once. When I worked in the hospital, people would leave in waves. You'd have ten people leave over a course of a few months. Even if the hospitals hired replacements right away (which they don't), those nurses have to be fully orientated. Travelers get 1-2 days of orientation and then hit the ground running. Local agencies don't staff hospitals AT ALL where I live. I've seen an agency CNA once and essentially the only thing my hospital used agencies for was to staff sitters. I've never met an agency nurse in my city.
Sorry you and that other person took my 'millions' literally. I'm quite certain the majority realized I meant there are a LOT of unemployed nurses, everywhere. And as far as your obvious reasons- maternity and people quitting? They may be obvious to you, for whatever reason- I suspect the majority of us, though, just learned two additional reasons for travelling nurses. Aside from that- what industry, if you can name one, uses travelling workers to cover maternity leave? Far as I know there are women working in other industries than nursing. I've never heard of travelling secretaries, or travelling clerks, etc. used to cover maternity leave.
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Specializes in retired LTC.

They used to call them Kelly Girls, and they were used to cover maternities and vacations in office work pools/environments.

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Specializes in Complex pedi to LTC/SA & now a manager.

Kelly temp agencies/Kelly Girls still exist.

I worked admin/clerical temp and filled in for maternity, vacation, & medical leave for several large companies and one of the major healthcare system. Apparently (pre-nurse but EMS/tech/unit clerk/admin assistant experience) the fact that I was not only able to pass the skills tests but the drug & background screens made me a shoe-in for the medical support jobs. ;)

It was cheaper for these companies to pay double rate to the temp agency for a 'ready to hit the floor with minimal orientation' and verified skills than do a direct hire temp to fill in even for extended leave of 8-12 weeks Much like hospital will hire an experienced travel or agency nurse for a finite contract.

Agencies are used in the pharmaceutical, research, scientific and financial industries just like travel / agency nurses are used to supplement staff nurses. The more specialized the position the more likely a company will use travelers (accounting /financial , science, lab/research , nursing). I worked in a QC micro lab and they used an agency for one of the microbiologists on extended maternity leave. When I worked pharmaceutical research we used agency for CRAs, clinical study managers, and other senior staff. Floor techs were replaced by per diem staff.

My father's accounting firm used a regional agency for CPAs on maternity or medical leave. (They often travelled 90-120 minutes to the assignment and were paid mileage rather than housing)

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