Kalee Calixto, a travel nurse at the University of Vermont Medical Center, has worked the floors all over the Burlington hospital since he started in November. He filled vacancies at the emergency department and worked in surgery. When orthopedics needed a hand, the 30-year-old helped there, too.
The Jacksonville, Florida, resident plans to remain in Vermont at least until his contract ends in February. He expects to move on to another temporary post in another community sometime thereafter.
“A nurse is a nurse,” he said. “It doesn’t matter if I’m in Vermont, if I’m in Florida. The only thing that changes is the policies and the system.”
Travelers such as Calixto have been a staple in Vermont’s health ecosystem for years, especially when hospitals are short on staff or fill up unexpectedly. As Covid-19 burnout and fatigue have thinned the ranks of full-time nurses, medical centers are using more travelers than ever before.
Just under 350 travelers worked at hospitals in Vermont in the year that ended Sept. 30, up from 270 the previous year, according to an October report by the Agency of Human Services. Hospitals are expected to pay these temporary hires a collective $75 million by the end of 2021, compared with $50 million the previous year.
“Our hospitals can’t turn somebody away at the door,” Green Mountain Care Board Chair Kevin Mullin said in an Oct. 20 meeting. “They have to treat everyone that comes in. So they’re forced to hire travelers at a much higher cost.”
Registered nurses in Florida made $32-33 an hour in 2020, a figure that’s about comparable to the going rate in Vermont, according to the U.S. Bureau of Labor Statistics. But a travel nurse in the Green Mountain State can bring home double or triple that amount, Mullin said at the October meeting.
The prospect of higher pay was enough to convince Calixto to give Vermont — and a travel gig — a try. Many of his colleagues at the University of Vermont Medical Center also have come to Vermont from as far as Nebraska or Idaho for the same reason.
As of October, more than 300 travelers worked at the Burlington hospital, data from the medical center showed. They were paid a collective $40 million in fiscal year 2021, up from just $20 million the year before, according to hospital spokesperson Annie Mackin.
Calixto said he has complicated feelings about his role. He is there to support full-time staff, but he said the pay differential can be a sore point with coworkers.
“Because we’re getting all the money, they think we need to do all the jobs,” he said.
Full-time nurses are often quick to help one another, Calixto said, but may not extend the same courtesy to a traveler.
“You are by yourself,” he said.
Meredith Roberts, executive director of the Vermont chapter of the American Nurses Association, knows that tension all too well. Roberts, a former shift manager at Northwestern Medical Center in Saint Albans in the early 2000s, would try to plug gaps in the schedule creatively.
“I would call every nurse that we had on the books — the ones who were not working, the ones who work per-diem,” she said. “But you get to the end of the list and you’ve left messages, and if nobody is coming, you’re going to have an unsafe situation if you keep on admitting.”
That’s when, if the budget allows, Roberts would ask her go-to staffing agency for a travel nurse. But that stopgap measure can backfire, she said.
“You have nurses working on the floors, and then next to them are working these travel nurses that are making these phenomenal salaries,” Roberts said. “And so what’s starting to happen is people are leaving their jobs to become travel nurses. … It’s a real dilemma because the hospitals, most of them can’t afford to pay the kind of pay that a travel nurse makes, and yet they need nurses to be able to take care of the patients.”
Calixto’s bosses recently asked if he would consider extending his contract beyond February.
“I said yes,” he said. “But I don’t know for how long.”