Worn-out nurses hit the road for better pay, stressing hospital budgets -- and morale

Blake Farmer, Nashville Public Radio on

Published in Business News

While some hospitals have offered retention bonuses or increased pay for permanent staff members, nurses say it doesn’t compare to the financial bonanza of traveling. Hospital managers now find themselves trapped in a pricey hiring cycle — competing for, in particular, the most highly trained critical care nurses who can monitor COVID-19 patients on the advanced life-support devices known as ECMO (extracorporeal membrane oxygenation) machines.

“Our turnover for ECMO nurses is incredible, because they’re the most seasoned nurses. And this is what all my colleagues are facing, too,” said Jonathan Emling, a nurse and the ECMO director at Ascension St. Thomas Hospital in Nashville.

The shortage of ECMO nurses has prevented the hospital from admitting additional COVID-19 patients who need their blood oxygenated outside their body, he said. No more staff nurses have enough experience to start the training.

“We will train these people and then six months later they will be gone and traveling,” Emling said. “So it’s hard to invest so much in them trainingwise and timewise to see them leave.”

And when they leave, hospitals are often forced to fill the spot with a traveler.

“It’s like a Band-Aid,” said Dr. Iman Abuzeid, co-founder of a San Francisco nurse recruiting company called Incredible Health. “We need it now, but it is temporary.”


Incredible Health helps to quickly place full-time staff nurses in some of the country’s largest health systems. The number of listings for full-time, permanent nurses on the company’s platform has shot up 200% in the past year.

To help hospitals, some states are chipping in to hire travel nurses. But for many hospitals, the higher costs are straining their budgets, which is especially difficult for those that have suspended elective surgeries — often a hospital’s biggest moneymaker — to accommodate COVID-19 patients.

“Every executive we interact with is under pressure to reduce the number of traveler nurses on their teams, not just from a cost standpoint but also from a quality-of-care standpoint,” Abuzeid said.

It’s hard on morale as well: Camaraderie suffers when newcomers need help finding syringes or other supplies but may be paid two or three times as much as the staff nurses showing them the ropes.


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