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The End of PHE: An Opportunity for Healthcare Staffing

The end of the COVID-19 Public Health Emergency (PHE) on May 11, 2023, marked a major inflection point toward a new normal for healthcare demand. According to the World Health Organization, reported deaths from Covid are now down 95% from their peak, and hospital systems are also clearing a backlog of delayed care. A new dynamic is emerging in healthcare staffing, and it could be an opportune moment for hospitals to recruit to fill staff positions.

With the acute-care demand surge subsiding, a cycle is emerging that reduces the need for travel nurses. One measure found that hospitals’ listings for travel nurse positions as of late April had fallen 51% from the same period last year. Travel nurse wages are in turn dropping, which is further encouraging registered nurses (RNs) to take on permanent positions, helping to alleviate shortages at many health systems and reducing the need for temporary hires.

The return to staff positions could not come at a more crucial time for hospitals and health systems as they start to scrutinize operating costs. The PHE created a wide swath of temporary funding channels and regulatory waivers that provided added support over the past few years. Now these channels, including funds for acute Covid care and special allocations for Medicaid and Medicare services, are returning to normal, which could create a growing share of unreimbursed services. Hospitals will be looking to manage costs. And one way to do that? Add to permanent staff and resource pools.

The Travel Nurse Wage Rollercoaster

Travel nurse wages went on a rollercoaster since Covid was first declared a global pandemic. In January 2020, the national average weekly rate was $1,896 according to Vivian's salary data—that would be roughly $2,230 today if adjusted for recent inflation, which can be our benchmark of the pre-pandemic norm. In the midst of the pandemic, wages had climbed to as high as $3,782 per week in December 2021, an 84.5% real wage premium over the pre-pandemic figures. This created great opportunities for RNs to earn more and try something different but created fiscal challenges for hospitals and other facilities that were short-staffed. 

The circumstances that led to those rates are now squarely in the rearview mirror. According to our wage data, 2022 year-end rates saw an average of $2,653 per week across all 50 states. In the months since then, weekly rates have fallen on average to $2,494 for April, a mere 12% premium over the rates paid just before the pandemic, when adjusting for inflation. In Kansas, Alabama, Oklahoma, Florida, and South Carolina, travel rates are actually now below the January 2020 national average.

Wage decreases are a nationwide phenomenon as well. Since December, travel nurse wages have increased in only two states, Alaska and Utah. Alaska’s increase may relate to a spike in healthcare service demand there. The state experienced its largest-ever oil-revenue royalty payment at the end of 2022, sending every Alaska resident a check for $3,284—more than $13,000 for a family of four. Meanwhile, the Utah economy is booming. The Beehive State has the tightest labor market of all the non-rural states with an unemployment rate of 2.4% in March. 

In two other states, travel nurse wages were flat, while in the remaining 46 they have fallen anywhere from 1 to 16% according to Vivian data. Double-digit decreases were recorded in Michigan, New Jersey, New Mexico, Oklahoma, and Pennsylvania. 

An Opportunity for Permanent Staffing

With prevailing travel nurse wages sitting only 12% above pre-pandemic levels, an opportunity is emerging to woo RNs back into permanent staff positions, particularly if they consider what nurses are looking for in lieu of higher wages. Some systems are experimenting with more flexible schedules, student debt relief, or child care for staff jobs.  

Our Future of Healthcare Work survey found that RNs share common concerns about their work environments. They include leading causes of fatigue and stress: understaffing of RNs and support staff, insufficient meal breaks, and inadequate time off. Nurses also find they are often asked to work extensive extra shifts, which is in direct contrast to the flexible lifestyle provided by travel nursing. 

As health systems look ahead to the revenue and expenditure dynamics of fiscal 2024, now is an opportune moment to recruit for staff jobs. Some 46% of clinicians that took travel contracts in 2022 plan to work in a permanent role in 2023, our survey found. Hospitals and health systems can create a more supportive environment for nurses by hiring staff now, which in turn may encourage other nurses back to the fold while helping to retain existing staff. 

Request a Demo

Vivian can help these efforts by shortening the time to hire and certifying nurse credentials to reduce hospital administrative tasks. Request a demo with Vivian Health as you recruit for staff jobs during this post-pandemic transition.


Michael Hines

Michael Hines

Michael Hines is a freelance researcher and writer based in Brooklyn, New York. For 20 years he has written on various healthcare topics including healthcare employment, telemedicine, healthcare legislation, obesity, immunotherapy, and genomics. He also writes on topics such as technology and AI, public policy, finance and investing, consumer products, and corporate environmental, social, and governance (ESG) practices.

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