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ON THE MOVE: Latasha Harris works as a float nurse at Mercy Hospital Springfield. She says it allows her to have similar pay and experience as a traveling nurse.
SBJ photo by Wes Hamilton
ON THE MOVE: Latasha Harris works as a float nurse at Mercy Hospital Springfield. She says it allows her to have similar pay and experience as a traveling nurse.

Traveling nurses fill gaps in talent shortage

Mercy using traveling staff at 12 times the rate of CoxHealth

Posted online

After Latasha Harris’ kids moved out to attend college, the California native was an empty nester.

“I was bored to death,” she said.

A nurse by trade and, as she joked, a self-proclaimed “gypsy,” Harris said she combined her passions to become a traveling nurse.

“I’ve been to Arkansas, St. Louis, a couple of contracts in California and then a couple years here at Mercy,” she said. “You can make quite a bit of money traveling, because there are areas in need.”

Nursing shortage
Mercy Hospital Springfield is among other hospitals across the country where the demand for nurses has grown amid a shortage in talent.
With 10,000 baby boomers turning 65 every day, according to the Pew Charitable Trust, the need for care is increasing, and with that, the need for nurses is increasing.

In the midst of the largest employee turnover in history, the Bureau of Labor Statistics projects job openings for nurses to reach 1.09 million by 2024.

Some hospitals are turning to traveling nurses, or external contingency labor, as one answer to fill vacant positions.

In Springfield, 588 people, mostly nurses, are external contingency workers for Mercy, representing 6 percent of its 10,000 staff members. Traveling employees work three-month terms, said Di Smalley, regional president of Mercy’s communities in Oklahoma and an executive over staffing and scheduling.

“In health care, our census varies, volumes vary, emergencies happen,” Smalley said. “There’s always a need for contingency labor in order to meet the peaks of our need.”

Traveling nurses can be placed across the country at various health systems where there is a need. Staffing agencies pay a stipend for temporary housing.

At CoxHealth, traveling nurses also are used to fill vacancies but to a minimal degree, said Rachel Wells, the health system’s administrative director of nursing.

About 30 of CoxHealth’s 2,700 nurses are external traveling nurses, and the hospital employs an additional 20 traveling staff, Wells said, meaning less than half a percent of its nearly 11,000 employees is filled by external staffing agencies.

Wells said CoxHealth may work with up to 10 agencies to fill vacancies, but officials try to limit those hires.

“We put a lot of effort into recruiting,” she said. “We focus a lot on retaining nurses so we don’t have a lot of contract staff.”

According to staffing agency AMN Healthcare’s 2017 Survey of Registered Nurses, the percentage of nurses who say that shortages have worsened in the last five years grew to 48 percent in 2017 from 37 percent in 2015.

The survey also found 36 percent of nurses plan to retire this year. More than half, 55 percent, of nurses are age 50 or older, according to the National Council of State Boards of Nursing.

Traveling help
Smalley spearheaded a pilot contract two years ago with AMN Healthcare in Oklahoma. Previously, Mercy contracted with about 80 agencies to temporarily fill vacant positions.

The AMN contract streamlines the process by providing Mercy with external staffing needs, and she said the arrangement has controlled costs by having a contracted rate to hire traveling staff. It also has increased the quality of talent, she said.

Subsequently, all hospitals in Mercy’s network are currently transitioning to a singular AMN contract, Smalley said.

Smalley said it still costs Mercy about 50 percent more, on average, to hire a traveling nurse compared with a “core” team member. Mercy declined to disclose an average pay for nurses.

“It’s more expensive for us to use an external agency,” she said. “We’re paying the agency fees as well as what they’re paying their staff.”

Smalley said at an organization as large as Mercy, pushing 10,000 employees in the Springfield region, staffing and scheduling remain a constant challenge.

She said Mercy is working with local colleges and high schools to fill the pipeline of future nurses.

“Across the Unites States, there is a shortage of health care workers,” she said. “Our hope is that we decrease external contingency and, in fact, develop internal contingency.”

After extending her contract to a year at Mercy in Springfield, Harris said she decided to put down roots this April as a “float nurse,” moving around the hospital to where she’s most needed.

“I love the culture. I love the people here,” she said. “I think being a float nurse and a travel nurse go hand-in-hand. I’m always meeting new people and I’m going to these new floors.”

She said being a float nurse offers similar pay, allows her to do something different every day and provides a place to call home. And her nearly 1-year-old grandson now lives in Springfield.

“Seeing my grandson, being here in one location,” she said, “that probably was one of the top things on my list as far as choosing Mercy.”

Recruiting & retaining
At CoxHealth, Wells said traveling nurses and other external support staff are used to take over for staff on medical leave or when a position is expected to be vacant.

“We use agency staff to fill open positions when there is a high vacancy rate,” Wells said. “We also do use them for (Family and Medical Leave Act) leaves when one person is gone and it would make a big difference.”

On average, Wells said the traveling positions cost the hospital nearly triple the average nurse’s base salary, which ranges from $50,000 to $61,000 annually.

“We don’t limit staff on whether they can pick up overtime or extra shifts. It’s certainly cheaper,” she said.

Similar to Mercy, Wells said CoxHealth has a “float pool” of nurses that pays more than a nurse in a particular floor or unit.

“We do lose a fair amount of staff to travel nursing,” she said. “We also like to recruit the good agency nurses to work with us full time.”

Mercy also tries to convert its travel nurses, like Harris, said Dea Geujen, chief nursing officer for Mercy Central Communities.

“Many people really do appreciate the mission … travelers come in and want to be a part of that,” Geujen said. “We work really hard to recruit them and ask them what it is about traveling that they like and are they ready to settle down and we have had success to do that.”

Harris said she expects to stay with Mercy as a float nurse for the foreseeable future, but she likely will take her skills on the road again. Why?

“Just seeing new places, being able to pick where I want to be and decide on what I want to do,” she said. “I am a traveling soul.”


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