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The Best Traveling Nurse Services to Work for in 2024

The travel nursing agencies we recommend for your next short-term post

Traveling nurses often find working in different parts of the country, or even the world, exhilarating and fulfilling. Many agencies focus on matching registered nurses (RNs) with short-term working opportunities in a variety of healthcare specialties and settings across the United States and internationally. Healthcare facilities in the U.S. rely on travel nurses to meet the demand for nurses, which is expected to soar by 275,000 between 2020 and 2030.

"Being able to explore other healthcare systems and connect with other providers can help give a travel nurse new experiences and perspectives," says Rachel Norton , BSN, RN, a clinician support manager at Vivian Health , a national travel nurse hiring marketplace.  We reviewed more than 20 agencies and studied hundreds of reviews to create this list of the best travel nursing agencies. We considered factors such as company quality, customer service scores, company reputation, wage ranges, housing options, and benefits.

  • Best Overall: Triage Staffing
  • Best for Sick Pay: Aya Healthcare
  • Best for Education: Travel Nurse Across America
  • Best Customer Service: Axis Medical Staffing
  • Best Track Record: FlexCare Medical Staffing
  • Best Newcomer: Advantis Medical
  • Best for Benefits: RN Network
  • Best Recruiters: Host Healthcare
  • Best for Recent Graduates: Fusion Medical Staff
  • Best Job Board: TotalMed
  • Our Top Picks

Triage Staffing

Aya Healthcare

Travel Nurse Across America

Axis Medical Staffing

FlexCare Medical Staffing

Advantis Medical

Host Healthcare

  • Fusion Medical Staff
  • See More (7)

Final Verdict

  • Compare Providers
  • Guide to Choosing

Best Overall : Triage Staffing

  • Pay: Hourly wage paid weekly, overtime, bonuses, per diem
  • Housing: Tax-free stipend or company-secured housing for 13 weeks
  • Benefits: Health coverage, dental and vision coverage, life insurance, 401(k) with company match, vacation, education reimbursement
  • Contracts nationwide: Yes

Triage Staffing tops our list because it provides a higher hourly wage and more frequent bonuses than its competitors. Additionally, the agency offers extensive perks, like tuition reimbursement and 401(k) on the first day.

Contracts available in all 50 states

Insurance available on first day

Paid by direct deposit each week

Dedicated support team available 24/7

Reports of poor weekend support for billing issues

Must have 2 years experience for most positions

Triage Staffing , founded in 2006, is considered by industry professionals as one of the most well-rounded travel nurse agencies among the companies listed here and in general. The company was recognized in 2023 by Inc. Magazine and Staffing Industry Analysts (SIA).

The company, which currently has about 1,500 employees, is based in Omaha, Nebraska, and has an impressive rating on Glassdoor .

Triage Staffing specializes in helping nurses and healthcare professionals find 13-week assignments across the U.S. The company strives for transparency and "to build relationships deeper than simple business transactions." Those who are hired are paid weekly (based on an hourly wage) via direct deposit.

The benefits package includes a wage, overtime, bonuses, per diems, and a housing stipend. Triage will also help its travel nurses find housing, if that's their preference. Health insurance is provided by Blue Cross Blue Shield, and those hired get dental insurance, vacation time, and a 401(k) plan.

Best for Sick Pay : Aya Healthcare

  • Pay: Hourly wage, overtime, bonuses, per diem, stipends when called off
  • Housing: Tax-free stipend or company-secured housing
  • Benefits: Health, dental, and vision coverage; life insurance; 401(k) with company match; sick pay; wellness and fitness programs; employee assistance programs; tuition reimbursement; loan forgiveness options

Of the many benefits Aya Healthcare offers, one makes it stand out from other agencies: providing sick pay should you become ill during an assignment. You can rest assured knowing if you get sick, Aya will support you through recovery.

Benefits include sick pay (after 90 days)

Offers local and nationwide travel assignments

Requires only 1 year of experience

Insurance coverage for you and your dependents from day 1

Complaints about communication during recruitment

Large agency size might be challenging

401k eligibility begins after 4 consecutive months of work or 1 year after hiring

Aya Healthcare is one of the most talked-about travel nursing agencies around, literally. A 2017 independent study analyzed the frequency of top travel nursing companies mentioned by users on social media sites. The study concluded Aya Healthcare is the most frequently referenced in user comments.

Aya Healthcare is also one of the only travel nursing agencies that have sick pay, which begins accruing on the first day of an assignment. Nurses can earn one hour for every 30 hours worked, but it can't be used until after at least 90 days after their start date.

In addition to its rare sick pay policy, the company boasts comprehensive benefits. Travel nurses working for Aya Healthcare can start contributing to a company-matched 401k plan after four consecutive months of work for the agency, or one year after their hiring date. It also promises to cover or reimburse nurses for the cost of licensure and help them navigate and expedite the process in the states where they are assigned. Aya Healthcare offers discounts, wellness, and nutrition plans in addition to its medical, vision, and dental benefits, which are available to nurses (and their spouses and children) from their first day with the company.

Aya Healthcare has a strong online presence, including a blog and active social media accounts on nearly every contemporary platform. Its website proudly displays several company awards and accolades, including the Joint Commission's Golden Seal of Approval. The agency has placed thousands of travel nurses and allied workers nationwide and offers a program for  travel nursing from Canada .

Best for Education : Travel Nurse Across America

  • Pay: Hourly wage paid weekly, overtime, bonuses, per diem (guaranteed)
  • Benefits: Health, dental, and vision coverage; liability insurance; 401(k) with company match; sick pay; travel reimbursement; free continuing education; mental health resources; employee assistance program; chaplain assistance program

Travel Nurse Across America (TNAA) offers comprehensive benefits; however, its continuing education programs are what really sets the agency apart. Thanks to a partnership with Aspen University, the agency helps you earn your BSN with tuition reimbursement upon completion.

RN to BSN tuition reimbursement

RN specialty exam/recertification reimbursements

Insurance coverage available on first day

Offers free mental health resources

Per diem guarantee

Unable to see pay rates on the site

Large agency size might feel less supportive

Travel Nurse Across America (TNAA) had the highest average score when analyzing the top 10 travel nurse agency lists across several well-known sites.

Founded in 1999 in North Little Rock, Arkansas, this company was present on three "Top 10" lists in 2019, a notable feat that speaks to its history of satisfaction. According to BluePipes, TNAA was among the top 10 travel nursing agencies, one of the biggest (in terms of company size) on its 2022 list.  

TNAA uses a full-team approach to assist travelers, with specialty staff equipped to handle a variety of needs, including housing experts and clinical leadership, This agency also offers a wide array of benefits, such as low census pay, tuition reimbursement, and paid licensure fees prior to travel. Overtime is included in the payment for any extra hours worked and in every state, paid sick leave starts to accrue from day one.

TNAA also partnered with Aspen University, so individuals can get their Bachelor of Science in Nursing in 12 months. Upon completion, TNAA will even reimburse tuition expenses. It also offers reimbursements for recertification fees to certain eligible nurses.

Best Customer Service : Axis Medical Staffing

  • Benefits: Health, dental, and vision coverage; 401(k) with company match; state license reimbursement; transportation stipends; continuing education

With around-the-clock support 365 days a year, Axis Medical Staffing has one of the best customer service reputations in the industry. It offers a wide array of benefits, including healthcare coverage and company-matched 401(k) plans.

Dedicated support team available 24/7/365

Wide variety of specialty contracts

Offers company matching 401(k) with immediate vesting

Can submit questions to real travel nurses

Provides quick email responses

Pays for housing and assists in securing it

Not transparent about pay rates

Doesn't include paid sick leave in benefits

User reviews for Axis remain the highest on this list. Formed in Seattle, Washington, in 2004, Axis provides several coveted benefits, including payment of paid personalized housing options (with pet deposit costs covered by the agency), as well as immediate vesting in its company-matched 401(k) plan.

This agency regularly features a new  Traveler of the Month nurse on its blog. Additionally, the Axis website has a page dedicated to Ask an Axis Travel Nurse , which features an easy submission form where a nurse can answer all your questions.

This encouraging way of connecting can provide novice or even seasoned travelers with a trusted source in the form of a nursing peer who has traveled with this specific agency several times, instead of hosting an impersonal message board. Axis also offers a live chat feature that's easily accessible on the homepage. These features earned Axis the top spot on BluePipes Best Travel Nursing Companies list in 2022.

Axis promises reimbursements and benefits similar to other companies, but it is not immediately clear from the company's website whether it offers paid sick leave.

Best Track Record : FlexCare Medical Staffing

  • Benefits: Health coverage, dental and vision coverage, 401(k) with company match, state license reimbursement, transportation stipends, meals and incidentals stipend, rental car, travel reimbursement, continuing education, license reimbursement

Boasting more than 50 industry awards, including BluePipes’s 2022 Best Travel Nursing Companies list, FlexCare Medical Staffing has a track record of exceeding expectations and fulfilling its promises to traveling nurses.

Award-winning, highly reputable agency

Single point of contact for all your needs

Outstanding benefits

Features a referral program

Have to make an account to view wages

BluePipes refers to FlexCare Medical Staffing as the "most decorated travel nursing agency of all time," with more than 1,727 reviews reported. This agency obtained a gold finish on Travel Nursing Central’s 2019 list of top travel nursing companies and has consistently placed since 2014. FlexCare has also been on the Highway Hypodermics list since 2011.

FlexCare’s website touts its  Premier Traveler Access program, offering prospective travel nurses the opportunity to unlock and view pay ranges for a wide variety of open jobs, in addition to personalized alerts via text and email. This agency explains its mission to support travelers by providing a single recruiter who is able to meet every need (termed “S1NGLEPOINT” on the website) and help simplify the entire process.

This one point of contact can advocate for the traveler, assist in searching for jobs and housing, provide a transparent and competitive salary rate, as well as ensure timely payment.

Best Newcomer : Advantis Medical

  • Benefits: Health coverage, dental and vision coverage, 401(k) without company match, transportation stipends, partial license reimbursement

Advantis Medical has a nurse care team available to help you every step of the way—from setting up your profile and walking you through the onboarding process to helping you find your next assignment—making it an excellent choice for those just starting out.

Excellent reviews from its travel clinicians

Quick response times from trained care team

Has a great reputation in the industry

Site offers several communication methods

Site lacks information on benefits package

No company match for 401(k)

Founded in 2018 as a subsidiary of Advantis Global, Advantis Medical's user reviews are limited in number but are glowing regarding people's experiences with the company.

Advantis Medical recruits travel nurses and places them in top institutions across the United States. The agency offers client connections with hospitals, outpatient clinics, same-day ambulatory surgical centers, as well as skilled nursing facilities.

Advantis Medical’s specialization opportunities include placements in divisions like medical-surgical (M/S), emergency department (ED), intensive care unit (ICU), labor & delivery (L&D), and more. Its benefits include highly competitive compensation packages, direct deposit available from day one, assistance with housing options, health insurance (medical, dental, vision), and a 401(k) option.

The agency also has payment incentives for referrals. To make the process as seamless as possible, Advantis Medical has a one-minute application form which could not be any easier, especially for a traveling nurse who is always on the go.

Best for Benefits : RN Network

  • Benefits: Health, dental, and vision coverage; life insurance; employee assistance program; Sanvello membership; Talkspace membership; Teladoc access; credentialing assistance; continuing education; traditional and Roth 401(k); travel reimbursement; loyalty program

RN Network provides a comprehensive benefits package that includes day-one health insurance and 401(k) options, plus additional perks like access to virtual therapy and medical care.

24/7 clinical support

Transparent about pay rate

Provides access to virtual therapy and medical care

Weekly pay via direct deposit

Completion, extension, and referral bonuses

No paid time off

Complaints of lower-paying contracts

Founded in 1998, RN Network has over two decades of experience in the travel nursing industry. Its experience shows in the company's user reviews, many of which highlight its great communication, support, and benefits.

The agency provides an impressive benefits package that includes day-one health insurance with a zero-premium option, as well as a 401(k) with company match, both traditional and Roth options. RN Network also offers access to Talkspace, Teladoc, and Sanvello's mental health app—ensuring its healthcare professionals have the mental health resources they need while on assignment.

Available contracts and pay rates are transparent on their user-friendly website, which can be a rarity in the industry. The company hires RNs, LPNs/LVNs, PCTs, and surgical techs for a variety of specialties throughout the country. Only one year of clinical experience is required, and the company offers a comprehensive onboarding program to help simplify the transition.

Best Recruiters : Host Healthcare

  • Pay: Hourly wage paid weekly, plus overtime, bonuses, per diem, COVID quarantine pay
  • Benefits: Health, dental, and vision coverage, life insurance; 401(k) with company match; travel reimbursement

Host Healthcare recruiters are some of the best in the business, according to clinician reviews. With exceptional customer service , the company strives to make the job hunt and placement process as smooth as possible for its candidates.

Excellent customer service

Straightforward job hunt and placement process

Offers a variety of housing options, including pet-friendly

24/7 support via multiple channels

COVID-19 quarantine pay available

Can’t view facility or pay without an account

Site lacks information on reimbursement offers

Founded in 2012, Host Healthcare is a travel healthcare staffing agency that works with some of the nation's top facilities. The company has earned multiple awards over the years, including being named one of the Top Travel Nursing Companies by BluePipes.

What sets Host Healthcare apart from other agencies are its recruiters, who are consistently praised by clinicians for their exceptional customer service. In reviews, nurses rave about their recruiters being responsive, receptive, and thorough in their onboarding and placement processes. The company also offers a variety of housing options, including pet-friendly ones, to ensure you have a comfortable place to call home while on assignment.

In addition to its comprehensive benefits package, which includes health insurance, dental, and vision coverage, Host Healthcare also offers a 401(k) with company match and COVID-19 quarantine pay. If your facility quarantines you due to possible COVID-19 exposure, the company will compensate you for the duration of your time off work.

One drawback is that the company requires users to sign up for an account before viewing facilities and estimated weekly pay . However, it hires across multiple specialties and licensure types, including nursing professionals, therapy professionals, and other allied health professionals.

Best for Recent Graduates : Fusion Medical Staff

  • Pay: Hourly wage paid weekly, plus overtime, per diem, and bonuses
  • Benefits: Health coverage, dental and vision coverage, life insurance, 401(k) with company match, short-term disability, travel and transportation per diem

Fusion Medical offers competitive pay, comprehensive benefits, and transparent information about opportunities, and welcomes new graduates to sign up.

Transparent information for each job posting

Nationwide network

Attentive recruiters

Competitive pay and benefits

Open to new graduates

Per diem reimbursements may be less convenient for expenses like travel

Past complaints from LGBTQIA employees

Fusion Medical Staffing urges applicants to "choose your own adventure." With thousands of travel nursing positions across the U.S. available on its website, Fusion will definitely give you a lot to choose from.

Founded in 2009 in Omaha, Nebraska, Fusion doubled its size by 2016. The company racked up awards from Inc., People, and Staffing Industry Analysts for being among the best places to work and is rated 4.7 out of 5 on Indeed.com .

Assignments through Fusion Medical typically run 13 to 26 weeks and are available across a broad spectrum of nursing specialties. We particularly like how transparent the pay, terms, and benefits for each opportunity are on Fusion's website.

But what really makes the company stand out is its recruitment. Fusion offers 24/7 support and many of its travel nurses rave about their attentive recruiters. Fusion has a new graduate traveling medical job program recruiting nurses who have just finished training. Most travel nursing agencies require at least two years of experience, so Fusion may be a great choice if you're about to finish school and eager to see the country or aren't sure of where you want to call home yet.

Of note: Some LGBTQIA+ travelers and employees have complained of inclusivity issues and unsupportive leadership. In 2021, the company published a blog post about forming an oversight group dedicated to LGBTQIA+ inclusivity and support and alluded to its efforts to "grow" and "learn."

Best Job Board : TotalMed

  • Pay: Hourly wage paid weekly, plus overtime, bonuses, and guaranteed hours
  • Housing: Company-provided housing or stipend
  • Benefits: Health insurance, dental and vision coverage, life insurance, 401(k) with company match, short-term disability up to 12 weeks plus up to 60% of monthly earnings

TotalMed is one of the biggest agencies in the business and has the job board to match. The company is known for making it easy for travel nurses to quickly find a new post in any state.

Large, well-connected agency with huge job board

Solid day-one benefits

Flexible housing options

Pay guaranteed

Generous short-term disability policy

Some nurses complain of long onboarding process

Pay is competitive, but perhaps not the highest of any agency

Focus on placing nurses in areas of urgent need

Few travel nursing agencies have a job board as full as TotalMed 's. The company leverages its wide network of partner hospital systems to offer nurses a plethora of assignments to choose from.

TotalMed prides itself on placing nurses and other medical workers in new postings quickly and prioritizes assigning workers to places urgently in need of additional staff. It offers a standard array of benefits, plus a pay guarantee and a generous short-term disability policy that covers up to 12 weeks of injury or illness with up to 60% of your pay.

Some travel nurses have complained of a protracted onboarding process, but once the initial paperwork is out of the way, most seem very happy with the company's efficiency and the quality of its recruiters. Its pay may not always be the highest of any agency, but travel nurses working with TotalMed still enjoy the benefit of payment guarantees and the confidence that a new job will almost always be available, and fast. TotalMed also goes a long way to smooth out the transition process by organizing and covering the cost of any licensing and certifications its travel nurses may need, as well as offering reimbursement for pesky costs like new scrubs.

Even though some agencies on our list require account registration to access pay rates, each one offers competitive benefits and wages. Triage Staffing is our choice for best overall travel nursing agency because of its positive reviews, superior customer service, and competitive wages. Day one 401(k) and tuition reimbursement are just a few ways it provides long-term support for travelers. 

Compare the Best Travel Nursing Agencies

Guide to choosing the best travel nursing agencies.

Travel nursing agencies are  staffing agencies  that place registered nurses and healthcare professionals in hospitals and clinics with short-term staffing needs. They often send individuals to national or international locations where there are nursing shortages.

Here are a few tips for choosing the best travel nursing agency to meet your needs.

Is a Travel Nursing Agency Right for You?

There are many advantages to working with a travel nursing agency in addition to the obvious benefit of being able to travel and explore new places. Some of the other advantages of working with a travel nursing agency include:

  • Competitive pay: Travel nursing agencies offer competitive pay rates that are often higher than what you would make as a staff nurse and recruiters can help you find lucrative positions.
  • Benefits : Health insurance, retirement plans, and other benefits are typically included in a travel nursing agency's compensation package.
  • Housing: Travel nursing agencies often provide housing or help nurses find housing in their assignment location.
  • Specialty assignments based on nursing field: Agencies can help place you in an assignment that matches your specialty, interests, and skills . Some facilities accept travelers into new specialties or a float pool that covers multiple units, as long as they have prior travel nursing experience. This is an added bonus for those who wish to explore new areas of nursing.
  • Flexibility: Agencies offer a variety of assignment lengths and locations, so you can choose an assignment that fits your lifestyle.
  • Perks and discounts : Free or reduced-cost continuing education courses, travel expenses, gym memberships, completion bonuses, and other perks are often available through travel nursing agencies.

How to Choose a Travel Nurse Agency

Consider the following when choosing a travel nursing agency:

  • Average pay rates: Pay rate varies by agency, location, and assignment. Travel nurses often work with multiple agencies at the same time to find the best assignments and pay rates.
  • Benefits package: Make sure the agency's benefits are comprehensive and meet your needs. Benefits may include health coverage , dental, vision, life insurance, short-term disability, 401K, vacation time, and education reimbursement.
  • Housing options: Determine if the agency provides housing or assists with finding housing. Some nurses prefer to find their own housing, while others prefer the convenience of having the agency secure housing for them.
  • Reputation: Check out online reviews and ratings to get an idea of the agency's reputation. Talking to other travel nurses who have worked with the agency is also a good way to get first-hand information.

Frequently Asked Questions

Which travel nurses are most in demand.

Staffing agencies report that demand is high for critical care and medical-surgical nurses. Emergency room staff and labor and delivery staff are also in great demand.

Do Travel Nursing Agencies Pay for Housing?

Your agency will either have housing available for you or will reimburse you for your housing expenses. If you choose to secure your own housing, most agencies will give you a stipend to help offset the cost of rent and utilities. Talk with your agency recruiter about your housing options and what will work best for you.

How Long Are Travel Nursing Assignments?

Some travel nursing opportunities can be as short as eight weeks, while others can last for up to six months at a time. There are often options and offers to extend assignments, too.

What Experience Do You Need to Be Recruited by a Travel Nursing Agency?

Most agencies require new travelers to have recent experience as a nurse—meaning you can't become a travel nurse right out of nursing school. A year or two of experience is commonly required. A qualified nurse may also need more experience to work in the intensive care unit (ICU) or another specialty area.

Can Travel Nurses Choose Where They Work?

Yes, and that's generally a benefit of the job. Some agencies work to assign candidates throughout the United States, while others place travel nurses internationally. Before deciding to work with an agency, it makes sense to find out where they place travel nurses if you have a specific placement location in mind.


We reviewed more than 20 agencies and studied hundreds of reviews from travel nurses around the country to identify the best travel nursing agencies. We then analyzed company quality and customer service scores across multiple sources to determine which companies are most reputable. Wages, housing options, and benefits were also a top priority. We reviewed the range of assignments, as well as the quantity and quality of each agency's listings in all 50 states.

VERYWELL Health / Design by Amelia Manley

U.S. Department of Labor. U.S. Department of Labor announces $80M funding opportunity to help train, expand, diversify nursing workforce, address shortage of nurses .

Healthcare Research & Analytics. Social listening: Evaluation of travel nurse companies: Analysis of travel nurse sentiment towards travel nurse companies .

BluePipes. Best Travel Nursing Companies 2022 .

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BluePipes Blog

The Best Travel Nursing Companies 2022

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The best travel nursing companies for 2022 are here! To determine our list, we evaluated over 380 travel nursing agencies by aggregating over 108,000 reviews from 6 leading review sources. We selected the 20 highest rated companies based on our transparent scoring system which we describe in detail below.

This is our sixth year of spending massive amounts of time aggregating review scores for hundreds of travel nursing agencies to surface the highest scoring agencies. We are compelled to do this each year for several reasons.

Why It’s Important and Difficult to Find the Best Travel Nursing Agencies

First, we have a deep appreciation for how important and difficult it is for travel nurses to find the right agencies to work with. Travel nurses rely on agencies to provide a robust and impactful set of services. Therefore, the service, or lack thereof, can have a profound impact on both a nurse’s career and personal life.

Increase in Number of Travel Nursing Agencies

Meanwhile, it’s become exceedingly difficult in recent years to find the best travel nursing companies on your own. The pandemic driven boom in the travel nursing industry has resulted in a massive increase in the already large number of agencies.

Increase in Best Travel Nursing Agency Lists

The boom has also brought increased attention to the travel nursing industry. As a result, there are now tons of different “best travel nursing company” lists. Unfortunately, these lists are often subpar and sometimes completely meaningless.

For example, this year we see lists of “The Best Travel Nursing Companies of 2022” that are unchanged from 2021 and even 2020. Basically, the websites created a list several years ago and now they just update the year on the list in order to trick Google into thinking the article is new because they know Google will rank it higher as a result.

Find your next travel healthcare job on BluePipes!

Of course, this behavior is a major disservice to the entire travel nursing industry. There is even one list on page one of Google’s search results that includes travel nursing companies that don’t even exist any longer!

We’ve also seen other lists that rely on a relatively small number of reviews. For example, one list purveyor boasts a survey of ‘the nation’s largest travel healthcare community”. That sounds awesome! However, only a couple thousand community members actually respond.

This might sound like a lot. However, it’s actually a relatively small number all things considered.

Uneven Review Distribution for Travel Nursing Companies

That’s because there are so many travel nursing agencies. Moreover, travel nurses are unevenly distributed among the agencies. For example, some sources estimate that 50% of all travel nurses work for one of the 25 largest travel nursing companies. That means that the remaining 50% work with the remaining 350+ travel nursing agencies.

Meanwhile, there are tons of different review sources. As a result, reviews are unevenly distributed such that it can be difficult to find a reliable sample size of reviews on any one review source.

How we Determine the Best Travel Nursing Agencies for 2022

For these reasons, we aggregate the review scores from 6 leading review sources for every travel nursing company we can find. To clarify, each year we enter the review counts and scores from each review source for each company into an Excel spreadsheet.

Once we have entered all the data, we program the spreadsheet to run a bunch of calculations to ultimately determine an aggregate score for each company. We compare this year’s scores to last year’s scores and issue bonuses or penalties based on score increases or declines. This way, we award companies that have truly outperformed over the last year.

Our scoring system is quite complex. In the interest of transparency, we provide a complete scoring breakdown for one company at the end of this article.

Here are the 6 review sources we collect scores from:

Rating Services We Aggregate

  • Highway Hypodermics
  • Travel Nursing Central

Highway Hypodermics has been publishing their own “Top 10 Travel Nursing Companies” list since at least 2005. Their annual list is based on reviews they collect on their own website. We highly recommend reviewing the list for 2022 here . And we highly recommend submitting your own reviews here.

Discover the ultimate travel nursing pay calculator.

We counted a total of 3,633 reviews from HH this year. That’s an increase of 511 from 2021. We should point out that HH only counts scores from the last 5 years in their totals. This way, they keep the review scores fresh which is a really nice touch because it helps travelers understand how a company is performing now.

It’s fair to say that companies are performing well now. The aggregate average score for all companies on HH is 17.96 out of a possible 20. That’s an increase from last year’s 17.71. It’s also an average of 89.8% which indicates that travel nurses are very happy with their travel nursing agencies.

We counted 11,753 reviews from Travel Nursing Central this year. That’s an increase of 580 from 2021.

The aggregate average score for all companies on Travel Nursing Central this year was 86.47. That’s an increase from last year’s 86.04. This is another indication that travel nursing companies provided exceptional service over the last year.

We counted exactly 8,800 reviews from FaceBook this year. That’s an increase of 1,546 reviews from the previous year.

The aggregate average score on FaceBook decreased from 4.83 in 2021 to 4.58 in 2022. However, FaceBook’s reviews were a mess in 2021. For example, FaceBook was showing that some companies had zero reviews when the companies actually had hundreds of reviews. FaceBook was showing that some companies had a negative number of reviews, which is impossible. It was also showing that some companies had “5 stars” even though those companies had tons of negative reviews. The point is that we simply can’t glean anything from FaceBook’s 2021 data because it was riddled with inaccuracies.

We included 42,063 reviews from Indeed this year. That’s an increase of 5,813 from the previous year. Indeed now has by far the most employer reviews of any of the six services we track. We find this dumbfounding given that Indeed offers among the worst and most horrifying job search experiences for travel healthcare professionals. Check out our job board for a much better experience.

The aggregate average score for all travel nursing agencies on Indeed increased ever so slightly from 3.73 in 2021 to 3.74 in 2022.

GlassDoor came in with 28,801 reviews this year. That’s an increase of 8,045 from last year.

The aggregate average score for all travel nursing companies on GlassDoor was 3.87 this year. That’s a slight increase from 3.81 last year.

We counted 13,475 reviews from Google this year. That’s an increase of 6,537 from last year. That’s almost a 100% increase. Google is growing reviews at a very fast pace.

The aggregate average score for all travel nursing companies on Google was 4.57 this year. That’s an increase from 4.46 last year.

Interesting Observations on the Overall Numbers

There are a couple of interesting observations in this year’s overall numbers and the list of best travel nursing companies these numbers resulted in. First, we find it absolutely amazing that the aggregate average score for all companies was up from 2021 to 2022. Please note that we collect the scores during the last 2 weeks of May. Therefore, this year’s list covers June of 2021 through May of 2022.

Travel Nursing Agencies Provided Good Service During Covid

This is a period that saw both the Delta and Omicron hospitalization spikes. This means that agencies were employing record numbers of travelers. The agencies’ operational systems like credentialing and payroll were definitely stressed this past year. Despite this, agencies clearly performed well.

The original Universal Profile and Credential Management for travelers.

It’s also a period that saw a huge draw down in hospitalizations. This resulted in contract cancellations , bill rate reductions and other unsavory circumstances. Here again, agencies appear to have handled these issues well.

“Recruiterless” Services Still Absent from the List

Second, we find it interesting that over 6 years into the “recruiterless” healthcare staffing experiment, not one “recruiterless” staffing agency has made our list…ever.

To be fair, this isn’t to say that any of these companies has horrifyingly bad reviews. It’s just that none of them have great reviews despite their promises of transformational service, demonization of recruiters and traditional healthcare staffing, and absolutely massive capital expenditures and losses.

The highest that any of these companies ranked on our list this year was at number 57. All 20 companies on our list continue to employ a traditional high-touch approach. It would seem as though travel nurses still highly value this type of service.

That said, we should point out that one company on our list does have a very powerful “self-service platform”. That company is Stability Healthcare and they ranked number 4 on this year’s list.

Why You Should Consider ALL The Best Travel Nursing Companies

We realize that 20 seems like a large number for a “best of” list. However, we have very good reasons to include 20 companies on our list and we strongly encourage you to consider all of them. Here is why.

Fist, all of these companies deserve to be on a “best of” list. Every single one of them has an aggregate average score of greater than 90 out of 100. This is exceptionally high for employment satisfaction. In fact, these scores would be high enough to get them on GlassDoor’s annual list of the best companies in the nation to work for.

Second, service offerings vary dramatically from agency to agency. Organizational structures also differ. We want you to be able to find the right fit all in one place.

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Finally, different companies have access to different jobs . Every experienced traveler will tell you that must work with multiple agencies . Also, you should ask agencies about their access to the job markets you’re most interested in so you can find the agencies that can get you jobs where you want to go.

Therefore, we highly recommend working a minimum 4 agencies. In fact, we think 7 agencies is even better.

Use BluePipes to Land Jobs with the Best Travel Nursing Agencies

Of course, this might sound like a ton of work. But that’s why we created BluePipes . You can communicate with nearly every company on this list through our platform. You can apply to jobs with many of these companies on our powerful travel nursing job board .

We have the original universal profile builder which includes a free travel nursing resume builder , document storage, skills checklists and more. We even have the industry’s most powerful travel nursing pay calculator . Select the button below to join over 100,000 healthcare professionals who are simplifying their careers and maximizing their pay with BluePipes.

BluePipes Best Travel Nursing Companies 2022

Without further ado, here are the best travel nursing agencies of 2022:

About the Best Travel Nursing Agencies 2022

Below we provide some basic information about each company on our list.

1. Axis Medical Staffing

Axis Medical Staffing continues to perform like a rock superstar. Since 2017, Axis has made our list at number 5, 9, 3, 2 and 5. Now, they are number 1 with an absolutely amazing year!

Axis’s aggregate average score increased from 95.63 last year to 96.16 this year. They now have 803 total reviews, an increase of 247 reviews from the previous year.

Axis’s scores increased on Travel Nursing Central, Highway Hypodermics, Facebook, Glassdoor and Google. Their Evaluation Score on Highway Hypodermics is 19 out of 20 which is extremely difficult to achieve given the volume of reviews they’ve racked up there.

Make no mistake, Axis Medical Staffing values service above all else. Axis’s leadership team is comprised of world-class customer service providers. They take great care in hiring internal staff members who share their commitment to exceptional service.

Axis Medical Staffing is based in Seattle, Washington. They staff travel nurses and travel allied professionals nationwide.

2. AHS NurseStat

AHS NurseStat comes in at number 2 on our list this year after placing number 6 last year. AHS’s aggregate average score increased from 90.94 last year to 95.38 this year with 245 new reviews. This brings their total number of reviews to 555.

AHS NurseStat is part of AHS Staffing which also operates RenalStat, PharmStat and MedStat. As the names imply, each division focuses on different set healthcare modalities.

Through all of their divisions AHS Staffing works diligently to place medical professionals of all types in travel healthcare jobs nationwide. All of AHS’s divisions have solid reviews which demonstrate that all of their divisions provide exceptional service.

AHS Staffing is based in Edmond, Oklahoma. Highway Hypodermics included them on their list of the “Top Ten Travel Nursing Agencies” in 2019, 2020 and 2021.

3. Host Healthcare

There is no question that Host Healthcare is one of the best healthcare staffing agencies in the nation. They have the second highest aggregate average score of all the companies on our list. To top it off, they have 2,949 reviews which is over 800 more than the next closest agency on the list.

Host Healthcare has been on our list every year since 2017. They were number 1 in 2020. They are number 1 on Highway Hypodermics’ list for 2022 as they were in 2021.

Perhaps the most amazing thing about Host’s world class performance is they’ve maintained it through a period of exceptional growth. In other words, they are not only scaling their service performance, but they are improving it while they scale.

Host Healthcare is based in San Diego, California. They staff nursing and allied health professionals nationwide.

4. Stability Healthcare

Stability Healthcare comes in at number 4 on our list for the second year in a row. At 97.09, Stability has the third highest aggregate average score of all the companies on our list. They added 400 new reviews this year, bringing their total to 515.

As mentioned above, Stability Healthcare has a powerful “self-service” platform with a “high touch” service approach. This means that Stability’s software platform has everything healthcare professionals need to “submit themselves” without really speaking with anyone. But, at the same time, you’ll always have a recruiter at the ready with world-class service.

Stability Healthcare is based in Los Angeles, California. They staff nursing and allied professionals nationwide.

5. Cynet Health

Cynet Health comes in at number 5 in their debut appearance on our list. They actually have the highest aggregate average score of all the companies on our list at 97.68. We counted 1,287 new reviews for them this year. That brings their total 1,335.

Cynet Health is based in Sterling, Virginia. They staff nursing and allied professionals nationwide.

6. Travel Nurse Across America

Travel Nurse Across America (TNAA) moves up to number 6 on our list this year. They were on our list in 2018, 2019 and 2021. They’ve been on Travel Nursing Central’s list every year since 2014. They were number 4 on Highway Hypodermics list this year!

TNAA has a great website that includes job listings with pay quotes. They also have a lot of cool compensation offerings like paid sick leave and fully guaranteed hours on many contracts.

TNAA has a high volume of jobs nationwide for nurses, techs and respiratory therapists. TNAA is based in Little Rock, Arkansas.

7. CrossMed Healthcare Staffing Solutions

We’re excited to see CrossMed on our list for the first time as a newer company founded in 2019. We counted 129 new reviews for them this year. Their aggregate average score is an impressive 96.84.

Don’t let their newness as a company fool you. CrossMed is led by a team of highly experienced industry veterans. They also have a very high volume of jobs available for a company of their age. They pride themselves on treating all their employees like family.

CrossMed is based in Omaha, Nebraska. They staff nurses and allied professionals nationwide.

8. Trusted Nurse Staffing

Trusted Nurse Staffing debuts on our list at number 8 this year. We counted 503 new reviews for them this year. They have a highly respectable aggregate average score of 96.63. They’ve racked up 347 reviews on Google with an average score of 4.9.

The reviews describe Trusted Nurse Staffing and their recruiters as responsive, patient and diligent. The company is based in Buffalo, New York. They staff travel nurses nationwide.

9. Premier Healthcare Professionals (PHP)

Premier Healthcare Professionals (PHP) has an aggregate average score of 91.09. That’s an increase of 5 points over last year’s score. This came largely from their excellent performance on Google where they added 128 new reviews and have an average score of 4.9.

PHP has been on Highway Hypodermics’ list every year since at 2014. They are number 3 there this year.

PHP is based in Cummings, Georgia. They’ve been in business since 1986. They staff nurses and allied professionals nationwide. They also have some international opportunities.

10. Coast Medical Service

Coast Medical Service debuts on our list at number 10. Their aggregate average score is 95.66 on 154 total reviews. The vast majority of their reviews, 136, are on Google where they have an average score of 4.9.

Coast’s Google reviews describe a service that is informative, thorough, transparent and responsive. Coast Medical Service is based in Hermosa Beach, California. They staff medical professionals of all types nationwide.

11. Fusion Medical Staffing

Fusion Medical Staffing has made our list 5 out of the last 6 years. They have an aggregate average score of 92.74 on 1,367 reviews. They got bonus points this year for increasing their review scores on Google and Glassdoor.

Fusion has access to a very high volume of jobs which is great because they can get you into a lot of different locations. They also have an excellent job board where you can view and apply to jobs with pay rates.

Fusion Medical Staffing is based in Omaha, Nebraska. They staff medical professionals of all types nationwide.

12. Cariant Health Partners

Cariant Health Partners made our list at number 11 in 2020. Here they come in at number 12 with an aggregate average score of 92.84 on 157 reviews. That’s a score-increase of 2.16 on 46 new reviews.

Cariant was founded by a married couple who are a Physical Therapist and a nurse. They have a large number of jobs available nationwide for medical professionals of all types.

13. FlexCare Medical Staffing

FlexCare is an amazing company! They’ve been on our list every year since 2017. They’ve been on Travel Nursing Central’s lists every year since 2014.

FlexCare has 2,004 reviews with an aggregate average score of 93.63. They increased their average score slightly from last year with 153 raving reviews.

FlexCare is a larger company with tons of jobs nationwide for nurses and allied professionals. They have an awesome career portal where you can search jobs with pay by signing up.

FlexCare offers the highest pay package they can on all jobs as matter of company policy. They have an organizational policy called “Single Point” that mandates that your recruiter will always be your single point of contact with the company to ensure continuity of service.

FlexCare was founded in 2006. They are based in Roseville, California with offices in Charlotte, North Carolina.

14. Atlas MedStaff

Atlas MedStaff has been on our list now 5 out of the last 6 years. Their aggregate average score increased to 91.75 on 45 new reviews this year. This year, their scores increased on GlassDoor and Google.

Atlas MedStaff’s reviews describe a company that is fun-loving, responsive, fair and diligent. They have a high volume of jobs and large team of recruiters to ensure that travelers are well taken care of.

Atlas is highly active on social media and they pump out a ton of great information about the industry and fun stuff to do on the road. For example, their YouTube channel has more than 1,600 videos!

Atlas is based in Omaha, Nebraska. They staff healthcare professionals of all types nationwide.

15. Greenstaff Medical

Greenstaff Medical debuts on our list at number 15. They have an aggregate average score of 94 with 222 reviews. 166 of their reviews are on Google where they have an average score of 4.8.

Greenstaff’s reviews describe a company that is highly responsive, caring and organized. Many reviewers express their satisfaction for the company’s onboarding process.

Greenstaff Medical is based in Plano, Texas. They staff travel nurses nationwide.

16. Marvel Medical Staffing

Marvel Medical Staffing debuts on our list at number 16. They have an aggregate average score of 93.63 on 192 reviews. 142 of their reviews are on Google where they have an average score of 4.8.

Marvel places healthcare professionals of all types nationwide. They have an abundance of jobs for nearly all modalities. They are based in Omaha, Nebraska and began in 2019. They have grown very quickly. Their reviews describe a company that is energetic, inspiring and well organized.

17. Medical Staffing Solutions, Inc.

MSSI makes our list for the third time in 6 years coming in at number 17 this year. MSSI has an aggregate average score of 92.87 on 269 reviews.

MSSI received 27 new reviews on Google in the last year. Every one of them was from a traveler and every one of them was 5 stars. The reviews describe a company that is highly accessible, organized and high paying.

MSSI is based in Rice Lake, Wisconsin. They staff nursing and allied professionals nationwide.

18. USSI an Aequor Company

USSI earned their way back on our list for the fourth time with 63 new and glowing reviews in the last year. That brings their total number of reviews to 309. Their aggregate average score is 91.40.

USSI has a very high volume of jobs available for nurses and allied professionals nationwide. They also have a lot of direct contracts and unique opportunities available.

19. White Glove Placement, Inc.

White Glove Placement, Inc. is back on our list with an aggregate average score of 90.96. They have 2,139 reviews which makes them the second most reviewed company on our list.

White Glove Placement, Inc. staffs travel nurses and therapists nationwide . They have a huge footprint in the Northeast. They offer Per Diem opportunities in the area as well.

White Glove Placement, Inc. was founded in 1995. They are based in Brooklyn, New York and are known for their amazing customer service.

20. Gifted Healthcare

Gifted Healthcare has been on our list 5 out of the last 6 years. They came in at number 3 in 2020. They have 486 total reviews with an aggregate average score of 91.70.

Gifted was founded by an RN in 2006. Their leadership team is stacked with healthcare professionals. Their reviews describe a company that is succeeding to put healthcare professionals first.

Gifted is based in Louisiana. However, they have multiple satellite offices. They staff travel assignments nationwide. They also have a large per diem offering in many locations throughout the country.

Background Info on Best Travel Nursing Companies List

If you consider all 20 companies on this list, then we are confident that you’ll find many that can meet your every need. That said, we want you to have confidence that our list is legit. Therefore, we’ll spend the rest of the article discussing issues you should be aware of and providing a detailed breakdown of our scoring system.

Review Sources and Score Collection

First, we do not use reviews from our own website. We also do not accept any money whatsoever in exchange for placement on the list.

Instead, we collect review-counts and scores from 6 leading review sources for every company we can find on any of those sources. We enter the scores into a spreadsheet and run the calculations as we describe below.

We only use publicly accessible review sources. This means that anyone is free to leave a review in accordance with the guidelines. This also means that we do not use “pay to play” review sources.

The websites we use are below:

Internal Staff and Travel Nursing Reviews

Only travel healthcare professionals can leave reviews on Highway Hypodermics and Travel Nursing Central. The other review sources accept reviews from both internal employees and travelers.

Some argue that this allows staffing agencies to stack reviews from internal employees on every review source in an effort to make it look like the company is amazing. To counter this, we require a minimum of 50 total reviews from travel healthcare professionals and a minimum of 15 within the previous year in order for a company to qualify to be on our list.

Moreover, we believe it’s useful and important to include reviews from both internal staff and travelers. Here’s why.

First, Google, FaceBook, Indeed and GlassDoor each receive way more traffic than the industry specific websites. That means that these services have more reviews for more companies. Additionally, it means that more people actually see these reviews so their impact is more far reaching. Therefore, we get a clearer picture of how these companies are perceived if we use these review sources.

Perhaps more importantly, we strongly believe that happy internal employees are good for travel nurses. Happy employees have lower turnover which means a more cohesive and experienced team for travel nurses.

Fake Reviews and Review Solicitation

We understand that fake reviews exist. As a result, we thoroughly check the reviews of each company that qualifies for our list. Over the years, we’ve discovered fake reviews for several companies. We permanently ban those companies from ever being on our list.

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We also know that “review solicitation” exists. We do not think this is a problem unless the company pays for reviews. We believe it’s normal for companies to ask customers and staff to leave them reviews. If we see that companies pay for reviews, then we disqualify them.

Sample Size and Minimum Requirements

We also have minimum requirements for companies to make it on the list and receive bonuses or penalties. These requirements help solve problems related to sample size.

First, we require a minimum of 50 reviews to make it on the list. We also require a minimum of 15 reviews from healthcare professionals within the last year. We have similar requirements for bonuses and penalties.

We do this to ensure that we have adequate sample sizes. For example, if a company has ten 5-star reviews, then they would have a score of 100 which is really high. However, ten is a very small sample size so it doesn’t necessarily tell us that the company provides 5-star service to their travelers.

We realize that these rules make it very challenging for the smallest healthcare staffing companies. Despite this, we’ve had many very small agencies make our list over the years. Moreover, we believe it’s important for a company to be large enough to handle the volume of inquiries that comes with being listed as one of the best travel nursing agencies in the nation.

Sample Breakdown of our Best Travel Nursing Agency Scoring System

Next, we provide a complete breakdown of the scoring for one of the companies on our list so you can see exactly how it works. We’ll use Travel Nurse Across America’s scores. TNAA is number 6 on our list this year.

Meeting the Minimum Requirements

First, we collect the review-counts and review scores from the 6 review services and enter them into our spreadsheet. Next, we add the number of scores together to get the total number of scores across all review sources. At this point, our minimum requirements are as follows:

Minimum Requirements for Best Travel Nursing Companies

  • A company must have a minimum of 50 total reviews across all platforms. That’s not 50 for each platform, but 50 for all platforms combined.
  • A company must have a minimum of 15 new reviews from healthcare professionals in the last year.

Again, these requirements ensure that we have an adequate sample size.

TNAA has 2,114 total reviews. Therefore, they meet our minimum requirement of 50.

Next, we look to determine if they have 15 reviews from healthcare professionals within the past year. We counted 221 total new reviews in the last year for TNAA. They had 1 new review on Travel Nursing Central and 11 new reviews on Highway Hypodermics. That’s 12 reviews from healthcare professionals right there. We need to find at least 3 more.

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We recognized that TNAA received a majority of their new reviews, 165, on Google this year. Therefore, we checked the reviews on Google and easily found 3 from healthcare professionals there. In fact, the vast majority of TNAA’s new reviews on Google were from healthcare professionals extoling the virtues of their amazing TNAA recruiters.

Calculating the Aggregate Average Score

After we enter all the review scores into our spreadsheet, we’re ready to calculate the aggregate average score.

To do so, we must convert all the scores to a common scoring scale. That’s because the review sources use three different scales between them. TNC uses a 100-point scale. HH uses a 20-point scale. The others use a 5-point scale. We convert them all to a 100-point scale.

Here are the scores we collected for TNAA this year:

Next, we add the number of reviews together to arrive at the total number of reviews.

Next, we calculate the weighted total for each review source. This is also where we convert all the scores to a 100-point scale. To do so, we multiply the scores by 20 for the rating services that use 5-point scales. We multiply by 5 for the rating service that uses a 20-point scale.

Here is how that breaks down for TNAA in 2022.

Finally, we divide the weighted aggregate total by the total number of reviews to get the aggregate average score. Here is TNAA’s calculation for 2022:

Aggregate Difference Score

With the aggregate average score for 2022, we can now calculate the “aggregate difference score”. This score rewards or penalizes a company based on the difference between this year’s aggregate average score and last year’s aggregate average score.

We follow the following guidelines for the aggregate difference score:

Minimum Requirements for the Aggregate Difference Score

  • To qualify for this score, a company must have had more than 50 total reviews in the previous year. This qualification ensures some modicum of adequate sample size.
  • We cap this score at plus or minus 5 points per company. This qualification also works to ensure some modicum of adequate sample size.

Let’s take a look at this score for our sample company. TNAA’s aggregate average score for 2021 was 92.10824089. Their aggregate average score for 2022 is 92.90736045.

So, we subtract 92.10824089 from 92.90736045. We are left with + 0.79911956.

Therefore, TNAA receives a bonus of + 0.79911956 added to their aggregate average score for 2022. 92.90736045 + 0.79911956 = 93.70648001.

And yes, all those decimal places are necessary. For example, our number 10 and 11 companies are separated by less than .08 of a point.

The Individual Difference Score

Finally, we calculate an “individual difference score” for each rating service. This score is similar to the aggregate difference score. However, in this case, we give bonuses or penalties based on the difference between last year’s score and this year’s score for each rating service.

The Individual Difference Score has several guidelines and qualifiers. We choose to keep this scoring mechanism private to ensure that content farms and other rapscallions can’t easily reproduce our scoring system.

However, please contact us if you are a traveler or staffing agency who would like a full breakdown of everything. We’ll gladly reveal and discuss all the calculations, guidelines and qualifiers.

Wow, that was a lot of nerdy number crunching! Are you still awake?! If so, then you’re probably ready for a nap!! But, you’re an expert on our scoring system.

As always, we hope you found this information useful. Please contact us with any questions or concerns about our ranking system. And, join BluePipes for free so you can manage your travel healthcare career with ease!

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  • I worked in the Spine Floor department(s) in the hospital. While on orientation my schedule which was supposed to be a " flex " thing was scheduled for me for the first 6 weeks of my assignment without even asking me. 11/26/2016
  • I worked in the Cvor department(s) in the hospital. Management is horrible. People are great to work with as well as the Drs. Housing is very difficult to find. 08/27/2016
  • I worked in the Float department(s) in the hospital. Staffing levels and moral are abysmal. The manager of the PCU ICU AND ER named Kelly can only be described by a french noun that describes a female dog, hint, it starts with a B. --- Communication between departments, HR, and other logistical elements is near ZERO. No one speaks to one another and everyone makes assumptions on what the other needs, this results in poor hospital performance and a lot of angry and confused people. --- The training department is really nice. The computer system seems like it could be user friendly, just depending on what you have used in the past. It is called PARAGON, Meds use Pyxis. Some charting and orders are still on paper. 01/22/2016
  • I worked in the MSPC/PMSD department(s) in the hospital. 07/25/2015
  • I worked in the n/a department(s) in the hospital. Worst experience of my traveling career. Do not believe anything that is told to you in the interview process; because it's all complete and utter rubbish. Make sure you get everything in writing, and I mean everything. Do know that as a traveler you will float first, and when I say float I mean you will start iff with a pt load, and then halfway through the shift have to give up your pt's and be pulled somewhere else to take over someone else's pt's so that they can float somewhere else, and then you may or may not be pulled again in the same shift to do the same BS again. There is no rhyme or reason to the way they staff; to many handovers of pt's creates dangerous practice, orders get missed, pt care suffers, and accidents are waiting to happen. I have literally had as many as 8 different pt's in one day in the specialty area where I was contracted; and these are not your walking talking pt's, they are sick, sick, sick. This hospital is trying to go fir Magnet status but doesn't realize that with the way they staff, and the rate of turnover it will never happen. You will be micromanaged to death, no independent thinkers need apply. The best part of this contract was knowing that I got to leave after 3 months, I feel truly sorry for the staff at this place. There are a lot of really great people here who are getting the shaft from management. Worst cafeteria food ever. 07/04/2015
  • I worked in the n/a varied department(s) in the hospital. First off this hospital exclusively used Cross Country as their traveling agency of choice; so it was a subcontract for my agency. There was an incredible amount of paperwork and educational videos that were required to be done prior to the contract even starting, strike one. Literally the educational videos and tests for the hospital that were required take about 12 hrs to complete, they are mostly policies and procedures that should be done after you start. Do make Cross Country pay you for them, they are that labor intensive. They flat out lied when I asked about the floating requirements, was told that you very rarely float and when you do it's to a "sister" unit. This was not the case at all, travelers float first, and to any unit they deem appropriate. Strike two. Staffing office is a complete joke, you will literally have your pt load in the morning, start working and then all of a sudden mid-day you will have to give up your pt's and float somewhere else and take over new pt's. No rhyme or reason to staffing at all; no concern for continuity of care, or that multiple hand offs can create pt safety issues. Strike three. At best it's a job, given the chance for a rewind I would have passed on this contract. The hospital is dangerously understaffed right now and routinely triple up really sick people on nights, but then expect all the "I's" to be dotted and "T's" to be crossed paperwork wise. I don't mind hard work, but I believe slave labor was outlawed a long time ago. They also practice "Mission" nursing, not necessarily what standard practice is, or even what national standards are, it's "the uber Mission" way or no way at all; and there's no deviation. So no independent thinkers need apply. Managers are extremely passive aggressive with staff and distanced from the reality of the situation. 06/18/2015
  • I worked in the CVICU department(s) in the hospital. Ditto on what the last person wrote. My contract was supposed to be in the CVICU; now 7 weeks into a 13 week assignment & I have worked in that unit once. I have literally been floated to the Telemetry floor the other scheduled work days. I don't mind floating occasionally, Sbut I didn't contract to work on the Telemetry floor. So ready for this contract to be over, and so ready to leave North Carolina. This hospital staffs at unsafe and dangerous levels. Example, they tried to give a nurse a balloon pump pt and a CRRT pt, like what the bleep. They are in desperate need of nurses, but who would stay under conditions like this. Administration needs a wake up call. 06/04/2015
  • I worked in the ICU's department(s) in the hospital. Mission is currently going through a massive turnover in personnel through their own fault. The State of North Carolina chose not to expand their Medicare/Medicaid programs under the ACA, Mission chose to preemptively cut staffing, decrease PTO hours, restructure mgt, implement mandatory OT, and only recognize two holidays. Now I am not a CEO or COO, but I can't help but to think that if you treat people like crap eventually you won't have anymore staff. Staff morale is at an all time low, and the people here are stretched too thin. Mission is the only large hospital for most of western NC with around 800 beds. There are smaller hospitals around, but they all dump their more complex patients at this facility. So it is an extremely vicious cycle here right now. They routinely triple really sick pts at night because of staffing issues. Also, unfortunately Cross Country has the monopoly on staffing here, so you will sub-contact if you work for someone else, and beware there are a ton of pre-employment modules they want done that take > 6 hrs to complete prior to orientation. I made them pay me for doing them prior to actually starting my contract 05/24/2015
  • I worked in the nursing department(s) in the hospital. staff is dishonest and lies. patients treat staff horribly 04/29/2015
  • I worked in the CVICU department(s) in the hospital. Enjoyed the assignment. 01/20/2014
  • I worked in the NICU department(s) in the hospital. The staff were amazing. I felt completely welcomed and accepted by all of the staff. They gave me list of things to do while in the area and helped me plan places to take my family and friends when they visited. The unit is a nice open hall type unit with a transition area that is private rooms for getting prepared for going home. The first month I was in this area. Mostly level 2 babies and parents doing the majority of the care. This I didn't like. I come for a very high level 3 unit and was bored with the patient load I was assigned here. That is the main reason why I only stayed for one contract. Otherwise, I would have stayed because of the wonderful team I worked with and the city was neat to explore. 10/23/2013
  • Housing was approximately 3 mile(s) from the hospital. The name of the housing complex was river ridge . Housing was located in city of asheville. On a scale from 1 to 5, I would rate it a 4. 01/25/2009
  • I worked in the ER department(s) in the hospital. Great place to work. Lots of travelers initially, but have now staffed well enough to not use them in the ER. Area trauma center, lots of car wrecks. Referral center for western NC, so lots of transfers from rural area. Great place to live and work. Exceptionally friendly and helpful staff, felt like family. 11/04/2006

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Helpful or hurtful? The ‘double-edged sword’ of travel nursing.

Rural hospitals are struggling with staffing shortages as more of their nurses leave for better-paying travel nurse roles—but some experts warn that hospitals' reliance on travel nurses may be a "double-edged sword."

The nursing shortage particularly strains rural hospitals

Hospitals around the country have seen a shortage of health care workers, particularly nurses, as Covid-19 case rates and hospitalizations continue to rise. Earlier this month, the American Nurses Association (ANA) sent a letter to HHS Secretary Xavier Becerra asking him to declare the current nursing shortage a national crisis and work to address it.

However, while hospitals nationwide are struggling with the current staff shortage, rural hospitals have been hit the hardest.

Around 60 million Americans who live in rural areas rely on small, local hospitals for medical care, and the pandemic has further exacerbated the staffing shortages these hospitals have long struggled with, NBC News reports.

"If you lose one or two nurses, that makes a difference," said Audrey Snyder, president of the advocacy group Rural Nurse Organization and a faculty member at the University of North Carolina Greensboro School of Nursing . "These hospitals are small hospitals and they don't have a large nurse workforce."

According to the Cecil G. Sheps Center for Health Services Research , a record number of rural hospitals closed last year after continuous low patient volume and high numbers of uninsured patients and patients with government-funded insurance plans. And Brock Slabach, COO of the National Rural Health Association , said another 216 rural hospitals are at high risk of closure.

"The rural hospital workforce has always been a challenge," Slabach said. "What Covid was uniquely suited to do was take advantage of every fracture and widen it significantly and make it even harder to cope with demands being placed on them."

Many staff nurses leave for travel jobs

A recent surge in demand for travel nurses has made long-running staffing shortages at rural hospitals even worse, NBC News reports.

Aya Healthcare , a medical staffing firm, said demand for travel nurses has increased 284% from the same time last year. And Kathy Kohnke, SVP of client relations at Fastaff Travel Nursing , said there are now more than 40,000 positions for travel nurses available on any given day. According to Modern Healthcare, 90% of hospital executives hired travel nurses to bolster their teams during the pandemic, compared with less than 60% in 2019.

In particular, many rural nurses are leaving for travel nurse positions that can pay up to 10 times more than their current salaries, NBC News reports.

According to data from the hiring website ZipRecruiter , nurses at rural hospitals are paid an average of $70,000 a year, or just over $1,200 a week. However, some staffing agencies, such as Nomad Health and White Grove Placement , are offering travel nurse positions that pay over $5,000 a week. And the health care hiring site Vivian has listed several travel nurse assignments that pay up to $9,562 a week.

Compared with rural hospitals, larger, better-funded health systems can pay travel nurses these higher rates, often in addition to a stipend for housing and travel expenses, Modern Healthcare reports.

"The travel nursing situation has essentially created a bidding war between hospitals," Phillip Coule, VP and CMO at Augusta University Health System , said. "A nurse can leave a facility, go on a 'travel contract' for a facility across the street, and earn more than double what they were making, while still living at home."

Separately, Susan Salka, CEO of the staffing company AMN Healthcare , said, "The delta virus is causing even more competition for scarce talent, and our clients are citing problems not only with permanent hiring but also with retention."

Salka added that demand is not exclusively due to surges in Covid-19 patients—it has been complicated by "leaves of absence, clinician fatigue, rising patient volumes and operating room backlog," which is "unlikely to change anytime soon," she said.

Relying on travel nurses may be a 'double-edged sword'

According to Modern Healthcare , this increased reliance on travel nurses may also lead to problems among hospitals' regular nursing staff.

"The good part of travel nursing is that when there's a natural disaster or there are very irregular levels of demand, hospitals can use travel nurses to sort of patch up the gaps," Patricia Pittman, a professor of health policy and management at the School of Public Health at George Washington University , said. "The bad side of travel nursing is that it becomes an excuse to not invest in your regular nursing staff. It's a double-edged sword."

According to Pittman, many staff nurses are being driven away due to frustrations stemming from working conditions and staff shortages, along with pay disparities between staff and travel nurses.

Kelly Rivera-Craine, a business agent for Teamster Local 332 and an RN at Ascension Genesys Hospital in Michigan, said offering bonuses to travel nurses but not staff members—who have remained loyal to their employers throughout the pandemic and amid staffing shortages— is a "slap in the face."

Rivera-Craine also said travel nurses may disrupt clinical care and workflow at hospitals since they typically don't receive as much training as their staff counterparts and don't stay at hospitals long enough to build relationships with patients.

Separately, Coule agreed with Rivera-Craine's assessment, saying, "When you go substituting team members, it certainly has the potential of impacting the quality of care… The potential for error, for communication issues will most likely go up."

And according to Matt Calzia, a nurse practice consultant with the Oregon Nurses Association , the reliance on travel nurses is only worsening the already existent staffing shortages in rural and underserved areas, most of which have fewer resources and are home to marginalized communities with poor access to care.

"You're perpetuating the disparities within the healthcare system overall," Calzia said. "We are taking nurses from areas that really need nurses, but don't pay as well, and moving them into areas that might pay better, who also really need nurses."

According to Pittman, as hiring travel nurses becomes more unaffordable for some hospitals, many are now realizing it was a mistake to furlough nurses early in the pandemic instead of investing in them as crucial workers.

"The silver lining of this crisis is that it is forcing nurse leaders and hospital leaders to take the nurse staffing situation much more seriously," Pittman said. (Miranda, NBC News , 9/15; Masson, Becker's Hospital Review , 9/16; Devereaux, Modern Healthcare , 9/16)

There’s a bidding war for nurses—how do organizations compete? See our 3 takeaways.

Monica Westhead

These articles highlight an unfortunate hard truth: the nursing workforce is not immune to the labor shortages and economic forces affecting nearly every industry in the wake of the pandemic. With demand for direct patient care jobs increasingly outpacing supply, the competition for nurses is fierce. Lucrative travel opportunities are exacerbating existing staffing shortages and impacting care quality. Here are three takeaways for health care organizations thinking about the boom in travel nursing:

Even though premium labor is costly, short-term reliance on premium labor to fill vacancies is necessary to maintain safe staffing and ensure the stability of the practice environment. However, be thoughtful about how you incorporate travel nurses into your workforce. Constantly communicate the necessity of agency labor to full-time staff—travel nurses are there to reduce their workload and serve as a temporary fix. Emphasize that your organization aims to convert agency labor to full-time staff. 

Financial incentives to join staffing agencies have significantly increased during the pandemic—expect some of your staff to take advantage of this opportunity. Consider allowing staff to leave for a travel contract but maintain their employment status and return to your organization when their contract ends. Establish a program to ensure returning travelers and other nurses at your organization can work together effectively in a positive practice environment.  

  • Allow staff to scratch their travel itch through opportunities to flex internally.

Nurses are asking for flexibility to alter their schedules, and sometimes, location, to better meet their individual needs. To meet nurses’ needs and compete with agency labor, some health systems are creating internal travel agencies to flex staff across regions. If your system has sufficient scale, consider developing an in-house travel staffing resource pool that competes with traditional agencies on compensation. Offering this type of flexibility helps reduce your reliance on contract labor, helps retain staff interested in travel opportunities, and ensures nurses working in your health system are familiar with system protocols and culture.

While a reliance on travel nurses will help keep your hospitals running today, this band-aid solution is unsustainable and will not stabilize your nursing workforce in the long-term.

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Posted on September 20, 2021

Updated on September 29, 2023

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Travel Nurses and Patient Care: Their Impact on Patient Outcomes and How Hospitals Can Help Them Succeed

Ann Feeney, CAE

  • Hospitals are using more travel nurses to fill staffing gaps.
  • Travel nurses typically cost more financially than staff nurses.
  • The use of travel nurses is sometimes associated with worse patient outcomes based on limited research.

Travel nurses help fill gaps in hospital staffing, but there are questions about their impact on patient outcomes. Hospitals have consistently relied on travel nurses for decades to fill temporary nursing shortages — and that number is only growing – so healthcare providers must understand the potential impact on patient care.

A recently published systematic review concluded that the relationship between travel nurses and patient outcomes is unclear. The use of travel nurses may be associated with some adverse events in patient care, but these events may be due to hospital staffing and work environment issues.

The review found limited or no impact on patient falls, the number of medication errors, or patient satisfaction but a consistent correlation with hospital-acquired pressure ulcers, the severity of medication errors, and the incidence of nosocomial infections (healthcare-associated infections).

Discover how hospitals can better accommodate travel nurses to reduce the effect on patient outcomes.

What Is a Travel Nurse?

Travel nurses take on shorter-term assignments at hospitals, often traveling out of town or state to fill staffing gaps. While many of them work to fill the role of a specific staff member absent for vacation, parental leave, illness, or other reasons, employers also use travel nurses to alleviate nursing shortages.

Travel nurses generally earn higher salaries than staff nurses because of the additional stress of travel, being away from home, and lack of benefits. Travel nurses must adapt readily to new situations, procedures, and colleagues. Registered nurses can become travel nurses as independent agents or through a travel nurse agency.

The total hours worked by travel nurses as a percentage of the total hours worked by hospital nurses grew from 4% in January 2019 to 23% in January 2022, according to the American Hospital Association .

How Does Patient Care Differ Between Traditional and Travel Nurses?

According to the review, staffing levels did show a consistent correlation with travel nurses and worse patient outcomes. This finding is unsurprising since hospitals employ travel nurses to address low staffing levels. There is also a strong and consistent evidence-based association between nursing staff levels and patient outcomes, according to a qualitative study.

Staffing levels were the key variable affecting patient outcomes, according to the systematic review. Some patient outcomes did not show a consistent correlation with the use of permanent/traditional nurses rather than travel nurses. The outcomes that did not show an association include:

  • Patient falls
  • Number of medication errors
  • Patient satisfaction

However, some negative outcomes did show a consistent correlation with the use of travel nurses. These include:

  • Hospital-acquired pressure ulcers
  • Severity of medication errors
  • Nosocomial infections (healthcare-associated infections)

Because the research on patient outcomes and travel nursing is still limited, the systematic review included only 21 articles. Many reviewed articles tracked only one or two patient outcomes, and sometimes, studies of the same outcome found different results. For example, some studies found better outcomes for some variables with greater use of travel nurses. More research is needed to further understand the relationship between the use of travel nurses and patient outcomes.

How Can Hospitals Better Accommodate Travel Nurses?

The review also examined how hospital structures, patient risk factors, and travel nurse experience levels impacted patient outcomes. Ultimately, the work environment strongly correlated to patient care.

The study did not find that the type of unit (such as critical care) had a consistent correlation with outcomes and the use of travel nurses. Similarly, patient risk factors and travel nurse experience levels did not show a relationship between travel nursing use and patient outcomes.

The work environment had the strongest impact on overall patient outcomes. Some, though not all, of the studies in the systematic review, indicated that work environment may be the underlying factor that determines whether travel nurse use is associated with adverse patient outcomes.

Some of the factors associated with a positive work environment include but are not limited to:

  • Appropriate level of challenges
  • Career advancement
  • Collaborative work environment
  • Control over work environment
  • Manager support
  • A non-punitive environment
  • Nurse input into error prevention
  • Job satisfaction
  • Patient-centric culture
  • Perception of being valued by leadership
  • Support for education and development
  • Workplace civility

Hospital work environments and staffing levels may have an association with greater use of travel nurses. If permanent staff find staffing levels inadequate or the work environment unsupportive, they may be more likely to leave. Negative work environments can fuel the nursing shortage, which may lead to greater use of travel nurses. Where adverse outcomes seem to be associated with travel nurses, it is entirely possible that the work environment and staffing levels are the underlying causes.

AHA Senate Statement on Examining Health Care Workforce Shortages: Where Do We Go From Here?” (2023). AHA

Blume K, et al. (2021). Staffing levels and nursing‐sensitive patient outcomes: Umbrella review and qualitative study . NIH

Kieft R, et al. (2014). How nurses and their work environment affect patient experiences of the quality of care: a qualitative study . NIH

Krupp A, et al. Intensive Care Unit Utilization Following Major Surgery and the Nurse Work Environment . AACN

Vander Weerdt C, et al. (2023). Travel nurses and patient outcomes: A systematic review . NursingCenter

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What Is a Travel Nurse?

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Are staffing challenges slowing down your health system's growth? Subscribe to our newsletter for expert solutions!

Beyond Travel Nursing: Building a Sustainable Healthcare Workforce Strategy

A nurse wearing a mask stares out the window as she commutes to work by bus.

While the COVID-19 pandemic is behind us, the nursing shortage remains front and center. Nearly 100,000 nurses left the profession during the pandemic, with 800,000 registered nurses and 184,000 licensed practical nurses likely to leave the profession by 2027, according to NCSBN's 2022 National Nursing Workforce Survey .

Roughly 20% of our country's licensed RNs and LPNs/LVNs will likely leave the profession by 2027.

During the pandemic, hospitals relied on travel nurses to ease staffing shortages. And since then, hospital administrators have seen contract labor budgets balloon by more than 250%. In early 2022, the national average pay for a travel nurse was $150 per hour.

A hospital can save an average of $3,140,000 for every 20 travel RNs eliminated .

According to the 2024 Cost of Caring Report by the American Hospital Association, hospital labor costs surged by over $42.5 billion between 2021 and 2023, reaching a total of $839 billion. These labor costs represent nearly 60% of the average hospital's expenses.

Hospitals have increasingly relied on costly contract labor to address staffing shortages and ensure continuous patient care, spending approximately $51.1 billion on contracted staff in 2023.

Relying on travel nurses is not a cost-effective, long-term strategy for healthcare workforce management. Consequently, hospitals and health systems are exploring various staffing solutions to establish a sustainable workforce for the future.

Continue Reading

Submit your information to learn how your healthcare organization can establish a stable, cost-effective nursing workforce by engaging your community's latent healthcare talent.

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