Why won't they pay us more to stay??

ShayNeq65 · Feb 26, 2021

I have often wondered that myself BB and this has come up in conversations with other nurses. We have gathered that it may be easier to get rid of traveling nurses when census is down, no benefits, no retirement plans to offer.
Great for the company so they think until like you say, the staff who are part of the facility are stretched thin due to training these nurses and not mention all of the mistakes due to the high learning curve that will be required by the TN.
It is sad but until it hits the corporation at the bottom line, they will make cuts where they can.

Disclaimer: The above is my own personal opinion(and some other nurses which I have spoken with about this topic, which means less than zero.)

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speedynurse, ADN, BSN, RN, EMT-P · Mar 7, 2021

I have completely wondered the same thing. Although it all honesty, I know my hospital was offering fairly big incentives during busier times and all of us in the ED were so fried that no amount of money could entice us any more ?

bitter_betsy, BSN · Mar 12, 2021

@ShayNeq65 I understand from the corporate standpoint its easier to release travel nurses, but when you grossly underpay your nurses at home and they leave to travel nurse - then when things subside - you are left with few nurses who want to be there. I wouldn't say that I'm "training" travel nurses because I'm not experienced enough to do that, but I'm showing them where to get things, how to document, even how to get into the Pyxis to do an override for something - and even how to get to other parts of the hospital including other parts of the ED. When travel nurses have to rely on a new grad to show them where things are - there is certainly a problem. I'm not angry that I don't have enough experience to go travel nurse, I'm angry that I'm staying, holding down the fort until those experienced come back and I don't even get a free meal out of it! I'm certain when they all return, they will renegotiate their salary and get an increase, while I sit in my corner holding onto my new grad pay, waiting until I get experience so I can go find a new hospital to get an actual raise. I guess I really am Bitter Betsy right now! I like my manager and don't want to leave to make more money but it looks like that's the way this all works. I suppose I just have to accept we are just bodies to fill a space at the lowest cost.

JKL33 · Mar 13, 2021

On 2/20/2021 at 4:19 PM, bitter_betsy said:

I am just wondering why our large corporate hospitals continue to hire travel nurses at these crazy rates, when they could just offer us nurses incentives to stay?

Because they like to completely be in charge of all negotiations and not have to deal with people who have any significant negotiating power. If they admit to regular staff that they are hurting and need help and are willing to pay xyz incentive for people to stay, then then that becomes a leverage for those on the receiving end. And why would they want that? They are fine with letting you stress about all of this and help the travelers learn their way around and train more nurses even newer than yourself while they don't care as long as someone with 'RN' behind their name shows up to work one way or another.

That's why.

22 hours ago, bitter_betsy said:

I suppose I just have to accept we are just bodies to fill a space at the lowest cost.

Yes. This ^ really is quite a reasonable and practical understanding of things. You're in for a rough road if you want the relationship to be more than that. I say don't do that to yourself. Get your experience, make the very best of that opportunity, then decide what you want to do with it.

Guest219794 · Mar 16, 2021

There actually two costs associated with travel nurses. Unless they are covering a surge in demand, each travel nurse is an expensive way to temporarily fill a hole that will ultimately be even more expensive to actually fill. And, in all likelihood, whatever poor management factors were in place to cause the problem will stay in place continuing this inefficient costly cycle.

I have been given $50,000 as the rough figure of actual cost of a new nurse hire. Tack on the temporary cost of a travel nurse, and it is truly hard to understand the business model.

Maybe it goes like this:

Facility has 100 nurses.
Meaningful retention would cost $10,000 per nurse, per year.
That comes to an additional $1,000,000 expense per year just to increase retention.

In order for that million dollar a year expense to pay off, you would have to prevent an an additional 20 new hires annually.

I have no idea if that is how the finances shake down, but it actually could be a calculated cost rather than the sheer incompetence it appears to be.

TheSquire, DNP, APRN, NP · Mar 17, 2021

On 3/16/2021 at 7:25 AM, hherrn said:

I have been given $50,000 as the rough figure of actual cost of a new nurse hire. Tack on the temporary cost of a travel nurse, and it is truly hard to understand the business model.

Maybe it goes like this:

Facility has 100 nurses.

Meaningful retention would cost $10,000 per nurse, per year.

That comes to an additional $1,000,000 expense per year just to increase retention.

In order for that million dollar a year expense to pay off, you would have to prevent an an additional 20 new hires annually.

I have no idea if that is how the finances shake down, but it actually could be a calculated cost rather than the sheer incompetence it appears to be.

I'm reminded of a scene in Fight Club, and I should bring up that one would have to factor in the increased rate of errors committed by new grads and other new hires and the resultant increase in malpractice settlement payouts, unless that's already included in the $50k/new hire figure.

SanDiFrangles, RN, NP, CNS · Aug 21, 2021

Hi all, in the past I had worked as a ICU clinical nurse specialist and have intermittent dealings with leadership regarding budgets, even though it is not really my favorite thing to do.

First, I completely agree with the theme of this thread that hospitals need to do a better job at retention by offering more attractive financial packages, that include retention of nurses. As mentioned by one of the other posters, there is a significant financial cost to re-training nurses. I think the cost differs based on where in the country you are actually working, however I’ve estimated it to be as low is $40,000 and as high as $75,000 a year depending on specialty.

As far as pay and compensation and why a hospital might hire travelers instead of permanent staff, there are often two buckets in a hospitals budget when it comes to labor. The permanent staff budget and then the temporary staff budget. Often times permanent staff budgets are established early in the fiscal year (starts in July at most places) and the monies are spent immediately in hiring new people. Whereas the traveler budgets are often spent throughout the year and there are some reduced costs in travelers for short term although they do cost more for the long term. Like many things in life, it is cheaper to buy things in bulk and travel agencies are no difference. Hospitals may sometimes get a special deal for multiple travelers at once at a significantly reduced rate.

Another thing to keep in mind regarding travelers versus permanent staff is that permanent staff are actually a bit more expensive aside from salary alone, benefits, training, PTO all are expenses to the facility. Another example is orientation, a traveler would typically get 1 to 2 days of orientation on a unit where a new employee might get about 3 to 6 weeks. During that time the orientee is considered non-productive (fiscally) and there’s a significant cost.

But as you might imagine this significant cost becomes even more expensive if somebody might leave therefore this whole argument comes full circle that hospitals really need to do their very best to retain their experience people because if they don’t in the end it cost them way more money and then they will also need to supplement with travelers. If they do supplement with travelers then it can get quite expensive especially if we’re talking more than six months.