Big salaries lure Medical Center nurses to hot spots
Hospital associations across country decry ‘poaching’ as health care workers receive job offers of up to $12K a week
Houston nurse Millicent Peters receives job solicitations pertaining to COVID-19 once or twice a week, but even she wasn’t prepared for the pitch texted to her cellphone last month.
If she could relocate immediately for a temporary assignment in one of the disease hot spots, Krucial Staffing was offering a salary between $5,000 and $7,000 a week, plus a travel bonus, free lodging and per diem meals.
It didn’t have the desired effect.
“It kind of upset me, dangling a carrot in front of a horse like that,” said Peters, a charge nurse at Houston Methodist Hospital. “It preys upon young nurses who, not used to negotiating contracts, get excited about the money, unaware of what they might be getting themselves in for.”
Peters ignored the solicitation, but at least two of her colleagues couldn’t resist, part of the increasing exodus of nurses for COVID-19 “travel assignments.”
Months after personal protective equipment was so coveted by hospitals, nurses are now the hot commodity, desperately needed around the country to staff beds filling up again because of the winter surge of pandemic patients.
To recruit nurses, hospitals turn to staffing agencies such as Krucial, Trusted Health and Nomad, which advertise salaries at least double what nurses typically make if they’ll come help plug the shortage. Most are like the offer Peters received — $121 an hour regular pay, $181 an hour for required overtime — but some go even higher. One agency recently posted a job in Fargo, N.D., paying $8,000 a week. A Methodist official said he just saw a travel assignment in California for $12,000 a week.
The recruitment goes over much better with the
hospitals that hire the nurses than those who lose them. Hospital associations across the nation report receiving many complaints from member institutions about agencies “poaching” their staff. One hospital spokesman compares the landscape to one in which vendors hawked exorbitantly priced bottled water after Hurricane Harvey.
Texas has indeed become one of the hottest destinations for nurse recruiting. Krucial, which in the spring led the effort to bring nurses to New York, is now focused on Texas, exemplified by recent travel job advertisements on its Facebook page for a Texas gig. Methodist reports a significant increase in nurses taking such offers in December.
The Harris Health System has lost 84 nurses to such assignments since June, the majority in the last few months.
“The poaching has hit us hard, made it difficult to cover shifts, put us over a barrel,” said Maureen Padilla, Harris Health System’s chief nurse executive. “What bothers me is that it’s price-gouging at its very worst during a national emergency.”
The use of traveling medical staff began in the 1980s, a response during a nursing shortage due to strikes and infectious diseases circulating in certain areas. But it took the pandemic to put the field on people’s radar. Industry officials estimate there are now at least 50,000 traveling nurses, up from about 30,000 in 2018.
Some of those are independent nurses, typically young, who make a living stringing together travel assignments, which typically last 13 weeks but sometimes go shorter or longer. But some of the nurses are lured from hospitals.
‘Rob Peter to pay Paul’
In the early days of the pandemic, travel assignments took traveling nurses to crisis spots — particularly New York. No one questioned the phenomenon because the need was so much greater in those areas than anywhere else.
What’s different now is that the winter COVID-19 surge has brought the need for nurses across the country. Hospital officials routinely
use the phrase “rob Peter to pay Paul” to describe the distribution of nurses.
“It’s cutthroat,” said Kristie Loescher, faculty director of the University of Texas’ Healthcare Innovation Initiative. “But it’s what you get when you have a perfect storm of a staffing crisis and a pandemic. Given those supply and demand issues, companies are going to charge what the market will bear.”
The demand took five Harris Health nurses to travel assignments in El Paso during the recent surge there.
Padilla said Texas jobs are appealing to Houston nurses because the deals are lucrative and they’re closer to home, which enables easier connections with family.
The Houston competition for nurses increasingly involves hospitals within the state — or the Houston region itself, where the recruitee doesn’t have to leave family at all. Padilla acknowledges Harris Health itself has used agencies that may have recruited locally.
Padilla said Harris Health will rehire those nurses who took a travel assignment as long as they gave the expected two-week notice. That’s not always a slam dunk inasmuch as many staffing agencies require immediate starting dates. If the nurse abruptly leaves for such a job, Harris Health will not rehire for at least a year, she said.
Padilla said it would be “demoralizing to the staff that remained loyal and committed to the hospital to see the recently departed
nurse right back on the unit.” It is likely of little concern to the nurse, said Padilla — he or she will have no trouble finding a willing hospital.
‘Putting their lives on the line’
For some nurses, the idea of travel assignments is very enticing.
“Ever since I heard about them in nursing school, travel assignments were on my mind,” said Caroline DeWitt, who started her second such job, in Colorado Springs, Colo., on the day the original pandemic lockdown went into effect. “I’m an adventurous soul so the idea of traveling to different places to do my job sounded great, even apart from the additional money.”
In the summer, DeWitt took an assignment at Texas Children’s, working with both pediatric COVID-19 patients and adults transferred from hospitals unable to handle the influx. She was tempted to stay, she said, but she’d just bought a house in the Texas Hill Country, where she began working remotely for Trusted Health, the staffing agency that moved her to different travel assignments.
Now a nurse advocate who helps facilitate others’ assignments, she laughs that she’s “missing out on the level of pay packages now being offered.”
Kathryn Tart, founding dean of the University of Houston College of Nursing, argues there’s nothing wrong with the pay levels, given that nurses are “putting their lives on the line.” She said hospitals would have less of a shortage problem if they had just been hiring more nursing graduates all along.
Still, there is no shortage of ill feelings at hospitals. John Henderson, CEO of the Texas Organization of Rural and Community Hospitals, says the state’s assistance kept some member hospitals “from buckling from staffing shortages” but fretted that many are now losing nurses because they can’t compete with the amounts being offered. He called it unsustainable.
The Texas Hospital Association fielded enough complaints from its member hospitals about agencies recruiting away front-line employees that Krucial Staffing issued a response in December saying it “doesn’t advertise, actively recruit and attempt to or knowingly employ healthcare workers from impacted facilities and intends only to supplement existing hospital staff.” The response did not define “impact facilities.”
The hospital association sent the response to its members, but spokeswoman Carrie Williams said that despite the assurance, the practice appears to be continuing.
“The problem is that hospitals don’t have a lot of choice when you have patients that need care and a shortage of staff,” said Cindy Zolnierek, CEO of the Texas Nurses Association. “But it definitely does seem that some people are exploiting the moment.”
Gary Randazzo, a professor of practice and marketing at the UH Bauer College of Business, says there’s no evidence that wage and price controls or other means of intervention work in such situations. Nor is the Texas Legislature expected to take up the issue.
Loescher, the faculty director at UT’s health care innovation initiative, holds out hope. The only good thing that might come out of the situation, Loescher said, is people giving up on the idea that supply and demand works during a crisis and that health care moves more toward a social justice philosophy rather than a market justice focus.
She admits, however, that she’s not optimistic. The most likely solution to the poaching is an end to the pandemic.