Burnout and high turnover have been taking a toll on nurse clinicians, resulting in a staffing deficit that will only worsen. According to McKinsey & Company, the U.S. will be short 200,000 to 450,00 registered nurses for direct patient care by 2025. Research from NCSBN further reports almost 900,000 RNs intend to leave the workforce by 2027.
With this in mind, leaders from our company wanted to examine what could be done to mitigate this growing crisis, one already impacting nearly every healthcare facility daily. So, we surveyed our traveling clinicians to find out what motivates and keeps them in the industry. Analysis of the data revealed the benefits that matter, what they appreciate in a facility, and perhaps more importantly, why they continue taking travel assignments and remain in the profession. Here are a few of the highlights.
Control Leads to Satisfaction
Over three-quarters of respondents surveyed said they were satisfied with their most recent travel job, whereas only half felt the same about their last permanent staff post. Burnout was a significant factor for staff clinicians due to problematic patient-to-staff ratios, lengthy shifts, and hospital politics. These issues were major influences in prompting clinicians to pursue traveling opportunities.
Not surprisingly, higher compensation and the ability to meet financial goals were the foremost reasons nurses seek traveling opportunities, cited by 84% of respondents. Other motivators included freedom and flexibility at 71%, followed by a sense of adventure (39%), work-life balance (28%), and an “ability to focus on the patient, not hospital politics” at 22%.
Top 5 Motivators for Seeking a Travel Position
Having experienced the freedom and flexibility afforded by traveling, 41% of respondents said they would never return to a staff position. Additionally, after completing their first assignment, data showed work-life balance increased in value by 4%, as did the chance to focus more on patients, not politics.
Traveling Nurses: The Value of Pay, Place, and Perks
Pay was the top motivator when selecting a travel assignment at 26%, followed closely by location at 20%. This is supported by what we see internally as many clinicians begin their searches filtering by city and state. Shift structures and the facility came in at 11%, with contract length (10%) and start date (8%).
Travel clinicians are particularly adept at negotiating monetary benefits. That said, we asked them to rank the compensation package features they find most important. The top responses were: Pay rate guarantees (18%), housing stipends (14%), travel reimbursement (12%), paid time off between assignments (8%), licensing and certification reimbursement (7%), affordable healthcare (7%), retirement contributions/401k matching (5%), support while on assignment (5%), scrubs reimbursement (4%), housing coordination and support (4%), and continuing education unit (CEU) reimbursement (3%).
As the data shows, pay, place, and perks are a few of the best ways to retain and attract these talented nurses.
Flexibility and Safety
Every healthcare facility has its processes and systems, ranging from unique float parameters to the type of electronic medical records (EMR) software it uses. When evaluating offers from a specific facility, traveling clinicians cared most about flexible scheduling (14%) and staff-to-patient ratios (13%).
Yet, while patient safety and support are critical, other factors have an impact, including facility reputation (9%), floating frequency (8%), charting systems (7%), opportunity for overtime shifts (7%), ability to request time off (RTO – 7%), thorough onboarding (7%), parking (7%), float parameters (6%), number of unit clinicians (6%), and lunch breaks (5%).
Interestingly, after completing their first assignment, responses showed some changes in value. “Work-life balance” grew by another four points, as did the ability to focus on the patient, “not the politics.” While still overwhelmingly important, money became somewhat less of a motivator for repeat travelers, dropping eight points.
Top 5 Motivators for Seeing a Travel Position
We also included a body of allied health professionals in our survey, those providing various diagnostic, technical, therapeutic, and support services. Topping their list of essential factors is thorough onboarding (12%), followed closely by the number of clinicians per unit. These healthcare professionals, on the whole, tend to be newer to traveling, likely explaining why they emphasize onboarding and ratios at a facility when considering offers. On a related note, Staffing Industry Analysts project continued growth in this space, with allied health travel jobs increasing by 5% in 2023 and 2024.
Satisfaction Guarantees?
The NCSBN study noted that more than 60% of nurses experienced workload increases during the pandemic. This left many feeling exhausted, emotionally drained, and disillusioned. With healthcare workforce shortages showing no signs of stopping and every indication they will continue to climb, the nursing profession must focus on rebuilding, or tragic consequences may follow.
Retaining talented, tenured RNs and attracting new talent are essential. The traveling nurses in our study have provided vital feedback related to job satisfaction. While there are no guarantees, their insights are important to consider across the industry as we work together to position healthcare for a healthier future.
Nurses are leaving the workforce at an unsustainable rate, pushing the entire U.S. healthcare ecosystem to the brink. As many as 100,000 nurses left the workforce during the pandemic, and within the next four years, 900,000, or almost one-fifth of the 4.5 million total registered nurses, will do the same. The wake of COVID-19 has left us with little choice: enact immediate, systemic change or risk accelerating the issue.
A buckling healthcare system puts millions of vulnerable patients at greater risk of negative health outcomes. Nearly a million nurses leaving the profession is not something that happens overnight, so there is an opportunity for healthcare systems, policymakers, and regulators to come together and implement solutions until we can say with confidence that we have done all we can to protect and support nurses and other frontline healthcare workers amidst record burnout and overwork.
Mental Wellness: a Very Real Issue
The environmental factors that can have a negative physical and mental impact on nurses are well documented. Conditions will only deteriorate as more nurses leave the workforce, placing further pressure on those that remain. Heightened health and safety concerns since the onset of COVID, mixed with rising patient mortality, are serious concerns on their own. But there is much more fuel being added to the fire.
Burnout is among the common influences hurting healthcare workers. Routine shifts already last 12+ hours, and many involve overnight work. Workloads have become more intense than ever, with 62% of nurses reporting an increase since COVID started.
Despite the mounting workplace pressures,more than two-thirds of nurses haven’t sought mental health support since the start of the pandemic. A survey from the American Nurses Foundation (ANF) discovered that 36% of nurses experience some stigma with seeking mental health support. It’s clear that despite a strong majority of nurses feeling anxious and burned out at work, many don’t think they should or can access support services.
Building a Support Infrastructure
So what can be done to enact positive systemic progress that will stem the tide of fleeing nurses and protect patients? It begins with ensuring nurses have access to essential mental and physical health resources to address the PTSD and burnout lingering in the post-pandemic world. But more than that, it requires creating a culture that normalizes and celebrates these services in hospitals and healthcare systems.
After years of feeling powerless against a deluge of sick patients and inconsistent staffing, there must be a concerted effort to empower nurses. These frontline workers must regain control over their careers to provide high-quality patient care. Employers can help, but it’s important to recognize that not all nurses are motivated in the same way. Some seek better work-life balance, others want consistent professional development opportunities, and others want to prioritize mental and physical health. If we are to stem the flow that is carrying these critical caregivers out of the workforce, we must push the industry in a direction where nurses thrive.
Reflecting on the lessons I’ve learned as an executive healthcare leader throughout my career, there are actionable steps I believe we can and should take to care for those who spend their lives caring for us. Let’s get into it:
-Encouraging a focus on mental wellness
Post-traumatic stress disorder is rampant among nurses. According to the APA, 96% of nurses report having one or more symptoms of PTSD following the pandemic. It’s well past time that facilities encourage healthcare professionals to focus on their mental health and provide the time to do so. We rely on – and expect – clinicians to provide patients with a high standard of care. They deserve the same opportunity to protect their mental health and well-being.
-Employer-provided support services
Hospitals and health systems already offer emotional support services for patients and their family members. Making similar services more readily accessible for clinicians could become part of a total care package for clinicians rather than a comprehensive compensation package. Furthermore, making it part of a care package could go a long way toward reducing the stigma against healthcare workers seeking help.
-Incentivize wellness
We have long applauded frontline workers for their ability and willingness to “tough it out” when working in challenging conditions. Thankfully, organizations recognize the strain this places on their staff and offer them incentive programs to ensure they look after their health. These include requiring or encouraging workers to meet wellness benchmarks such as healthy eating and smoking cessation and providing fitness reimbursements. A similar reward system should also be extended to nurses committed to protecting and improving mental health and wellness.
Doing Our Part for Nurses
As an organization that helps connect healthcare facilities with travel nurses to meet their staffing needs, we employ a team who works to counsel and support all our clinicians at all stages of their assignment. The types of guidance we provide are custom tailored to our travel nurses, and we coach them on how to handle various situations, including managing relationships on a unit, difficult patient outcomes, clinical skills remediation, and education, as well as how to care for themselves both physically and mentally. We encourage our nurses to take time to focus on them, know their limits, and be aware of those triggers that indicate they may be approaching a breaking point. The mental well-being of all our nurses is paramount to us, and we work hard to ensure that commitment is evident in our policies and best practices that we share with our traveling nurses. We strongly urge our peers within the industry to value the same.
Where We Go from Here
The U.S. healthcare system has ventured into uncharted territory. We have never seen this volume of nurses leaving or expected to leave the field, but we also have a better understanding of the importance of mental and emotional health. While physical wellness has long been championed in workplaces across industries, psychological and emotional health services must become an institutional imperative.
Creating personalized mental health and self-care standards supported by accessible coaching and education in healthcare requires clinical infrastructure dedicated to supporting, coaching, and educating all clinicians. All options must be explored, including seeking federal reforms to support programs and initiatives that improve overall mental health and nurse job satisfaction.
The industry is still reeling from COVID-19, but an unwillingness to promote additional support and care services could push it over the edge. Worrying about the cost of mental health and wellness services in the near term is folly because aggressive action would ultimately decrease costs moving forward. Improving nurses’ total health and well-being is critical to stabilizing the workforce and staunching turnover before it’s too late.
