Nomad Health provided this article.
By Valerie Gale, RN, BSN, MOAM, vice president of clinical excellence, Nomad Health
A nursing shortage that began in 2012 continues and, in fact, has gotten much worse. The National Council of State Boards of Nursing (NCSBN) has reported that 100,000 registered nurses (RN) have left the field since 2020, and roughly 900,000 will follow suit by 2027. A pandemic, stress, and burnout have taken a toll, so much so the Biden-Harris Administration has just committed $100 million to training more nurses and growing the workforce.
Our company wanted to see what could be done to turn the tide, so we reached out to our traveling clinicians to understand what keeps them in the profession. Foremost, we found more than three quarters were satisfied with their most recent travel job, while only half could say the same about their last permanent staff assignment post. That’s the start of frontline feedback providing insight into the attraction of travel assignments and what motivates RNs.
A means to motivate
For staff clinicians, issues with patient-to-nurse ratios, long shifts, and hospital politics were not only a recipe for burnout; they were a catalyst for exploring traveling opportunities. Still, more than 80% of respondents note higher pay and being able to attain financial goals as the top motivators for pursuing travel positions.
Drilling down further, additional reasons in order of significance include freedom and flexibility, adventure, better work-life balance, and the ability to focus on patients versus hospital politics. Clearly, having more control over their own journeys – including their personal lives, careers, and workplaces – are key to higher satisfaction.
What’s more, after experiencing the freedom and flexibility that comes with a traveling position, more than 40% of respondents ruled out ever returning to a permanent staff role. And while some clinicians did opt to return to staff positions, the decisions were usually driven by family obligations and a need for increased stability.
Criteria for compensation
When it came to actually choosing a travel assignment, pay was the primary motivator from respondents at 26%, whereas the location of a particular assignment came in a close second at 20%. Rounding out the top five motivators were the way an entity structures shifts, the facility itself, and contract length, all hovering around 10%.
We also asked our traveling clinicians to rank the perks and benefits they find most important in a compensation package. Among the many options, the top 10 they consider most are:
- Pay rate guarantee: 18%
- Housing stipend: 14%
- Travel reimbursement: 12%
- Paid time off (between assignments): 8%
- Licensing and certification reimbursement: 7%
- Affordable healthcare plan: 7%
- Retirement contributions, 401k matching: 5%
- On-assignment support: 5%
- Access to retirement contributions/401k: 5%
- Scrubs reimbursement: 4%
Safe and supported
When considering a specific position at a facility, flexibility in scheduling (14%) and patient-to-staff ratios (13%) were what traveling clinicians cared about most.
While these factors are critical to practitioners, others associated with feeling safe and supported also influence their assignment choices. In order of importance, these include Facility reputation, floating frequency, charting systems, a chance for overtime, time off, onboarding, parking, floating parameters, number of clinicians, and lunch breaks.
A healthy sample of allied health professionals participated in our survey, too, encompassing a range of diagnostic, therapeutic, and support positions. The most important factors for these professionals were thorough onboarding and the number of clinicians assigned to a unit. In general, this group is newer to traveling roles, so it makes sense they place greater emphasis on a facility’s onboarding and staffing ratios when evaluating offers.
Upon completion of their first assignment, and across all respondents, money dropped 8% as a motivator, though it remained foremost. At the same time, greater work-life balance and being able to focus more on patients (and not politics) saw an uptick in importance.
Satisfaction in staying
The majority of nurses saw workloads increase during the pandemic. They were left emotionally drained and physically exhausted, and many were left questioning their careers. The current shortage of RNs is now being exacerbated by the aging of Baby Boomers and their growing need for health care. And the fact that nursing schools in the U.S. are struggling to expand capacity makes the situation even more unsettling.
These factors make recruitment and retention top priorities and essential to warding off a health crisis. To get to the heart of why RNs are leaving the profession, it is important to consider frontline feedback that highlights the reasons why they are staying as well.
For additional data, please visit the Nomad Health Job Satisfaction Index.
Valerie Gale, RN, BSN, MAOM, is vice president of clinical excellence at Nomad Health. In this role, she leads the clinical excellence team, which is charged with educating and coaching travel clinicians through their assignments to ensure they are delivering the highest quality patient care at health systems across the country. Valerie holds a Bachelor of Nursing degree from the University of Calgary and a master’s degree in Organizational Management from Dallas Baptist University.