Wage Discrepancies Between Staff Nurses & Travel Nurses

The Origins of the Wage Discrepancy Between Staff Nurses & Travel Nurses

Travel nursing was already growing in popularity between 2009 and 2019, but the pandemic completely broke the old models of its math. In March 2020, there were approximately 12,000 job opportunities for travel nurses, a figure double what was available in 2019; by December 2020, the number of job opportunities for travel nurses was up to 30,000 (NYT 2022). 

While travel nurses have historically earned more than their core staff counterparts, to compensate for reduced job security, the astronomical wage discrepancies seen during the pandemic were a sign of serious and systemic underlying problems with nurse staffing.

“Even pre-Covid, nurses were short-staffed and understaffed, always running a little tight,” Norton says. “Over the years, we’ve been asked to do more things and take on more responsibilities without any additional compensation. A lot of nurses just burned out. They were sick of not having the proper resources.”

Health systems went deep in the financial red for 2022, and many looked to recoup costs by once again leaning on their already stretched-thin nursing staff. But cuts to non-medical support staff and technology budgets only made the problem worse. Some nurses turned to travel jobs not just for the higher pay, but for fresh work environments. But there are some barbed questions as to why health systems and hospitals would continue to overpay for temporary fixes rather than invest in long-term solutions that effectively support all nurses. 

“Just because a health system or hospital is in the red doesn’t mean they’re on the brink of bankruptcy,” Dr. Boston-Leary says. “There is room to maneuver, to restructure, and to redistribute resources.”

Why Nurse Shortages Are Persisting Post-Covid

Post-Covid, nurse shortages persisted due to several factors. The Baby Boomer generation heading into old age is creating its own complex healthcare crunch; pent-up demand from people who held off seeking healthcare services during the pandemic trickled in; and nurses reported high levels of stress and an increased desire to leave the healthcare workforce.

“When nurses aren’t properly valued, there are consequences,” Dr. Boston-Leary says. “We’ve seen large numbers of nurses leave the workforce, we’ve seen nurses state their intention to retire early, and we’ve also seen strikes.” 

Vivian Health’s 2022 report on the state of the healthcare workforce found 63 percent of survey respondents were considering leaving the workforce in the next five years; only 43 percent said the same a year ago. Notably, that increase comes despite 73.5 percent of respondents reporting an increase in compensation over the same time period. 

“Part of the issue has to do with pay,” Norton says. “But a lot of it also has to do with the burnout and moral injury nurses felt before the pandemic. So while there are some travel nurses who are looking to move back into permanent staff positions, they’re looking for hospitals that are going to show them that they are valued.”

Many health systems build nursing shortages into their business model to reduce costs. (Better to ask nurses to overperform situationally than to have them underperform expensively, perhaps the thinking goes). 

This is a dangerous and unsustainable practice. Nurse shortages lead to worse patient outcomes, while appropriate staffing reduces mortality rates, reduces the average length of stay, and reduces hospital readmissions.

“More staff at the bedside equals better care,” Norton says. “There’s no way around that.”

How to Effectively Support Staff Nurses & Travel Nurses

In January 2022, a collaboration of five professional organizations, the Partners for Nurse Staffing, launched the Nurse Staffing Task Force. Dr. Boston-Leary was one of the representatives from the American Nurses Association. In tackling a multi-variable problem, the task force proposed a multi-pronged set of solutions, of which total compensation was only one part. [Update: The recommendations from this group led to nurse staffing being listed as a Joint Commission national performance goal for 2026.] 

Key areas of focus in the report included:

• Promoting a healthy work environment
• Supporting diversity, equity, and inclusion
• Building a flexible workforce with flexible scheduling
• Addressing stress and including nurse well-being as an organizational value
• Implementing innovative care models (e.g., a tribrid approach that balances on-site care, IT integration of patient monitoring, and virtual or remote care)
• Instituting a formalized total compensation program 

“Health systems and hospitals need to show nurses that they value them,” Dr. Boston-Leary says. “If you can provide nurses with dignity and respect—not just with words, but reflected in policy and decision-making and resourcing—you will boost retention, you will attract new talent, and you will see improved outcomes.”

Vivian Health has also researched how healthcare workers look for and assess job opportunities. Their research team talks to nurses weekly to learn more about what they want from their jobs, and what they don’t. For nurses, traits such as mental well-being, staff ratios, and respect continue to rank higher than ‘benefits’ when selecting what’s important to them. Offering flexible schedules and making nurse-centric decisions can help health systems retain veteran nurse staff members; prioritizing retention bonuses over sign-up bonuses can make a difference, too. 

Nurses are the lifeblood of the American healthcare system. It does not work without them. An increased focus on the retention of core staff nurses is critical, especially for low-wage and rural areas. Nurses who remain at the same healthcare facility can more quickly grow into nursing leaders, who, in turn, foster attractive work environments. 

Part of this is a data problem: if more healthcare administrators had a dashboard clearly displaying the cost of an understaffed nursing unit, versus the value of an appropriately staffed one, wage discrepancies might return to a healthier balance more quickly. But both Norton and Dr. Boston-Leary are hopeful that health systems will value all nurses more accurately instead of simply reducing compensation for one group of nurses. 

“Nurses are humans taking care of humans,” Norton says. “This volatility in pay isn’t something we’re used to. The pandemic was the first time that some nurses really felt like they were being paid how they deserved to be paid. We were highlighted as heroes. There was all this clapping. Then, as soon as it’s over, it’s back to dropping wages and cutting rates, and it’s just really disappointing. I’d love to see a way for us to be able to elevate nurses, close the wage gap, and show all nurses that we value them.”

Update 2026: Nurses Take Organized Action

In 2026, the world has firmly moved past the Covid-19 pandemic, but many of the underlying issues related to nursing compensation and safe staffing remain. Nurses are taking collective action. In early 2025, a 46-day strike by the Oregon Nurses Association sought to address wage and staffing issues. In late 2025 and early 2026, over 30,000 healthcare workers, including nurses, went on a 5-day strike across California, Oregon, and Hawaii. Soon afterward, 15,000 nurses went on a six-week strike across New York City—the largest and longest nurses’ strike in the city’s history. 

“We’re seeing a lot of activity where nurses are flexing their advocacy muscle and collective agency to address issues they feel are unjust,” Dr. Boston-Leary says. “The key themes come down to compensation and safe staffing.”

Today, the issues are less about the wage discrepancy between staff and travel nurses—the demand for travel nurses is not nearly as stark as it was in 2022. But compensation is still a major concern, and it’s tied to broader workforce issues, which in turn affect nurse and patient safety. 

Workforce issues extend beyond RNs to the rest of the care team: nursing assistants, patient care techs, and other support roles that help nurses with their workload. Nursing is a physically demanding job: up stairs, down stairs, on your feet all day, providing care, filing paperwork, and moving patients. Without a fully supported team, nurses are stretched even thinner. 

“Since the pandemic, a lot of institutions have struggled with retaining support positions,” Dr. Boston-Leary says. “And a lot of it has to do with the fact that they haven’t been able to keep up with the wage demands, or with the competition from other industries where people do less physical work for the same, or more, compensation.” 

It’s a vicious cycle. A reduction in support places more burden on nurses, which in turn leads to more burnout and can cause more nurses to leave the workforce. Fewer nurses are expected to fulfill a greater share of responsibilities—without a commensurate increase in compensation. Meanwhile, the cost of living has increased sharply across the United States. 

“With everything happening economically around the country, with increased expenses and nurse salaries not moving accordingly, of course, you’re going to see a reaction,” Dr. Boston-Leary says.

Nursing requires more investment, not less. In November 2025, Goshen Hospital committed to a nurse-to-patient ratio of one-to-four, a move intended to strengthen nurse retention, improve care, and ultimately reduce costs. So far, the results have been positive: nurses who had planned on retiring are now planning to stay longer, and early indicators suggest improved patient care and better staff engagement. 

“There have been a lot of investments in physicians, and it’s important to invest in nursing, too,” Dr. Boston-Leary says. ”And we’re not talking about just paying them their salaries. It’s also all the programs that keep them whole. That’s part of the investment, too.”

Those investments can and do yield returns. According to the 2026 INVEST study by American Nurses Enterprise (ANE), investments in safety and well-being, recruitment and retention, and minimum wage adjustments were most strongly and positively associated with operating margin. 

Other ways to support the nursing workforce include a return to nursing apprenticeships, a commitment to more equitable team makeups, and a hospital minimum wage above the state minimum wage (which would benefit support staff and the broader community). 

Another, less financial, but just as important component of compensation is a more equitable distribution of power. Nurses are integral to American healthcare, but most nurses—even those in leadership—often feel they have less power than other groups. 

“The way to stay ahead of the curve is to understand the needs of your team,” Dr. Boston-Leary says. “Talk to them. Engage with them. Run the numbers. Get creative. You don’t need to be a lone ranger in leading teams. Co-creation and partnering are key. You can create it together.”

Covid-19 was a wake-up call. But years later, many issues remain for nurses—and many of those issues predate the pandemic. Nationwide, there’s still a maldistribution of talent in rural versus urban settings, and pronounced specialty gaps. Issues of compensation and staff staffing affect practically every nurse in every state. Nurse leaders attempting to address those problems are running into dysfunctional systems that require collective action. 
“What I’m seeing now more than before is nurses are saying enough already,” Dr. Boston-Leary says. “Things didn’t work before. They aren’t working now. Let’s fix it—together!”