To help fill any nursing gaps, the hospitals use a method known as flexible budgeting based on hours per patient day. When the patient census dips, staffing drops back down. Beside asking nurses to identify time-consuming tasks that don't add value to patient care, there are several options. One is to pay regular nurses to work overtime. Another is to use creative staffing, which allows nurses to work three 12-hours shifts and have an extra day off.
Some nurses are cross-trained so they can fill in as temporary staff in another unit.
As for traveler nurses, the Joint Commission on Accreditation of Health Care Organizations requires them to be highly qualified and meet patient care criteria. Pam Cosper, department director for medical services at Crawford Long Hospital, uses traveler nurses in her units and understands why these young and experienced nurses prefer temporary work. They can work in different places at higher pay because they are willing to relocate frequently between hospitals and cities. But Cosper prefers full-time nurses any day. Wesley Woods he is also a firm believer in using education as a retention tool.