Nebraska could be short more than 5,000 nurses three years from now, according to the Nebraska Hospital Association. Hospitals now depend on traveling nurses to fill in the gaps. The high demand from the Omicron surge but low supply of nurses make hospitals spend two to three times more money to hire traveling nurses.
McCook Community Hospital's 25 critical care beds were over capacity for a couple of weeks in early January as Omicron cases rose in rural southwest Nebraska. Chief Executive Officer Troy Bruntz said sometimes each nurse had seven to eight patients to care for, and that’s why the hospital hired three traveling nurses for $150 per hour – or three times the salary of a staff nurse.
"It's expensive," he said. "But, what are you going to do when you have a full hospital and your nurses are getting so wore out and so exhausted, from being called in constantly to pick up shifts, either because we're full or because some of their co-workers are now quarantining at home because they're positive with the Omicron?"
The traveling nurses help support staff and care for COVID patients while they’re contracted for about 13 weeks.
The Nebraska Center for Nursing reports a 34% increase in travel nurses between 2018 and 2021, and over 1,600 Nebraska nurses are very likely to leave their current employment in the next 12 months. Dissatisfaction with salary and personal and family reasons were the main reasons why young nurses are leaving.
Pamela worked as a staff nurse at Kearney Regional Medical Center for four years. She requested to not mention her last name because she fears she could lose future job opportunities.
"I was pretty burned out at my job and just needed to go somewhere else for a while," she said.
The pandemic didn’t help either, so the Broken Bow native started travel nursing in August 2020. She even ended up working at the same hospital again, but making about twice her salary as a traveling nurse.
Chief executive officer at Great Plains Health in North Platte Ivan Mitchell said, in his 20 years working in healthcare, he's never had a hard time finding traveling nurses until now. The hospital pays about double the premium for their 14 travelers to keep up with the current demand.
"Every time someone increases their pay, and there's limited supply, so the other hospitals have to decide, 'Okay, do we match the pay? Or do we not provide a service?" he said. "Those are the tough decisions that are being made right now."
Great Plains Health Hospital has 80 nursing positions unfilled, he said.
The American Hospital Association sent letters to Congress this month and last year, urging them to look at nurse staffing agencies. This month's letter, spearheaded by Reps. Peter Welch, D-VT, and Morgan Griffith, R-VA, said, "We have received reports that the nurse staffing agencies are vastly inflating price, by two, three or more times pre-pandemic rates, and then taking 40% or more of the amount being charged to the hospitals for themselves in profits." The letter is being circulated around the House of Representatives in Congress asking for colleagues to sign.
"I always loved seeing nurses get paid for the work they do, but the prices that are being asked are being asked during a national and global health care crisis," said Lisa Walters, chair of the Nebraska Center for Nursing.
Another travel nurse, Elizabeth Zellner, thinks nurses should get paid more in Nebraska. The Kansas native has been a travel nurse for six years. She’s out on assignment in an intensive care unit in western Nebraska.
"It makes me sad that nursing salaries aren't higher for staff nurses. I think that the nurses that I work side by side with deserve so much more," Zellner said. "It makes me very sad to see them struggling as we go through the pandemic nursing together. It makes me want to work harder and do as much as possible for them."
But Walters said it’s not as easy as raising rates when hospitals still need to make a profit to keep their doors open but aren’t getting more revenue.
"There's nothing wrong with travel," she said. "I mean, we need them. We need nurses, no matter where they're from, no matter where they work. We need them to be there. It's more of an economic ethical question than it is a nursing issue at that point."
She said the real issue isn’t the travel agencies.
"The real issue is the pandemic," Walters said. "We have a health care crisis in our country."
She said if more people got vaccinated against COVID-19, there would be less hospitalizations overwhelming staff.
The Nebraska Center for Nursing plans to hold some focus groups with nurses around the state to hear the root causes of some of these issues.