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The only thing keeping ICUs fully staffed in much of the country is a rotating cast of traveling nurses. And hospitals have to pay them so much money that nurses who are already on staff are tempted to hit the road, too. Blake Farmer of member station WPLN in Nashville reports.
BLAKE FARMER, BYLINE: There's some truth in a joke circulating among frustrated ICU nurses right now. They ask for their hospitals to appropriately pay them for the hazards they've endured through the pandemic, and they're rewarded with a pizza party.
THERESA ADAMS: I heard a lot of noise about, well, this is what you signed up for. No, I did not sign up for this.
FARMER: Theresa Adams is an ICU nurse who helped build and staff COVID units in one of Ohio's largest hospitals. She just left to do a lucrative stint of travel nursing in California. She hopes to return to her home hospital, though she's a little irritated at management at the moment.
ADAMS: I did not sign up for the facility taking advantage of the fact that I have a calling. So there is a difference between knowing my calling and knowing my worth.
FARMER: And the hospital wasn't offering big raises. Traveling nurses have always helped fill in staffing gaps and are paid more for their flexibility. But now some traveling nurses can pull in up to $10,000 a week, which can be several times more than staff nurses earn. And while some hospitals have been offering retention bonuses and upping pay for staff nurses, it's nothing like the traveling bonanza. It's become a vicious cycle, though, especially for the most highly trained critical care nurses who can monitor COVID patients on high-level life support machines.
Jonathan Emling is a nurse manager at Ascension Saint Thomas in Nashville.
JONATHAN EMLING: We will train these people, and then six months later, they'll be gone and traveling. So it's hard to invest so much in them trainingwise and timewise to see them leave.
FARMER: And when they leave, hospitals are often forced to fill the spot with a traveler.
IMAN ABUZEID: It's like a Band-Aid. Like, we need it now, but it is temporary.
FARMER: Dr. Iman Abuzeid is the founder of a San Francisco-based nurse recruiting company called Incredible Health, which estimates the number of full-time nurse openings has shot up by 200% in the last year. Some states are subsidizing the expense of travelers to maintain hospital capacity. But for many hospitals, it's busting their budgets. And that's especially difficult at a time when they've called off elective surgeries, where they make most of their money.
ABUZEID: Every executive we interact with is under a lot of pressure to reduce the number of travel nurses on their teams, not just from a cost standpoint, but also for quality of care standpoint as well.
FARMER: Team camaraderie suffers when the newcomers who need help finding the syringes are also making two or three times more than the nurses showing them the ropes.
Hospitals are going to new lengths to reverse the trend. Henry Ford Health System in Michigan has announced plans to bring in hundreds of nurses from the Philippines. Smaller community hospitals are looking internationally, too. Scott Lethi is the chief nursing officer at Cookeville Regional Medical Center in a Tennessee town of 33,000.
SCOTT LETHI: The cost for what we pay for a local recruiter to bring us one full-time staff member is more expensive than what we are going to be spending to bring one foreign nurse.
FARMER: And the hope is that the immigrant nurses will stay more than a year or two. Lethi says they've hired new graduates who quit after just a few months. A survey by the American Association of Critical Care Nurses finds that two-thirds have considered leaving the profession entirely because of the pandemic. But the exodus also means the remaining nurses are stretched dangerously thin, caring for more patients at once. Kevin Cho Tipton is an advanced practice nurse in South Florida.
KEVIN CHO TIPTON: My ability to care for people has suffered. I know that I have missed things that otherwise, I would not have missed had I had the time to spend.
FARMER: It makes you feel bad at your job, Tipton says, which weighs heavily on nurses. But in the end, it's the patients who suffer.
For NPR News, I'm Blake Farmer in Nashville. Transcript provided by NPR, Copyright NPR.
