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Travel nursing, housing costs add extra layer to Idaho’s COVID-19 crisis

Job Growth Spurs Drop In Unemployment Rate To 4.7 Percent
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MIAMI, FL - MARCH 10: A Now Hiring sign is seen as the Bureau of Labor Statistics reports that nonfarm payrolls increased by 235,000 in February and the unemployment rate was 4.7 percent in the first full month of President Donald Trump's term on March 10, 2017 in Miami, Florida. (Photo by Joe Raedle/Getty Images)

Idaho hospitals are hiring travel nurses, while losing others to travel gigs

The top nursing officer for St. Luke’s Wood River Medical Center in July wrote a letter to the editor. She pleaded with Blaine County leaders and the community to help her find affordable housing for her workforce.

Almost half the nurses offered jobs at the hospital between October 2019 and October 2020 turned them down.

And since October 2020, 38 more job candidates turned down offers, she wrote.

“The most cited reason … was cost of living,” wrote Carmen Jacobsen, chief operating officer/chief nursing officer for the hospital.

The pandemic has piled a crisis on top of a crisis: housing costs have skyrocketed, while health care workers reconsidered their careers.

Nurses, doctors and administrators have said in interviews that their workforce took a beating, and continues to, in this fourth coronavirus surge.

One Idaho hospital administrator, though, says there’s plenty of reason to be optimistic about the future of Idaho’s health care workforce.

The travel nursing dilemma for Idaho hospitals

Since the pandemic began, nurses have retired early, left bedside care, cut back on hours, moved to another state or began school to become nurse practitioners.

Interviews also suggest that demand for travel nurses in COVID-19 hot spots has given rise to an expensive swap: Idaho nurses leave for high-paying travel jobs, and their hospitals fill the vacancies with high-paid travel nurses.

Some of those travel nurses cost $3,000 to $8,000 a week.

“Currently, 15 travelers are working at (St. Luke’s Wood River),” Jacobsen wrote. “Costs for travelers, who traditionally work a three-month contract, are two to three times the hourly rate of a regular employee. … Given the recruiting difficulties at SLWR, we are now routinely extending traveler contracts for additional time. Furthermore, we are seeing an increase in our travelers declining work offers due to lack of housing as well.”

Jacobsen asked for help.

“If you have a rental property you’ve been offering to visitors … please think about renting to those who work for sectors that help serve the community, such as health care, education, social services, the arts, and hospitality,” she wrote.

By late August, the hospital still had 15 travel nurses. St. Luke’s added two RV hookups in the hospital parking lot, for a total of four RVs to house travelers; they were all occupied, said Joy Prudek, a spokesperson for St. Luke’s. Another of the system’s small hospitals, in McCall, had eight travelers in late August, Prudek said. “The reason why travelers decline coming to McCall is due to housing costs,” she said. St. Luke’s recently bought a duplex in McCall to use for short-term housing.

The nursing workforce is lopsided in Idaho. COVID-19 made it worse

Idaho has long struggled with a nursing shortage, mostly in specialized areas like emergency nursing and intensive care.

It is impossible to know how many Idaho nurses have left the bedside during the COVID-19 pandemic. Licensure records don’t say whether nurses are employed in a hospital, or if they’re working at all.

Some health care workers took early retirement or quit their jobs to avoid exposure to the coronavirus.

“It’s disappointing, and it’s kind of a low-morale feeling to have a lot of the staff leave,” said Dr. Allison Gauthier, a St. Luke’s emergency physician. “And I don’t blame them. I think part of them are leaving because of the vaccine mandate. I think part of them are leaving because there are better opportunities for them to travel. I think we have a larger number of them going into nurse practitioner school.”

What role could opposition to COVID-19 vaccines play in the future of Idaho’s health care workforce? That won’t shake out for weeks, as St. Luke’s and Saint Alphonsus check to make sure employees have complied with the new vaccine requirement. President Joe Biden on Thursday announced broad COVID-19 vaccine requirements that would apply to millions of workers, including those in hospitals.

St. Luke’s and Saint Alphonsus health systems have offered medical and religious exemptions to staff but are not allowing people to remain unvaccinated and vulnerable to catching and spreading the virus.

St. Luke’s Health System’s deadline for employees to be vaccinated was Sept. 1. About 91% of its nearly 17,000 staff members were vaccinated or exempt from the requirement by that day. It will be a couple of weeks before St. Luke’s will know the full outcome of its new requirement, a spokesperson said.

One local ER nurse told the Sun that a former coworker quit their hospital, joined a travel-nursing agency and took an assignment at another hospital in the Treasure Valley, making three times the wages.

“When you’re paying your nurses who have been there for a decade $35 an hour versus $95 an hour (rates for travelers),” those longtime employees start eyeing the door, a nurse said. “Many have left to be travel nurses,” the ER nurse said.

Travel nurses are generally just as qualified for the job as any other nurse. But there are downsides to staffing an ER, ICU or medical-surgical unit with people who just arrived.

The travel nurses don’t have a hospital’s policies and processes memorized. They don’t know each doctor’s quirks and habits. And they can’t replace the nurses who have left; for one thing, hospitals often have policies limiting what they can do, such as taking critically ill patients in the ER.

How can Idaho stop the nursing exodus?

The state, federal government and individual hospitals have taken steps to try to keep Idaho nurses from leaving their jobs.

The Idaho Department of Health and Welfare this month announced $4 million in funds to help Idaho’s hospitals hire and keep their staff. Hospitals will get $1,000 per licensed bed.

Idaho Gov. Brad Little also told the Sun in an interview Thursday that the federal government is providing 400 health care workers to the state — double the 200 he expected — through General Services Administration contracts. He said the federal government will pay for the surge staffing.

“That should be a big help,” he said.

‘This pandemic has inspired’ people to become nurses

One hospital official said he is optimistic about the future of Idaho health care.

“You might think it’s not the ideal time, but it’s absolutely fantastic; we’re seeing significant increases in the number of people entering nursing school and entering medical schools, seeing a real desire to serve, and this pandemic has inspired that in a way that maybe would be surprising,” Dr. Frank Johnson, chief medical officer for St. Luke’s Health System in Boise, Elmore and McCall said in a recent media call.

“Here at St. Luke’s, we just completed our onboarding of a big cadre of new nurses who (are) thrilled to provide care,” Johnson said. “And that’s really helped us here, just in the last week, to add to our staff. … So, yeah, I think I’m optimistic for the next year. I think we’re going to see a real injection of new enthusiastic individuals who are here to serve their communities.”

The Idaho Capital Sun is a nonprofit news organization delivering accountability reporting on state government, politics and policy in the Gem state. As longtime Idahoans ourselves, we understand the challenges and opportunities facing Idaho. We provide in-depth reporting on legislative and state policy, health care, tax policy, the environment, Idaho’s explosive population growth and more. Our mission is relentless investigative journalism that sheds light on how decisions in Boise and beyond are made and how they affect everyday Idahoans. We aim to tell untold stories and provide data, context and analysis on the issues that matter most throughout the state. The Capital Sun is part of States Newsroom, a national 501(c)(3) nonprofit supported by grants and a coalition of donors and readers. We retain full editorial independence.