As demand for travel nurses increases, hospitals in the South struggle to stay competitive

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A lot of people cut back on work travel during the pandemic, but throughout the past year and a half, Jimwesley Williams has constantly taken out-of-state gigs. A travel nurse who lives in Jackson, Mississippi, Williams got assignments in Texas, Wisconsin and Maine, where understaffed hospitals were desperate for help during surges in COVID-19 cases. 

When he acquired a contract to work in Texas for COVID relief, Williams had to work six days a week. 

“We just had to do what we had to do to take care of the patients,” he said. “And they were getting hit pretty bad, so they needed us.”

The work was exhausting, but also lucrative. 

Depending on the specialty, some travel nursing contracts right now can pay $3,000 – $6,000 per week. The average registered nurse in Mississippi makes around $1,250 a week, for a $60,000 annual salary. 

But now, Williams is back home. 

“I think now in the South — because Mississippi isn’t the only place — there’s a need here for nurses. And [hospitals] have upped their pay,” Williams said.

Williams wanted to come back home for school and family, and said he was “blessed” to find a high-paying contract of around $100 dollars an hour in Mississippi, which is comparable to rates he’s been granted elsewhere during times of high demand. 

COVID-19 hospitalizations are now twice as high in Mississippi, Louisiana, and Alabama as they were two weeks ago, contributing to record hospitalization numbers nationwide. In response, some Southern hospitals are offering more pay as the need for travel nurses skyrockets. 

“We’ve got a number of hospitals that are still utilizing travel agencies, but we’ve had several facilities that have decreased the number of beds they can utilize because there was no funding to cover it,” Tim Moore, president of the Mississippi Hospital Association, said. 

‘A really shifty enemy’ 

On top of the uptick in hospitalizations, nurses are burnt out and quitting. In just the first seven months of 2021, the Mississippi Hospital Association reported a decrease of more than 2,000 licensed registered nurses in the state. Many were quitting, retiring, or taking breaks because of exhaustion.

During the pandemic, the estimated number of travel nurse positions hospitals have posted has soared. 

Alan Jones, vice chancellor at the University of Mississippi Medical Center, said this week in a press conference that the hospital system has about five times more nursing positions open than usual. And at the same time, droves of staff have tested positive for COVID-19 and can’t work.

“We’re dealing with a really shifty enemy and it’s changing the rules of the game,” Jones said. 

Jones said hospitals expect to have staffing shortages at any time, but not so many at once. He said there are 175 or 200 employees out on any given day, because they could have the coronavirus. UMMC has around 10,000 employees. 

“Maybe in some places we get one step ahead, maybe in some places, one step behind,” Jones said.

An unsustainable workforce gap 

While infections with omicron tend to be less severe than delta, the new variant is more transmissible. Most hospitalized patients are unvaccinated and the South has among the lowest vaccination rates in the country. 

April Hansen, president of workforce at Aya Healthcare, a nursing travel agency, says staffing was a crisis nationally before the pandemic. Hospitals and health systems were actively searching for talent and brought in short-term contractors as a ”Band-Aid approach” just to get through hiring cycles. 

“But they weren’t having to operate health systems at 100 percent plus capacity,” said Hansen. “They had a little bit of a breathing room that they just don’t have today.”

Now, the workforce gap is unsustainable.

Hansen said the number of core permanent vacancies for staff nurse positions has doubled over the course of the pandemic from around 100,000 to nearly 200,000. With the first wave of COVID-19, she says demand for travel nurses was generally quiet outside major cities, like New York and Seattle.

“It didn’t take long until that changed,” Hansen. “Location drives interest and so places that are highly desirable, like Hawaii, don’t have to try as hard to lure staff and talent there.” 

According to Aya Healthcare data, the number of average monthly travel nurse positions open increased by 200% between 2021 and 2020. Hansen said surges in travel nurse demand mirrored rises in COVID-19 hospitalizations up until around March 2021, when vaccines became more widely available.  

While hospitalizations saw a decline, travel nurse demand continued to stay high. Hansen said hospitals opened back up to serve patients for needs that had previously been postponed, such as elective surgeries. 

Pulling healthcare workers back to the South

As demand for travel nurses in places like the Gulf South remains high, Dr. Robert Hart, executive vice president of Ochsner Health, a hospital system in Louisiana and coastal Mississippi, said they are trying to stay competitive.

Ochsner includes 40 hospitals and about 35,000 employees across Mississippi and Louisiana. And, at its peak the system had around 1,400 people, 4% of the staff, out sick. Hart said Ochsner has likely doubled pay rates for travel nurse contracts to fill the gaps in staff.

Even before the pandemic, Ochsner was working to address the worker shortage by developing more of a pipeline. 

“We’ve got multiple plans in place and partnerships with various universities to educate nurses and increase the size of nursing schools,” Hart said. 

And there are other factors that convince nurses to come to the South.

“There is a population out there that has ties to this area,” Hart said. “There is a reputation that people like to stay here. There’s a lot of good things about this region. So we are able to pull those people back in.” 

This story was produced by the Gulf States Newsroom, a collaboration among Mississippi Public Broadcasting, WBHM in Alabama, WWNO and WRKF in Louisiana and NPR.