You enter your unit 8 hours after your previous 12-hour shift, which actually stretched into 16. You yawn and sigh, reaching for your PPE to begin the donning and doffing process that has become second nature. The noticeable holes with missing staff feel overwhelming as you glance at the assignment sheet. 

The anxiety you worked so hard to push back rises and feels like an elephant sitting on your chest. You hope it is “only” anxiety. Some days you do not know how your unit will survive another shift with the endless call-offs from illness and the mental health toll, as well as staff leaving simply because they cannot continue. 

What felt tough before the pandemic now feels insurmountable as staffing ratios have dropped well below national averages as hospital censuses flex to provide care for record numbers of COVID patients, in addition to all the other patients. You have strong concerns that the burnout experienced by healthcare providers nationwide could spill over into patient care in all the ways it is seeping into all the crevices of your life as you battle the extreme mental health effects of what you have been enduring. You tearfully tell yourself you can get through today and then move on to the next. 

Your manager comes around the corner, and you see her adding to the assignment sheet. She says, “well, we were given two travelers for this week.” Your heart soars. A tiny smile curls at your lips hidden under your masked face. Tears obscured by your protective goggles now flow freely, streaming down your face. It feels like a glimmer of hope so desperately needed. I can make it another week, you silently repeat to yourself in words only you can hear. I know I am not the only nurse who has felt the enormous burden as we fought to keep our units and hospitals afloat during the pandemic, and the sparks of relief that travelers bring. As the COVID-19 pandemic overtook the world, travel nurses bravely rushed to areas requiring the most need, and with them came hope. Many nurses felt called to leave traditional nursing positions to travel, providing respite and assistance to areas hit hard. As the balance of nurses shifted, many eyebrows were raised over the climbing salaries of those choosing to travel over those remaining in traditional bedside roles. Nurses felt emboldened to leave their organizations to provide the same care but at rates that felt more in line with the tremendous care and risks taken to provide care during the pandemic.

What nurses have felt for years was exemplified during the pandemic in feeling their pay was not commensurate with the care delivered and stressful work environments. The disconnect grew rapidly between what seemed fair and reasonable compensation as cases of COVID-19 escalated, leaving a vacuum of instability in the workforce that threatened to collapse the healthcare system. The bitter divide soared over the pay gap between nurses remaining in their long-term roles and those leaving to travel. Ironically the loudest voices speaking on this were not even those on the frontline or in the healthcare industry, many of which were judging from the court of public opinion. 

Many nurses leave their roles only to return to their same organization at rates that more than doubled and even tripled. Hospitals have reported that they felt exploited by travel staffing agencies whose fees skyrocketed when they had few other choices. Traveling nurse agencies have been in the throws of a lucrative business model that has left many questioning the moral and ethical dilemmas attached to this heated debate.

This is all while travel nurses are caught in the crosshairs of being martyrs stepping up to fill critical staffing needs while disrupting their lives to provide life-saving care for others while the rest of the world was sheltering in place. The hefty decision that weighed the price tag on rates for care provided versus your personal mental and physical health and that of your family while working as a travel nurse during the pandemic is a hidden dilemma not captured in this conversation.

The disconnect feels stifling. 

Now that the pandemic is winding down (in some ways), the balance is shifting yet again in hospitals and healthcare organizations. The demand for travel nurses nationwide dropped by a third as of April 2022, and with it pay rates have decreased by as much as 50%. Some travel nurses are having their contracts canceled while they are orienting to their current assignment. Nurses who have been deemed heroes of the pandemic are now finding their lives disrupted in ways that leave them with reduced options for a way of life and income they now rely on. The tremendous sacrifices they have traded for a higher wages scale now seem diminished by the executives negotiating their pay. This opens up a serious discussion on how the supply and demands for things like care feel deeply misguided. However, if you are a nurse, you likely feel a pay scale proportionate to the work we do needs a sharp reevaluation.

In a recent poll I conducted on NurseSocial, members reported travel nurses are being used less. Among the NurseSocial community, 36% of respondents felt travel nurses were being used less, 29% of reporters felt travel nurses were being utilized more, and 21% felt the use was about the same in the last few years. Also, 14% stated their organization did not use travel nurses at all. When posed with the question of how nurses in the NurseSocial community felt about the use of travel nurses during the pandemic, nurses feel grateful to have help. Some found the only downfall was related to interactions of travel nurses with students and ways it limited their learning experiences. Members attributed this to several reasons, among them limited knowledge of nursing programs and expectations. Many felt the use of travel nurses and pay disputes has shed light on many deeply rooted work grievances nurses have held for many years and have only recently come to the surface. 

Staffing and salary concerns have come to the forefront along with discussions regarding travel nurse pay scales. Many within the NurseDeck community feel travel nurses have and always will play a significant role in the nursing profession. Their role in the pandemic punctuated a critical need and a voice that speaks to the value of nurses providing direct patient care which is a vital component of the healthcare delivery system.