MedCity Influencers

Travel Nursing Won’t Solve the Staffing Shortage, But Reimagining Staffing Models Might

Shift flexibility is critical to nurse satisfaction.

It started as a response to quell the unexpected overflow of hospitalizations during Mardi Gras in 1970s New Orleans but today travel nursing is a contentious topic that has turned into a Band-Aid solution for the nationwide nurse shortage. 

During the pandemic, travel nurses played a key role in filling major gaps stemming from historic levels of staffing shortages. However, the infusion of a temporary, contracted workforce employed by external staffing groups has come under scrutiny, sending shockwaves through the profession and sparking questions about pay equity. One report from the Massachusetts Health Policy Commission even suggests that employing travel nurses contributes to the high turnover rate of permanent clinical staff. The report surveyed nurses from across the state and showed that the staffing shortage is not caused by fewer people wanting to become nurses, but instead is caused by nurses leaving the field after they have already begun working, signaling that health leaders must focus on retention to secure the longevity of a thriving workforce. 

To say that nurses are burned out is an understatement – nursing is in crisis. A recent study found the leading reasons nurses left healthcare employment from 2018 through 2021 included emotional exhaustion, insufficient staffing, family obligations, concerns related to Covid-19, and unsafe working conditions. Looking ahead, the American Hospital Association projects that 610,388 registered nurses (RNs) plan to leave the field by 2027. Over the next three years, hospitals must think creatively and act with an intentional focus on improving core staff retention to fill these staffing gaps. The reason behind the mass nursing exodus from healthcare signals an opportunity for employers to do more to support their current staff and provide the flexibility they are looking for.

Travel nursing

If you ask a staff nurse what they think of their visiting colleague, you’ll hear the familiar sentiment that the pay discrepancy between staff is unfair. As one analysis puts it, “[the] perception of pay inequity between the two groups provokes animosity, jeopardizing morale and teamwork.” In addition, an appealing element of travel nursing is the ability to focus on patient care and avoid being involved in the administrative duties of a staff nurse. However, this very benefit for travel nurses can exacerbate permanent staff’s dissatisfaction as they feel that travelers are not invested in the unit they are working in. On the health system side, the high cost of travel nurses is straining hospitals’ already limited resources. Employing a high number of travel nurses is not a sustainable solution to the clinician staffing shortage; health systems must innovate to reduce full-time staff turnover and improve nurse satisfaction, allowing them to only deploy travel nurses where they truly do make an impact during seasonality fluctuations and other extenuating circumstances. The perks of travel nursing – higher pay, a larger focus on patient care and a lesser emphasis on administrative work, and more schedule flexibility – highlight exactly what nurses want from their careers and give health systems a road map to support their permanent staff.

Investing in permanent staff

We all want to feel like we are in the driver’s seat of our careers – and clinicians are no different. That’s why it is imperative to reimagine hospital staffing models to ensure that they center on nurse satisfaction and career longevity. One way to do this is to deploy a ‘float shift’ staffing model. Float shifts operate similarly to float pools, but instead of being confined to the float pool and stepping into the hospital every day without knowing which unit you will be placed in, float shifts give staff the ability to pick up extra shifts for a dollar incentive, while having full visibility into which unit they will be assigned to for that day. An important element of the float shift model is that these shifts complement a clinician’s full-time schedule, giving them more opportunities to make more money or a part-time gig that gives them more control over their schedules and the flexibility they desire. Shift flexibility is critical to nurse satisfaction. As we imagine a future where our health systems have happier and healthier full-time staff, let’s empower nurses to pick what works for their unique needs and limit the likelihood of their burnout and departure from the bedside – or worse, the profession.

Photo: baona, Getty Images

Becky Kahn, Chief Client Officer at Works & Trusted Health, is an experienced healthcare workforce solutions and staffing leader. She joined the company in 2019 as the Head of Client Solutions and took a brief hiatus from the company to serve as the Chief Executive Officer at Republic Health Resources, a mid-sized hospital staffing firm. She later rejoined Works & Trusted Health as the Chief Client Officer where she has been responsible for the development of the company’s account management and direct staffing efforts, significantly growing the Trusted presence across the US. Khan was a key player in launching the Works VMS platform to hospitals and health systems across the country.

Before joining Works & Trusted Health, Kahn served as the Managing Director, UK Operations, at Medacs Global Group, the largest provider of international healthcare staffing and workforce solutions in Europe. Prior to that, she spent nearly sixteen years of her career at AMN Healthcare where she held several executive leadership positions and was responsible for the oversight of AMN Healthcare's travel nurse client sales and services and local staffing divisions, as well as the account management of AMN's Managed Services and Workforce Solutions product offering, and technology divisions. Khan launched AMN’s Managed Services solution and grew it over her tenure to over $2 billion in spend under management. Khan is a passionate leader who is dedicated to bringing sustainable workforce solutions to healthcare.