ICU nursing is a calling for Sara Dean of Mt. Juliet, Tenn.
She loved Ascension Saint Thomas where she worked when the pandemic hit. But then she saw how much nurses were getting paid to travel — as much as $10,000 a week.
“That’s a life-changing number. That’s a number that helps you pay off debt, move out of your grandma’s basement or whatever you want in that case,” she says. “I’m not saying we were struggling. We were a two-income household. But we made ends meet.”
So she took leave from her hospital job and signed a three-month contract to go to New Mexico. Her boyfriend worked remotely. Her daughter was in virtual school. It was an adventure they took together. And when not working, they enjoyed exploring the desert — often on motorcycles.
The money got better and better from New Mexico to Maryland to rural Alabama — following COVID hotspots. For a short time, Dean’s overtime rate was more than $200 an hour, and she was working 60 hours a week saving the lives of COVID patients.
But after nearly two years, the road was wearing on her daughter.
Dean yells up the stairs to her 12-year-old, Harper, while blending a protein shake. They’re on their way out the door to offseason tumbling practice. She has to perfect her back handspring before next season.
“I didn’t really have that many friends,” Harper says. “I miss it so much being able to be surrounded by different people all the time.”
There came a point where being uprooted or separated wasn’t worth the sacrifice. Dean says Harper is the ultimate boss.
“She’s the one that says, ‘No more traveling … I want to go home,’” Dean says. “But that also puts me in a bind.”
The pandemic has proven just how valuable highly-trained nurses are. Hospitals are still paying several times their normal wages to traveling nurses filling in staffing gaps. And turnover is still increasing, with the highest rates in the southeast with roughly one-in-four RNs leaving annually.
But often hospitals won’t hire local travelers, even though they’re hurting for nurses. They want RNs to accept full-time positions. And full-time pay, while marginally higher, doesn’t come close to the $120 an hour — or more — that travelers make.
“This makes me sound like I’m in it for the money, but essentially I’m in it for what’s best for my family,” says Dean, who is now the breadwinner in her household.
She’s applying at Nashville area hospitals that are still employing hundreds of travelers. So Dean is holding out for a more acceptable offer.
Hospitals push back
Hospitals have been exploring ways to get out of relying so much on staffing agencies, who tack on 30% or more to what nurses are paid. The American Hospital Association has formally accused agencies of price gouging during the pandemic. The AHA has requested that the Federal Trade Commission investigate, though an FTC spokesperson says there has been no inquiry.
Vivian Health posts travel nursing jobs and tracks pay rates across the country. But the firm is also assisting hospitals moving away from their reliance on temporary staffing. And that will take paying full-timers more, says CEO Parth Bhakta.
“You’re caught kind of between a rock and a hard place,” he says. “I think ultimately health systems need to figure out how to retain their workers more and ultimately, probably, have to pay and incentivize their existing staff more.”
Middle Tennessee hospitals are responding to this pressure to pay more. Some are trying out temporary positions that essentially allow a nurse to work like a traveler without having to leave town. Bonuses have also become the norm for new hires in some parts of the country.
“We are actually seeing a very, very good labor market for nurses with upwards of $15,000 to $20,000 sign-on bonuses for nurses almost anywhere you look around this Nashville area,” says Julie Hamm, the president of the Tennessee Nurses Association.
Still, the average pay bump last year for full-time nurses was only slightly more than usual nationwide at roughly 4%. And when making $8,000 to $10,000 a week, a one-time bonus of $20,000 doesn’t sound quite so generous, says Sara Dean.
Which is why she and other pandemic travelers face such a difficult homecoming.
Dean is making the most of her downtime — from spending Christmas with her daughter in New York City to cheering on her preteen as she perfects her back handspring.
Meanwhile, she’s trying out something entirely different — working part time at a wellness clinic near her house that offers rejuvenating IVs.
Many nurses are beyond burned out. While Dean is trying to remain by the bedside, this year the American Nurses Association predicts another half million nurses are expected to leave the profession forever.
“It is refreshing to do preventative health,” Dean says. “I have done nothing but death and dying for two years.”