At first glance, Tracie Padgett seems like any other nurse assigned to the neonatal intensive care unit at Pomona Valley Hospital Medical Center.

She cares for newborns often weighing less than a pound. She works a tiring shift that keeps her constantly busy. She attends to parents worried about the prognosis of their babies.

But Padgett comes at a high price to the community hospital. Recently relocated from Florida, Padgett is a "traveling nurse," a breed of gypsy health care professional which can cost a hospital about 30 percent more than a staff nurse.

"I was working in a small hospital in Daytona Beach and was barely making ends meet," said Padgett. "I'm not in a hurry to go back to a staff job. I love the freedom and the variety and the pay."

It's never been easy for hospitals to staff the right number of nurses each shift to adequately care for patients without blowing payroll. But a nationwide nursing shortage and tougher state staffing requirements have forced hospitals to expand their use of out-of-state nurses, as well as "local" traveling nurses.

That's created an unprecedented seller's market for the nurses, who contract for least 13 weeks and can make $60,000 to nearly $100,000 a year, depending on experience and amount of overtime they're willing to work.

A significant portion of the premium goes to the registry that played matchmaker often by enticing nurses from out-of-state by covering housing and food costs, in addition to the higher per-hour pay. That compares to the lower cost of filling holes with locally-based temps who fill in on a daily basis, as needed.

The Hospital Association of Southern California indicates that spending on registry nurses increased by at least 57 percent between 2003 and 2004, with anecdotal evidence suggesting comparable growth this year.

"All the demographics point to more patients, an aging nursing population that's retiring and not enough training opportunities for new nurses, especially in (California)," said Barry Asin, chief researcher of the trade newsletter Staffing Industry Analysts.

Shifting demands
The traveling nurse workforce tends to concentrate on both ends of the career cycle. Nurses a few years out of college want to expand their experience and check out various cities and hospitals before settling down. Older nurses may decide to wind down their careers or stave off burnout with extended vacations interspersed with three-month assignments.


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