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There’s a high demand for nurses and short-staffed hospitals are meeting patient needs with traveling nurses. However, those nurses cost two to three times more than local staff. Nebraska hospitals are using different ways to recruit and keep their nurses from going to travel agencies.
Meeting the needs of patients and staff
Staff at Columbus Community Hospital can take a little time out to relax in the respite room. Nurses can rest with a cup of tea on the massage chair, unwind with sounds from the white noise machine, and smell essential oils. Dorothy Bybee is the hospital’s chief nursing officer and vice president of patient care services. She said they started the room back in fall 2020. However, the respite room doesn’t seem like enough to retain staff now.
"The things I worry about is being able to meet the needs of our patients, and at the same time meet the needs of the staff," she said. "I work for them to be really honest. I am here to serve them and to figure out what's best for them, and sometimes I don't always know what that is."
Bybee writes notes to nurses to figure out what would help to keep them. For example, she asked senior leaders to pay staff a $5 per hour hazard pay for wearing personal protective equipment six months ago. Bybee said they’re also looking at long term ways to recruit and keep nurses like partnering with the local high school to offer students certified nursing assistant certificates.
Competing with local travel nurses
But, they still have had to hire six traveling nurses to keep up with the hospital's demands.
"It's kind of crazy right now.. an OB nurse quit to be a traveler to Omaha, and then I accepted the traveler from Omaha. So all we're doing is kind of trading people around," Bybee said. "So it's kind of a bad situation in that respect. It's really driving costs up for everyone. And I have to tell you, it is not sustainable."
Lisa Vail sees this in her hospital too. She’s the vice president of patient care services and chief nursing officer at Bryan Medical Center in Lincoln.
"The current market allows nurses from Lincoln to take a travel assignment to drive 45 miles to go work in a hospital in Omaha and still come home and sleep in their own bed at night," Vail said.
They could end up hiring a traveler from Omaha who does the same thing and drives to Lincoln, she said. They may have to do that to keep up with patient needs.
"It's really kind of crazy when you think about it," she said.
Vail hopes Bryan Health’s new workforce incentive program will help keep their nurses and recruit more. The program includes retention bonuses, student loan repayment, and an additional premium pay for overtime bedside registered nurses of up to $54 per hour.
"This is a multi-million dollar investment in our team," Vail said.
Last year, Bryan Health spent $15, 475, 789.25 on traveler expenses; in 2019, they only spent $5,475,789.25. Vail said they need to reduce those costs.
Hiring more nursing assistants
Over at Nebraska Medicine in Omaha, chief human capital officer Frank Venuto said they don’t hire local travel nurses. However, the tension between staff and other travelers can’t be ignored.
'The logical question most nurses ask is, ‘Well, why can't you just pay me what the agencies are paying and then we would be fully staffed?" Venuto said.
Venuto adds the hospital wouldn’t be able to survive if they paid all of its approximately 2,500 nurses the same rate as travelers. However, through a staff survey, they realized they had to revamp the entire pay program for nurses and figure out ways to make their day better, like allocating some tasks to nursing assistants. McCook’s Community Hospital is also working to hire more assistants.
Vaccine mandates
Misti Soderlund directs inpatient services and is in charge of about 60 staff nurses in McCook Community Hospital. They lost about two nurses to travel agencies. Now she’s worried they could lose up to 13 nurses to the new vaccine mandates for healthcare workers.
"I know 13 doesn't sound like a big number, but to a small facility, it's huge, to lose a third of your nursing staff," she said. "It's just very scary to know that we are to a place that we will have so many patients to care for, and nobody to help care for them."
Soderlund had six job openings for the last three months and only two applicants. McCook’s Community Hospital nurses need to receive at least one dose of the COVID vaccine or apply for an exemption by Feb. 14.
"I'm really torn. I believe that it's your choice," she said. "But I also see that we're nurses, and we're here to care for them and showing that we get the vaccine and trust it, they're going to be more willing to trust it too. But, it's kind of a hard place to be."
Vaccine mandates may push some nurses out of local hospitals, but others are demoralized by patients who do not get vaccinated. Standing at the bedside of an unvaccinated patient could be the last straw for an exhausted nurse, said Venuto of Nebraska Medicine.
"And as a consequence, I think a number of providers, mostly nurses have just said, 'You know, enough, I can't take this anymore. It's just too taxing emotionally on me," he said. "And so many of them left for other options, or they left to go travel and essentially said, 'Hey, look, if I have to deal with this, then I'm going to go get paid.. and I'm going to go to travel agencies."
While hospitals are seeing some relief now from the Omicron surge, they have to be careful how they manage their worn-out workforce, he said. The hospital’s patients aren’t the only ones who need extra care as we all work to get through this pandemic.