Travel nurses first started to appear throughout the U.S. in the late-1970s and offered a novel solution to understaffed hospitals in regions where a temporary but high demand for healthcare workers existed. Hiring nurses for short-term roles presented a cost-effective way of dealing with staff shortages. For nurses, it was an avenue for more experience and higher pay. Travel nursing grew in demand throughout the 1980s and remains a particularly vital part of the healthcare system to this day, especially since the onset of Covid-19.
Prior to the pandemic, staffing agencies were usually viewed as an efficient, flexible way to fill temporary gaps in staffing needs. Travel nursing grew in popularity as Covid-19 progressed, and nurses were seeking more flexibility in their work, the ability to work in new places or different specialties, and sometimes significantly higher pay. Many were open to temporary assignments requiring relocation as their spouses were suddenly working from home and their children were receiving their education virtually. Healthcare organizations were scrambling for staff as they tried to anticipate care needs in a suddenly unpredictable world and staffing agencies were able to offer a much-needed level of stability and certainty.
As the Covid-19 pandemic spurred a sudden transition to work-from-home (or anywhere with internet access), employees around the globe experienced newfound flexibility in their work. While healthcare workers typically are not able to perform their jobs remotely, nursing professionals sought to leverage their flexibility through staffing agencies that provided the ability to work in a different city or state, try a different specialty, or even experience a new organization within their hometown. Travel nurses were able to have more control over the type of shifts they wanted to work and where they would go. Many enjoyed filling short-term roles at hospitals that allowed them to work as many shifts as possible, followed by a month or two off between assignments. By working in different departments or having the ability to travel to new locations on a whim, employees expanded their social network and enjoyed new experiences, all enabled by their workplace.
However, as the newness and unpredictability of the pandemic have subsided, many now fear that agency staffing can be a detriment to patient care. If a department is staffed too heavily with agency staff, there may be a lack of knowledge about the organization and its policies or procedures, and the culture of the organization can be diluted. Something as simple as not knowing where items are stocked can take away precious time that should be spent on patient care. Hospitals with already tight operating margins struggle to provide affordable, quality patient care when they are forced to rely so heavily on agency staff.
There is a balance that needs to be struck between ensuring hospitals are adequately staffed, and ensuring hospitals are employing the right staff. In early 2022, the median wage for contract nurses was more than three times the cost of employed nurses, according to a study by Kaufman Hall. Additionally, the use of contract labor more than doubled pre-pandemic findings. While many expenses to healthcare organizations have increased over recent years, labor costs have increased at a greater proportion than others. On average, labor as a percentage of expense per adjusted discharge increased from 46% in 2019 to 49% in 2022. In fact, travel nursing or agency nursing became so popular over the last couple of years that the American Hospital Association submitted a statement to the U.S. Senate in early 2022 asking the government to intervene with the healthcare worker shortage listing nurse-staffing agencies or contract labor as one component leading to staffing shortages and high costs of labor.
Seemingly because of the increased popularity and high cost of contract labor, many large healthcare organizations have now created their own internal staffing agencies. To successfully implement an internal staffing or travel agency that may span multiple cities or states, organizations need the technology and data available to support this endeavor. Having visibility into an entire organization’s staffing needs is important to ensure staff are deployed in the most efficient manner possible. Once staff arrive at their new, often temporary location, they will likely require some training and education to ensure they are fully enabled to provide optimal patient care. Under-leveraged, on-demand micro-learning activities can help an employee feel confident in their work and provide the opportunity to learn at their own pace and when necessary. Adding QR codes to equipment that might vary from one location to another and automatically launch training courses can help the employee be productive on day one and feel supported in their new role.
As the healthcare industry continues to navigate a labor shortage that is predicted to worsen, it is important to utilize technology to support operations and to continually innovate new ways to work. By providing employees with options of where, when, and how they work, many of the top reasons employees are leaving their jobs can be addressed. Keeping in mind that employees today are seeking different types of flexibility in their working conditions, internal travel agencies may be a great answer to retaining current staff and attracting new talent.