December 3, 2020

A 'national bidding war' is driving nurse pay to $10K per week. (But the pay comes with hidden risks.)

Daily Briefing

    Hospitals across the country are in the midst of a new wave of Covid-19 cases—and as a result, hospitals are competing for a limited supply of nurses, with health care staffing companies able to coordinate travel nurses who can make up to $10,000 a week, Markian Hawryluk and Rae Ellen Bichell write for Kaiser Health News.

    How Covid-19 will impact the nursing workforce

    Inside the 'national bidding war' for nurses

    When the coronavirus first struck, hospitals had to compete for coronavirus tests, personal protective equipment (PPE), and ventilators, but they were largely able to shift staffing resources from areas unaffected by the coronavirus to hot spots, Hawryluk and Bichell report.

    But the latest surge in Covid-19 cases is not isolated to few hot spots; it's affecting nearly every state, and hospitals are competing for the limited number of available nurses to fill gaps in their staffing, Hawryluk and Bichell write.

    "We all thought, 'Well, when it's Colorado's turn, we'll draw on the same resources; we'll call our surrounding states and they'll send help,'" Julie Lonborg, a spokesperson for the Colorado Hospital Association told Hawryluk and Bichell. "Now it's a national outbreak. It's not just one or two spots, as it was in the spring. It's really significant across the country, which means everybody is looking for those resources."

    The result, according to Hawryluk and Bichell, is hospitals are now engaging in a "national bidding war," with hospitals in affluent areas offering nurses high salaries to ensure they have the staff they need. For example, a nursing job in Fargo, North Dakota, could offer a nurse more than $8,000 a week—and depending on overtime, some nurses could take home as much as $10,000 a week, Hawryluk and Bichell write.

    However, Angelina Salazar, CEO of the Western Healthcare Alliance, a consortium of 29 small hospitals in Colorado and Utah, said rural hospitals can't compete with those salaries. "There's no way rural hospitals can afford to pay that kind of salary," Salazar said.

    Jordan Sorenson, a project manager for the Utah Hospital Association, said nurses across Utah's four major health care systems have resigned to accept higher-paying traveling nurse positions. "Nurses quit, join traveling nursing companies and go work for a different hospital down the street, making two to three times the rate," Sorenson said. "So, it's really a kind of a rob-Peter-to-pay-Paul staffing situation."

    As a result, many hospitals are turning to traveling nurse agencies—but that means, in addition to paying the higher salaries advertised by these staffing firms, hospitals must also pay a commission to these firms, KHN reports. Other hospitals, constrained by budgets, are assessing other ways to overcome gaps in staff, such as establishing new nurse-to-patient ratios or working with the state to allow final-year nursing students to get early certification.

    The hidden cost of higher wages

    Adam Seth Litwin, an associate professor of industrial and labor relations at Cornell University, said he's pleased to see hospitals are rewarding nurses who are essential workers with higher salaries. But nurses who have accepted traveling nurse positions have said their higher wages come with hidden costs, including a lack of health insurance and the nature of the work itself, which is a "boom-and-bust market," KHN reports.

    For instance, Amber Hazard, a traveling ICU nurse from Texas, said the situations the nurses are being paid so highly to endure can strain their mental health. "How your soul is affected by this is nothing you can put a price on," Hazard said.

    During the epidemic's first wave, Hazard traveled to New York for a high-paying job caring for Covid-19 patients. Hazard said she remembers walking into the break room in a Bronx hospital and seeing a sign on the wall about a nurse strike. "It said, you know, 'We're not doing this. This is not safe,'" said Hazard. "And it wasn't safe. But somebody had to do it."

    Hazard said although she had the opportunity to place a wedding ring back on the finger of a recovered patient, she spent far more time in New York finding body bags for Covid-19 patients who died.

    Similarly, Claire Tripeny, who left St. Anthony Hospital in Lakewood, Colorado, to become a traveling nurse in March, said her experience treating Covid-19 patients in New Jersey during the epidemic's first wave left her scarred.

    Tripeny said she remembers being unable to provide Covid-19 patients with the treatment they needed, removing deceased Covid-19 patients off ventilators, and witnessing the damage the coronavirus caused to patients as she removed tubes filled with darkened blood from their lungs.

    "I would just look at my paycheck and be like, 'OK. This is OK. I can do this,'" Tripeny said.

    To help cope with the experience, Tripeny said she's signed up for mental health therapy, which she now pays for out of pocket since she isn't on staff at a hospital (Hawryluk/Bichell, Kaiser Health News, 11/24).

    Our take: How Covid-19 will impact the nursing workforce

    Nursing workforce cover

    Covid-19 will not fundamentally change nursing supply and demand but it will accelerate pre-existing trends. Collective experience in the nursing workforce will decline faster as a result of the pandemic, and care delivery will become even more complex.

    Read on to learn more about the four actions to close the widening experience-complexity gap.

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