Travel nursing has created seismic waves across the nursing landscape.

Nearly 25%

Travel nurses account for nearly one-quarter of all nursing hours worked in the U.S. in 2022, up from 4% in 2019

Between January 2019 and January 2022, travel nurses’ hours leapt from just under four percent of total nursing hours worked in the United States to nearly one-quarter [1]. Though alluring because it’s lucrative (peak travel nurse wages are roughly triple that of typical staff nurses [2]), there are many other costs to travel nursing beyond just dollars and cents. Travel nursing strains hospitals, the nursing workforce, and, ultimately, patient care.

I’ve been a bedside nurse for six years. Before the pandemic, my unit was entirely staffed with permanent nurses. Now, the majority of the staff are travelers. It isn’t uncommon for me to work a shift where everyone else is a traveler. This is a trend seen nationwide since the pandemic.

Their presence, which prizes availability over loyalty, chips away at a hospital’s community, morale, and sense of fairness.

Chloe Michaelis

Every day working with the revolving door of travelers feels like quicksand.

Travelers need constant guidance on protocols, medical and safety equipment, and the location of supplies, and they look to me, the charge nurse, for all the answers. While many of my traveler colleagues are highly skilled and competent, there is no way they can arrive up-to-speed on our hospital’s distinct workflows, documentation processes, and the infinite details particular to our patient care. Working like this is draining, inefficient, and ultimately reduces the time each nurse can spend with patients, thereby increasing the likelihood of errors. When combined with high patient acuity and the communication lapses that happen under strained systems, hospitals and their workforce are acutely stressed. And travelers are unwittingly at the heart of it.

The alluring financial incentives of travel nursing contracts aren’t worth the costs they bring.

Though they’re often attracted to higher wages and detachment from workplace politics, travelers may not always realize the complexities inherent to their new roles. A 13-week contract often consists of an hourly rate plus a tax-free living stipend, but after accounting for temporary housing costs, which can be exorbitant, a travel nurse at today’s rates may just break even with permanent staff wages.

Additionally, the lifestyle can take a toll on mental and physical health due to isolation and exhaustion, contributing to burnout. Sometimes travelers leave positions at well-resourced hospitals to take short-term assignments at lower-resourced hospitals and experience high rates of moral distress from the work they’re asked to do. In many cases, travel nurses must build in a month or longer recovery periods between assignments, which chips away at the financial windfall they might’ve hoped for.

Unlike permanent staff nurses, travelers often don’t have the time, energy, and resources to pursue additional education, leadership opportunities, and learning paid for by health systems and can risk stagnating in their clinical roles.

Finally, travelers may impact hospitals’ Magnet status, a hard-won designation that reflects higher nurse satisfaction, lower turnover, and high-quality patient care, and often requires efforts that are years in the making to attain. Hospitals with large populations of travelers are, then, often disengaged from quality improvement efforts that are essential to quality patient care outcomes, such as CAUTI (catheter-associated urinary tract infections), CLABSI (central line bloodstream infection), HAPI (hospital-acquired pressure injury), and fall reduction. If this trend continues, more travelers surely will mean fewer Magnet hospitals.

In my experience, travelers are high-quality clinicians who too often perform their work in a way detached from the hospital systems they serve. Their presence, which prizes availability over loyalty, chips away at a hospital’s community, morale, and sense of fairness.

While I support higher salaries for nurses everywhere, the focus of pay increases should be on permanent staff nurses rather than the temporary workers that sap the strength of our hospital communities and care models. And with four in every five travel nurses committed to this lifestyle for less than two years [3], it’s not a cost that hospitals, the nursing profession, or patient care should bear. The alluring financial incentives of travel nursing contracts aren’t worth the costs they bring.

Michaelis is a charge nurse in a neurological intermediate care unit where she’s worked for the last six years. Originally from Connecticut, she will graduate from the DNP program in May 2023.

[1] American Hospital Association. (2022, April 22). Massive growth in expenses & rising inflation fuel continued financial challenges for America’s hospitals and health systems. https://www.aha.org/costsofcaring

[2] Lee, J. (2022, September 3). Travel nurses’ gold rush is over. Now, some are joining other nurses in leaving the profession altogether. NBC. https://www.nbcnews.com/health/health-news/travel-nurses-gold-rush-now-are-joining-nurses-leaving-profession-alto-rcna45363

[3] Zippia Careers. (2022, September 9) Traveling nurse demographics and statistics in the U.S. https://www.zippia.com/traveling-nurse-jobs/demographics/