How travel nurses are filling the staffing gap

Working to keep up with its growing Atlanta market, Northside Hospital has acquired physician practices and other healthcare outpatient facilities within Georgia. The acquisitions resulted in more patients coming in from referrals — as well as an increased amount of individual physician practices in need of additional staffing.

To fill this need this year, Northside brought in about 50 travel nurses — nurses who are hired through staffing agencies to work in a specific location for a limited amount of time — as well as additional agency healthcare professionals at its three hospitals and outpatient locations. That's a 55 percent increase in the overall agency staffing since this same time last year.  

Northside Hospital is not alone in facing staffing challenges. With an improved national economy and millions of people gaining coverage under the Affordable Care Act, many hospitals and health systems find themselves using experienced travel nurses to fill gaps in staffing. The demand for travel nursing is at a 20-year high and projected to increase another 10 percent this year, according to Staffing Industry Analysts' latest Staffing Industry Growth Forecast. At the same time, a shortage of registered nurses is projected to spread across the U.S. between 2009 and 2030.

"The permanent talent acquisition for hospitals and health systems is a bit delayed because the talent is so scarce out there," explains Landry Seedig, division president of travel nursing at San Diego-based AMN Healthcare, a provider of workforce solutions and staffing services to healthcare facilities across the nation. "It's taking them a little longer to hire permanent [nurses], so they're bringing in the travel nurse to help fill that gap."

Using travel nurses can benefit hospitals, but there can be some negative aspects of the practice. Below are four examples of advantages and disadvantages of using travel nurses.


Travel nurses can leave hospitals and health systems with a more flexible staffing model, according to Mr. Seedig. He says hospitals and healthcare systems need to find the right mix of permanent and temporary nursing staff to provide quality care for patients and achieve cost efficiency. However, increased admissions may result in increased overtime for permanent nurses, potentially leading to burnout. So instead of bringing in a permanent nurse when there is a seasonal or temporary staffing need, the organization can bring in a travel nurse, to fill that need.

"While they're trying to secure a permanent nurse, it's a lot faster to bring in a temporary nurse to fill that gap, so we're seeing [hospitals and health systems] use a travel nurse for that scenario," Mr. Seedig says.

David Votta, human resources operations manager at Northside Hospital, which is a client of AMN Healthcare, agrees that travel nurses allow organizations to quickly flex up staffing levels. For instance, if his organization has an immediate staffing need, he can call a staffing company and have a nurse on the floor working in a week or less — a much shorter time frame than hiring a full-time nurse.

"The ultimate goal of the hospital is to take care of the patient and have continuity of care," he adds. "If we're able to get someone qualified in here quickly, we are better equipped to take care of our patients, which is first priority."


Although the hourly personnel cost may be more for supplemental RNs than for permanent RNs, minimal to modest use of supplemental RNs in certain situations could be cost-efficient or let hospitals break even, a study published in the Journal of Nursing Care Quality suggests.

Neither strategy is good in extremes, researchers found. Neither heavy reliance on supplemental RNs nor placing permanent RNs on overtime may be cost-effective.

From a financial standpoint, Mr. Votta sees multiple sides. Travel nurses can cost more per hour than regular nurses, but he believes they are useful, especially when called upon for an immediate staffing need. "I think there is a definite need [to utilize travel nurses] because at any given time my unit can be called upon to fill a void in staffing. I don't always know what is going to come at me next, but our partnerships with agencies help us deliver on the care of our patients," he says. "You never know what natural disaster or event you might face and you need to have a contingency plan, especially for changes that occur in staffing as your market changes."

Patient satisfaction

According to a study published in the Journal of Nursing Administration this year, hospitals shouldn't be concerned with travel nurses affecting patient satisfaction scores. The study found that the employment of supplemental RNs, which include travel nurses, does not detract from patients' overall satisfaction or satisfaction with nurses specifically. In fact, the research showed little evidence that patients' satisfaction with care was related to the use of supplemental RNs.

"This study confirms that the use of supplemental nurses is a sound strategy for medical institutions to employ to maintain appropriate nurse to patient staffing levels and ensure high levels of patient satisfaction and patient care," Richard Wahlquist, president and CEO of the American Staffing Association, said in a statement.


Although there are undoubtedly advantages to using travel nurses, some hospitals and health systems overuse travel nursing, according to Mr. Seedig. In those cases, he says the organization may have a problem with their culture and/or talent acquisition strategy, leaving them in a position to overstaff with travel nurses. "You want to find that right mix of both permanent and travel staff, and if you get too heavy either way, it becomes inefficient," he explains.


More articles on workforce and labor management:

Contra Costa County nurses reach tentative agreement: 7 things to know
RNs ratify 4-year contract with Lower Bucks Hospital: 4 things to know
15 things to know about caregivers


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