Will travel nursing survive Obamacare?

[Janethenurse]

I know hospitals are going to get hit hard by Obamacaare. Any ideas or opinions on how this will affect travel nursing?

[NedRN]

Of course I agree with you about flat rates (I said it above). This will put extreme pressure on hospitals to reduce complications to protect their bottom line, and as I said, that is a good thing. I don't think that will favor cheaper nurses any more than it does now. Normal corporate practice is to reduce labor costs as a mechanism to increase profitability (yes, even non-profits). The problem with that in healthcare is that complications and hospital stay lengths increase when you do that (by reducing nurse to patient ratios). Looks good to the short term bean counter, but there is now a ton of research suggesting that not only are hospital stays shorter at well staffed hospitals, but complications and very expensive sentinel events go down as well. The evidence isn't quite as clear, but it looks like hospital may save money by staffing better. Hospitals that utilize per diem staffing and travelers have similar positive results and that kind of staffing does cost more.

By the way, nurses are not medical staff. Their pay come from hospital reimbursement, not fee generation like doctors and allied health staff provide. As a result, nurses are a cost center, not a profit center. That perspective as the highest hospital expense accounts for the constant pressure by hosital bean counters to reduce nursing costs.