Travel nurse pay caps

[stickman80]

This is extremely common.

I’ve had some clients that had certain units that treated travelers like shit. Just awful to them. Eventually it became damn near impossible to find a Med Surg Rn for D4 of a certain hospital in PA.

It can be highly toxic between travelers and reg staff.

Travelers aren't invested in the patients or hospital. They are merely chasing the highest bidder.

Reg staff feels resentment and aren't invested in helping the travelers with their patients.

The patients and hospital both lose.

Some institutions have relief from the cost and toxicity by whenever possible replacing travelers with LPNs. Of course that creates a strain on the skilled care facilites (nursing homes) who are in a bidding war with hospital.

The whole thing is a real mess.....during covid hospitals didn't care about cost....but do now since the taxpayers teat dried up.

 

[QuadCityHawkeye1976]

Were they having a blast doing the work, or traveling the country and making bank?...........

They were touring with Ozzy and following him.

 

[speak34]

I've been a RN for 15 years, 11 in ICU, currently travelling for the last 4 yrs. I feel the biggest reason RNs are leaving staff positions in the leadership of the hospitals. I don't see myself working for a healthcare system because I don't have to rely on my pay being dictated by performance of the hospital as a whole. Administrator get paid way too much $$$ and number one job is to get as much reimbursement from insurance and CMS so they can keep there wallets nice and fat. They don't give one iota of care to staff retention or moral.

I have been to numerous hospitals in Iowa and the Midwest and hospital leadership is usually the number one gripe for hospital staff members. Guaranteed this piece of legislation is being push by hospital administrators across the state. They can't deal with the fact that RNs have the ability to control their work pay and environment. This is the first time in healthcare history RNs have the ability to choose and free themselves from oppressive administrators and healthcare systems. Best decision I've made.

 

[speak34]

Like mentioned prior, this is a slippery slope the State of Iowa is going down. What profession has ever had to be capped for pay? Only a profession that is dominated by females, would this ever happen.

 

[EvilMonkeyInTheCloset]

They were touring with Ozzy and following him.

So, neither then.......

 

[EvilMonkeyInTheCloset]

Like mentioned prior, this is a slippery slope that Iowa is going down. What profession has every had to be capped for pay. Only in a profession that is dominated by females, would this ever happen.

Hey......if I don't have enough money yet to buy Iowa a national championship, then these f***ing people surely don't need any more money.

Priorities, got dammit.

 

[Here_4_a_Day]

Good thing we have all those eager ILLEGALS pouring into the country looking for jobs!!

 

[binsfeldcyhawk2]

I did a search and couldn’t find anything on this. This bill which passed the Iowa House would cap pay for nurse travelers in the state. If you’re not familiar these are nurses which come in on a temp contract to fill in at a hospital.

First of all I’m disappointed in Iowa Democrats who voted for this. Way to sell out to suppress the wages of workers. Second, for Republicans, what happened to free market economics? Wage caps? Really? Nurses will absolutely not travel here and nursing shortages will worsen. This will absolutely backfire.

Iowa House backs travel nurse pay cap amid concerns

The Iowa House of Representatives voted to set pay limits for temporary nursing staff working in Iowa hospitals and nursing homes, Radio Iowa reported.

www2.staffingindustry.com

Good way to ensure travel nurses don't come to the state.

Pretty stupid...with a nursing shortage.

 

[onlyTheObvious]

Good way to ensure travel nurses don't come to the state.

Pretty stupid...with a nursing shortage.

Maybe it will force hospitals in the state to pay more ?

 

[NoleATL]

...the total amount would not just include the temporary nurse’s hourly wage but also include administrative fees, contract fees, transportation or travel stipends, per diems and any other costs such as overtime and taxes that a healthcare staffing firm is authorized to charge clients.

So, if I'm reading that right, the 150% cap includes everthing needed to incentivize them traveling to another location? If that's true, I could see them having to take a cut in base pay to afford to travel to some remote backwater. That'll work.

I think nurses would either quit traveling to IA or take permanent jobs if they are already tied to IA. I imagine most of those who voted for this are all about the "free market".

 

[Bloody Run Hawk]

Were trying to convince our son to become a traveling nurse. Seems like a great gig for someone right out of college. I knew a couple girls that travelled around the country together doing this. Seemed like a blast and they were making bank.

It's a terrible idea for someone just out of nursing school. They should work a couple of years at one place and get experience. Better for the nurse and the patients.

 

[FranklinHawk]

It’s ridiculous how many people here are crying about the poor hospitals. Their information is public, look at it here https://hospitalfinances.org/search?type=facility&facility_name=&state=IA&city=&zip=

You can see many are making millions, after expenses, but sorry we don’t have money for hospital workers. What a load of crap.

I work for a not for profit healthcare company. Taking a quick look at the locations I'm familiar with, those operating margins are maybe 1.5-2% at best. Also, in order to retain not for profit tax status, they are required to put a certain percentage of their overall revenue towards charity care. I don't think that is calculated in the expenses, as I know our systems in Iowa are and have been running a net negative operating margin since the pandemic began (and particularly since the free government $$ related to covid went away)

 

[Bloody Run Hawk]

Many good points about the nursing shortage have been made in this thread. Another problem is a lot of nurses just don't want to do bedside nursing anymore. Very hard work and not enough pay. Many further their education to become a nurse practitioner, crna, or leave the field altogether.

 

[JWolf74]

Really good discussion so far. A few of my thoughts:

1. Healthcare systems in this state need to pay staff nurses better if they don't want to lose them to traveling. Pay them a retention bonus for staying. Iowa is damn near dead last in the country in average nurse pay. Bedside nursing is really difficult work and should be paid as such. The hospital literally wouldn't run without them. It's about the money, always.
2. I don't fault any nurse for going the traveler route. Go get your money, especially during COVID since salaries that high weren't going to last forever. But with that, they often have no loyalty to the system and this leads to resentment and a worse working environment for everyone.
3. Travelers seemingly get minimal orientation. I can't tell you the number of pages I've got from a new traveler who just doesn't know how to do x/y/z because they weren't shown how, or just flat out don't know how to do it. I do think some of these newer travelers are fairly fresh out of school and needed more time at the bedside before traveling.
4. We need to incentivize more people to go into nursing and keep them at the bedside. It seems most new grads end up going the nurse practitioner route as soon as they have the required time at the bedside. I think part of this is the better pay and easier job. I do think some use it as a backdoor way to get a doctorate/masters if they couldn't get into traditional medical school.
5. To accomplish #1, we need to drastically cut the administrative middle men. Both in the healthcare systems and the evil insurance companies that are the real driver of healthcare costs. It's pathetic how little of our healthcare dollars go to actual patient care. The rest of the world doesn't have this issue, but I don't want to sound like an evil socialist.

 

[stickman80]

Really good discussion so far. A few of my thoughts:

1. Healthcare systems in this state need to pay staff nurses better if they don't want to lose them to traveling. Pay them a retention bonus for staying. Iowa is damn near dead last in the country in average nurse pay. Bedside nursing is really difficult work and should be paid as such. The hospital literally wouldn't run without them. It's about the money, always.
2. I don't fault any nurse for going the traveler route. Go get your money, especially during COVID since salaries that high weren't going to last forever. But with that, they often have no loyalty to the system and this leads to resentment and a worse working environment for everyone.
3. Travelers seemingly get minimal orientation. I can't tell you the number of pages I've got from a new traveler who just doesn't know how to do x/y/z because they weren't shown how, or just flat out don't know how to do it. I do think some of these newer travelers are fairly fresh out of school and needed more time at the bedside before traveling.
4. We need to incentivize more people to go into nursing and keep them at the bedside. It seems most new grads end up going the nurse practitioner route as soon as they have the required time at the bedside. I think part of this is the better pay and easier job. I do think some use it as a backdoor way to get a doctorate/masters if they couldn't get into traditional medical school.
5. To accomplish #1, we need to drastically cut the administrative middle men. Both in the healthcare systems and the evil insurance companies that are the real driver of healthcare costs. It's pathetic how little of our healthcare dollars go to actual patient care. The rest of the world doesn't have this issue, but I don't want to sound like an evil socialist.

Amen.

 

[Rifler]

It's a terrible idea for someone just out of nursing school. They should work a couple of years at one place and get experience. Better for the nurse and the patients.

I agree,.. It's definitely a position for someone established in the trade, and able to operate independently..

 

[speak34]

It's a terrible idea for someone just out of nursing school. They should work a couple of years at one place and get experience. Better for the nurse and the patients.

Most reputable travel agencies will require RNs a minimum of 1 year of bedside experience before travelling. After that, it is up to the hospitals to hire the travel RN that they feel will be a good fit. Lack of bedside experience is evident in travel RNs and staff RNs at every hospital I have travelled to in the last 4 years.

 

[Urohawk]

1. Not enough nursing schools/programs
2. Not enough nurse educators
3. Not enough HS students being steered toward healthcare.

I have to disagree with this. There are plenty of nurses. There are not plenty of nurses doing nursing things. The market was largely created by the health care industry on its own and exacerbated by mass resignations during the pandemic.

That and we have created fake labels like "Magnet Status" so we can advertise all of your nursing care is provided by RNs with BSNs. That drives up costs. There are no longer LPNs working so we have took out a lower level worker and made RNs work at lower levels than their license.

Nursing is about the most versatile degree you can have and it's mostly BS. None of these people are more qualified but somehow they have wormed their way into all these positions.
1. You can get into hospital administration. Someone with an MBA will do better.
2. You can become a hospital IT training. Some HROT keyboard warrior will do better.
3. You can get into education. Somehow they are educating without education training.
4. You can get into fundraising.
5. You can get into government.

All these jobs in healthcare are filled by nurses. All those nurses don't do any patient care. During the pandemic to raise morale, they had the VP of nursing and VP of Communications (Both nurses) pushing a candy cart around to give employees a snack. They asked if they need anything and thanked us for all we do?
I asked, "Do you both still carry nursing licenses?"
They responded, "Yes, it's frowned upon to let it lapse in management."
I said, "We are down six nursing hires in this clinic and have been for over five years. You're distracting my current staff. May be you should go room the patients that are supposed to go into room 7 and 8 so I don't start clinic 20 minutes late and stop mystifying the workers with breads and circuses." They looked slightly aghast.

 

[speak34]

Really good discussion so far. A few of my thoughts:

1. Healthcare systems in this state need to pay staff nurses better if they don't want to lose them to traveling. Pay them a retention bonus for staying. Iowa is damn near dead last in the country in average nurse pay. Bedside nursing is really difficult work and should be paid as such. The hospital literally wouldn't run without them. It's about the money, always.
2. I don't fault any nurse for going the traveler route. Go get your money, especially during COVID since salaries that high weren't going to last forever. But with that, they often have no loyalty to the system and this leads to resentment and a worse working environment for everyone.
3. Travelers seemingly get minimal orientation. I can't tell you the number of pages I've got from a new traveler who just doesn't know how to do x/y/z because they weren't shown how, or just flat out don't know how to do it. I do think some of these newer travelers are fairly fresh out of school and needed more time at the bedside before traveling.
4. We need to incentivize more people to go into nursing and keep them at the bedside. It seems most new grads end up going the nurse practitioner route as soon as they have the required time at the bedside. I think part of this is the better pay and easier job. I do think some use it as a backdoor way to get a doctorate/masters if they couldn't get into traditional medical school.
5. To accomplish #1, we need to drastically cut the administrative middle men. Both in the healthcare systems and the evil insurance companies that are the real driver of healthcare costs. It's pathetic how little of our healthcare dollars go to actual patient care. The rest of the world doesn't have this issue, but I don't want to sound like an evil socialist.

This whole thread hasn't dipped into the Presidential election or COVID vaccinations. I forget what it is like to see a post on the GIAOT without one of those two topics involved.

#5 is the obvious answer that no one wants to address. Insurance companies have their politician on speed dial to squash any resistance to the system.

 

[Urohawk]

It can be highly toxic between travelers and reg staff.

Travelers aren't invested in the patients or hospital. They are merely chasing the highest bidder.

Reg staff feels resentment and aren't invested in helping the travelers with their patients.

The patients and hospital both lose.

Some institutions have relief from the cost and toxicity by whenever possible replacing travelers with LPNs. Of course that creates a strain on the skilled care facilites (nursing homes) who are in a bidding war with hospital.

The whole thing is a real mess.....during covid hospitals didn't care about cost....but do now since the taxpayers teat dried up.

Travelers are a mixed bag. I can't do my job without them so I can't complain when we hire them. This however, speaks volumes to the lack of institutional loyalty and lack of professionalism in the field. Go anywhere for a better buck. I haven't seen a quicker deterioration in the workforce. No need to stick it out for the patient. "My shift is over" is the overwhelming mentality. Then again may be they're the smart ones because we doctors keep taking it in the pants and keep coming to work due to some moral obligation that we feel we need to complete.

 

[HawkeyeShawn]

I have to disagree with this. There are plenty of nurses. There are not plenty of nurses doing nursing things. The market was largely created by the health care industry on its own and exacerbated by mass resignations during the pandemic.

That and we have created fake labels like "Magnet Status" so we can advertise all of your nursing care is provided by RNs with BSNs. That drives up costs. There are no longer LPNs working so we have took out a lower level worker and made RNs work at lower levels than their license.

Nursing is about the most versatile degree you can have and it's mostly BS. None of these people are more qualified but somehow they have wormed their way into all these positions.
1. You can get into hospital administration. Someone with an MBA will do better.
2. You can become a hospital IT training. Some HROT keyboard warrior will do better.
3. You can get into education. Somehow they are educating without education training.
4. You can get into fundraising.
5. You can get into government.

All these jobs in healthcare are filled by nurses. All those nurses don't do any patient care. During the pandemic to raise morale, they had the VP of nursing and VP of Communications (Both nurses) pushing a candy cart around to give employees a snack. They asked if they need anything and thanked us for all we do?
I asked, "Do you both still carry nursing licenses?"
They responded, "Yes, it's frowned upon to let it lapse in management."
I said, "We are down six nursing hires in this clinic and have been for over five years. You're distracting my current staff. May be you should go room the patients that are supposed to go into room 7 and 8 so I don't start clinic 20 minutes late and stop mystifying the workers with breads and circuses." They looked slightly aghast.

No disagreement. Maybe I should have said there are not enough nurses willing to work in a hospital setting. Outpatient clinics and surgery centers are popping up everywhere. Easy shifts. A lot less BS to put up with than at a hospital. The pandemic also burned out a lot.

 

[tarheelbybirth]

I have to disagree with this. There are plenty of nurses. There are not plenty of nurses doing nursing things. The market was largely created by the health care industry on its own and exacerbated by mass resignations during the pandemic.

That and we have created fake labels like "Magnet Status" so we can advertise all of your nursing care is provided by RNs with BSNs. That drives up costs. There are no longer LPNs working so we have took out a lower level worker and made RNs work at lower levels than their license.

Nursing is about the most versatile degree you can have and it's mostly BS. None of these people are more qualified but somehow they have wormed their way into all these positions.
1. You can get into hospital administration. Someone with an MBA will do better.
2. You can become a hospital IT training. Some HROT keyboard warrior will do better.
3. You can get into education. Somehow they are educating without education training.
4. You can get into fundraising.
5. You can get into government.

All these jobs in healthcare are filled by nurses. All those nurses don't do any patient care. During the pandemic to raise morale, they had the VP of nursing and VP of Communications (Both nurses) pushing a candy cart around to give employees a snack. They asked if they need anything and thanked us for all we do?
I asked, "Do you both still carry nursing licenses?"
They responded, "Yes, it's frowned upon to let it lapse in management."
I said, "We are down six nursing hires in this clinic and have been for over five years. You're distracting my current staff. May be you should go room the patients that are supposed to go into room 7 and 8 so I don't start clinic 20 minutes late and stop mystifying the workers with breads and circuses." They looked slightly aghast.

So there shouldn't be nurses in management positions? I guess I'm not understanding your point. Is a nurse who's been in a management position for a decade really going to be required to return to bedside care? If an administrator was a surgeon a decade ago...would they return to an operating room in a pinch?

Sounds like they might want to figure out why no one wants to work as an LPN.

 

[markfromj]

JFC! Three pages of a nurse thread and one pic of a nurse and it’s a guy!

What had happened to HORT?

 

[stickman80]

Travelers are a mixed bag. I can't do my job without them so I can't complain when we hire them. This however, speaks volumes to the lack of institutional loyalty and lack of professionalism in the field. Go anywhere for a better buck. I haven't seen a quicker deterioration in the workforce. No need to stick it out for the patient. "My shift is over" is the overwhelming mentality. Then again may be they're the smart ones because we doctors keep taking it in the pants and keep coming to work due to some moral obligation that we feel we need to complete.

You are correct. Its a generality. There are some travelers on the floor that are very good and nursing is a calling for them. There are also some staff nurses who arent worth a damn (they are also the ones who have the biggest issues with the travelers).

 

[Urohawk]

So there shouldn't be nurses in management positions? I guess I'm not understanding your point. Is a nurse who's been in a management position for a decade really going to be required to return to bedside care? If an administrator was a surgeon a decade ago...would they return to an operating room in a pinch?

Sounds like they might want to figure out why no one wants to work as an LPN.

No, but the issue is they dominate administrative positions which they aren't necessarily trained to do. There aren't as many physicians as admins because the positions never pay as much. It's a pay cut for doctors and a pay raise for nurses.

The OR safety committee I was on had 18 members with a combination of physicians and nurses. The committee now has 72 invited members. About 6 are physicians now, the rest are nurses. All the nurses do is have meetings for the sake of meetings to justify for their jobs. They aren't specifically trained or have any advantage to holding those positions.

 

[HawkeyeShawn]

Some numbers just came out today in a Becker’s Healthcare article. In the US, 4 year colleges and universities turned down 66,766 qualified nursing school applications from 2022 a 2023. The previous year, 78,000 were turned away.

The primary barriers are insufficient clinical placement sites, faculty, preceptors, classroom space and budget cuts. Nearly 10,000 applications were turned away from graduate programs which may further the pool of potential nurse educators.

 

[goldmom]

I know a nurse that does this. Goes all over the country,she makes bank!

My niece and her hubby are friends with a guy who is an experienced surgical scrub nurse (military vet) who does this and he is single, straight, and having the time of his life making 💰💰💰 and traveling. I think he expects to settle in one spot in a few years - probably at Mayo here or even at Moffitt in Tampa or in Gainesville at Shands. Whoever has the bigger checkbook.
I guess he won’t be spending time in Iowa.