#1
I believe many of us working in hospitals have experienced this scenario in the last few years. My unit is a medical-surgical unit, and in our most recent unit meeting, my manager showed us our budgeting (in hours and staff numbers, not cost), which included travel nurses and float pool nurses. Staffing is a very hot topic in the world of nursing, and it did not come as a surprise that our textbook said that hospitals want to keep vacancy rates at 4% (Mason, et el, 2021). When COVID-19 was going strong, many nurses left their stationary jobs and became travel nurses. These nurses were offered large travel bonuses, higher wages, and stipends for housing and travel. On my unit, travel nurses are generally contracted to work a set number of weeks, and they are paid regardless of whether they are needed to work or not. The main advantages to them are that they are another licensed body that can deliver care to patients, allow for the charge nurse to not have patients, keep patient-to-nurse ratios lower, and allow the unit to take more patients from the ED. The disadvantages of the travel nurse are that, depending on how their contract is written, they get paid even if they are not needed, or an as-needed/part-time employee may get a shift cancelled, they do not know the unit, or sometimes do not know the computer system, and they are not always familiar with the things done at each place they work.
I kind of already touched on some financial impacts that a travel nurse can have on a hospital or a unit. The major ones are that they tend to get paid more than the normal employees, they might get a bonus for choosing to work a set contract, they are often paid regardless of if they are needed for a shift or not, they are often given stipends for housing and travel, and they still have unproductive time because they need to be oriented to the hospital before they can work.
Alternative ways to improve staffing and to keep current staffing present their own set of challenges. Many large companies view their staff as an asset that should be invested in to get the best return. HCA, for example, created the STAR N program to train new nurses and get them involved with the company. While it may seem like a waste of money, these new nurses learn in a carefully controlled environment that gets them ready for their career in the hospital. The goal is that these new nurses will stay with the company for a few years and the hospital will not have to pay to replace them sooner. The only problem with the training program is that it takes time and new hires and may not be of particular help right away; it is along long-term strategy. For short-term relief in staffing, companies often offer pick-up shift bonuses, short contracts in which a nurse agrees to work four to more days a week at a slightly different pay rate with the end of the contract giving them a large payout bonus, and having an in-house float pool which can send licensed staff to short-staffed units. The in-house float pool gives a decent advantage in that the staff can work in different units depending on their training and is less expensive than hiring travel nurses or contracted nurses. Pick-up incentives are short-lived and only kick in under special conditions, so they can also be easy on a budget.
#2
Travel nursing provides a solution to staffing shortages within healthcare. The option of travel nursing has benefited facilities with safe nurse-patient ratios and reduce the burnout many nurses can face. However, staffing travel nurses can be expensive. They are often compensated much more than permanent staff nurses. Another downside travel nurses face is a short orientation to learn policies and procedures. On a patient satisfaction scale, patients may not feel they are receiving the best care if they feel the workflow between travel and permanent staff have been disturbed.
Balancing the financial implications of travel nursing can be difficult. The majority of travel nurses are contracted through an agency. The agency will charge a fee, in addition to the nurse’s wage. Moreover, there are housing costs for travel nurses that will need to be provided. Permanent staff nurses may feel dissatisfied with the use of travel nurses which can lead to turnover or retention incentives from the facility.
Between nurses leaving the bedside due to dissatisfaction and the shortage of nurses estimated to be 9 million by 2030, it is crucial that healthcare facilities find a way to retain their staff now (Pressley & Garside, 2023). Improving the retention of permanent staff nurses will come down to safe nurse-patient ratios, workplace environment, and increased compensation. Offering a competitive salary, child care assistance or retention bonuses can be enticing to permanent staff nurses. This can reduce turnover, which reduces the costs of hiring and orienting new nurses. Having a management team that listens to their nurses and fights for safe nurse-patient ratios can reduce the burnout of nursing, thus reducing the expenses of recruiting for more nurses.
By implementing some of these strategies, healthcare organizations can provide a stable environment for their nurses, while providing safe patient care and reducing the costs that come with turnovers.