10/19/21, 4:17 PM
High Pay for Covid-19 Nurses Leads to Shortages at Some Hospitals - WSJ
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HEALTH
High Pay for Covid-19 Nurses Leads to Shortages at
Some Hospitals
Some hospitals pay signing bonuses of up to $40,000; ‘We’re desperate for nurses’
By Robbie Whelan | Photographs by Verónica G. Cárdenas for The Wall
Street Journal
Aug. 29, 2021 12:11 pm ET
Before the coronavirus pandemic, Ivette Palomeque made $45 an hour on a flexible
schedule as a staff intensive-care nurse at Memorial Hermann Health System in Houston.
Today, she earns $120 an hour working in an ICU in McAllen, Texas, the latest in a string
of “travel nurse” jobs she has held over the past 16 months. The journey has taken her
from Miami to New York City and back to Texas.
She plans to work high-paid crisis contracts as long as she can. Nursing pay may never be
this good again, she said, and persistent understaffing means that working conditions for
staff nurses aren’t likely to improve.
“Going back to a staff job is just not an option,” said Ms. Palomeque, 45 years old.
“Absolutely not.”
The pandemic has altered the labor market for nurses and other medical staff. As Covid-19
spread in spring 2020 and filled emergency rooms with sick patients, thousands of
hospital staffers were drawn by sky-high pay and the chance to help hard-hit communities
like New York City. Others left the profession after long months treating critically ill
patients.
Fueled by intense demand, and paid for in part with federal emergency funding to
hospitals, travel-nurse pay has skyrocketed. In December 2019, average gross weekly
wages for a travel nurse were around $1,600 a week, according to data from Vivian Health,
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High Pay for Covid-19 Nurses Leads to Shortages at Some Hospitals - WSJ
a healthcare recruiting company. One year later, average pay was more than $3,500 a
week.
After declining from a winter peak, pay is rising again as the Delta variant rages through
states with lower vaccination rates. Average weekly gross wages for a registered nurse
working on a travel contract in the U.S. rose to $2,597 in early August, the highest rates
since February, Vivian Health said.
High crisis pay is exacerbating a chronic shortage of permanent medical staff across the
country, which predates the pandemic and extends to all parts of the healthcare system.
Hospital leaders expect their labor crunch to persist long after the pandemic has calmed.
At Harris Health System in Houston, vacancy across 2,200 bedside nursing positions is
about 22%, up from 8% before the pandemic. Harris Health said in mid-August that it
would raise pay for all emergency-department and adult-ICU nurses to $140 an hour until
staffing levels stabilize.
Ivette Palomeque at her apartment in Texas. She is living with her sister, who is also a travel nurse.
“The hospital is not going to be able to survive on hiring travel nurses in perpetuity,” said
Maureen Padilla, Harris Health’s senior vice president for nursing services.
Shortages have created a skills gap at Harris Health, Ms. Padilla said: Inexperienced
nurses are helping with more complex care, leading to higher risk of mistakes.
“These days, where I lose sleep every night is, how are we going to stop this vicious
cycle?” she said.
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Hospitals have reported chronic nurse shortages for several years. The National Institutes
of Health estimates that there was a shortage of about one million nurses in the U.S. in
2020.
The added pressure from the pandemic and high pay rates for travel nurses could spur a
permanent reset of wages for all nurses, said April Kapu, president of the American
Association of Nurse Practitioners.
“This pandemic has highlighted how important nurses are to the workforce, so bringing
their pay in alignment with the market is more important than ever, because nurses are
going to expect that,” Ms. Kapu said.
Rachel Norton, a registered nurse from Albany, took a temporary travel assignment in
Denver in mid-2019. When the pandemic hit, the hospital in Denver offered her a $1,000
weekly bonus to extend the assignment, and she accepted. Since then she has taken crisis
assignments in Arizona and California as well, and doesn’t plan to return to the East
Coast.
Ivette Palomeque and her twin sister, both travel nurses, after working the night shift at a hospital in
McAllen, Texas.
“Once nurses are done with a crisis contract, they don’t want to go back to the bedside
where they know they’re going to be short-staffed and underpaid,” Ms. Norton said.
Some hospitals are offering once unheard-of signing bonuses for nurses who accept
longer assignments: $40,000 at Monument Health’s hospital in Rapid City, S.D., $20,000
at Temple University Hospital in Philadelphia, and $10,000 at St. Charles Health in Bend,
Ore., according to the hospitals.
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Allegheny Health Network in Pittsburgh is offering $15,000 bonuses to nurses who sign
long-term contracts. Chief Nurse Executive Claire Zangerle said the system and many
other hospitals can’t match the pay and benefits, such as vacation time, that some staffing
agencies offer.
“Most of us are not-for-profit, and these labor costs are not in our budgets,” she said.
“We’re desperate for nurses.”
Catrina Rugar, an ICU nurse who lives with her husband and six children in Homosassa,
Fla., has left her house every Wednesday at 2:45 a.m. since February for her 7 a.m. crisis
shift at a hospital in Fort Myers. She works 12-hour shifts for three days straight, then
drives three hours home again to spend the rest of the week with her family.
Over the past year she has worked in ICUs and at testing sites in New York, Texas and
Florida. Each job has paid more than $100 per hour, compared with the $34 she made at a
hospital near her home before the pandemic. When her Fort Myers contract ends in a few
weeks, she’s lined up another crisis-pay gig in the Miami area.
“It’s a no-brainer if you’re making double or triple money,” Ms. Rugar said.
Phoebe Putney Health System, which operates four hospitals in Southwest Georgia, added
two ICUs in recent weeks, and hit a record for Covid-19 hospitalizations on Aug. 19. For
every additional intensive-care bed, Phoebe Putney needs about four more nurses, said
Scott Steiner, the system’s chief executive officer.
“It adds up real quick,” he said.
SHARE YOUR THOUGHTS
Healthcare workers, we want to hear from you. What is the situation like in your community when
it comes to staffing? Join the conversation below.
Phoebe Putney tries to extend contracts of its travel-agency nurses; that can mean
offering a higher wage to persuade them to stay, Mr. Steiner said. The system is training
employees without clinical skills to do jobs that don’t require medical knowledge, from
bathing patients to emptying urine bags, he said.
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“We’re living for the moment right now,” he said in mid-August. “That’s not a good place
to be.”
—Melanie Evans contributed to this article.
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Write to Robbie Whelan at robbie.whelan@wsj.com
Appeared in the August 30, 2021, print edition as 'High Pay for Nurses Fuels Staffing Woes.'
Copyright © 2021 Dow Jones & Company, Inc. All Rights Reserved
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