While the politicians recognize the absolute necessity to curb rising healthcare costs without hampering patient care, it is the people within the industry who try to strike that balance on a daily basis, beginning with staffing. As the nursing shortage continues, recruiting and retaining competent personnel demands more creativity from acute care executives than ever before. With some insiders noting that staffing represents at least one-third of a hospital's total administrative expenses, all options—overtime, float pool, per diem, and travelers—must be weighed care-fully as short- and long-term solutions.

To fill immediate vacancies, many nursing directors are incorporating supplemental staffing services into their staffing plans. Admittedly, while this alternative is one of the most reliable and dependable methods of maintaining nursing levels and providing quality care, it can be costly. The selection process, ultimately, comes down to how a facility can make the best vendor choices in order to employ the highest quality personnel the most cost-effectively. There are various schools of thought, and in the following pages, Healthcare Traveler's Staffing Solutions (HTSS) addresses the many elements involved in finding the perfect match.

HTSS: What are the benefits of working with supplemental staffing agencies and travelers?

Beth Landis, RN, FNP (BL): The most obvious answer is that they help hospital executives deal with nursing shortages. Travelers fill in the gaps. There is also the potential for mobile professionals to enhance information sharing, offer new perspectives, and contribute an influx of energy.

Kathy Taylor (KT): Of course, hospitals prefer to hire permanent employees, but staffing companies open up talent sources for recruitment. Executives can utilize the skills of nurses from different areas of the country without draining local pools. Plus some nurses choose traveling as a way to discover possible areas for relocation, eventually converting from temporary to permanent staff.

Patricia Layton, RN (PL): Supplemental staff gives facilities more flexibility. If the patient census drops, hospital nursing administrators do not have to reduce their full time staff or lay off permanent employees. At these times, supplemental staffing and travel contracts are reduced or eliminated. Supplemental nurses can also be helpful and offer assistance to core personnel avoiding burnout from working overtime. When nurses can maintain their regular schedules, it increases morale and helps reduce staff turnover.

Odalys Font (OF): Unlike per diem staffing, which has the potential to send a different person each day, a travel contract guarantees the same clinician for an average of three months. These nurses are blended into the unit's schedule just like staff, which equals continuity in patient care.

Judy Johnson, RN (JJ): To ensure quality care, hospitals tend to employ multiple staffing solutions, including permanent staff, travelers, and per diem. Companies offer multiple contract lengths, such as 4, 6, and 13 weeks, to fit institutional needs.

HTSS: How can a facility maximize the benefits of using supplemental staffing services?

BL: Experienced travelers can play more developed roles, contributing to staff development and quality patient care. In addition to mentoring new hires or graduate nurses, mobile providers can offer consulting services, noting how staff in hospitals nationwide performs different procedures to attain the same goals or give insights into managerial techniques or approaches seen in institutions with similar acuity levels. As I have at least 10 topics on which I am qualified to teach—from cultural sensitivity to diabetes and heart failure—I offer to hold inservice training classes while on assignment. It all comes back to matching the right traveler with the right position at the right facility. Under those circumstances, the mobile professional is an excellent clinical asset to the team because of the expertise he or she brings to the table.