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Hospitals ask biden administration to help lower the soaring cost of travel nurses.

Shalina Chatlani

It's now been a year since the American Hospital Association alleged price gouging and asked the White House to investigate and act. Bidding wars among states have only escalated.

ARI SHAPIRO, HOST:

The American Hospital Association says health care staffing agencies are exploiting the pandemic, forcing them to pay astronomical wages for temporary nurses and other staff. Nurses who sign on with the agencies and who are willing to travel can more than double their salaries. That's because of the large sums of federal COVID relief money given to states. Shalina Chatlani, with the Gulf States Newsroom, reports hospitals are asking the White House to do something.

SHALINA CHATLANI, BYLINE: Last year, Kimberly Carson got tired of the nursing job she'd had for eight years at a hospital in Illinois. She didn't think she was being paid well enough to compensate for the pandemic workload.

KIMBERLY CARSON: I feel like you should be able to afford to pay your staff more money and better wages.

CHATLANI: Carson says, by the time the hospital started offering bonuses, it was too late.

CARSON: Like, where were you at, at the beginning when we really needed you? Where were you?

CHATLANI: So she quit and since December has worked as a traveling nurse, making twice her old salary on a temporary contract with a Mississippi hospital.

Demand for travel nurses has soared. Before the pandemic, hospitals sought to hire about 7,000 traveling nurses at any one time. By 2021, they were looking for 28,000. That's in part because of COVID relief money Congress sent states. Most are using it to hire travel nurses. Texas alone has spent $7 billion on temporary medical staff.

ROBYN BEGLEY: It's just not sustainable.

CHATLANI: Robyn Begley is with the American Hospital Association.

BEGLEY: Some hospitals that really struggle to break even at - year after year, we are really in a crisis.

CHATLANI: Nurse wages have also gone up because there are now far fewer nurses than before the pandemic. The 100,000 open positions then has now doubled.

BEGLEY: Some nurse staffing agencies, we believe, are exploiting the severe workforce shortages and charging exorbitant fees.

CHATLANI: Toby Malara of the American Staffing Association, a trade group, says staffing companies are just responding to the current labor market.

TOBY MALARA: And their prices are being driven by the wages and the cost of labor that have come about by the pandemic.

CHATLANI: He says some hospitals and governments are actually making things worse by not being good stewards of COVID relief money.

MALARA: If the federal money is used to pay and retain nurses and pay them bonuses, that could be helpful. But also, it gives them a chance to push out money and pay those higher rates without thinking about it as much.

CHATLANI: Some states, like Massachusetts, are trying to create rate caps, but Malara says that could drive nurses away. Better, he says, would be increasing nurse numbers overall and Medicaid payments to hospitals.

MALARA: Increase federal funding for nursing schools. You have to increase the Medicaid reimbursements.

CHATLANI: The hospital association asked the Federal Trade Commission to investigate staffing agencies a year ago. The FTC won't confirm whether it's doing so. The association has sent multiple letters to the White House, too.

A Biden administration official declined to speak publicly about a complaint to the FTC, an independent agency, but said that the White House has deployed federal search teams, and it's helped cover costs for National Guard deployments to hospitals with staffing shortages. It's also trying to accelerate visa processing for 5,000 foreign health care workers.

JAMIE HEARD: It all boils down to, I'm doing this for my family. It boils down to money.

CHATLANI: Jamie Heard, an ICU manager in Mississippi, says for now, nurses know the labor market has changed, and there's a lot less incentive to stay at a given hospital.

HEARD: I can bounce within my career and make more money. Staying long at places is, I think, a thing of the past.

CHATLANI: Last week, nearly 200 members of Congress signed on to a letter to the White House, urging quick action to rein in high travel nurse costs.

For NPR News, I'm Shalina Chatlani in Jackson, Miss.

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Home / Nursing Careers & Specialties / Travel Nurse

Travel Nurse

What is a travel nurse, how to become a travel nurse, travel nurse faqs, what does a domestic or international travel nurse do, travel nurse salary and employment, helpful organizations, societies, & agencies.

Travel nurses are RNs from various clinical backgrounds who work for independent staffing agencies. They are assigned to different care areas on a temporary basis to fill in short-term employment gaps.

Travel nursing is a specialty that took root when the field of nursing faced a nationwide shortage. Hospitals, clinics, and other care areas had unfilled positions, yet had patients needing care. To try and attract nurses to the open positions, employers offered higher pay, housing, and covered the cost of relocating.

Due to these shortages, health care facilities have vacancies that need to be filled—and travel nurses are often the ones to fill open positions. Not only do travel nurses work in health care in any state in the country, but they also work outside of the United States as international travel nurses. The adventure and excitement of new opportunities, along with higher-than-average pay, are facets of travel nursing that many RNs find attractive.

Why Are Travel Nurses Important?

Travel nurses are an important part of the health care team because they help bridge the gap between supply and demand in the field of nursing. Mandatory nurse-patient ratios have led to increased patient safety and lower patient mortality . While this is a positive finding, and more and more states are passing legislation to implement staffing ratios, there are not enough nurses to fill the openings. Travel nurses assigned those open positions help to increase patient safety and improve patient outcomes.

Additionally, nurses from different educational backgrounds, care areas, and geographic locations bring a great deal to the practice of nursing. Sharing ideas and practices not only benefits patients, but also other nurses.

A travel nurse should have the following characteristics to excel in the role:

• Enjoys experiencing new cities, towns, and organizations
• Enjoys freedom. Travel nurses choose when and where they work, and choose their duration of employment
• Enjoys flexibility. Travel nurses create their schedules, benefits packages, and income based on which agency they choose to work
• Thrives on challenges. Moving to different states or overseas and being “the new nurse” repeatedly is challenging. Learning new organizational systems and workflows is particularly challenging
• Loves learning new things. Each assignment takes travel nurses to new health care facilities, some with higher levels of technology or different standards of practice. Each experience helps nurses build upon their knowledge base

Additionally, travel nurses should have supportive families and friends. It's difficult to either pack up and move an entire family or leave your family and friends behind. The flip side to this is that new relationships are formed in each new location.

What Are the Educational Requirements for Travel Nurses?

Those interested in the specialty of travel nursing should first pursue a nursing degree through a two or four-year university. Obtaining an associate's degree ( ADN ) or bachelor's degree ( BSN ) in nursing is required. A BSN is not required to be a travel nurse, but some health care facilities only hire BSN-prepared nurses. The staffing agency in which the nurse is employed should match the nurse appropriately based on educational requirements.

After completion of an accredited nursing program, successful completion of the NCLEX-RN is required for licensure.

Most travel nurse agencies require a minimum of one year of hands-on experience in the chosen specialty of nursing. Additionally, some agencies will only hire BSN-prepared RNs. International travel nurses should speak the language of the country they are to practice in, as communication is an important part of effective healthcare delivery. Nurses are encouraged to research agencies when considering travel nursing.

Are Any Certifications or Credentials Needed?

No additional exams are required for travel nursing. Based on the specialty, certification(s) may be required. Examples include:

• Basic Life Support (BLS)
• Advanced Cardiac Life Support (ACLS) may be required
• Stroke care certification
• Telemetry certification
• Advanced Cardiac Life Support (ACLS)
• Pediatric Advanced Life Support (PALS)
• Critical care nursing (adults, pediatric, neonatal)
• Pediatric Advanced Life Support (PALS) may be required
• Neonatal Resuscitation Program (NRP) certification
• Neonatal Resuscitation Program (NRP)
• Trauma Nurse Core Course (TNCC) certification

Additional specific requirements may be necessary for international travel nurses. These include:

• Acquiring a passport and work visa (usually handled by the agency)
• Additional immunizations
• Learning a new language
• Learning about diseases unique to the area

How Can a Travel Nurse Receive a Tax-Free Housing Stipend?

Housing is one of the most significant concerns for a travel nurse. There are a few options available, and it depends on the travel nurse agency/company regarding how accommodations are set up. Some companies provide housing (i.e., apartment, duplex, etc.). Some companies offer a housing stipend, or a fixed amount of money each month to apply towards housing.

First, nurses need to be aware of where their “tax home” is, as stipends are tax-free if working away from the tax home. Having a tax home is necessary to receive tax-free housing. A "tax home" is defined as the general vicinity of an individual's primary place of work (regardless of where the primary residence is). Generally, the IRS considers someone traveling away from home (i.e., their "tax home") if it exceeds one workday.

Different travel nurse agencies offer different stipends - it’s important to research what the living expenses are in a specific area to ensure housing is adequately covered. The General Services Administration (GSA) lists the maximum daily amount for lodging, meals, and incidentals with regards to travel expenses . The key word is MAXIMUM. It's not required that a company pay employees the listed stipend. In fact, some travel nurse agencies offer higher hourly wages instead of housing stipends. Additionally, the GSA rates are based on short-term travel - usually less than a month. Travel nurse contracts can last three months or more.

Are Nursing Licenses Valid When Traveling and Working in Other States?

Those interested in travel nursing may have questions about licensing; specifically, how are licenses recognized if practicing in another state.

Depending on the state, new licensure is not necessary. The National Council of State Boards of Nursing (NCSBN) developed the Nurse Licensure Compact which is an agreement between specific states to recognize nursing licenses without having to apply separately for licensure in another state. In other words, a nurse living in a "compact state" (one which is part of this agreement) can practice in another compact state without having to obtain additional licenses. There are now uniform licensure requirements that must be met when seeking a multistate license under the compact agreement. States that participate in the compact agreement can be found on the NCSBN website .

If not part of the compact agreement, some states allow nurses to obtain temporary licenses by endorsement. These are valid for specific lengths of time, so nurses must visit each state’s Board of Nursing website to determine specific temporary license requirements. If extending the assignment past the temporary license time frame, nurses must apply for a permanent license. Permanent licenses are also required for states that don't grant licensure by endorsement and don't participate in the NLC.

Travel nurses have a broad range of responsibilities and duties, and specific tasks depend on the specialty in which the nurse is trained. General nursing responsibilities and duties include:

• Using the nursing process of assessing, diagnosing, planning, implementing, and evaluating to care for patients in a variety of healthcare settings
• Administering medications, and fluids, assisting with activities of daily living and patient mobility
• Reviewing and interpreting diagnostic tests such as lab work and imaging
• Provide monitoring and oversight in all aspects of patient care
• Collaborating with physicians in developing a plan of care
• Assessing the psychosocial needs of patients and families
• Recognizing and intervening in clinically unstable patients
• Providing resources for patients and referring as necessary
• Educating patients and families in all areas of healthcare maintenance and prevention
• Working in assignments anywhere from eight to thirteen weeks (on average) in the U.S., one to two years if outside the U.S.
• Learning various patient care systems/documentation
• Providing immediate medical care and aid for large populations during times of war or disaster

Domestic and international travel nurses also have different characteristics specific to their roles.

Domestic Travel Nurses

• Work within the U.S.
• Typically work assignments that range from eight to thirteen weeks
• Can respond to areas of the U.S that experience natural disasters or disease outbreaks

International Travel Nurses

International travel nurses should have excellent communication skills, should be open to new experiences and challenges, and should have a strong desire to learn. These nurses are responsible for performing a wide array of duties. As stated previously, the tasks an international nurse will have to perform depend entirely upon their medical specialty. Some of the more general or everyday tasks that international travel nurses will perform include administering medication, wound care, and providing emergency medical services and care. Since there are often nursing shortages in many of the regions that international nurses travel to, another general role of these nurses is to educate family members and caretakers about the appropriate patient and medical care. In summary, international travel nurses:

• Work outside the U.S.
• Typically work assignments that range from one to two years
• Respond to areas that experience natural disasters or disease outbreaks, such as the Ebola outbreak in West Africa
• Provide medical care and aid to underserved, rural , and remote populations
• Usually, must wait for document processing before traveling

Travel Nurse Working Conditions

As with any career, there are positive and negative aspects to working as a travel nurse. Nurses can suffer from stress as they may carry a heavy patient load and have many critical decisions to make. Additionally, travel nurses may suffer from feelings of isolation since they tend to relocate often. Having a strong sense of independence and a support system available, even remotely, can help.

Additionally, nurses may work in high-risk areas that may expose them to workplace violence, blood-borne pathogens, and chemicals. Travel nurses must always familiarize themselves with and adhere to safety standards set by the organization.

International travel nurses can face different challenges. Travel nurses must be familiar with the country's laws, and geographic-specific diseases, and always keep their overall safety as a priority.

Despite these considerations, travel nursing can be immensely rewarding. Many organizations and staff nurses appreciate the help travel nurses offer. Travel nurses help relieve staff nurses from burnout, as can happen when working short-staffed.

International travel nurses are also highly appreciated. They provide medical care and assistance to many patients in remote settings who otherwise would have no access to healthcare. They help with relief efforts in war zones or after disaster events, which can be both rewarding and enriching.

According to the American Nurses Association, as of 2015 fourteen states had mandatory nurse-patient ratios . Nurses are pushing for federal legislation supporting safe staffing and because of this, if more states pass safe-staffing laws, nurses will be in even more demand. Travel nurses will help mend the current and projected nursing shortage. The Bureau of Labor Statistics projects a 16% overall growth for nurses until 2024, which is much faster-than-average growth for all occupations.

RELATED :  RN License Transfer and NLC Guide

Travel nursing has many incentives for nurses regarding pay and benefits including:

• Travel reimbursement
• Free housing
• Medical, dental, and vision coverage
• Retirement plans
• Assistance in obtaining passports/work visas
• Choice of location
• Selection of hours/shifts worked
• Competitive pay
• Higher-than-average pay for RNs

According to Indeed, the average yearly salary for a travel nurse is $75,109. However, since pay is competitive in travel nursing, some companies are offering salaries of around $100,00 annually for domestic travel nurses.

International travel nurses tend to have lower salaries than domestic, except for assignments in some middle eastern countries. This is because, for the most part, nurses tend to make less outside of the U.S.

Salary is dependent on the agency, and nurses should research each company to find the right salary and benefits that best fit their needs.

• International Council of Nurses
• Professional Association of Nurse Travelers
• National Association of Travel Healthcare Organizations
• American Travel Health Nurses Association

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• Tips on Maintaining a Healthy Diet as a Traveling Nurse
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The Future of Work Issue

‘Nurses Have Finally Learned What They’re Worth’

As the coronavirus spread, demand for nurses came from every corner. Some jobs for travelers paid more than $10,000 a week. Will the boom last?

Chris Detten earned enough as a traveling nurse to make a down payment on a home in Lubbock, Texas. Credit... George Etheredge for The New York Times

Supported by

By Lauren Hilgers

• Published Feb. 15, 2022 Updated June 15, 2023

Listen to This Article

In the early morning on Mother’s Day in 2020, Solomon Barraza walked into an intensive-care unit in Amarillo, Texas, and, with the fluorescent lights clicking on above him after the night shift, flipped through the stack of papers attached to a gray clipboard — his roster of patients and nurses for the day. Barraza, who was 30 at the time, had only recently become a charge nurse at Northwest Texas Healthcare System hospital. He was technically still a “baby nurse”: Just over a year earlier, he started working his first shifts in the I.C.U. Now he was responsible for overseeing the care of everyone there, making sure his nurses and patients had whatever they needed, answering questions and directing care in case of an emergency. As he looked through his roster, he saw that there were 11 patients on his floor; eight had Covid-19, and five of those were intubated. Then he looked at the other sheet of paper. There would be four nurses working for the next 12 hours. He needed at least six.

He could see the day play out: a cascade of emergencies, a cacophony of beeping alarms and running feet, disasters that ended with overwhelmed nurses and patients crashing alone. And so for the first time, Barraza made the decision to call for “safe harbor” under a Texas law that can be invoked to protect nurses’ licenses while working in conditions that are potentially unsafe for patients. Barraza grabbed a form from the nurses’ station, and one by one, they all signed it.

Almost immediately, the emergencies began. “You need to get over to 18!” someone shouted. Barraza grabbed his mask and ran. He started hand-pumping air into the patient’s lungs with a ventilation bag while two other nurses hooked the bag up to oxygen. They stabilized that patient, and Barraza jogged down the hallways to check on the other seven. One person’s blood pressure was dropping precipitously, and Barraza was preparing to go inside the room when he thought to check on another patient, one door down. That patient’s blood-oxygen level had dropped into the 40s, far below the normal range of 95 to 100. “So what do I do?” Barraza said. “Who do I help first? There are multiple people’s lives at stake at the same time. What if I pick wrong and someone dies?”

A year and a half later, Barraza was sitting on the desk in the middle of the cardiac-intensive-care unit, or C.I.C.U. — which handles both coronary and Covid patients — looking around the group of nurses, remembering those first months of an ongoing crisis. “There were some funky things going on with staffing back then,” he told the group. Nurses were leaving the hospital to take traveling jobs in New York. The rest of the hospital was shut down, so the I.C.U. floor was the chaotic heart of a ghost town. The hospital had yet to hire traveling nurses to pad its local staff, and Mother’s Day felt like a turning point. It was the day Barraza recognized that the pandemic would be defined by twin emergencies, two figures that he would watch anxiously as they rose and fell: the waves of patients on ventilators in his I.C.U., and the number of nurses available to take care of them.

In 2020 alone, Northwest lost 185 nurses — nearly 20 percent of its nursing staff. In the I.C.U., that number was closer to 80 percent. Many of those nurses left to take jobs with travel-nursing agencies, which placed them, on a temporary and highly lucrative basis, in hospitals throughout the country. When the nurses at Northwest quit, the hospital eventually hired its own travelers, who flowed onto Barraza’s floor to work for weeks or months at a time. There have been days when the unit was barely staffed and days when 20 travelers showed up unexpectedly. Barraza has watched friends burn out and retire. He has watched nurses leave for better pay or less stressful jobs. He has welcomed the strangers who have come to take their place — befriending them, folding them into his I.C.U. team and then watching them leave all over again.

Bedside nursing has always been, as one hospital chief executive put it, a “burnout profession.” The work is hard. It is physical and emotional. And hospitals have built shortages into their business model, keeping their staffs lean and their labor costs down. When the pandemic hit, shortages only increased, pushing hospitals to the breaking point. Nationwide, the tally of nurses with both the skills and the willingness to endure the punishing routines of Covid nursing — the isolation rooms, the angry families and the unceasing drumbeat of death — is dwindling. In a survey of critical-care nurses last year, 66 percent of respondents said they were considering retirement.

Sitting on the desk that day, Barraza didn’t know why he kept reflecting on May 2020. He had stabilized those two patients that morning, but that would not always be the case. For the most part, he said, the days bleed together in his mind. Sometimes it felt as if he had spent the last two years running the world’s longest marathon, his adrenaline pushing him from patient to patient, watching people die and trying his best to pause for a moment, just enough time to recognize each as an individual without being overwhelmed by emotion.

“That was the first time we called for safe harbor,” said Matt Melvyn, a veteran nurse who has stayed with Barraza throughout the pandemic. “But it was definitely not the last.”

In the flood of resignations, retirements and shortages that have redefined workplaces across industries these past two years, nothing has been as dramatic or as consequential as the shifts taking place in nursing. The scramble for bedside nurses is tied to everything from how we run our hospitals to the way we value the work of caring for others to our understanding of public health and medicine. And if our health care system has faltered under the weight of the pandemic, it will need hundreds of thousands more nurses to build itself back up.

For at least three decades, hospitals across the United States have followed a model that aims to match nurses precisely to the number of occupied beds. It’s a guessing game that has charge nurses performing daily tallies and hospital administrators anticipating the seasonal movements of illness and people — winter flus and migrating retirees. Many hospitals don’t offer nurses clear paths toward career advancement or pay increases. Depending on demand, they may trade nurses between units. When there are shortages throughout the hospital, they will send out emails and text messages asking nurses to come in and take an extra 12-hour shift. And when the shortages are too great, hospitals turn to travelers.

Even before the pandemic, there were many reasons to hire travelers. Nurses would be brought in for a season, a maternity leave or the opening of a new department. This kind of gig work grew increasingly common, and from 2009 to 2019, according to data from Staffing Industry Analysts, revenue in the travel industry tripled, reflecting a work force that was already in flux. There are hundreds of staffing agencies in the United States — national agencies, regional agencies, agencies that specialize in bringing in nurses from other countries, agencies that send American nurses abroad. In mid-March 2020, there were over 12,000 job opportunities for traveling nurses, more than twice the number in 2019.

Then, as the coronavirus spread, demand came from every corner. By December 2020, there were more than 30,000 open positions for travelers. And with the help of federal dollars — from the CARES Act Provider-Relief Funds and the American Rescue Plan — their salaries started climbing. Job listings in Fargo, N.D., advertised positions for $8,000 a week. In New York, travelers could make $10,000 or more. The average salary of a staff nurse in Texas is about $75,000; a traveler could make that in months.

Nurses often refer to their jobs as a calling — a vocation that is not, at its core, about money. At the same time, nurses have spent years protesting their long hours and nurse-to-patient ratios. In 2018 alone, there were protests in California, Michigan, New York, Pennsylvania and several other states. When the pandemic hit and travel positions opened up in hospitals all over the country, nurses suddenly had more options than ever. They could continue serving patients, continue working grueling hours in frantic conditions, but they would be paid well for it. Travelers were valued. Their work was in demand. The money would be enough that after a few weeks or months on the job, they could go home and recover.

Hospital associations were already beginning to see the steep costs of these workers, but they had little choice in the matter. The shortages were too severe, and they would only get worse. In July 2020, Texas established a statewide emergency staffing system, coordinated by select regional advisory councils. The state has put $7 billion in relief funds toward supplementing staffing, which has allowed hospitals like Northwest to attract travel nurses without shouldering the full cost. “The problem is that their salaries were so much higher than our employee salaries,” said Brian Weis, the chief medical officer at Northwest. “Our employed nurses were doing the same job, but they’re saying, ‘Why are we getting paid a fraction of what these nurses are?’”

The following year, the demand for travel nursing broke loose from Covid. In April and May 2021, as case counts dipped, hospital requests for travel nurses only grew exponentially. “They now know what pent-up demand does to a health care system, and it’s not healthy,” said April Hansen, the group president at Aya Healthcare, one of the largest providers of travel nurses in the country. “If you look at our demand today, it looks like our demand pre-Covid in terms of specialties: med surge, telemetry, I.C.U., emergency room, surgical. It’s just the volume that is being asked for in every specialty.”

It isn’t the traveling-nurse boom alone that has transformed the market. There are also more job opportunities beyond the bedside than ever. Nurse practitioners treat patients in doctors’ offices; insurance companies employ thousands of nurses; Microsoft and Amazon have hundreds of open nursing jobs. Today, only 54 percent of the country’s registered nurses work in hospitals. “There was competition for talent before the pandemic,” Hansen said. “But the pandemic took a small crack and made it as wide as the Grand Canyon.”

To make things worse, the nursing shortage is part of a worker shortfall that spans the entire health care industry. “This is labor across the hospital,” said Rose O. Sherman, an emeritus professor of nursing at Florida Atlantic University. “This is respiratory therapy. This is lab. This is dietary, environmental services. They have not been immune to having an Amazon warehouse open up and losing a significant chunk of their staff.” If labs are backed up, patients have to wait for a diagnosis. If rooms aren’t cleaned, nurses step in to do the work themselves. Barraza has been known to empty bedpans when the housekeeper is too busy.

Even as hospitals have scrambled to hire travel nurses, many have been chafing at the rising price tag. A number of states are exploring the option to cap travel-nursing pay, and the American Hospital Association is pushing for a congressional inquiry into the pricing practices of travel-nursing agencies. Sherman, however, believes that the problem will not be solved until hospitals start considering how to make bedside jobs more desirable.

After two years, nurses have borne witness to hundreds of thousands of deaths. They have found themselves in the middle of a politicized illness and faced countless angry, grieving family members. Many, now, are moving on. They are looking for jobs outside the hospital. Others are simply uprooting themselves — leaving their homes and their families and continuing to do their jobs for a higher salary. “Nurses have finally learned what they’re worth,” Nora Shadix, one I.C.U. nurse, told me. “I don’t think they’re going to go back to the way it was before. I don’t think they’re going to settle.”

One of the nurses who has cycled through Barraza’s staff is Kulule Kenea, who was furloughed from her job as a nurse practitioner in Minneapolis in March 2020 as part of the city’s initial lockdown. She spent her early years working in I.C.U.s and trauma wards. Her uncle was a registered nurse, as was her cousin. It was something she had always wanted to do. Kenea, who is 33, liked her job. She never had that itch to travel or move. Even before starting her furlough, she got text messages from travel agencies looking for nurses willing to fly to New York. She wasn’t sure how the agencies got her number, but the offers kept coming. “I saw and heard other nurses too,” she said, “just getting mass texts out of nowhere.”

Many nurses like Kenea started traveling in the early months of the pandemic. They were nurses who had also been furloughed, nurses whose personal circumstances allowed them to travel, nurses who felt the call to help people in an emergency and nurses who were drawn by the salaries. Ivette Palomeque, who lives in Texas, traveled to Florida during her divorce. Shadix, who was working at BSA Health System in Amarillo, the hospital across the street from Northwest, decided to travel for six months starting in the summer of 2020 after her boyfriend at the time gave her the number for a staffing agency. Susie Scott, a charge nurse in Abilene, Texas, left her job in the fall of 2020, after 19 years at the same hospital; it had become so short-staffed that Scott was doing the jobs of two or three people. Traveling was an escape. “Now, what I do,” Scott told me, “I go in, I take care of my patients and that is it.”

“People were so desperate for this particular skill,” Kenea told me. “My only responsibility at home is to water my plants. I don’t have kids. I don’t have any other responsibilities. It felt wrong. It felt unfair to be able to just sit at home in the comfort of my house when other people are suffering.” Kenea took a contract to travel to New York and was on an airplane within days — there were only a handful of other people on her flight. She spent a night in a hotel, woke up the next morning and boarded a bus heading to a hospital in Harlem. She was assigned to a medical surgical unit and, on her first shift, was given 11 patients, compared with the typical four or five. It was, Kenea said, unreal. “It did not feel like America.” She worked 14 days in a row, 12-hour shifts, compared with the three-day-a-week standard before the pandemic. She did chest compressions on one patient while another was in the room, watching her, terrified.

Kenea’s father sent her text messages daily, asking her to come home and to stop risking her health. “He would send me all these statistics,” she said. “And I would be like: ‘I’m in the hospital. I know.’” A few months later, in July 2020, Kenea contracted with a traveling agency called Krucial Staffing, which specializes in emergency disaster response. She knew her assignment would be in Texas but had to call in to learn which city — the agency was working primarily with nurses who were willing to go anywhere at a moment’s notice. Kenea would have about a day to get her bearings, taking quick tours of I.C.U.s, notebook in hand. The alarms in each I.C.U. have their own sounds. The charting systems change from place to place. “You need to know the pins for certain doors and a telephone number or email for a manager or somebody who can make stuff happen for you quickly,” Kenea said. “You need to get those things down pat first within the first couple of hours: eyes wide open, ears listening sharp, constantly aware of things.”

Kenea was sent to Corpus Christi and assigned to an older part of the hospital that had been reopened to help accommodate the influx of Covid patients. Not long afterward, she was transferred to another ward, where many of the nurses were younger than she was. Kenea worked a relatively manageable five days each week, although the job was still grueling. “I am not afraid of running toward the fire,” she told me. And the staff nurses were welcoming. Some stopped to ask Kenea for advice on how to start traveling themselves.

Barraza’s unit sits on the fourth floor of a tower on the north side of Northwest. It is brightly lit and wide, and most doors have a yellow sign alerting everyone to the need for personal protective equipment. The medical intensive-care unit, or M.I.C.U., where Shadix has been working as a staff nurse after her stint as a traveler, is separated from the C.I.C.U. by a bank of elevators. There, the lights are dim, and most of the patients have been medically paralyzed so the ventilators can work without resistance. Alarms beep, and monitors are facing the glass, the oxygen levels of each patient blinking toward the hallways.

I.C.U. nursing demands a particular set of skills. Nurses here monitor life-support equipment, track patients’ reactions to medications and respond quickly in an emergency. It can be physical work — it takes multiple people, for example, to turn a patient without unhooking any equipment. I.C.U. nurses are trained to titrate several medications and drips. Good nurses can anticipate when a patient is about to crash. They’re expected to handle situations that are unpredictable and patients who are unstable. “If you don’t use those skills,” Kenea said, “you lose it.”

In December 2020, Kenea arrived in Amarillo for an assignment on Barraza’s team. By that time, the hospital had already seen waves of travelers come and go. Before the pandemic, potential travel nurses were carefully vetted by agencies for expertise and good standing. They were required to have clocked at least a year in their specialty, sometimes two or three. Kenea, for her part, had eight years of nursing experience under her belt. During the early days of the pandemic, however, with hospital staffs suffering from shortages and looking for immediate relief, many local nurses and administrators had doubts about the level of experience of some of the travelers who were landing in their I.C.U.s.

When groups of travel nurses started arriving in Amarillo, Barraza barely had time to connect with them before they disappeared. Their contracts didn’t stipulate how long they needed to stay in any particular hospital, and some would be gone within weeks. Barraza worked shifts in which he was the only member of the core staff, unsure of who had the experience to handle an emergency. “There were some travelers that came, and they were amazing,” he told me. “They were some of the best nurses I’ve worked with. But then there were the ones who shouldn’t have been there.”

If the challenge for travelers, before and during the pandemic, has been to do their job in an unfamiliar environment, the challenge for the nurses who stayed was to offer consistency amid the chaos. Barraza knew early in the pandemic that he would stay. He took on the job of keeping up morale and arrived at his shifts with the energy of a favorite aunt. He started taking in baskets of candy and snacks. He knew the moods of his nurses and which patients were feeling scared and in need of company. He knew who needed a break and who could keep going.

As time went on, the work of boosting morale became more difficult as nurses found themselves facing an unprecedented level of hostility from the outside world. A majority of Covid patients now in the I.C.U. at Northwest are unvaccinated — the region hovers below a 50 percent vaccination rate — and restaurants and malls are filled with unmasked people. Melvyn, the veteran on Barraza’s team, said that one of the most difficult parts of the job is walking outside the hospital into a world where it seems that the pandemic is already over. “You are here and it’s a war zone, and you walk outside and there’s no war,” he said. “My whole life we’ve been preparing for a pandemic, but in none of those meetings, in none of those drills, did anyone say, ‘What if there’s a pandemic, and nobody believes it’s a pandemic?’”

Families of patients now yell at staff daily, asking for unproven treatments or accusing nurses of doing harm. They oppose intubation or refuse to wear masks. Shadix still remembers the time a family blamed her for the death of their loved one. “I will always have compassion for my patients,” she said. “But I’m running out of compassion for the families.”

Nurses have compassion fatigue, fatigue fatigue and alarm fatigue, becoming desensitized to the beeps of monitors. Nurses at Northwest have nightmares about crashing patients, nightmares that they’re being intubated themselves, nightmares that wake them up doing chest compressions on their mattresses. Shadix turns on cartoons while she falls asleep to drown out the soundtrack of alarms that plays in her head. A lot of nurses are stoic, she said. They hold it in. They make jokes. “Surely the Lord is going to bless me for putting up with all of this crap,” one nurse told me.

On bad days, Barraza holds the nurses’ hands while they cry. “We have a pretty well versed nurse that has been a nurse for a long time,” he told me. “But there was a day when her patient was going to be intubated, and she was in the hallway crying, saying that this isn’t fair and she couldn’t do it. I hugged her, and I said: ‘It sucks that it is this hard, but you’re here for a reason. I am here for you, and you’re here for me, and we’re here for these people.’” He went on: “I’m still trying to keep holding on to that aspect of my personality and who I am. If I start losing that part of me, then I need to get out.”

When Shadix was traveling, she left her daughter in the care of her mother and ex-husband and struggled to leave her work at work, she said. For months she took it back to her hotel rooms and Airbnbs — the faces of the patients she lost, the feeling of doing chest compressions, the fear in people’s eyes when they came in. Now when she loses someone, she counts to 10 and allows herself to feel all her emotions. Then she takes a breath and does her best to put them aside.

But for many other travelers, the exhaustion and the hostility they regularly face is blunted by their ability to do something staff nurses can’t: leave. Kenea thinks that moving around has helped her navigate the emotional toll of the pandemic without losing hope — she has witnessed death firsthand, but in episodes, each hospital providing a change of scenery. And when she “decommissions” from an assignment, she allows herself a break before she takes a new job. She feels overwhelmed at times but never burned out. At the end of each shift, she assesses her day, and if she feels she has done everything she can, she lets go of it as soon as she leaves the parking lot.

Then, of course, there’s the pay. Kenea has made enough money to help cover the tuition to become a nurse anesthetist. Shadix’s six-month stint as a traveler allowed her to put a down payment on a house. Chris Detten, a traveler at Northwest, was also able to afford a down payment. Adrian Chavira, Detten’s friend and another traveler at Northwest, said the money has made it possible for his partner to stay at home with their new baby. “Money is a very good motivator,” Detten said. There’s a sense that all the hard work is being rewarded. “You don’t have to worry about the politics of the hospital you’re in.” The power plays, the interoffice dramas, the personalities you can’t escape — the travelers are insulated from it all.

“I appreciate that they’re here,” said Karen Hammett, a longtime charge nurse at Northwest. “Am I a little salty that they’re making more than me? Yes.” Hammett was a veteran of the hospital. She had made it through every wave of the pandemic. But last year was her hardest. “It’s having to deal with the secondary stuff that gets to me — the hate is what sucks. And it’s the worst it’s ever been.” She had her last shift at Northwest on Nov. 21. After nearly 20 years at the hospital, she quit.

As I.C.U. beds in city hospitals filled up and staff nurses started leaving in droves, another story of a precariously overextended health care system was unfolding in smaller hospitals across the country. Rural hospitals, which have long sent their most acute cases to larger hospitals, were left with patients they were ill equipped to handle. Many of these hospitals, with lower profits and wages, struggled to retain nurses and compete with the enormous salaries offered by travel agencies. With no padding, entire departments shut down. Only 40 percent of rural hospitals in Texas offer labor-and-delivery services, and with staffing shortages, many deliver babies only a few days a week. There are 71 counties in the state with no hospitals at all. Across the country, 22 rural hospitals have shuttered in the past two years. According to one 2020 study, 453 more are in danger of closing.

Hereford Regional Medical Center is roughly 50 miles southwest of Amarillo. Shortly before Christmas, hospital officials there declared an internal state of disaster — all the travelers had gone home for the holidays, leaving the remaining staff and administrators struggling to keep the doors open. Administrative staff took shifts over Christmas and New Year’s to avoid a complete shutdown. Nursing teachers from Amarillo drove in to help bridge the gap between the departing and arriving traveling nurses. The hospital had stopped performing surgeries and was sending its labor-and-delivery patients to other hospitals. It could no longer take referrals — serving only the people who showed up in the emergency room — and none of the larger hospitals nearby were able to take its acute cases.

Other rural hospitals are reeling from similar shortages. In Missouri, one rural hospital was unable to transfer a patient with acute pneumonia after contacting 19 different hospitals. A nurse saved the woman’s life by staying up all night, loosening the mucus in the patient’s lungs with a hand-held massager. Rural hospitals in New Mexico have reported calling 40 or 50 hospitals in order to find a bed for acute patients. Candice Smith, the chief nursing officer at Hereford Regional, said: “We need staff, we need supplies, we need medicines. We have spent multiple hours on the phone to try to get patients out of here. If they’ve had a stroke or a heart attack or a traumatic brain injury, we’ve been getting them to Dallas or Oklahoma.” Smith sent a request to its regional advisory council asking for more travelers, but she was unsure of when, or whether, they might show up. “As a rural hospital, we can’t pay for them forever,” she told me. “It will cripple the health care industry.”

“There has been an evolution in the travelers,” Smith continued. “Now they don’t come here or to any facility and say: ‘What can I do? I’m willing to work any day you tell me to.’ Now they say: ‘I’m only going to work Sunday, Monday, Tuesday. I’m going to take off for Christmas.’” When I asked Smith if there was anything else she wanted to share, she said simply, “Just tell people to pray for us.”

In light of the grim staffing numbers, both city and rural hospitals have tried to focus on retention efforts, in some cases mirroring the benefits of the travel-nursing industry. Northwest now offers higher overtime rates for nurses who take extra shifts, and BSA started offering better pay overall. In Florida, hospitals are hiring recent nursing graduates and placing them in nursing teams with more experienced personnel. UAMS Medical Center at the University of Arkansas for Medical Sciences is offering a signing bonus of $25,000 to qualified nurses willing to stay for three years. At Parkland Health and Hospital System in Dallas, doctors have been helping ease the burden on nurses by performing some of their duties.

Ronda Crow is the chief nursing officer at Moore County Hospital District, a nonprofit that serves Dumas, Texas, and the surrounding rural areas. She has spent nearly 10 years working on hiring and retaining nurses, including implementing scholarship programs to help local students through nursing school. Everyone was paid a full salary throughout the pandemic whether they were scheduled to work or not — an incentive, Crow hoped, to stay. “We’re lucky here in Dumas,” she told me. The hospital has the backing of a foundation that helps with funding. During the pandemic, Crow has managed to increase her staff and now has the ability to open every bed in the hospital. “By staffing up, it gives me the opportunity to grow nurse leaders,” Crow said. “Is it an expensive gamble? Yes. Will it pay off in the end? Yes.”

Other rural hospitals, however, will continue to struggle. Without state support, many can’t afford to pay the higher wages that nurses are commanding. Fewer patients are insured, and many are older, their illnesses more severe. And experienced nurses are continuing to leave for other, lower-stress jobs. There are around 153,000 new nurses being licensed every year, but based on projected demand, it will not be enough.

For Barraza, each new spike in Covid patients seems to happen overnight. He may know a surge is coming. He may worry about families gathering for the holidays, but the influx always feels sudden. In the fall, Covid cases in Amarillo dropped, and the hospital was assigned fewer state-subsidized nurses. But the moment the travelers started to leave, a wave of new Covid cases began to fill the hospital’s beds. Northwest scrambled to bring in travelers again. Then the Omicron variant arrived. The hospital’s exhausted nurses went into overdrive. In late December, Shadix texted me a GIF of an exploding house.

“It’s bad,” she said. “But it’s fine. We’re fine.” There were new nurses in the medical intensive-care unit, people who had just graduated, and Shadix was watching them flounder. “It’s a sink-or-swim situation,” she said. “And you learn to swim really quickly, because otherwise, people die.” She had taken on many of the hard conversations with families — telling them that their loved ones would probably not make it. “They started calling me the hospice queen,” she said grimly. Families were allowed to enter the I.C.U.s, and Shadix let them, hoping that once they saw how bad things were — how low the quality of life was for their family members — they would start to let them go. Early in the pandemic, Shadix told me, nurses in the M.I.C.U. tried to stay positive, to offer family members a ray of hope until the end. Now they are more realistic. They need to set expectations.

By January, Northwest had made appeals to the regional advisory council and FEMA for more nurses. Covid patients were filling up the emergency room and surgical floor. At one point, Brian Weis, the chief medical officer, knew of 43 patients in rural hospitals waiting for a transfer. Around 75 staff members at Northwest were in quarantine. While travel and military nurses began arriving, core staff continued leaving. Dellani Spradling, a charge nurse in the M.I.C.U. who never anticipated leaving, abruptly resigned in early February. Another Northwest nurse took a traveling job that moved him to the hospital across the street.

Shadix hopes to be a traveler again. She loves the physicians she works with at Northwest — she knows what labs they need and what questions they’re going to ask. But staying doesn’t make sense. “Here you are, killing yourself for five days making pennies,” she said, “versus working four days or three days making three times what you’re making right now.” Once Shadix goes, some of the longest-serving nurses in the M.I.C.U. will be travelers.

Many nurses are hoping to move on from the I.C.U. entirely. Kenea is starting the nurse-anesthetist program in May. Shadix is taking classes toward her nurse practitioner’s license. “Maybe once this is all over and done with, I’ll come back to the I.C.U. and take my normal patients,” she told me. “But if I never have to see another N95 mask in my life, I will not be sad.”

Barraza is hanging on for now, providing as much continuity as he can. In December, he was working six days a week. The C.I.C.U. was so full of Covid patients that it couldn’t take transfers from the emergency room. “We have beds; we just don’t have the ability to staff them,” he told me. “If we do bring them in, we just overwhelm people even more and possibly push them out the door.”

Barraza has begun taking patients himself in addition to overseeing all the nurses in his unit. He tries to take his candy cart down to the nurses in the emergency room now — he knows they are tired, too. Emergency-department doctors are in such huge demand in smaller hospitals that Weis recalled at least one at Northwest who was contacted and told to name his price.

As the new year started, however, even Barraza was beginning to fray at the edges. He has been having trouble falling asleep. He passes out on his couch most nights. “I lay there, and I see the people that I saw all day and the people that I saw before. I try to keep myself centered and not dwell on it too long, because it puts me in a low place.” He thinks, instead, of his staff. He thinks of the nurses who have made it out. He thinks of a patient who recently recovered. He tries to relax, but sometimes his body won’t let him forget.

Lately, as he tries to fall asleep, he has been feeling the phantom pressure of a hand in his — the feeling of a patient about to be intubated, another frightened person on the edge of life and death. “You get all these sensations and feelings,” he told me. “Feeling them grasp you, and feeling their grasp letting go when the medication hits them.”

Lauren Hilgers is a writer based in New York. She is the author of “Patriot Number One: A Chinese Rebel Comes to America.” George Etheredge is a New York City based photographer raised in North Carolina. He was recognized as one of “The 30: New and Emerging Photographers to Watch in 2020.”

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What Is a Travel Nurse?

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How Long to Become 2-4 years

Job Outlook 6% growth from 2020-2030

Average Weekly Salary $2130/week for RNs

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What Does a Travel Nurse Do?

A travel nurse is a registered nurse (RN) or licensed practical nurse (LPN) who works short-term contracts in various locations. Hospitals or other healthcare facilities hire travel nurses to fill shifts during periods of short staffing.

A travel nurse contract typically lasts 13 weeks, which is how long it takes to hire and train permanent nursing staff. Contract lengths may vary based on a facility’s needs and a travel nurse’s availability.

Travel nurses work for third-party agencies that match them with facilities based on their experience.

When they arrive at an assignment, their training period can be as short as three days compared to three months for a staff nurse. For this reason, a traveling nurse must be well-prepared to care for patients in their specialty. Travel nurses typically need at least 2-3 years in their specialty. This combination of preparedness and experience contributes to the higher pay they receive.

While on assignment, travel nurses perform the same duties as the permanent nursing staff. Depending on the unit they’re working on, a typical shift for a travel nurse may look like this:

• Clock into work and check your assignment (or find out if you’re floating to another unit)
• Get a report from the off-going nurse
• Perform patient rounds
• Collaborate with the multidisciplinary team and nursing staff to facilitate patient movement, including procedures, diagnostic tests, surgery, and higher or lower levels of care
• Complete orders based on patient needs and the flow of the unit, like ambulating patients and monitoring intake and output
• Give a report to the oncoming nurse
• Clock out and get ready for the next shift

When their assignment is complete, the facility may ask travel nurses to extend their contract at a facility. Other times, they travel to other locations based on their preferences.

JGI/Tom Grill / Getty Images

Key Responsibilities

A travel nurse is responsible for following orders and protocols to carry out individual patient care plans. On a typical shift, their job duties may include:

• Performing head-to-toe assessments
• Giving medications
• Monitoring vital signs
• Collecting labs
• Participating in multidisciplinary rounds
• Assisting with procedures
• Managing IVs or central lines
• Performing wound care
• Admitting and discharging patients

Career Traits

A successful travel nurse is:

• Confident in their nursing skills
• Experienced in their specialty for at least 2-3 years
• A quick learner
• Not afraid to ask for help
• A strong patient advocate

Where Do Travel Nurses Work?

Travel nurses can work in several settings, from hospitals to long-term care facilities. A travel nurse must have experience within their practice area to deliver the safest patient care.

Here are some examples of settings where a travel nurse might work:

Long-Term Care

A long-term care nurse may become a traveler and care for assisted living or nursing home residents. In these settings, a travel nurse’s key responsibilities include passing medications, assisting patients with activities of daily living, and collaborating with families.

Medical-Surgical Unit

Medical-surgical travel nurses care for hospital patients with various conditions, diseases, and therapies. They monitor vital signs, administer medications, and perform wound care. They have a wide skill set and are constantly learning about new conditions on the fly.

Intensive Care Unit

An ICU travel nurse cares for critically ill patients in the hospital. Intensive care nurses manage equipment like ventilators, cardiac monitors, invasive pressure devices, and continuous dialysis machines.

They’re ready to respond to emergencies anytime because their patients can take a turn quickly. A nurse must complete advanced competencies in an ICU before becoming a critical care travel nurse.

Why Become a Travel Nurse

Many nurses become travelers because they’re ready for a new adventure. Travel nursing allows you to see different parts of the country — and the world — while getting paid more than a staff nursing position.

But the travel nurse lifestyle comes with some frustrations, like always being on the move. Learn more about the pros and cons of being a travel nurse.

Advantages of Becoming a Travel Nurse

Disadvantages of becoming a travel nurse, how to become a travel nurse.

To become a travel nurse , you first need to become a nurse . Then, you need to get enough experience in a specialty to feel comfortable caring for patients in new locations with minimal training. Here’s what you need to do:

Get a nursing degree.

Complete nursing education to earn a bachelor’s, an associate, or a licensed practical nursing degree.

Become licensed.

Pass the NCLEX-RN or NCLEX-PN and earn an RN or LPN license in your state of practice.

Get experience in a nursing specialty.

Most facilities require a nurse to have two years of recent experience in a specialty. However, this depends on the unit, facility, and travel agency.

Get licensed in other states.

If you have a compact nursing license , you can practice in any state it covers. If you plan to travel to a non-compact state, you must apply for licensure with that state’s board of nursing.

Get certifications.

Nursing certification requirements vary by specialty. Some requirements may include ACLS, PALS, NRP, and chemo certification.

Join a travel nurse agency.

After getting plenty of nursing experience, you’ll apply to a travel nurse agency to get matched with jobs. They’ll walk you through a hiring process and help you transition into working as a traveler at a new healthcare facility.

How Much Do Travel Nurses Make?

A travel nurse’s pay structure differs from a staff nurse’s because a travel agency covers their cost of living. When nurses accept an assignment, their compensation package determines their pay. The details like housing stipends, travel reimbursement, and hourly pay are set during contract negotiations .

The pay range for travel nurses depends on the location and specialty. For example, nurses skilled in a high-demand department may get higher offers at short-staffed facilities.

Travel nurse salaries change constantly due to healthcare industry changes and hiring demands. A recent market report shows a national average of $2,130/week for RNs and $1,479/week for LPNs. Another report shows an average hourly rate of $49 for travel nurses.

Many factors go into a travel nurse’s pay rate, like:

• Nursing specialty

Frequently Asked Questions About Travel Nurses

What does a travel nurse do on a typical day.

A travel nurse assumes care of patients just like any other nurse on a unit. Examples of daily responsibilities include doing assessments, giving medications, monitoring vital signs, starting IVs, and dressing wounds.

In addition to performing standard nursing care, they may have to handle administrative tasks required by their travel agency. This might include submitting time sheets, compliance paperwork, and check-ins with a recruiter.

How competitive is being a travel nurse?

Travel nurse jobs may be competitive at locations with the highest pay — meaning there may be more than one nurse interested in an open position. Some travel nurse agencies have long-standing relationships with certain facilities, which gets travelers into interviews faster. An experienced travel nurse recruiter can help you get interviews at your desired location.

How long are travel nursing assignments?

A standard travel assignment is 13 weeks. However, a travel nurse contract can be as short as four weeks, and facilities may offer to extend the contract. If a facility has critical needs, a travel nurse may take a crisis staffing assignment to help quickly. Also called rapid response nursing, these assignments range from 2-6 weeks and often require nurses to work 48 hours or more weekly.

Why are travel nurses paid more?

A travel nurse’s compensation package reflects the costs of traveling away from home. Different factors go into their pay, including hourly wages, travel reimbursements, housing stipends, and benefits.

Page last reviewed on February 26, 2024

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Weekend Rundown: Here's the biggest news you missed this weekend

Travel nurses raced to help during Covid. Now they're facing abrupt cuts.

Tiffanie Jones was a few tanks of gas into her drive from Tampa, Florida, to Cheyenne, Wyoming, when she found out her travel nurse contract had been canceled.

Jones, who has been a nurse for 17 years, caught up with a Facebook group for travel nurses and saw she wasn’t alone. Nurses had reported abruptly losing jobs and seeing their rates slashed as much as 50 percent midcontract.

“One lady packed up her whole family and was canceled during orientation,” she said.

Many career nurses like Jones turned to travel gigs during the pandemic, when hospitals crowded with Covid-19 patients urgently needed the help. Some travelers — who made double, sometimes triple, what staff registered nurses earned — gathered on TikTok and other social media platforms to celebrate payday , share tips on how to calculate net income from contracts , and boast about how much they were taking home weekly . So great was their good fortune that federal and state lawmakers considered capping their pay , mobilizing nurses in protest.

The tide has swiftly turned. As Covid hospitalization rates stabilize, at least for now , and federal and state Covid relief funding dries up, travel nurse contracts that were plentiful and lucrative are vanishing. And after the pressure cooker of the past two-plus years led to staff turnover and a rash of early retirements, hospitals nationwide are focused on recruiting full-time nurses.

Nationally, demand for registered nurse travelers dropped by a third in the month leading up to April 10, according to data from staffing agency Aya Healthcare, although openings have rebounded slightly in recent weeks.

When Oregon’s governor declared the pandemic emergency over April 1, state-level Covid relief money evaporated. Oregon Health & Science University Hospital in Portland lost funding for close to 100 travel nurses. That, along with lower Covid rates and more full-time hires, has led to “a bursting of the bubble,” said Dr. John Hunter, CEO of OHSU Health.

The health system had about 50 contractors of all kinds before the pandemic, compared with 450 at its height, when patients, many in need of close monitoring, flooded in and turned the hospital’s recovery room into an intensive care unit.

“It has been very expensive,” Hunter said. But things are turning around, he said, and in recent weeks the hospital has negotiated contract rates with its travel nurse agency down as much as 50 percent.

Staff nurses make far less than their traveling counterparts. Rates for a new staff nurse at Northeastern Vermont Regional Hospital in St. Johnsbury, for example, start at $30 an hour — plus benefits and extra for night shifts. At the pandemic peak, the hospital paid staffing agencies about $175 an hour for each travel nurse. The rate remains well over $100 an hour, but the hospital is trying to negotiate it down. Because the hospital pays the agency directly, how much nurses pocket is unclear, said CEO Shawn Tester.

For some travel nurses, the abrupt drop in pay has been a shock. Since December, registered nurse Jessica Campbell had extended her 13-week contract at an Illinois hospital without any hiccups. In early April, a week into Campbell’s latest contract, her recruiter said that her rate would drop by $10 an hour and that she could take it or leave it.

“I ended up accepting it because I felt like I had no other option,” Campbell said.

The situation for some travel nurses has gotten so bad that a law firm in Kansas City, Missouri, said it is considering legal action against more than 35 staffing agencies. Austin Moore, an attorney at Stueve Siegel Hanson, said some agencies are “breaching their contracts” and in other cases “committing outright fraud” through bait-and-switch maneuvers on travel nursing contracts.

The firm opened an investigation in March, drawing comments from hundreds of nurses, Moore said. “Our phones are ringing off the hook,” he said. “Nobody has experienced it like this — historically, contracts have been honored.”

How much is a nurse worth?

Stephen Dwyer, senior vice president and chief legal and operating officer of the American Staffing Association, the trade group that represents the travel nurse staffing industry, said in an emailed statement that “as market conditions change, hospitals and other healthcare facilities may change the terms of travel nurse contracts.”

“For rate reductions or contract cancellations that take place mid-assignment, staffing companies often recommend advance notice,” he said.

Moore said that the fine print can vary but that when a staffing agency cancels a contract at the last minute or gives a nurse one or two days to consider a lower rate, the agency is often breaching a contract. According to the contracts, the loss should fall to the agency, not the nurses, when a hospital requests a lower rate, Moore added.

Pay rates have always fluctuated seasonally as the demand for nurses to plug staffing holes at hospitals changes, said XueXia Bruton, an ICU nurse based in Houston. She has traveled since 2018, drawn to the flexibility and financial freedom, and has no plans to return to staff nursing. Along the way, Bruton has cataloged her experiences on TikTok and Instagram, telling her more than 91,000 followers that, for instance, “it may make more sense to wait to take a contract until rates go back up.”

“It was very hard across the board during Covid when cases were really high,” Bruton said. “We were all burned out and exhausted, so it was important to be able to take as much time off as needed.”

Bruton saw crisis rates as high as $10,000 a week. Travel nurse rates now average about $3,100, according to online hiring marketplace Vivian Health . Still that’s higher than before the pandemic, and well above what a typical staff nurse makes.

Last year was particularly profitable for staffing agencies. Cross Country Healthcare, one of the few publicly traded companies that staff travel nurses and other health care workers, posted a profit of $132 million in 2021 , compared with a loss of $13 million the previous year and even bigger losses in 2019. Then-CEO Kevin Clark called the company’s 2021 financial results a “historic milestone for both revenue and profitability.”

Big profits across the nurse staffing industry have drawn the attention of lawmakers, including U.S. Rep. Peter Welch (D-Vt.), who said he feared that private equity firms that were buying up staffing agencies were charging exorbitant fees during the pandemic, a pattern reported on by Stat . In January, Welch and U.S. Rep. Morgan Griffith (R-Va.) wrote the White House a letter requesting an investigation of possible “anticompetitive activity” by staffing agencies after receiving reports that they were “vastly inflating price, by two, three or more times pre-pandemic rates.”

Some travel nurses are returning to full-time gigs, drawn by hefty incentives and stability. Jones, whose contract in Wyoming was canceled in early March, considered a staff nurse position in Montana — swayed in part by a $10,000 starting bonus. But she ended up in a travel nurse contract in rural Kansas, where the pay is better than a staff job’s would be but not quite what she’d gotten used to during the pandemic.

Jones said her traveling stint raised a big question: How much is a nurse worth?

On the road, Jones said, she “could breathe financially for the first time in years,” at times making almost double what she made as a staff nurse.

“It’s a tough profession,” she said. “We love doing it, but we have bills to pay, too.”

Hannah Norman is a digital producer for Kaiser Health News. 

Transition Back from Crisis: The Future For Travel Nurses After COVID-19

The COVID-19 pandemic has impacted and continues to impact everyone worldwide. It’s no surprise that healthcare systems and travel nurses still are being impacted and experiencing significant changes. But how has the pandemic changed the world of travel nursing? Let’s discuss the state of travel nursing during the pandemic, the future of travel nursing , and ways to transition for travel nurses.

The State of Travel Nursing During COVID-19

Travel nursing has always been a high-in-demand field. During the pandemic, the state of travel nursing changed worldwide. Let’s explore how the pandemic affected the state of travel nursing.

Demand For Travel Nurses

The demand for travel nursing during the COVID-19 pandemic exploded. The average hours that travel nurses worked increased to over 23% in January 2022 . This number reflects the total number of travel nursing hours worked as a percentage worked by nurses in hospitals. This is a tremendous increase compared to less than 4% hours pre-pandemic numbers.

Hospitals were experiencing and continue to experience nursing shortages due to a variety of reasons. Reasons include staff nurses contracting COVID-19, patients needing a higher acuity of care, or a lack of safe nurse-to-patient ratios. Also, a large number of staff nurses left their full-time jobs. Staff nurses were seeking higher wages, scheduling flexibility, and the opportunity to travel, all of which travel nursing offers .

Changes to Safety Protocols

Safety protocols have also changed during the pandemic. Nurses have always needed to wear personal protective equipment (PPE). Pre-pandemic, PPE most of the time included only surgical masks and gloves. However, since COVID-19 is an airborne illness , this changed PPE and safety protocols worldwide. Travel nurses now additionally wear surgical gowns and N-95 masks or respirators , which protect against airborne droplets.

Sick leave protocols changed because of the pandemic as well. If nurses were experiencing any flu-like symptoms or had a mild headache, they called out sick. This is because COVID-19 symptoms present differently in everyone. Nurses were required to receive a negative COVID-19 PCR test before returning to work. These return-to-work protocols are still changing and vary per healthcare system.

In addition to COVID-19 testing, hospitals have been more lenient on sick time for nurses. Before the pandemic, it was more often than not that travel nurses worked when they were sick. Now, it has become more accepted that it’s ok to not go to work when you are sick-even if it’s not with COVID-19.

👉 Read more: Trusted Benefits

Changes in Pay and Incentives

Travel nurses made approximately $1,673 per week before the COVID-19 pandemic . During the pandemic, travel nurses saw an increase in hourly wages. Sometimes wages were up to three times their pre-pandemic salary. They were also offered sign-on and assignment completion bonuses. Travel nurses were willing to work longer hours due to better benefits and hourly pay. This helped fill the gap with hospital staff nursing shortages.

👉 Read more: Trusted Guide to Nurse Pay

Adaptations To Work and Living Conditions

Travel nurses also had to learn to quickly adapt to the ever-changing work conditions. Early pandemic safety protocols were changing daily, which travel nurses had to keep up with.

Most travel nurses were afraid to visit or go home to family members and friends. This is because, in the early stages of the pandemic, much was still unknown about safety and transmission. Many travel nurses opted to not return home or waited 14 days in quarantine after completing their assignments for fear of transmission to loved ones. 

Many travel nurses have worsening stress levels and burnout rates . Nursing can be a stressful career, but COVID-19 added another layer of stress. Many nurses are seeking counseling from mental health professionals.

👉 Read more: The State of Mental Health in Nursing in 2022

How Will Travel Nursing Change as We Move To a Post-pandemic World?

Now that it appears the pandemic is winding down, it continues to impact the future of travel nursing . There are several ways travel nursing will change as we move post-pandemic.

For instance, healthcare systems are now transitioning back to hiring permanent, full-time nurses, instead of travel nurses. Some travel nursing contracts are being canceled . During the pandemic, many travel nurses were asked to extend their contracts. Now, it’s becoming rarer that healthcare facilities are asking for contract extensions.

Pay rates for travel nurses are starting to decline as well and are returning closer to pre-pandemic numbers. While the demand for travel nursing will decrease, travel nursing contracts will still exist. Many travel nurses will likely return to permanent, full-time positions for more stability. However, they may ask for higher wages, sign-on bonuses, and benefits.

Most likely, healthcare facility and mask safety protocols will not change. While masks are optional outside of healthcare facilities , it’s unlikely this will change inside hospitals for quite some time, if ever.

Call-out and sick protocols have also been impacted by the pandemic. If travel nurses are sick, it requires a negative COVID-19 test to return to work. If they are positive for COVID-19, an isolation period is required before returning to work. Due to the high transmission rate, this protocol will unlikely change in the years to come.

How Can Travel Nurses Adapt to This Transition

The COVID-19 pandemic has impacted travel nurses pre- and post-pandemic. During the pandemic, travel nurses have overcome unforeseen challenges. Now that we are slowly transitioning into a post-pandemic workplace, let’s review how travel nurses can adapt to this transition and the future of travel nursing .

Prepare For Financial Impacts

The need for travel nurses will never completely go away. However, travel nursing contacts are beginning to decline when compared to mid-pandemic numbers. This can have a large impact on travel nurses financially . While salaries are still higher than pre-pandemic numbers, travel nurses should expect to receive less pay.

To prepare, make sure you are saving at least six months of living expenses. 

Another way to prepare is to accept a lower-paying contract that is guaranteed for a longer time frame. This way, it may help you financially prepare and give you a long time to find another contract after your current one ends. Always have a backup contract in mind and voice this to your travel nursing recruiter. Voice your concerns for financial stability to your Nurse Advocate , and most likely, they will help you create a backup plan in case something goes sour.

Lastly, see if your travel nursing agency offers local assignments. As most local assignments have a 50-mile minimum radius, this will allow you to work closer to home. The pay and stipends may be slightly lower than a true travel nursing assignment. But your wages will still be higher than accepting a permanent staff nurse position. Also, if you work closer to home, then you may be able to work another part-time job or find another local assignment.

Update Your Resume

Since some travel nursing contracts are being canceled, it’s also a good idea to start updating your resume . There are several resume writing companies that specialize in travel nursing that can help you update it.

Consider adding new skills to your resume. For example, maybe you are a medical-surgical nurse but floated to the cardiac step-down unit several times. Make sure to add that you cared for COVID-19 patients. Including these shows versatility, commitment to nursing, and learning new skills. 

Also, consider obtaining certifications for your nursing specialty . Certifications will make you stand out amongst other travel nursing candidates. It shows commitment to and advancement in your field of nursing.

Take Care of Your Mental Health

During the pandemic, mental health declined and burnout rates increased amongst travel nurses. Since we are transitioning to life after a pandemic, remember that it’s important to take care of your mental and physical health. Set aside time for self-care activities that you enjoy, such as reading, getting a massage, or meditation. Promoting self-care can improve your mental health and stress levels. 

Since the pandemic, many have reflected on the importance of interactions with family and friends. Talk and plan events with your friends and family to help boost your mental health. If you have a busy schedule, plan phone dates with family and friends. Maintaining healthy relationships can help provide a strong support system. Strong support systems are often needed amongst travel nurses since you’re often far away from home.

If you feel like you are struggling with your mental health, seek support from a licensed therapist or counselor. They can listen to your concerns and improve your mental health. If you feel like you don’t have time to see a mental health professional, there is also Telemedicine. Telemedicine connects you with mental health professionals via smartphone apps.

Take Care of Your Physical Health

It’s also important to take care of your physical health. It can be difficult to take breaks while on shift, making it that much more imperative to take care of your physical well-being. Make sure you are eating healthy. Consume the required amount of vitamins and nutrients in your diet to boost your immunity. Exercise at least 30 minutes five times a week to boost your cardiovascular health. Try activities like walking, riding a bike, or doing yoga.

Remain Flexible

Travel nurses are prime examples of flexibility. It’s crucial to remain and communicate your flexibility when considering nursing assignments. Remaining flexible may help you land your next travel nursing assignment over other candidates. While floating to other areas of the hospital is not always ideal, still, be open to the idea. 

Stay Positive

It’s also imperative to keep a positive attitude. Staying positive can help boost your mood and the moods of those around you. If your travel nursing contract isn’t going as planned, remember that it’s only a few weeks. You will get through it!

Practicing gratitude is another great way to stay positive. Remember that a lot of coworkers and travel nurses are under the same pressures as you. Express your gratitude to them whenever possible by writing them a thank you note or offering to pay for their lunch. A little gratitude goes a long way!

Trusted Health is here to help you navigate the future of travel nursing

If you’re looking for your first or next travel nursing assignment, try Trusted Health . They offer many travel nursing resources, guides, and articles. Trusted Health’s many job listings and travel nursing recruiters will help you navigate the post-pandemic future of travel nursing .

‍ Sign up or log in to get started today!

Amanda Marten NP-C, MSN has been a certified nurse practitioner for over three years. With eight years of nursing experience, she has worked in a variety of specialties including urgent care, travel nursing, post-surgical, and intensive care.

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What do Travel Nurses Do?

Table of contents.

And what an introduction it was! These brave souls jumped head-first into a situation most people wanted to escape. According to many nursing forums and subreddits, they were also being generously compensated for it.

However, travel nursing has been around for a while – and its contracts are not always linked to national emergencies or natural disasters. This well-paid niche will continue to offer varied opportunities, flashy incentive packages, and the chance to see the world for years to come.

Does this sound like an exciting lifestyle to you? Is it really as glamorous or backbreaking as they say?

What is Travel Nursing?

Travel nursing is as old as the nursing shortage: it first popped up in the 1970s . It’s not really a specialty, at least not in the way Labor and Delivery or Operating Room nursing is.

Instead, travel nursing is a type of work contract that allows nurses to move between short-term assignments in different settings across the country. Usually, these assignments last anywhere between 8 and 13 weeks. You can sometimes have a “repeat” contract – but generally, they don’t go over 26 weeks.

Although an RN can technically apply for these temporary positions directly, most nurses choose to go through a healthcare staffing agency. These agencies are part matchmakers, part travel agents: they help hospitals find the types of nurses they need to fill their vacancies, and they help the nurse with the paperwork, relocation arrangements, and pay negotiations. In exchange, agencies charge the hospital a commission-based fee for helping them meet their staffing needs.

Where Do Travel Nurses Work?

Most travel nursing assignments are for bedside positions, but they can cover almost any specialty. There are also a few temporary travel positions in primary care, as Nurse Practitioners, or even on cruises and in schools – but the bulk of the job offers are made by hospitals that are temporarily understaffed.

Understaffing can happen because of the following:

• Abrupt spikes in hospitalization numbers, like Covid-19
• Natural disasters
• Planned or ongoing strikes
• Seasonal increases in patient numbers, typical of flu season and vacation towns
• Staff members who go on temporary leave or sabbatical

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What Makes Travel Nursing So Attractive?

With constant moves, frequent recertification procedures, and a certain degree of uncertainty, travel nursing can open the gates for a pretty unorthodox life. So why are so many nurses eager to embrace a semi-nomadic lifestyle?

Above-average pay

The flashiest benefit of travel nursing is certainly the salary. Travel nurses can easily make double the hourly salary of a staff (permanent) nurse at the same hospital. In addition, “quick deployment” contracts (which require you to start working within days of being hired) often carry extra bonuses that cross the four-figure mark.

Extra non-taxable stipends

In addition to your salary, many travel nursing contracts include extra stipends or bonuses to cover cost-of-living differences, exposure to hazards, or even rent. These count as non-taxable income, especially if you live in a different state and keep your contract under 26 weeks.

Flexible scheduling

Would you like to work only half the year and spend the other half backpacking? Or ensure you will be off-work for the December holidays? With each new contract, travel nurses get a new chance to negotiate for specific days off or scheduling conditions. You can also leave a gap between contracts as necessary, recharge, or to take care of your personal life.

The chance to see the country (or the world)

Travel nursing contracts can take you to a quiet coastal community one month and a large metropolis the next. In a country as large and diverse as the U.S., this provides an excellent opportunity to get in touch with lifestyles and personalities that you wouldn’t find if you stayed in a single town.

If you opt for international contracts (which also exist, although they’re not as numerous), the opportunities for adventure will multiply rapidly.

The chance to train as a “jack of all trades”

Travel nurses will rarely work in the same unit type for two contracts in a row. Even if they’re keeping their contracts to a specific specialty, you can switch between large trauma centers, research hospitals, or rural Emergency rooms.

If you are still trying to choose your “ideal specialty,” this will provide an unbeatable opportunity to get a taste of everything. If you’re aiming for a Master’s or Ph.D., the experience will also help your resume stand out.

Respite from office politics and burnout

Settling into one hospital or company allows you to climb the responsibility ladder – but it may also put you in the middle of other people’s ambitions. Not all hospitals display this kind of toxic management culture – but if you are tired of seeing nurses eating their young or supervisors and managers constantly at odds with each other, you can quickly get fed up or be at risk of burnout.

As a travel nurse, you will get a chance to get in, do your job, and get out. You won’t be seen as a competitor by those trying to get ahead, and staying out of the local gossip mill will be easier.

How to Become a Travel Nurse

Or better yet, should you become a travel nurse?

Life on the move is definitely not for everybody – but neither does everyone thrive under a predictable, stable routine. Let’s look at the hard and soft skills you’ll need to excel in travel nursing.

On your resume: experience and certifications

Although there are many travel nursing agencies out there, most will insist on the same minimum qualifications before signing with you: a Bachelor’s degree in Nursing, an active nursing license, and at least two years of bedside experience.

Why a full two years?

The thing with travel nursing is that there isn’t much time to train you if you’re only going to be with a unit for a short time.

Plus, as many of your workplaces will already be understaffed, they likely won’t have the resources for any “hand-holding.” Most floors will expect you to start taking assignments without any orientation. You may get a few hours to be shown around the unit, but otherwise, you will be expected to know how to do the job itself without further training. There are travel nursing jobs out there in pretty much any specialty. But if you really want to be able to “pick and choose” or score a good salary in a highly sought-after location (such as a vacation town or a big city), you should also have some advanced healthcare certifications.

At the very least, ensure your Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) certifications are still valid – they usually need to be renewed every 24 months.

Other valuable certifications include:

• Pediatric Advanced Life Support (PALS)
• Trauma Nursing (TNCC)
• Pediatric CPR or Neonatal Resuscitation (NRP)

On your heart: soft skills needed for travel nursing

Because of how varied the assignments can be, these two qualities will be essential to stay sane, safe, and efficient as a travel nurse: adaptability and strong communication.

The need for adaptability and flexibility should go without saying. Every time you start in a new unit, you will need to adjust to the unit’s existing procedures and policies. Their documentation systems and internal etiquette may be completely different from your last assignment.

In rural or remote areas, you might not have access to all the equipment you’d take for granted at a large city hospital, and you’ll have to rely more on your manual assessment skills.

Next, there’s the social aspect of travel nursing. With short orientation times and a constant stream of new faces, you’ll need to easily fit into an existing team. As a travel nurse, you will likely be protected from most internal workplace drama – but at the same time, you may feel like you’re perpetually stuck in the role of “the new girl.”

The paperwork: licenses and agencies

Finally, there’s the legal aspect of travel nursing. After all, nursing is a regulated profession, so before you can work as an RN in a new place, you’ll need to ensure you have a valid license.

If you graduated or are currently working in a state that belongs to the Nursing Licensure Compact (NLC) , your current nursing license will be valid in several states.

But what happens when you get offered a job outside of this area? You’ll need to apply for an additional temporary license for that state. This can involve a fair amount of paperwork and even a couple of fees – but as long as you’re in good standing in your home state, you won’t have to retake the NCLEX. Here’s where travel nursing agencies show their worth: most will help you out with the paperwork required, and they will typically cover any fees attached to it.

Finally, remember that signing with a travel nursing agency is not an exclusive deal. You can contact several at once and then browse their latest or “urgent” postings until you see a contract that catches your eye.

Want to Know More?

There are many travel nurse agencies and positions, all of them dealing with different specialties and healthcare settings. This means it would be impossible to recommend one travel agency, so why not learn from travel nurses themselves? Many nurse influencers have covered their experiences with travel nursing before and are happy to share their tips, tricks, and agency recommendations. Check out their blogs and podcasts here !

Ximena is a copywriter and medical interpreter turned Nursing student. She feels very strongly about patient education and about opening healthcare access among women from immigrant and rural communities. During her downtime, she enjoys jogging, RPG gaming, and reading about classical history.

Further Reading

Nursing Home Nurse vs. Hospital Nurse: What Is the Right Environment for You?

Do Nurses Need Malpractice Insurance? Lawsuit Statistics and Advice

What is a Nurse Residency?

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How to Make the Most Money as a Travel Nurse

What is a travel nurse.

• How to Become
• Travel Nurse Salary
• Salary by State
• Travel Nurse vs Staff Nurse Salary
• Salary Factors
• Making the Most Money
• Highest Paying Assignments

A  travel nurse is a registered nurse (RN) who works in short-term roles at hospitals, clinics, and other healthcare facilities worldwide. Daily  travel nurse duties are often similar to traditional RN roles, but their flexibility allows them to fill gaps in areas with nursing shortages. As a result, the average travel nurse's salary can be quite high!

>> Click here to see available high-paying travel nurse opportunities!

During the COVID-19 pandemic, travel nurses were seeing some of the highest pay packages ever because of the overwhelming need for nurses, especially in hot spots like New York, Florida, and California. While pay packages might not be as high as they were a few years ago, there is still significant money to be made for those interested in pursuing travel nursing.

But, there are still a number of factors you need to consider when it comes to your travel nurse salary. Here's what you need to know to navigate pay as a travel nurse.

How to Become a Travel Nurse 

Travel nurses do need a few requirements before being considered, including being a registered nurse with a license in good standing, and typically 2 years of nursing experience. They don't need any additional certifications or credentials other than the ones they need for their specific specialty. 

While a BSN is not required to become a travel nurse, it will open more opportunities to nurses such as Magnet hospitals and Level 1 trauma centers. Without a BSN, your options might be more limited. 

How Much Money Do Travel Nurses Make? 

Under normal circumstances, many travel nurses have the potential to earn over $3,000 per week. Travel nurses can bring in over  $50 per hour, plus company-paid housing accommodations. Making it entirely possible for travel nurses to make well over $100K per year.

Travel Nurse Salary by State

Source:  Ziprecruiter

>> Show Me Online Nursing Programs  

How Does Travel Nurse Pay Differ From Staff Nurse Pay? 

Staff nurses  in a hospital are usually paid a set salary based on education and experience. They typically receive incremental pay increases at various time frames. Staff nurses can also see pay increases with overall cost of living increases.

Travel nurse pay is totally different and can be a bit of a gray area. Typical pay packages are composed of various components, including hourly pay, non-taxed travel nurse housing stipends, non-taxed per diems, travel reimbursements, and more. It’s important to speak to your recruiter about specific pay package breakdowns. 

>> Related: Top 10 Six-Figure Nursing Jobs

What Factors Impact Your Pay as a Travel Nurse?

There are a number of factors that can influence how much you can expect to make as a travel nurse. These include:

Location -  The specific location of the assignment most heavily influences travel nurse pay. Simply put, pay rates often reflect the cost of living in the area and also regional trends.

Which states pay the most for travel nurses?  Historically speaking, the highest-paying states for travel nurses include California, Texas, Massachusetts, Washington, and New York.

Southern states  tend to have lower living costs and, in turn, lower travel nurse pay.

Areas that are considered “destination locations”  (like, Hawaii and Florida) may pay lower. Though, with rapid-response assignments, this isn’t always the case.

Specialty -  The travel nurse’s specialty also impacts pay. Non-specialty nurses, such as the medical/surgical and psychiatric specialties, are typically paid a lower rate than specialized nurses. Furthermore, specialized nurses with highly sought-after skills  and credentials have the ability to earn more lucrative pay with seemingly endless opportunities. 

• Shift -  If you haven’t noticed, night shift assignments are more prevalent in the world of travel nursing. The good news is that many hospitals offer higher rates for their night shift assignments. If you want to make the most money, flexibility is key. A word of caution, if the night shift is not your thing, no amount of money is worth your safety, happiness, or license. If you provide better patient care during the day shift, stick to that. Your patients will thank you. 
• Practice level/Education - Travel RNs make more money than stationary RNs. But those who also pursue advanced practice nursing credentials stand to earn even more. For example, the average travel nurse practitioner's salary is around $131,543 per year but can go up to $218,000.

>> Show Me Online Nursing Programs

How To Make The Most Money As A Travel Nurse 

While the factors listed above do influence travel nurse pay, the following types of assignments almost always pay exceptionally well. Oftentimes, these types of assignments are not influenced by location, specialty or shift.

Everything else aside, if you’re looking to make the most money as a travel nurse, seek out these specific assignments: 

1. Rapid Response and “Crisis” Assignments

These assignments boast some of the highest rates in the travel nursing industry due to their urgent requirements. As the name suggests, these assignments require nurses to arrive at work fast -- usually within 2 weeks.

Nurses working in these assignments may have limited options in terms of location. They are also typically shorter than the general 13-week assignment - if you're ready to go, you can get started right away  in areas that need you the most. 

Assignments range from 36 to 48 hours per week but are certainly more lucrative for the nurse working 48, particularly given overtime pay rates. 

Crisis Examples

• A crisis assignment is not always because of a natural or man-made disaster. However, in some cases they are. For example, one agency was able to send nurses within 48 hours to provide support to hospitals treating patients in the aftermath of Hurricane Harvey.  
• More often, though, facilities in need of rapid response solutions include those managing unexpected census spikes, unit openings, emergency responses, EMR upgrades, and more.
• However, some facilities may leverage flexible-length assignment options to manage patient care during short-term staff shortages.
• Crisis assignments might also occur if a large number of nurses on the unit are on maternity leave at the same time, or can occur if there is an outbreak on the unit (GI illness) and the hospital needs staff immediately.

This type of assignment may be appealing to hospitals because they do not require the 13-week commitment that many other travel companies require. This means that agencies offering these types of assignments have the ability to offer travelers a larger selection of shorter and higher-paying assignments. A great option especially if you’re looking for a position to better fit your lifestyle. 

So, what's the catch? 

As mentioned, rapid response assignments require a quick turnaround. Therefore, it is absolutely crucial for nurses to have their paperwork in order if they want to reap the benefits of top pay. Credentials, tests, licenses, and other documents should be submitted to the agency as quickly as possible. Frequently, there are a limited number of positions available for these types of assignments and some agencies will be first-come, first-serve.

What Travel Nurse Agencies Say About Rapid-Response Assignments

We reached out to travel nursing agencies for more information about their rapid-response assignments. They said that most agencies will occasionally help nurses acquire licenses and certifications, including paying for new state licenses for nurses who complete an assignment with the company there. 

Agencies also offer the option to cover housing costs if the nurse stays in one of their preferred hotels. Alternatively, many travel nursing agencies provide a housing stipend calculated to cover the cost of a nurse acquiring his or her own housing during the assignment. Lastly, they also cover the travel costs nurses incur at the start and end of an assignment. 

Hospital vs Agency Bonuses

Hospital bonuses  are paid separately from the bill rate, are usually offered as completion bonuses. This means they are not paid until after you complete your assignment. These bonuses usually range from  $250-$5000.

Agency bonuses  may be taken out of the bill rate and affect your overall pay. This isn’t necessarily a bad thing, especially if you enjoy getting a large amount of money as a lump sum. 

How do you know the difference between hospital and agency bonuses? For starters, you can ask your recruiter where the bonus comes from -- hospital or agency? 

• Retention Bonus

Some agencies will pay nurses bonuses once they end up working with that agency for multiple assignments. This is commonly referred to as a retention bonus and each agency will have its own requirements. These bonuses usually range from $100-$2,000 or more. 

• Referral Bonus

A referral bonus is a fee the agency pays to travel nurses who refer other nurses to work for their agency. The funds often come out of a separate budget allocated to referral fees and should not affect the travel nurse’s pay package. 

Referral bonuses typically range from  $500-$4,000  per nurse referral. Some of the best agencies in the industry pay nurses lucrative referrals bonuses once their referral completes an assignment.

Strikes occur when a labor contract or bargaining agreement between a hospital and a union is up for renewal. When the two sides aren’t able to come up with an acceptable compromise, the union may strike. 

In such a case, patients still need care. Therefore, hospitals will usually hire travel nurses to fill the temporary need. Due to the urgency, travel nurses who work strikes make much more money than they do when working on typical travel nurse assignments. 

How to Find the Highest-Paying Travel Nurse Assignments

First of all, you can always  ask recruiters directly about their highest-paying assignments.  Let them know that money is a motivator and that you are not interested in assignments that pay less than a certain amount. The best travel nurse recruiters will be honest with you about pay while giving you their best pay packages from the beginning. 

We suggest working with agencies that are known to pay high rates and who specialize in rapid-response and strike nursing. Hospitals pay these agencies higher rates to urgently provide highly specialized staff on a short-term basis. Those high rates are passed along to their travel nurses. 

Top 11 Tips For Travel Nurses (From a Travel Nurse Recruiter!)

1. crisis contracts.

Crisis contracts were extremely popular during the pandemic. Travel nurses were able to garner premium pay and had the opportunity to make significant amounts in a short period of time. While these specific types of crisis contracts are not readily available, healthcare companies around the country still need to fill gaps, especially for short periods of time. 

2. Find Your Own Housing

We suggest taking a housing stipend and securing your own housing. This will give you the freedom to choose your price point. Agencies will often house nurses in pricier accommodations (they have a reputation to uphold.) Additionally, agencies sign corporate leases -- leases that come with a “corporate” price tag. Some agencies are able to offer free housing if you stay in one of their preferred hotels. Most other agencies do not cover this cost outright, though, they’ll help you set it up.

3. Be Flexible

If money is your motivation, flexibility is key. Sometimes the highest paying assignments pay higher because they are not the most ideal. They may be in a less-than-desirable location or on a hard-to-fill time shift, such as nights or variables. Though it’s not always the case, nights, variables and weekends may come with higher pay or shift differentials.

4. Work With Agencies Who are Known for Their High Pay and Transparency

Every agency is different and will structure its pay packages differently as well. Transparency is key. The most trustworthy agencies will publish their compensation packages publicly and will disclose take-home pay. This focus on transparency allows nurses to skip the negotiating or fact-finding step and rapidly decide if the position is right for them. 

Industry jargon and terms like “blended rates” get confusing. Negotiations can increase confusion and lead to mistrust between nurses and recruiters. That’s why working with agencies that do not allow for negotiations may prove to be the best agencies to work for. They likely give the nurse their best rate from the “get-go” and therefore actually have no room left for negotiations. If you’re able to negotiate with a recruiter, why weren’t they offering you their best rate from the beginning? Something to consider.

5. Make Sure Your Profile is Up-to-Date

Top-paying travel nursing assignments come with a timestamp -- they are in high demand and competition is fierce. Truth is, agencies can’t simply submit you for a job just because you want to be considered. They literally have to “sell” your skills to the hospital.

How do they do this?  Through your paperwork, commonly referred to as your “profile” -- resume, references, skills checklists, license, etc. Having organized paperwork that can quickly (and easily) be submitted to a new agency will increase your chances of landing high-paying assignments. The quicker you get your paperwork to your recruiter, the faster they can submit you to a top-paying job.

Side note,  many nurse managers hire travel nurses on a "first come, first serve" basis. Why? Because your agency has already vetted you, the hospital doesn’t need to do more research to determine if you’re qualified. The hospital needs your skills to fill a temporary staffing need. If you treat every high-paying job with extreme urgency your chances of landing the job will increase. We recommend keeping your paperwork up to date and storing it online on the cloud using something like Dropbox or Google Drive. This will make it easy to simply share your paperwork folder with your recruiter.

Another tip, if you don’t have a scanner, download a scanning app -- works like a charm and you don’t have to lug around a bulky machine. Many agencies are getting tech-savvy and developing mobile apps that allow nurses to directly upload documents to their profile with the company, where they can be stored and updated when the app notifies nurses of their expirations, etc.

6. Work With Multiple Agencies

The truth is, no agency will have assignments available in every location in the US. More truth, some hospitals pay each agency at a different rate and local agencies may have better relationships with the hospitals in their area. Bottom line, it’s a good idea to work with multiple agencies, this will increase your opportunities.

Word of advice -- if you work with multiple recruiters, don’t be shady. Be honest with them about each other. Don’t "pit" them against each other. And, by all means, keep in touch with them even if you don’t choose their assignment (this time). Chances are they’ll want to work with you again in the future. Who knows, you might even make a new friend!

7. Maintain Multiple State Licenses

Did you know that many hospitals will not even look at your professional profile if you are not licensed in their state? It’s true. You’ll increase your chances of continuously landing high-paying jobs by maintaining active licenses in multiple states.

For example, rates in northern states usually increase during the winter months -- so, a license in Massachusetts is a must! If you want to work in a certain state, you need to have a license. Period. Even better – have a compact nursing license? This will automatically set you up for success. 

If you don’t have a license in that state, and you want to travel there soon, apply now! Some states have quick licensure turnaround of just 48 hours. Other states, like California, can take up to 6 months to process licensure paperwork.  Some agencies do assist or reimburse for licensing fees.

8. Work Agency Per Diem and Pick Up Extra Shifts

Travel nurses who want to make even more money will often work local agencies’ per diem shifts. They’ll also volunteer to work extra shifts during their assignments.

9. Communicate With Your Recruiter

Recruiters are the connection between you and the highest-paying travel nursing assignments. It’s important to communicate with them about your compensation needs. Looking for a high-paying assignment? Ask. Need a sign-on or completion bonus? Ask. Can’t live happily with an income below a certain amount? Tell them. Remember, a closed mouth doesn’t get fed.

10. Ask for Sign-On, Completion, and Retention Bonuses

Some travel companies may offer bonuses. Bonuses are paid either on day #1 of your assignment, upon completion of the assignment, or when you work multiple assignments with your agency. Inquire about bonuses. 

11. Refer Your Friends to Agencies

In the travel nursing industry, referrals are golden. Nurses are much more likely to trust their friend’s opinion of an agency they’ve actually worked for than they are an advertisement or recruiter. This is why agencies pay nurses referral bonuses to refer their friends. Referral fees differ but some agencies pay as high as $4,000 per nurse referral! 

Find Nursing Programs

Travel nurse faqs, what does a travel nurse do.

• A travel nurse is employed by a temporary staffing agency to work a contract with a healthcare facility for a short amount of time, usually around 13 weeks. 

What is the highest paid travel nurse? 

•  Any specialty area travel nurse, such as OR, ICU, MICU/SICU will have a higher earning potential. Additionally, APRNs such as a CRNA, will earn the highest wages. 

Is travel nursing worth the money?

• Travel nursing can be highly profitable, but you’ll want to consider all of the factors involved with the job, such as short-term contracts, inconsistent benefits and pay, new environments, and sometimes, high stress. 

What do you need to be a travel nurse? 

• In addition to being a Registered Nurse, typically, you need at least one year of experience on the floor to become a travel nurse. 

Is it hard to become a travel nurse? 

• Travel nursing can be competitive, but if you want to become a travel nurse, there are endless opportunities. You can increase your appeal by earning certifications in specialty areas. 

How much money do travel nurses make? 

• The take-home pay for travel nurses can vary widely based on the area’s need, the nurse’s specialty and any certifications, and other factors, but most travel nurses make well over six figures. 

Why do hospitals hire travel nurses? 

• Hospitals and other healthcare facilities may hire travel nurses when they are lacking their own staff, when the patient census becomes too high for their current staffing, or when a medical crisis, like COVID-19, or an emergency occurs. 

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Travel Nursing RN State Licensing Resource

Obtaining a nursing license, whether initial or through endorsement can be confusing and overwhelming, especially since each state has its own set of individual requirements and timeframes.

With the expansion of the Enhanced Nursing Compact License (eNLC) , working in multiple states or accepting travel nursing assignments quickly is much easier. Nurses have the ability to obtain licensure in their state of residence, and also work in an additional 31 states with more pending legislation. 

Pro tip: Timeframes for license processing can change without notice. It’s best to apply as soon as possible to ensure your license is issued in plenty of time.

There are two different types of temporary nursing licenses.

The first is a traditional temporary license . These are issued in some states, but only if an individual has a confirmed job offer and needs to start before a permanent license is issued. These licenses are valid for roughly one year. To obtain a temporary license there are additional fees and required paperwork. Temporary licenses can be a good option for travel nurses if they plan on working in a state for a brief period of time and not returning. A temporary license will simply expire, while a permanent license requires renewal fees. 

The second type is a walkthrough temporary license and there are only a few states that issue this type of license. The state boards of nursing issue these licenses same-day, sometimes as quickly as an hour. Walkthrough temporary licenses are typically valid between 30 days and six months, depending on the issuing state. 

It’s important to discuss with your travel nurse recruiter the different licensing options and which are the best for your current travel nurse assignment. 

RNs can earn up to $2,300 a week as a travel nurse. Speak to a recruiter today!

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