Travelers fill the nursing gap

When a hospital needs a nurse to step in immediately but briefly, Sorrel Teuscher answers the call. She is among more than 40 traveling nurses working in Arkansas medical facilities.

“We’re here, and we’re helping,” Teuscher said.

Teuscher, a cancer and blood disorder specialist, works at Arkansas Children’s Hospital under a three-month contract.

Other hospitals that hire traveling nurses include Northwest Health System in Springdale and Sparks Hospital in Fort Smith.

Teuscher said she is among about seven nurses working at Children’s. More than 120 medical clinics, including hospitals, dialysis centers and medical clinics, hire out-of-state nurses to fill temporary positions in Arkansas, according to the two largest companies placing nurses in the state.

A Sparks Hospital spokesman said the hospital uses traveling nurses but declined to comment for this story. Northwest Health also uses traveling nurses to “augment staff,” but would not elaborate on the number of nurses or cost to the hospital.

Hospitals did not release information showing how much travel nurses cost their budgets, but experts said that as the Great Recession hit, hospitals have been forced to tighten budgets and freeze positions, including reducing the use of traveling nurses.

“We’re in a period that hospital revenues are declining,” said Paul Cunningham, executive vice president of the Arkansas Hospital Association. “Right now, there is an emphasis on cutting costs.”

The number of traveling nurses nationwide peaked in 2008 at 25,000, and then dropped dramatically to 4,500 in 2009, said Becky Kahn, senior vice president of client sales and services at AMN Healthcare, the company that placed Teuscher.

Those numbers are crawling back up to between 9,000 and 10,000 traveling nurses as the economy slowly recovers, she said.

Companies say the number of positions open to traveling nurses has dropped by about half since the start of the recession at the end of 2007. Some nurses are leaving the traveling nurse industry for permanent positions after spouses lose jobs, and hospitals are cutting back on temporary nurses, Kahn and others said.

Despite a looming state and national nursing shortage — registered nurse positions are expected to see a net growth of about 37% in Northwest Arkansas by 2018 — hospitals are not relying on traveling nurses currently. Instead, they are seeking more permanent nurses, said Fred Knight, general council for the Arkansas Board of Nursing.

“I think (traveling nurses) are fairly popular, but the vast majority of nurses are not traveling nurses,” Knight said.

The state board did not have a number showing how many traveling nurses are in Arkansas. The state hospital association did not have information listing which hospitals use the service.

Kahn said traveling nurses are more economical for hospitals to use than hiring more full-time staff because temporary nurses fill in for events like maternity leave and the seasonal flu.

Teuscher said traveling nurses fill in where they are needed.

“We fill in gaps that they can plan for,” Teuscher said. “You can’t create [permanent] jobs that don’t exist.”

At Children’s, traveling nurses are used only during winter and make up less than 1% of the total nurse makeup, spokeswoman Hilary Demillo said in e-mail.

But traveling nurses are more expensive than a full-time nurse.

One temporary nurse costs a hospital about the same as having two people do one job, said Susan Erickson, the nurse recruiter for the University of Arkansas for Medical Sciences, which uses its own pool to hire temporary nurses and avoid hiring travelers.

Hospitals foot the bill for housing or a living stipend, utilities and salaries for traveling nurses — but spokesmen for hospitals and companies that use traveling nurses say the temporary positions account for a small portion of budgets.

Nationwide, about 50% of hospital budgets are dedicated to full-time registered nurses, so traveling nurses don’t make as large of an impact on the total budget, said Howard Goldman, director of investor relations for Cross Country Healthcare.

The company places nurses at two Arkansas hospitals and has about 13 traveling nurses in the state, Goldman said in e-mail.

“We’ve put the pencil to the paper (and) there is a time when it makes sense to bring in traveling nurses,” Goldman said. “If there’s not enough nurses, then it makes sense to bring in other nurses from out of the market to meet the demand.”

Back at Children’s, Teuscher is finishing up her three-month contract. She said traveling nurses allow hospitals to be more efficient when a new wing opens or permanent nurses need training time. She said it’s safer for patients to have an experienced traveling nurse to fill in temporarily.

“We’re not taking any jobs that exist there — we’re just filling in the gaps,” Teuscher said.