Travel nurse pay dipping in Pa., not indicative of labor pool stabilizing

Apr. 7—Average weekly pay for travel nurses working in Pennsylvania fell 10% in March month-over-month, the steepest dip in a continued decline since the start of the year.

Traveling registered nurses (RN) taking temporary work in commonwealth hospitals and healthcare facilities nationwide since the start of the pandemic proved as necessary as it was costly.

Staffing shortages plagued hospitals, and still do, necessitating an increase in hiring temporary nurses from staffing agencies positioned to capitalize on surging demand.

Average weekly pay for travel nurses jumped from $1,896 in January 2020 to $3,782 in December 2021, according to data from Vivian Health, a healthcare hiring marketplace, and reported by Becker's Hospital Review. Weekly rates declined beginning in summer 2022 even as vacancy rates remained high. The national average dropped by $2,645 by December 2022 and settled at $2,590 in March 2023.

In Pennsylvania, the average rate in March was $2,466, down from $2,741 in February. It was the steepest decline in the country and nearly double the next closest state, New Mexico, according to Vivian and Becker's. The weekly rate in Pennsylvania has dropped in each of the first three months of 2023.

Robert Shipp, vice president of Population Health and Clinical Affairs with The Hospital and Healthsystem of Pennsylvania (HAP), said the drop in pay doesn't directly indicate the labor market for nurses is stabilizing.

More likely it's attributable, at least in part, to seasonal shifts and fewer cases of flu, RSV and COVID-19, he said.

"If a hospital can use its regular staff it is in their best interest to do so," Shipp said.

Vacancy rates in Pennsylvania hospitals for registered nurses, nursing support staff, respiratory therapists, nurse practitioners and medical assistants hovered above 30% as recently as November, according to the latest data available from HAP.

Shipp said hospital chief nursing officers maintain that staffing remains a huge need in the first quarter of 2023. The cost of travel nurses became too much for some facilities necessitating creative adjustments such as creating an internal hospital system service where full-time employees shift when needed among a system's facilities.

Others adjusted the workflow of existing hospital staff, working within a particular employee's license to change assignments and realign nursing teams. He said hospitals are beginning to recruit licensed practical nurses (LPNs) back to the workforce after the industry began moving away from that particular nursing segment.

Geisinger did just that, according to Janet Tomcavage, executive vice president and chief nursing executive.

The health care system created an internal travel staff of 240 nurses moving among its 10 hospitals about every three months. Tomcavage estimated up to 40% of those nurses were hired away from external staffing agencies.

"We quite honestly can't afford the cost of the travel agency," Tomcavage said.

The bill rate charged by agencies and split with their employees averaged about $175 hourly. Prior to the pandemic it had been about $80, she said, and it is now settled from $95 to $130, roughly.

Geisinger uses about 350 travel nurses a month, down from upward of 650, she said.

LPNs are returning to Geisinger hospitals, too, she said, after many of those positions were moved out of hospitals and into clinics. And, she said the system is working to institute blended care teams of varied nursing and support staff to better leverage their respective abilities.

There also is increasing reliance on automated technology to complete nursing tasks, like auditing, that would otherwise take their attention away from patient care. Virtual nurse visits are also increasing for admission and discharge, allowing nurses on the floor to focus on patient health.

"I think folks will see a different care team in the near future when we get this model where it needs to be," Tomcavage said.