Becker's Hospital Review

76 CMO / CARE DELIVERY Travel nurses bring gig-minded approach to profession By Molly Gamble A message board for travel nurses is filled with posts from nurses who have quit their full-time jobs at hos- pitals to pursue high-paying, temporary staff- ing contracts around the U.S. On the Reddit board, rookie or aspiring travel nurses ask for input on which trav- el nurse staffing companies are most rep- utable, where to find the most lucrative contracts, and the repercussions of breaking a contract early if they don't want to stay in one location for long. In one post, a new travel nurse said FOMO — fear of missing out — set in aer accepting a 13-week assignment that paid $3,200 gross for 36 hours a week. "en offers jumped sky high to $4-5k/week, local too," the nurse wrote. "Anyone else getting lesser paid con- tracts? Make me feel less FOMO." In another post, a nurse shared how a recruit- er advised them to list their sister's Vermont address to accept an assignment in Massachu- setts for which travelers need to reside at least 200 miles away. "He said it's a grey area but done oen," the nurse asked. "What do you think?" Several posts from September are written by nurses curious about travel but hesitant to re- sign from their hospital employers in case the high pay for temporary staff recedes, leaving them without a safety net. Other nurses see travel jobs as an off-ramp from the profession completely rather than taking a pay cut to return to a full-time staff position. Users note that their pay is four- to seven-times what they made as staff nurses. "e pay increase I've realized over the past few years has changed my life and I'm current- ly making 4x what I was making as a nurse out of school," one user wrote. "However, aer being spoiled by travel money there's no way I'm going to go back to staff nursing. I've been looking at private sector jobs and those seem to be the most promising, including consult- ing or informatics." Hospitals relied on travel nurses during COVID-19 surges, and the high-dollar con- tracts to attract staff to areas facing severe shortages or into COVID-19 units have helped fuel a major labor market shi in which hos- pitals compete with lucrative, temporary con- tracts year-round. ere are currently about 30,000 open travel nurse positions across the U.S., up about 30 percent from 2020's peak, according to data from healthcare staffing firm SimpliFi, as reported by Bloomberg. In addition to high pay, many travel nurse staffing companies offer benefits like weekly paychecks and private housing. One compa- ny, American Traveler, boasts that many of its accommodations include access to swim- ming pools, hot tubs and scenic views. "Live like a star and enjoy a luxury lifestyle in this beautiful traveler housing in California, conveniently located near restaurants, shopping, and entertainment," according to a listing for housing in Los Angeles. In February, the American Hospital Association called on the Federal Trade Commission to ex- amine temporary staffing agencies' pay practices and prices for travel nurses, noting that some had tripled their rates for travel nurses. "Such outrageous rate hikes appear to be naked attempts to exploit the pandemic by charging supracompetitive prices to des- perate hospitals," AHA General Counsel Melinda Hatton wrote to Rebecca Slaughter, acting FTC chair. "While the nurse staffing agency industry too oen blames hospitals for driving up the rates, the fact is that hospitals are in dire need of nursing staff to care for their patients and have little choice but to pay the rates demanded and refrain from com- plaining publicly for fear of being cut off from the supply of travel nurses by staffing agencies that set the prices." e California Hospital Association on Sept. 15 put forth a similar request, asking Califor- nia Attorney General Rob Bonta to investigate travel nurse companies for anticompetitive pricing. e association noted that "skyrock- eting prices'' affect hospitals in poorer com- munities and communities of color the most because they are less likely to be able to afford the high rates. n Older people more likely to experience severe breakthrough COVID-19, study finds By Erica Carbajal T he median age of fully vaccinated people who de- veloped a severe breakthrough COVID-19 infection from March through June was 80, a study published Sept. 7 in The Lancet Infectious Diseases found. The research was based on an analysis of 969 COVID-19 patients who were admitted to Yale New Haven (Conn.) Health between March 23 and July 1, 2021. Of those, 103 had received at least one dose of a COVID-19 vaccine, and 54 were considered fully vaccinated. Researchers considered the 54 fully vaccinated people who contracted COVID-19 as breakthrough cases, meaning they began experiencing symptoms or received a positive test at least 14 days after their final dose. Twenty-five (46 percent) of these patients were admitted to the hospital for reasons unrelated to COVID-19 and received an incidental positive test, meaning they were asymptomatic. A total of 14 breakthrough patients (26 percent) had severe or critical illness. The median age of these patients was 80.5 years. Most of these patients had heart disease, seven had lung disease, and seven had diabetes. All 14 of the pa- tients with severe or critical illness were on ventilators, four were admitted to the intensive care unit and three died, re- searchers said. "Identifying who is more likely to develop severe COVID-19 illness after vaccination will be critical to ongoing efforts to mitigate the impact of these breakthrough infections," said Hyung Chun, MD, associate professor of cardiology at Yale School of Medicine. "These cases are extremely rare, but they are becoming more frequent as variants emerge and more time passes since patients are vaccinated." n

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