Healthcare staff say they’re feeling burned out and emotionally exhausted after working during the pandemic.
Mario Tama/Getty Images
Half of nurses said in a survey they were considering leaving the profession.
More than 90% said a shortage of nurses had made their job worse.
Many said that better pay could convince them to stay.
About half of US nurses said they may leave the profession within the next two years in a new survey.
In the survey of 250 nurses by ShiftMed, an on-demand staffing platform that connects nurses to healthcare facilities, 20% said they were either extremely or very likely to leave the profession within two years.
In total, 49% said that they were at least somewhat likely to leave. ShiftMed ran the poll between September 16 and 28.
Ninety-one percent of the respondents to ShiftMed’s survey said they’d been negatively affected by the nurse shortage.
Just over half, or 52%, said they’d had to work more hours or longer shifts, while 45% said they’ve been given larger patient loads than was feasible. A similar proportion said that the shortage had affected their mental health and that they were worried patients weren’t getting the right care.
Of the nurses who told ShiftMed they may quit, 38% said they would switch to non-patient-facing roles in healthcare, while 31% said they’d leave the industry altogether. Around one in eight of the group said they’d go to college or a technical school so they could retrain for a different industry.
When these nurses were asked what would convince them to stay in the field, 59% said higher pay. The next most common reasons were better staffing levels so that patient care improved, more paid time-off, and a more cooperative work environment.
Some nurses said better shifts, a more flexible schedule, and fewer working hours could convince them to stay, too.
Just over 20 million Americans worked in the healthcare and social-assistance industry in September, per preliminary data from the Bureau of Labor Statistics. This is around 728,000 fewer workers than in February 2020.
ShiftMed’s survey shows that vaccine mandates remain divisive among nurses. Twenty-three percent of nurses said they’d be more likely to stay if their employer introduced a COVID-19 vaccine mandate, while 19% said they’d be more likely to stay if their employer scrapped their vaccine mandate.
31% of hospital nurses across the country have reported a small or significant increase in workplace violence as of September 2021.
Brandon Bell/Getty Images
31% of hospital nurses have reported an increase in violence, up from 22% in March 2021.
Nurses told Insider the tense politics around vaccines and masks may be leading to patient aggression.
1 in 4 nurses faces physical violence on the job, and the hospital is one of the most dangerous workplaces in the country, according to OSHA.
Kevin Romanchik, an emergency room nurse in Michigan, said he’s been punched, hit, kicked, spat on, and called “every name in the book” during his 13 years on the job.
Romanchik said he thinks abuse towards nurses has escalated recently because patients are easily agitated. Asking a simple question like whether a patient has received a COVID-19 vaccine can induce anger and aggression, he told Insider.
Once dubbed “heroes” of the pandemic, frontline workers in America are reckoning with increased violence and aggression on the job. Flight attendants are seeing a historic rise in unruly passengers. Shoppers have even killed retail workers for enforcing local mask mandates.
Nurses are not excluded from the worrisome trend. On top of dealing with short staffing and burnout, 31% of hospital nurses across the country have reported a small or significant increase in workplace violence, up from 22% in March 2021, according to a recent survey from the National Nurses United union.
“These nurses are there to help. That’s a trauma in itself to feel that now they are unsafe at work and there’s that risk of violence against them,” Kerry Peterson, an associate professor at the University of Colorado College of Nursing, told Insider. “That can have detrimental consequences.”
Why violence has increased towards nurses during the pandemic
Despite being places of healing, hospitals are one of the most dangerous places to work.
Hospitals recorded more than 221,000 work-related injuries in 2019 according to the US Occupational Safety and Health Administration, and had a workplace injury rate almost double the average for all private employers.
Nurses, who spend the most time at a patient’s bedside, can bear the brunt of the violence. One in four nurses is physically assaulted on the job, according to a 2019 survey by the American Nurses Association. Assaults range from getting cursed at to grabbing and kicking, a 2014 survey of more than 5,000 nurses found.
Erica, a hospital nurse in Nevada, said she suspects the rate of injury towards nurses is even higher, but thinks many nurses do not end up reporting incidents due to fear of retaliation. (Insider agreed to identify Erica only by her first name for her personal safety.)
Last year during the pandemic, Erica co-founded The Last Pizza Party, a nurse advocacy group with 14,000 Facebook followers, to support professionals dealing with the onslaught of COVID-19 cases.
A 2020 NBC investigation found 77% of hospitals in California reported making no safety improvements after receiving an assault report. The assaults against healthcare workers ranged from bruising to fractures to cuts, and happened primarily in in-patient rooms and ERs.
Erica said instead of preventing assaults from happening, some hospitals have resorted to stopgap measures, like giving nurses rape whistles and panic buttons.
Better solutions to decrease workplace violence come from system-wide changes, Erica said. Nurse unions and advocates have drafted legislation to states and the federal government that would criminalize nurse abuse. Erica said hospitals must also provide nurses with enough resources and mental health support to effectively carry out their roles.
Erica encouraged other nurses to get involved with anti-abuse groups, such as The Last Pizza Party, the Silent No More Foundation, and Nurses Take DC. The momentum Erica has seen on social media – including TikTok, where she has 200,000 followers and over 3.5 million likes – during the pandemic gives her hope.
“What COVID did is it highlighted all of the issues in nursing that have been around forever, but it’s made them impossible to ignore,” Erica said.
Without addressing the growing crisis, however, Romanchik expects more nurses to leave the job, which will lead to the quality of care worsening overall.
“Nursing has been one of the most trusted professions for years now,” he said. “So when nurses are telling you that there are problems or things are difficult, the best thing that the public hospital administration can do and local leaders can do is listen.”
In this Thursday, April 9, 2020, file photo, the Intensive Care unit at the St. Vincent Medical Center building in Los Angeles is viewed.
AP Photo/Damian Dovarganes
Thousands of healthcare workers in California have gone on strike or plan to strike, CalMatters reported.
They’re striking over burnout and continued staffing shortages fueled by the coronavirus pandemic.
About a third of California hospitals reported “critical staffing shortages” to the federal government last week.
Thousands of healthcare workers in California have gone on strike or plan to strike over continued “critical staffing shortages” at nearly a third of the hospitals in the state.
According to a report from CalMatters, workers at more than two dozen hospitals in California went on strike at some point over the past four months. These workers included engineers, respiratory therapists, nurses, midwives, physical therapists, technicians, janitorial staff, according to the report.
Around a third of hospitals in the state this week reported “critical staffing shortages” to the US Department of Health and Human Services, according to the report. The shortages come amid increased patient demand due to the coronavirus pandemic, healthcare workers’ early retirement over the past year, and other stresses put on the system by the pandemic, CalMatters reported.
Unions that represent healthcare workers told the outlet that the shortages existed before the COVID-19 outbreak nearly two years ago, but said the pressure of the pandemic has pushed the staffing issues to new levels. In addition to concerns over staffing, strikes have also been fueled by disagreements regarding pay, according to the report.
The unions say traveling healthcare staff brought into the state to make up for the shortages get paid more than the full-time staff at the understaffed hospitals.
Members of the United Nurses Associations of California/Union of Health Care Professionals recently voted to approve a strike against Kaiser Permanente, CalMatters reported. If negotiations continue to stall between Kaiser Permanente and UNAC/UHCP, 24,000 workers at facilities in over a dozen California cities would strike, according to the report.
The union wants more efforts made to retain staff and address burnout among staff, according to the report. The union says 72% of its members experienced anxiety and burnout and around 45% reported insomnia and depression. About three quarters said hospital staffing was their primary concern, CalMatters reported.
Kaiser has urged employees to avoid a walk out.
“We ask that our employees reject a call to walk away from the patients who need them,” Kaiser spokesperson Marc Brown told the Washington Post. “Our priority is to continue to provide our members with high-quality, safe care. In the event of any kind of work stoppage, our facilities will be staffed by our physicians along with trained and experienced managers and contingency staff.”
The problems fueling the tensions in California aren’t unique to the state. The Wyoming News Exchange reported Saturday that 12 hospitals in the state this week reported a critical staffing shortage to the federal government. Four hospitals in the state resorted to crisis standards of care due to shortages, according to the report.
As Insider previously reported, burnout, poor working conditions, and job dissatisfaction have enabled the ongoing nationwide shortage of healthcare workers. A recent study conducted by the University of Pennsylvania School of Nursing found that hospitals in New York City were understaffed as early as December 2019, months before the city became the US epicenter of the COVID-19 pandemic.
“The stress of working in a COVID ICU, and all the death that I’ve had to see, altogether, it has really set me back; I’m often very anxious, and angry,” Sarah Chan, a registered nurse at St. Joseph’s Hospital in New York, told Insider’s Allana Akhtar in September. “So much death weighs heavy on me.”
31% of hospital nurses across the country have reported a small or significant increase in workplace violence as of September 2021.
Brandon Bell/Getty Images
31% of hospital nurses have reported an increase in violence, up from 22% in March 2021.
Nurses told Insider the tense politics around vaccines and masks may be leading to patient aggression.
1 in 4 nurses faces physical violence on the job, and the hospital is one of the most dangerous workplaces in the country, according to OSHA.
Kevin Romanchik, an emergency room nurse in Michigan, said he’s been punched, hit, kicked, spat on, and called “every name in the book” during his 13 years on the job.
Recently, Romanchik said he thinks abuse towards nurses has gone up recently because patients are easily agitated. Asking simple questions like if a patient has received a COVID-19 vaccine could become political and give rise to anger and aggression, he told Insider.
Once dubbed “heroes” of the pandemic, frontline workers in America are reckoning with increased violence and aggression on the job. Flight attendants are seeing a historic rise in unruly passengers. Shoppers have even killed retail workers for enforcing local mask mandates.
Nurses are not excluded from the worrisome trend. On top of dealing with short-staffing and burnout, 31% of hospital nurses across the country have reported a small or significant increase in workplace violence, up from 22% in March 2021, according to a recent survey from the National Nurses United union.
“These nurses are there to help. That’s a trauma in itself to feel that now they are unsafe at work and there’s that risk of violence against them,” Kerry Peterson, an associate professor at the University of Colorado College of Nursing, told Insider. “That can have detrimental consequences.”
Why violence has increased towards nurses during the pandemic
Despite being places of healing, hospitals are one of the most dangerous places to work.
Hospitals recorded more than 221,000 work-related injuries in 2019 according to the US Occupational Safety and Health Administration, and had a workplace injury rate almost double the average for all private employers.
Nurses, who spend the most time at a patient’s bedside, can bear the brunt of the violence. One in four nurses is physically assaulted on the job, according to a 2019 survey by the American Nurses Association. Assaults range from getting cursed at to grabbing and kicking, a 2014 survey of more than 5,000 nurses found.
Erica, a hospital nurse in Nevada, said she suspects the rate of injury towards nurses is even higher, but many nurses do not end up reporting incidents due to fear of retaliation. (Insider agreed to identify Erica only by her first name for her personal safety.)
Last year during the pandemic, Erica co-founded The Last Pizza Party, a nurse advocacy group with 14,000 Facebook followers, to support professionals dealing with the onslaught of COVID-19 cases.
A 2020 NBC investigation found 77% of hospitals in California reported making no safety improvements after receiving an assault report. The assaults against healthcare workers ranged from bruising to fractures to cuts, and happened primarily in in-patient rooms and ERs.
Erica said instead of preventing assaults from happening, some hospitals have resorted to stop gap measures, like giving nurses rape whistles and panic buttons.
Better solutions to decrease workplace violence come from system-wide changes, Erica said. Nurse unions and advocates have drafted legislation to states and the federal government which would criminalize nurse abuse. Erica added hospitals need to provide nurses with enough resources and mental health support to carry out their roles.
Erica encouraged other nurses to get involved with anti-abuse groups, such as The Last Pizza Party, the Silent No More Foundation, and Nurses Take DC. The momentum Erica has seen on social media – including TikTok, where she has 200,000 followers and over 3.5 million likes – during the pandemic gives her hope.
“What COVID did is it highlighted all of the issues in nursing that have been around forever, but it’s made them impossible to ignore,” Erica said.
Without addressing the growing crisis, however, Romanchik expects more nurses to leave the job, which will lead to the quality of care worsening overall.
“Nursing has been one of the most trusted professions for years now,” he said. “So when nurses are telling you that there are problems or things are difficult, the best thing that the public hospital administration can do and local leaders can do is listen.”
Hospitals across the US are having to limit the number of patients they admit because there aren’t enough staff to treat them.
At the TaraVista Behavioral Health Center in central Massachusetts, nearly a quarter of its 116 beds are empty, CEO Michael Krupa told Bloomberg.
He said that across the state, there were hundreds of empty beds, and “the reason is exclusively staff.”
Krupa said that the hospital had struggled to find nurses and lower-paid aides in the past, but that this hadn’t limited its intake of patients before.
Just over 20 million people across the US worked in the healthcare and social assistance industry in August, per preliminary data from the Bureau of Labor Statistics (BLS). This is around 746,000 fewer workers than in February 2020.
New York Governor Kathy Hochul signed an executive order Monday declaring a “disaster emergency” due to “severe understaffing” in hospitals and healthcare facilities across the state. She warned that this could affect people’s ability to get adequate medical treatment.
The shortage of staff comes as some hospitals and healthcare facilities are mandating COVID-19 vaccines for their staff. Some states, like New York, are mandating the shot for healthcare staff, too.
Houston Methodist Hospital said in June that it had lost 153 workers who either quit or were fired over its vaccine mandate. Novant Health, which has 15 hospitals and more than 350 physician practices across North Carolina, said this week that it had fired around 175 members of staff who refused to get vaccinated.
Kevin Smith, president of Massachusetts-based healthcare agency Best of Care, told CNN in August that he wanted to mandate the jab for his team, but that the policy “puts you at risk of alienating the staff, if not losing them to a competitor.”
“No one can afford to do that,” he added.
TaraVista’s vaccine mandate comes into effect on November 1, and Krupa warned that it could exacerbate the hospital’s understaffing.
“I am hopeful we will not lose many staff,” he told Bloomberg. “But I know we will lose some.”
Connecticut has mandated the vaccine for state staff, and its governor warned that he could even call in the National Guard to replace workers who don’t comply to prevent staffing shortages.
Hospitals are boosting pay in an effort to attract more workers. One hospital in South Dakota is offering a $40,000 bonus for intensive-care and operating-room nurses. Krupa told Bloomberg that TaraVista and its sister hospital were investing an extra $1 million a year in pay, improved benefits, and bonuses for 310 staffers.
Sarah Chan, a registered nurse at St. Joseph’s Hospital in New York, did not expect the pandemic to plague hospitals for the last nineteen months.
Chan said she believed the rollout of the vaccine would decrease the number of COVID-19 patients she had. But as cases involving the delta variant of COVID, which is more easily spread, rise and fewer people get shots, hospitals are once again crowded.
Some health systems have blamed unvaccinated healthcare workers for staffing shortages, but the problem with unvaccinated healthcare workers may be overstated: the American Nurses Association found 9 in 10 nurses have received a COVID-19 vaccine or are planning to.
Instead of leaving in protest of vaccine mandates, many of Chan’s peers left their jobs caring for patients due to exhaustion, she said. The exodus of nurses has created staffing shortages at her hospital, which means she is working overtime to care for sick patients.
Poor work environments and burnout are putting pressure on already strained nurses – and without better resources, trauma and fatigue will cause a nurse staffing crisis, experts told Insider.
“The stress of working in a COVID ICU, and all the death that I’ve had to see, altogether, it has really set me back; I’m often very anxious, and angry,” Chan told Insider. “So much death weighs heavy on me.”
I’m often very anxious, and angry…So much death weighs heavy on me. Sarah Chan, an ICU nurse in New York
Dr. Eileen Lake, a professor at the University of Pennsylvania School of Nursing, has been researching the impact nurses’ work environments have on staffing for the last 20 years. From her research, Lake has found poor work conditions – characterized by hospitals that don’t allow nurses to have a say in their practice, disorganized work environments, and limited resources – leads to burnout and job dissatisfaction.
“That decision to leave I believe reflects system factors that the nurse evaluates and decides are no longer acceptable circumstances for me to work,” Lake said.
Her research and other data indicate that staffing shortages now reflect a systemic problem in a hospital or health system that likely began prior to COVID-19.
Nearly every state has no limit on the number of patients a nurse can care for at once, leading many to care for too many people. A recent study by University of Pennsylvania School of Nursing found New York City hospitals – the epicenter of the pandemic back in April 2020 – were understaffed as early as December 2019.
Nurses caring for COVID-19 patients may have PTSD
Along with poor work environments, post-traumatic stress disorder among nurses who cared for COVID-19 patients may be fueling the staffing crisis.
Chan, for instance, said the constant exposure to death has been “gut-wrenching.” She said she has tried to cope by emotionlessly go through the motions at work, but the trauma has led to insomnia, fatigue, short tempers, and an inability to focus.
Nearly 40% of 500 healthcare workers experienced symptoms of PTSD in a longitudinal study launched last year, according to Dr. Debra Kaysen, a professor of psychiatry at Stanford University developing strategies for healthcare professionals to cope with treating COVID-19 patients.
Frontline healthcare workers might be experiencing post-traumatic stress disorder symptoms, said Dr. Debra Kaysen of Stanford University.
Francine Orr / Los Angeles Times via Getty Images
In order to be diagnosed with PTSD, patients must be exposed to specific kinds of environments and events, including threatened death, serious injury, or sexual violence. The disorder can also stem from repeated exposure to the adverse effects of a traumatic event, such as death from COVID-19.
Healthcare workers that experience PTSD may have nightmares about the event, avoid people and situations that remind them of trauma, and experience strong emotions like shame, anger, or fear.
Untreated, PTSD in healthcare workers can lead to cardiovascular diseases, as well as suicidal ideation and attempts, Kaysen said. She said trauma among nurses could explain worker shortages health systems are facing.
Kaysen added nurses who experience PTSD may stop trusting institutions, due to feeling betrayed.
Major health systems across the country are blaming unvaccinated nurses for staffing shortages
The COVID-19 vaccines have been proven to be safe and effective, so the small number of nurses refusing to get vaccinated might be exhibiting a trauma response, said Dr. Antiqua Smart, a board-certified family nurse practitioner and professor at the University of Loyola-New Orleans.
Smart, who lost several family members to COVID herself, said many non-clinicians forget nurses have to grapple with grief both inside and outside the hospital. That grief, she added, may turn into anger and resentment toward institutions, like those offering COVID-19 vaccines.
Though the majority of nurses are vaccinated or planning on getting vaccinated, some anti-vaccine nurses are going viral on social media.
Kelley Reep, a registered nurse in North Carolina, said she and her colleagues have grown angrier as the pandemic goes on. They “feel a simmering rage that this is worse than ever and it did not have to be,” Reep told Insider.
Smart said nurses refusing the vaccine might be a “type of retaliation, or kind of an anger or coping mechanism part of just being burnt out from seeing people die.”
A doctor checks the vital signs of a patient at the Intensive Care Unit of Providence Cedars-Sinai Tarzana Medical Center in Tarzana, California, on January 3, 2021.
Apu Gomes/AFP via Getty Images
An Idaho COVID-19 patient’s family threatened a nurse for refusing to treat him with Ivermectin, BuzzFeed News reported.
The nurse said a family member told her they have “ways to get people to do something, and they’re all sitting in my gun safe.”
The threats are a part of a larger pattern of violence against medical staff during the pandemic.
The family member of a COVID-19 patient in Boise, Idaho, threatened a nurse who wouldn’t treat the man with ivermectin, BuzzFeed News reported.
The night shift nurse recalled how the police had to remove the man’s son-in-law from the hospital after he told her, “If you don’t do this, I have a lot of ways to get people to do something, and they’re all sitting in my gun safe at home,” according to BuzzFeed News.
Ivermectin is a deworming drug popularly used in animals that the FDA has warned against using in COVID-19 patients. The drug has become widely promoted among conspiracy theory circles as a treatment for COVID-19 – often by those who refuse to get vaccinated.
The nurse, Ashley Carvalho, told BuzzFeed News that hostility to healthcare workers and a new surge of COVID-19 cases are taking their toll, adding that she’s more anxious now than she was before vaccines were available.
“I think it’s just kind of a hopeless feeling,” she said.
Healthcare workers across the US have seen a rise in violent threats
The threat against Carvalho is a part of a larger trend of violence against medical staff during the pandemic.
Karen Garvey, the vice president of patient safety and clinical risk management at Parkland Health & Hospital System, told the Texas Tribune in March that her hospital has seen a rise in violent threats since the pandemic began.
Garvey said there have been “people being punched in the chest, having urine thrown on them, and inappropriate sexual innuendos or behaviors in front of staff members.” She also said medical staff have been called names and racial slurs in addition to getting broken bones and noses.
Natalie Higgins, a nurse at CoxHealth in Springfield, Missouri, told KYTV that the number of physical and verbal assaults in her hospital rose in 2021 as the pandemic raged on.
“The first time I got verbally attacked by a patient, I was like ‘Oh, my gosh.’ Like I expected it, but not to the extent we see it every day,” Higgins said. “The first time someone lunges at you, even still today, when they lunge at you, it’s terrifying.”
Higgins said CoxHealth has installed panic buttons on each staff member’s ID badge to alert security when staffers are in danger.
Researchers and nurses have sounded the alarm on the rise in workplace assaults in hospitals, but according to The Joint Commission on Accreditation of Healthcare Organizations, the real number of assaults on healthcare workers may actually be much higher due to a lack of mandatory reporting.
“Alarmingly, the actual number of violent incidents involving health care workers is likely much higher because reporting is voluntary,” the commission wrote.
On the condition of anonymity, a Louisiana nurse spoke with Insider about their experiences as Hurricane Ida hit their hospital, which was already overwhelmed by COVID-19. This is their story, as told to Elle Hardy.
Before COVID-19 was an issue, I’d gone through numerous hurricanes as a nurse here in Louisiana.
The usual protocol when we know a storm is coming is that we need to evacuate people. A situation like Hurricane Ida would see the hospital discharge almost everybody, or transfer them to other facilities. Before COVID-19, we would get the census down to a minuscule number. You’d have an empty ER and 90% of employees sitting around waiting for the influx of patients.
However, you can’t do that if everyone within a four-hour radius of you is getting damage from the storm too. You also can’t transfer people if everyone within a reasonable distance is also full because of COVID-19.
That meant my hospital was at full census before the storm hit. It looked as though the hospital hadn’t done anything to prepare, and we were working our butts off.
We were watching the news until the cable went out, which usually means there are probably power outages. We started getting hundreds of calls from emergency services asking if we had beds, and we didn’t. Consider that a lot of phone services were cutting out too, and a lot of calls weren’t getting through to emergency services.
Then we started seeing patients in the hallway.
The reason people come to hospital in hurricanes is not what you’d think
During a hurricane, you do see some people coming in because they’ve been hit by falling debris, but my hospital is not the trauma center. Most of what we see after a storm is the side effects of not having infrastructure, such as power or water.
For instance, we had numerous people coming in trying to get dialysis, because you can’t do dialysis without clean water and you can’t sacrifice what little clean water you have. They might usually go to a neighborhood clinic, but these things are closed.
We also saw a lot of people who use oxygen coming in with shortness of breath, or those with heat-related injuries or exacerbations of chronic illness.
When the power goes out, it’s suddenly a big deal that mom can’t get out of bed because it’s 100 degrees in the house. She’s sweating. You’re sweating. You can’t keep her clean; she’s uncomfortable. We saw a lot of admissions because people’s caretakers couldn’t provide care for them.
People wanting to use the hospital
During Ida, we never lost power or air conditioning. We didn’t even have a flicker. But that also meant we had people coming in with bogus complaints because they wanted to sit in the air conditioning and charge their phones.
They were doing it because we have COVID-19 restrictions. If your mom’s here, you can’t sit in your car running gas, because we don’t have much gas in the city. So people will check in and say they have a headache, knowing that we probably won’t get to them for 12 to 18 hours. That way they can stay in the waiting room with mom.
I don’t blame them for it, but it’s a worry. Extra people in the waiting room are creating a breeding ground for COVID-19, as plenty of other people are still coming in sick with that, too.
The Delta outbreak of COVID-19 feels worse
I’m not sure in terms of numbers, but Delta definitely feels worse than the COVID-19 outbreaks last year. I feel like we’re seeing more and more people.
Our admission criteria is a bummer sometimes – a person might not meet admission criteria on Tuesday, but they do on Friday. That means people are coming in and coming back a lot, and that’s putting a strain on the system.
When you combine two public-health emergencies into one, you’re exponentially increasing the risks and the difficulty associated with them.
Needless to say, my hospital is offering a lot of overtime. I don’t pick any extra hours up because I’m worn out. There are only so many hours humans can work.
For Tiffany, a nurse currently working in the Pacific Northwest who originally came from Western Pennsylvania, the prospect of travel nursing was a no-brainer.
“I was like, ‘Cool! I can make money, pay my bills and see the country.'” she told Insider in a recent phone interview.
A key part of what enticed her away from a staff job at a Pittsburgh hospital back in 2013 was the promise of double or more her salary if she were to take on a traveling nurse contract.
“I started at the ER, loved the ER, did it for a couple of years, and then started getting emails from companies that were saying like, ‘Hey, we’ll pay you twice as much as you’re making,'” she said. Even better, Tiffany said, was that those jobs were always far from Pennsylvania, in places like California and Oregon.
At her last contract job, Tiffany said she made $3,500 a week. That was before the pandemic, and things have only gotten more lucrative in the past year and change. “You could make $5,000, $7,000 per week easily,” she said.
“We’re seeing rates in excess of $200 an hour, $225 an hour,” Northwell Health chief nurse executive Maureen White, RN, told Insider. “Some places I hear as high as $250.”
At those rates – approximately $10,000 a week – some nurses are making more than the doctors in the same hospital ER they’re working in. Even in New York, America’s highest-paying region for emergency physicians, the average weekly pay for ER doctors is about $6,400, according to ZipRecruiter data.
Unlike hospital staff nurses, travel nurses work on temporary quarterly contracts of 13- or 14-week periods.
One quarter they might be outside of Seattle, another quarter they might be in Baltimore or Chattanooga, all depending on where the demand is at the moment.
With COVID hospitalization surging once again, hospitals are paying such huge contracts for travel nurses who can quickly relocate. This is especially true for nurses who work in hospital intensive care units (ICUs).
A job description for a nurse contract at Northwell Health Long Island Jewish Medical Center, in Queens, NY. It pays $6,200 per week.
Trusted Health
“It comes down to simple economics of supply and demand,” White said. “It’s unprecedented that we see, across the country and probably across the world, such a high demand for ICU nurses.”
There are other, more banal factors as well.
“During the summertime months, all hospitals – Northwell included – we try to give as many of our employees [as possible] time off,” White said.
There’s also the backup of people dealing with more minor health issues that arose during the pandemic.
“Even here in the Northeast, where we’re not seeing right now that tremendous bump up in COVID patients,” White said. “It’s just people seeking healthcare more now and going in and saying, ‘Oh, I probably should take care of this now.'”
Though the payout is massive, being a travel nurse adds another layer of complication to an already stressful and complicated job. And for some of the highest paying gigs, there are potentially much bigger institutional and/or regional issues that don’t come through on the job application.
“There’s a reason why people don’t want to work there,” Tiffany said. “Maybe the management sucks. Maybe you don’t have the supplies you need. Maybe the patient populations really nasty or really sick. You’re getting paid for your troubles.”
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When many people think of a school nurse, they imagine a person who hands out Band-Aids for boo-boos.
But school nurses do so much more. They are school leaders who address the physical, mental, and emotional health needs of students.
As the COVID-19 pandemic played out, many school nurses took on even greater responsibilities. These include monitoring and evaluating staff and students for COVID-19 exposure and symptoms, contact tracing, and educating students, staff and community partners on vaccine and prevention measures. School nurses are also developing initiatives to deal with the anticipated increase in mental health services that students, families and staff will need in the post-pandemic world.
As a former school nurse and current nurse scientist and professor of nursing, I know that this one-size-fits-all model does not consider the full role and responsibilities of the school nurse.
School nursing is a specialized practice that operates in environments very different from an acute care hospital setting. School nurses work alone, practice independently and are typically the sole health care provider in the building.
As part of our public health system, they play a critical role in disease surveillance, disaster preparedness, wellness and chronic disease prevention interventions, immunizations, mental health screening and asthma education.
Most school nurses will tell you they are unable to carry out many of these functions, often due to huge workloads or poor staffing.
I know from personal experience. From 2009 to 2014, I was the sole school nurse responsible for the health and safety of over 900 public elementary school children. This included special education classrooms for preschoolers and students with nonverbal autism. I now research how school health policies and practices effect the work environment of school nurses, and the challenges and barriers they face.
Research shows how a positive work environment for school nurses increases job satisfaction, reduces turnover and improves academic outcomes for students. A study of school nurses in Massachusetts schools demonstrated that for every dollar invested in school nursing, society would gain US$2.20 as a result of kids’ better health and disease prevention.
No one-size-fits-all ratio
A school nurse’s workload depends on a number of significant variables. For example, how many students in the school have chronic illnesses and need medication administered? How many students attend the school? What ages are they? What is the average number of student visits to the health office each school day? Are students spread across multiple buildings? What level of experience and specialized skills does the school nurse have?
The number of students in a school who are dealing with poverty or other health equity issues – including access to quality education, safe housing and health care – also impacts and increases the workload for school nurses.
These evidence-based variables can be used to guide school administrators and school nurses on what constitutes safe staffing. Making sure school nurses have a safe, appropriate workload is critical to ensuring that students have their health needs met at school.
Parents who are concerned about their child’s health at school may want to find out how many students their child’s school nurse cares for. How many students does the school nurse see on a typical day? Is a school nurse in the building every day? Does the school nurse cover more than one building? What happens when there is an emergency, such as a child with a life-threatening allergic reaction? Where are the emergency care plans kept? Is there stock medication available such as epinephrine and albuterol for students with severe allergies or asthma?
I believe school nurses need more manageable workloads in order to provide the safe care needed for better student health and academic outcomes. This leads to better health not just in individuals but in communities that need it most.
