Nearly 1,000 advanced practice nurses worked as volunteers to roll out COVID vaccines for Florida seniors in January 2021. Credit: Florida Association of Nurse Anesthetists, January 2021
Amid nationwide challenges with nurse staffing during the COVID-19 pandemic, some Florida hospitals feel threatened by nursing temp agencies that recruit travel nurses for jobs out of state, oftentimes offering higher pay compared to Florida.
With more nurses in the state choosing to take traveling roles elsewhere through temp nursing agencies, hospital systems in Florida have pointed to ways to keep long-term nurses. That would include virtual nursing or what’s called team-nursing, among other strategies, according to hospital executives in Florida.
Lawmakers this week began committee meetings leading up to the January 2022 legislative session, and hospitals and health care staff have been on the radar during those hearings.
Overall, the demand for nurses and other health care workers has increased during the global pandemic, as the more contagious Delta variant continues to circulate.
The American Nurses Association said in a report that the U.S. Bureau of Labor Statistics “projects the need for 1.1 million new RNs” nationally by 2022, in response to “expansion and replacement of retirees, and to avoid a nursing shortage.”
But health care unions have argued that staffing shortages aren’t necessarily what’s going on — they say that nurses are refusing to work in unsafe health care environments.
Meanwhile, the travel nurses have become more popular, working on contract at hospitals and other health care settings, taking on short-term roles and getting employed by independent nursing staffing agencies, according to nurse.org.
Hospital executives from two different committee meetings in the Florida House this week discussed challenges involving nurses leaving for travel nurse jobs in other states. And they cited overall staffing concerns even before the pandemic.
John Couris, president and CEO of Tampa General Hospital, said during the House Pandemics & Public Emergencies Committee that the situation places a strain on hospital systems.
“When those nurses leave to travel — and I do not begrudge them for that, they have student loans to pay off, they have bills to take care of and they look at this for an opportunity to take care of bills and student loans — when they travel, it puts a tremendous amount of pressure on our ability to care for people,” Couris said.
“In my opinion, that needs to stop. We need some help,” he added.
However, travel nurses working in Florida have been receiving higher pay, according to another hospital executive in Florida.
Tom VanOsdol, president and CEO of Ascension Florida, said at the legislative committee meeting that the hospital system has been hiring more travel nurses who are paid much higher hourly rates.
“For the same reasons driving nursing shortages…we’ve now had to hire over 350 traveling nurses across our market,” he said. “We were unable to fluidly bring our nurses from Ascension markets to Florida like we were in 2020 because of the time it takes to apply for Florida licensure. So now we are paying these nurses five to six times our normal hourly rates.”
Dr. Neil Finkler, chief clinical officer at AdventHealth’s Central Florida Division, told state lawmakers in the Florida House that COVID-19 has exacerbated the issue, resulting in heightened awareness of solutions to retain more long-term nurses.
“Prior to COVID, we were challenged with regards to our nursing and quite frankly all of our clinical care within health care,” Finkler said during a House Health & Human Services Committee meeting.
As a result of the pandemic, nurses have either left the field or have become travel nurses in other states making “upwards of $10,000 a week” caring for COVID patients, Finkler said.
He said that the situation with travel nurses leaving the state for better perks through nursing agencies needs to be addressed.
“79 percent of nursing job postings today are currently being filled with agency nursing staff,” Finkler said. “I will tell you that this is one of the great existential threats to our ability to continue to deliver health care. This is not sustainable, it limits consistency, it limits our mentor capability, it limits team building.”
In fact, there are many current openings for travel nurses across the country that offer better pay than Florida.
According to Fastaff Traveling Nursing, states with the highest estimated weekly pay include current openings in Idaho, paying around $8,000 per week, followed by California, with a position offering around $7,900.
Fastaff, a travel nurse staffing agency, has a job featured in Florida for an emergency room nurse, offering around $5,500 a week, significantly lower than the openings in other states.
At AdventHealth, Finkler said they’ve implemented new strategies such as “stretch nursing,” where nurses must care for “an extra one or two patients” to increase the patient-to-nurse ratio and “team nursing.”
Team nursing involves a skilled nurse managing a group of other health care workers including other nurses, he added. “We would surround this experienced nurse with other health care professionals,” he said. “This was really very successful because that nurse now became the manager of a team.”
AdventHealth is also looking to push the envelope even further to improve patient care by employing “virtual nurses” to innovate staffing models, Finkler said.
“We’re taking this a step further and now looking at ways to do a virtual nursing or a virtual integrated model where we could have one of these experienced nurses in a virtual platform actually monitoring multiple units,” he said.
Meanwhile, the American Nurses Association wrote a letter Sept. 1 to the U.S. Department of Health and Human Services, imploring the federal agency to declare the current nurse staffing shortage as a national crisis, and provided policy solutions to respond to the crisis.
June Browne, an intensive care unit nurse at Osceola Regional Medical Center, told the Florida Phoenix that dangerous work conditions have contributed to the nursing shortage in Florida, including caring for more than three COVID patients at a time.
Browne is a member of the National Nurses United, a nationwide union representing registered nurses. The organization asserts that the hospital industry has failed to protect the health of nurses by overloading them with COVID patients.
“I know a lot of people are saying there’s a nursing shortage,” Browne said in a phone conversation. “But the truth is there isn’t a nursing shortage, there’s a shortage of nurses willing to work in an unsafe environment, without adequate pay.”
Browne said she’s witnessed many of her coworkers leaving the state for better pay. “Many of my coworkers have left, many have gone to California,” she said, “and they are being paid better.”
Clarification: A word in a quote used earlier in the Florida Phoenix story should have been “willing,” not “unwilling.” The Phoenix has corrected the wording in the sentence.
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