The Numbers Game
Linda Bird Randolph · Nursing Management · 2003
FIGUREFigureCan one travel nursing company meet your needs? Or is using multiple companies the secret to success? When it comes to contracting with travel nursing companies, is there a “right” number to work with? If you’re happy with the first company you sign on with, should you diversify and add more companies to the mix? Can problems occur if you choose to work with several companies at the same time? For many nurse managers and nursing administrators we spoke with, contracting with multiple companies has proved to be the best plan because it allows them to make the best use of available staffing resources. “Our hospital is much better off using a variety of companies,” said Judy Grant, RN, director of nursing resources for Yale–New Haven Hospital. “Certain companies specialize better than others. Some companies develop a reputation for delivering skilled pediatric nurses, for example. “Smaller companies are often useful for specialized situations. Larger companies give us a larger volume—and many of them are currently purchasing smaller companies,” she said. Cynthia Godfrey, MSN, RN, CNAA, agrees. “No one company can provide us with all the nurses that we need,” she said. Godfrey, director of nursing operations for New York Presbyterian, contracts with about a dozen travel nursing agencies. “The companies I prefer to use are well established and have been in business for a long time,” she said. “They’re big companies and they seem to attract the best nurses. They screen the applicants well before they send them to me and they’re very responsive to me when I discover a problem with a nurse. “We’ve had occasions when we were about to open a new program [and needed nurses]. The bigger companies, by virtue of their size, were able to find nurses in any specialty so that we could get the program started.” An Administrative Dream Administratively, of course, there’s an advantage to sticking with only one travel nursing company. Dealing with one vendor to meet all the facility’s needs and to process just one invoice is an administrator’s dream. But for most, it’s simply not reality. “Sticking with one company can be a plus in terms of time management,” said the president of a large travel nurse company. “Working with one vendor can simplify the matter of planning ahead and determining what gaps there may be in the schedule. If a single provider can supply nurses on a steady, scheduled basis, then it’s simpler to use one company than to use a hodgepodge of different companies.” Another plus to using only one company might be improved employee morale, he added. “One of the cons of using more than one travel nursing company is that different companies can require varying levels of experience and might pay their nurses different rates and provide different housing accommodations,” he said. “This can cause tension between travel nurses from different companies and indirectly affect their ability to provide patient care.” A Dose of Reality “However, it isn’t realistic to expect that one—and only one—travel company or supplemental staffing provider will satisfy the needs and the staffing objectives that a facility may have,” said Karen Fields-Flaster, executive vice-president and chief operating officer of HRN Services. “One travel agency will likely struggle to provide the clinical expertise, experience, critical thinking and communication skill, flexibility, and demonstrated competency—and yes, the numbers—required without subcontracting with a few or many others agencies themselves.” Fields-Flaster added that HRN Services doesn’t recommend dealing exclusively with one company. “We do, however, promote a partnership and believe more effective staffing can be achieved by being selective with a specific number of supplemental staffing providers who can demonstrate the benefits of collaboration” and make a mutual commitment to the facility, she said. A Diversified Approach Overwhelmingly, the nurse manager, nursing administrators, and travel nursing company representatives we spoke with recommended a diversified approach to working with travel nursing companies. The benefit to the health care facility is clear: The facility can find the best nurses to fit the job by tapping into small companies that specialize in certain types of nurses and large companies that can provide volume. This satisfies both targeted needs and overall nursing shortages. Nurse managers benefit by comparing and contrasting various companies and the nurses they have available. “Nurse managers need to experience the difference between companies and have the opportunity to see a variety of candidates,” said Michael Yao, national sales director for Comforce, a contingent staffing, consulting, and financial outsourcing company. “They need diversity.”