With hospital staffs across Minnesota and the country stretched thin due to the ongoing pandemic, many health care providers have been augmenting their staffs with traveling nurses filling temporary positions to help reduce the strain.

These nurses are hired through travel nursing employment agencies and secure contracts for up to six months, with a health care provider that can pay them more in a week than many permanent staff nurses earn in a month.

"What a lot of nurses are really of going after … is the crisis pay," said Erica Wagner, a travel nurse based in Rochester, Minn. "The contracts that are about 48 hours per week, in a crisis level environment, where the hospital is overwhelmed with COVID patients and you are brought in to help, and you could be taking on more patients than you typically do, so it's a little harder work, those contracts I've seen anywhere from, gross pay, $5,000 to $10,000 per week, depending on the state."

She also said, for some contracts, she had to provide her own health benefits, which can be one of the drawbacks to being a nursing independent contractor. But some contracts also include food and housing stipend, she said, which is untaxed money nurses are supposed to use to pay for their living expenses.

"You get to decide how to use it," she said. "You are given the money to duplicate your housing in a different city."

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When the COVID-19 pandemic hit in spring 2020, Wagner said she decided to take her first contract out-of-state to hopefully make an impact.

"My first contract out-of-state was to go to Manhattan," she said. "I immediately wanted to help as much as I could, and I also knew in the back of my mind that I could stay in Minnesota and work with COVID patients when it got hit, or I could go to where it was most needed, and not wait for it … so that's what I decided to do."

Sidewalk chalk decorates a New York street during the COVID-19 pandemic as residents express their thanks for frontline healthcare workers. (submitted)
Sidewalk chalk decorates a New York street during the COVID-19 pandemic as residents express their thanks for frontline healthcare workers. (submitted)

Thankful signage aimed at frontline healthcare workers is displayed in New York City during the COVID-19 pandemic. (submitted)
Thankful signage aimed at frontline healthcare workers is displayed in New York City during the COVID-19 pandemic. (submitted)

Throughout the pandemic, she said, she's worked at about 11 different hospitals for varying durations, across multiple states including Minnesota, New York, North Dakota and California.

Wagner said the length of contract with a provider can vary, but she prefers contracts in the 6 to 12-week range. She recently returned from a 6-week contract in Guam, which will be her last traveling contract since she will be attending anesthesia school.

"I really wanted to go out with a bang and do something that was really memorable," she said. "And I also wanted to serve a different culture."

Thankful signage from residents adorn the windows of a Guam healthcare clinic during the COVID-19 pandemic. (submitted)
Thankful signage from residents adorn the windows of a Guam healthcare clinic during the COVID-19 pandemic. (submitted)

Erica Wagner, a traveling nurse, displays an affixed U.S. flag during a scuba diving trip in Guam during the COVID-19 pandemic. (submitted)
Erica Wagner, a traveling nurse, displays an affixed U.S. flag during a scuba diving trip in Guam during the COVID-19 pandemic. (submitted)

The resources were more scarce being on an island, since most supplies relied on shipments, she said.

"If your patient is requiring a certain medication to keep them intubated while on a ventilator, you may have that medication on Monday, but you may not have that medication on Tuesday because the shipment doesn't come in until Wednesday and we ran out," said Wagner. "So it takes a lot of finagling, getting creative and being very patient."

Wagner had worked as a travel nurse in Minnesota for about a year before the pandemic hit, with one of the employment stipulations being her contract must be more than 50 miles away from her permanent residence.

"My house is in Rochester, but I was actually working in Minneapolis," she said. "My idea was just to survey the different hospitals, do a contract here and there, before I was eventually going to possibly move to Minneapolis. I wanted to see which hospital would be the best fit for me."

Wagner also said that being experienced and flexible are two important qualities in travel nurses, because they are expected to step into crisis centers and perform as well as staffers who have been at their respective hospitals for years.

"It's been absolutely crazy and definitely the most challenging time in my career, although I do get to explore cities like Manhattan, and go to Guam and scuba dive on my days off," she said. "To my young friends, who are single and without children, especially without pets, I say go for it. There is no better time."

Travel nurses have helped some rural hospitals, like Essentia Health St. Mary's in Detroit Lakes, expand their ICU bed capacity during times of peak COVID-19 cases.

"Our ICU is an 8-bed unit and we went up to 12 beds at that time," said Melissa Peterson, regional director of nursing at Essentia Health St. Mary's in Detroit Lakes. "Having travelers come in and help during the initial surge back in November, December, when we had travelers here, it was really to help augment … we needed additional help to maintain our continuity of care."

Peterson said she expects the travel nurses hired at Essentia Health St. Mary's to function "fully" and expects them to fulfill their contracts that they are hired to do. She also said, when she was going to nursing school, they told her to have between three to five years of experience in nursing before you start to travel.

"It's always good to have your own employees that know your business, know your patients, know your community and know how to take care of your people," said Peterson. "Obviously, we'd rather have our own staff … but if you have to go (the traveling nurse) route, then you'll go that route and help support the best you can."

Currently, across the Essentia Health system, they are employing about 100 travel nurses, where as before the pandemic, travel nurses would rarely be needed at all, said Sarah Carlson, a senior director of human resources at Essentia Health.

"It's probably not the most sustainable," said Carlson. "In a pandemic, it's great that we're able to tap into travel nursing, but there is no guarantee of hours as a travel nurse either."

She added, as the COVID-19 case numbers began to recede after the winter surge, the contract positions for travel nurses quickly dissipated.

Fastaff, a travel nursing employment agency, displays its current Minnesota openings and the estimated weekly salary on its website. (screenshot)
Fastaff, a travel nursing employment agency, displays its current Minnesota openings and the estimated weekly salary on its website. (screenshot)

Heather Sehnert, a senior branch director at Favorite Healthcare Staff in Roseville, Minn., said they usually have between 100 to 150 nurses looking for traveling contracts and some of those nurses have been traveling with them for more than 20 years.

"We have a lot of nurses that will stay, and get extended at certain facilities," said Sehnert. "There are some that will do 26 weeks at a time, but they'll stay on. Sometimes they'll take a two-week break just to have a breather, to go back home maybe, and then they'll come back."

She added that travel nurses are the reason some providers are able to staff some facilities currently.

"They are playing a huge role in helping, even the smaller community facilities, to fill a need that they have, whether it be short term on a 6-week, or longer term and extensions," said Sehnert. "There will always be a need."