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Travel nurses ran to help during Covid. Now they face brutal cuts.

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Tiffanie Jones had a few tanks of gas in her commute from Tampa, Florida to Cheyenne, Wyoming when she discovered her contract as a travel nurse had been cancelled.

Jones, who has been a nurse for 17 years, came across a Facebook group for traveling nurses and saw she was not alone. The nurses had reported abruptly losing their jobs and seeing their rates reduced by up to 50% while on contract.

“A lady packed her whole family up and got canceled during orientation,” she said.

Many career nurses like Jones turned to travel gigs during the pandemic, when hospitals crowded with Covid-19 patients were in dire need of help. Some travelers — who earned double or even triple what staff registered nurses earned — gathered on TikTok and other social media platforms to celebrate payday, share tips on how to calculate net income from contractsand brag about how many they were to take away every week. Their luck was so great that federal and state lawmakers considered salary capmobilizing nurses in protest.

The tide quickly turned. As Covid hospitalization rates stabilize, at least for nowand federal and state Covid relief funding is drying up, travel nurse contracts that were plentiful and lucrative are on the way out. And after the pressure cooker of the past two-plus years led to staff turnover and a wave of early retirements, hospitals across the country are focusing on hiring full-time nurses.

Nationally, demand for registered traveling nurses fell by a third in the month to April 10, according to data from recruitment agency Aya Healthcare, although openings have rebounded slightly in recent weeks.

When Oregon’s governor declared a pandemic emergency on April 1, state-level Covid relief money evaporated. Oregon Health & Science University Hospital in Portland has lost funding for nearly 100 traveling nurses. That, combined with lower Covid rates and more full-time hiring, led to “a bursting of the bubble,” said Dr. John Hunter, CEO of OHSU Health.

The health system had about 50 contractors of all kinds before the pandemic, down from 450 at its peak, when patients, many of whom needed close monitoring, poured in and turned the hospital’s recovery room into a ward. intensive care.

“It was very expensive,” Hunter said. But things are changing, he said, and in recent weeks the hospital has negotiated contract rates with its travel nursing agency of up to 50%.

Caregiver nurses earn significantly less than their traveling counterparts. Rates for a new staff nurse at Northeastern Vermont Regional Hospital in St. Johnsbury, for example, start at $30 an hour — plus benefits and extra for night shifts. At the height of the pandemic, the hospital was paying recruiting agencies about $175 an hour for each traveling nurse. The rate is still well over $100 an hour, but the hospital is trying to negotiate it down. Because the hospital pays the agency directly, it’s unclear how much nurses will pocket, CEO Shawn Tester said.

For some traveling nurses, the sharp drop in wages has come as a shock. Since December, registered nurse Jessica Campbell had smoothly extended her 13-week contract at an Illinois hospital. In early April, a week after Campbell’s last contract began, her recruiter said her rate would drop by $10 an hour and she could take it or leave it.

“I ended up accepting it because I felt like I had no other choice,” Campbell said.

The situation for some travel nurses has become so dire that a Kansas City, Missouri law firm said it is considering legal action against more than 35 recruitment agencies. Austin Moore, attorney at Stueve Siegel Hanson, said some agencies were ‘breaching their contracts’ and in other cases ‘committing outright fraud’ through bait and switch schemes on travel nurse contracts .

The company opened an investigation in March, drawing comments from hundreds of nurses, Moore said. “Our phones are ringing non-stop,” he said. “No one has experienced it like this – historically contracts have been honored.”

How much is a nurse worth?

Stephen Dwyer, senior vice president and chief legal officer and chief operating officer of the American Staffing Association, the trade group that represents the travel nurse recruitment industry, said in an emailed statement that “as As market conditions change, hospitals and other healthcare facilities may modify the terms of travel nurse contracts.

“For rate reductions or contract cancellations that take place while on assignment, staffing companies often recommend advance notice,” he said.

Moore said the fine print can vary, but when a recruiting agency cancels a contract at the last minute or gives a nurse a day or two to consider a lower rate, the agency often breaks a contract. Under the contracts, the loss should fall on the agency, not the nurses, when a hospital charges a lower rate, Moore added.

Pay rates have always fluctuated seasonally as the demand for nurses to fill staffing gaps in hospitals changes, said XueXia Bruton, a Houston-based critical care nurse. She has been traveling since 2018, attracted by flexibility and financial freedom, and has no plans to return to nursing. Along the way, Bruton cataloged his experiences on TikTok and Instagram, telling his more than 91,000 followers that, for example, “It may make more sense to wait to take a contract until rates go up.”

“It was very difficult on every level during Covid when the cases were very high,” Bruton said. “We were all exhausted and exhausted so it was important to be able to take as much time as needed.”

Bruton has seen slump rates as high as $10,000 per week. Traveling nurse rates currently average about $3,100, According to Vivian Health Online Hiring Market. It’s still higher than before the pandemic, and well above what a typical nurse earns.

Last year was particularly profitable for recruitment agencies. Cross Country Healthcare, one of the few publicly traded companies that employs traveling nurses and other healthcare workers, recorded a profit of $132 million in 2021compared to a loss of $13 million the previous year and even bigger losses in 2019. Then-CEO Kevin Clark called the company’s 2021 financial results a “historic milestone for revenues and profitability”.

The nurse recruitment industry’s big profits have caught the attention of lawmakers, including U.S. Rep. Peter Welch (D-Vt.), who said he feared private equity firms buying of recruitment agencies charge exorbitant fees during the pandemic, a model reported by Stat. In January, Welch and U.S. Rep. Morgan Griffith (R-Va.) wrote to the White House a letter calling for an investigation into possible “anti-competitive activity” by recruitment agencies after receiving reports that they were “dramatically inflating prices, by two, three or more times pre-pandemic rates”.

Some travel nurses return to full-time gigs, lured by strong incentives and stability. Jones, whose contract in Wyoming was canceled in early March, considered a nursing job in Montana – swayed in part by a $10,000 severance package. But she found herself in a contract as a travel nurse in rural Kansas, where the pay is better than a staff job, but not quite what she had grown accustomed to during the pandemic.

Jones said her time on the trip raised a big question: How much is a nurse worth?

On the road, Jones said, she “could breathe financially for the first time in years”, sometimes earning nearly double what she earned as a nurse.

“It’s a tough job,” she says. “We love doing it, but we also have bills to pay.”