Healthcare in the US may not be what it wants to be, but it most certainly isn’t what it used to be. Things are different now. Virtual access to care is the wave of the future. The Centers for Medicare and Medicaid Services has expanded reimbursement to chop down delivery barriers. And the balance of power between employer and employee swings back and forth like a teetering carnival ride as healthcare workers continue to walk away from their jobs in droves. But one of the biggest and most impactful changes the industry has witnessed is the shift in how this country views nurses and the way in which they now view themselves. Now, more than ever, nurses have become aware of their stamp on the healthcare delivery system. And, while the pandemic may have forced a temporary correction in the way this profession is regarded, nurses all over the country have united to define and sustain this new normal.

SIA’s March 2022 Pulse Survey Report revealed that of healthcare staffing firm respondents, 88% believe that travel nurse bill rates will decline in 2022. It is difficult to definitively say if this school of thought is correct; however, there are many variables at play that will determine the direction of bill rates aside from whether or not a healthcare system wants to continue to pay the soaring rates that were initially fueled by the pandemic, or if it is even feasible that they are able to sustain the expense independently. The decision to pay the unprecedented rates that have become commonplace was born of necessity as opposed to desire or affordability. Staffing shortages forced the pockets of healthcare leaders as hospitals went to great lengths to save units from shuttering while simultaneously shielding nurse-to-patient ratios from disaster. So, what has changed to make a significant decline in bill rates possible?

The world is hopeful that the worst of the pandemic is behind us, but in its aftermath awaits a staffing crisis this country has rarely, if ever, seen. The difference now, however, is that nurses are standing together to demonstrate their refusal to go to back to pre-pandemic days. Events like The Million Nurse March, taking place in Washington, DC this May, are a show of how the profession has come together to decide how they will be regarded moving forward. And just last week, voting members of the Committee for Recognition of Nursing Achievement (CRONA) union authorized its leaders to call for a strike against Stanford and Lucile Packard Children’s Hospitals, citing a need for higher wages, greater staffing levels and benefit changes. Current bill rates may not be sustainable, but with no viable plans in place to press them down, hospital leaders are left with few options.

Requiring more of staff nurses is a risky solution to the problem, and one that many hospitals seem to be adopting. However, some healthcare organizations, like Henry Ford Health in Detroit, have gotten creative by recruiting foreign-born nurses to fill their employment gaps. Others, such as Pittsburg-based UPMC, have recently begun to create in-house staffing agencies to recruit and retain talent. Innovative programs of its kind also seek to address wage gaps that exists between staff and traditional travel nurses.

At a time when staff nurses are leaving the bedside to escape burnout, demanding more of existing staff is unlikely to yield the desired outcome. Travel orders will continue to be a part of the toolbox to bridge the delivery system over an ongoing shortage, and for some clinical areas, the demand will continue drive high bill rates. The key is not to abolish justifiable bill rates. The key lies in how to move forward and thrive, while playing within the parameters of this new way of delivering care. Yesterday is not today. For more information on the current state of healthcare occupations in the US, visit SIA’s April 2022 Jobs Report.