Local hospitals and clinics are struggling along with others across the nation to find enough nurses.
Long-term demographic trends including the aging of the giant baby boomer cohort have been exacerbated by the stresses placed on the health care system by the COVID-19 pandemic. In addition, a critical shortage of nurse educators has limited the supply of new nurses to the profession — just as many current practitioners are leaving.
The crisis compounds as nurses leave in mid-career, citing burnout and unsafe workloads. Hospitals are filling essential slots with temporary traveling nurses, who typically earn substantially more per hour than regular staff. This creates inequalities in pay that frustrate staff nurses, and limits hospitals’ ability to bring in more people to share the workload.
Burnout, stress — and boomers
Nursing shortages are not necessarily a new issue. The fear of a dwindling healthcare workforce has arrived as the baby boomer generation becomes older and more in need of health care resources.
Another aspect of the shortage is burnout and job stress. During the height of the COVID-19 pandemic, nurses frequently were asked to work in unfamiliar departments and in areas with a high number of COVID-19 patients — and longer hours.
Staff at Skagit Regional Health see traveling nurses daily. Hospital administrators report they employ about 75 traveling nurses currently, in addition to 700 nurses already on staff.
The hospital has about 100 open positions for registered nurses, according to the hospital. These positions could take several months to fill, some even longer if they are specialty positions.
Care, at a cost
In the meantime, traveling nurses allow the hospital to continue to provide care.
According to Skagit Regional Health chief executive officer Brian Ivie, institutions are acutely aware of the issues related to a travel nursing staff.
“It’s significantly more expensive to pay the traveling nurse agency,” he said. “That doesn’t necessarily mean the traveling nurse receives all of those funds, but it is more expensive.”
Ivie said the cost of a traveling nurse is typically two to three times what it costs to pay a staff nurse.
“We would rather give the money to our nurses, there’s no doubt about it,” he said. “But the travelers are an investment, frankly, in our ability to continue to provide services to our community.”
Regardless of the need, Ivie said travel nurses still pose a significant financial burden on the institution — a burden large enough that creative changes are being made to help alleviate the strain of nurses already on staff and bring on new ones.
“Organizations simply can’t maintain the additional cost, and it is an unsustainable model,” he said.
A Google search on “travel nursing jobs in Friday Harbor” turned up about 30 job openings in the past week. The same search showed about 35 travel nursing positions in Mount Vernon, where Skagit Valley Hospital is located.
For want of teachers
National headlines have long chronicled the need for increased nursing staff in the United States. A survey conducted by the American Hospital Association showed about a 30% increase in nursing job vacancies across the U.S. between 2019 and 2020, even before the pandemic packed hospitals.
One reason is the shortage of teaching nurses. Instructors need a master’s degree in nursing in addition to experience as an RN. The time and cost of that extra training when better-paying nursing jobs are widely available have discouraged people from going into teaching.
Whatcom Community College, for example, offered a starting pay of $62,536 in a September 2022 job posting, less than the average pay for an emergency-room nurse at PeaceHealth St. Joseph Medical Center in Bellingham. Nursing programs locally and nationwide have had to turn away thousands of qualified students for lack of teachers.
Travel nursing, which typically pays more than double that amount, has become an attractive option.
According to a report by KUOW, travel nurses are paid about 20% more in Washington than they were last year, with an average weekly pay of $3,210. The average salary for nurses in Washington state, according to glassdoor.com, is around $100,000 or about $1,923 a week.
“PeaceHealth has worked hard to address the affordability of care and has reduced reliance on high-cost temporary workers,” PeaceHealth said in a statement. “Like health systems around the country, PeaceHealth is working to attract new caregivers and retain those who already work here.”
Becoming a nurse is no simple task. To become an RN typically requires about two years in a nursing program involving class time, testing and clinical education
Shelley Price, Dean of Nursing and Allied Health at Skagit Valley College, estimated that about 60% of graduates of the program stay in the area.
She said she does not see travel nursing as becoming the main preference of future nurses. Although it has become a recent topic of discussion, the pay and benefits of travel nursing are not as consistent as for a full-time position.
Funding for educators
Price said the Skagit program has seen a steady number of students in her eight years at the nursing program, with a slight, expected dip due to the pandemic.
However, “there has been a profound shortage [of nursing educators] in Washington state, and there still is a shortage,” Price said. That improved significantly when House Bill 2158 was passed, she noted.
The bill approved significant funding for people going to college, including free tuition for students of families making less than $50,000 a year. It made headlines during its signing in 2019 as a progressive take on improving college costs and encouraging higher education.
However, a portion of the bill that gained less attention was funds appropriated to community colleges in Washington. Price said the bill enabled salary increases for nursing educators and improved on the staffing shortage present before its passage.
Changes … and patience
Hospitals are devising new ways to attract and train nurses and support staff.
At Skagit Regional Health, new programs enable nurses and other healthcare workers to get training and experience they need for advancement. The hospital has also introduced a training program for nursing assistants and support staff.
“It’s going to require a change in care model,” said Ivie. “We’re going to look at how we maximize the use of these experienced nurses … supported by others who might not be registered nurses.”
Ivie advocated for funding and help on a statewide level, for additional programs to train and support health care workers.
However, he also asked the community itself to be patient with health care providers as they traverse this time of short staffing and longer wait times.
“We certainly want to treat people appropriately and, frankly, ask the same in return,” he said.
— Reported by Zach Kortge
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