A local approach
After six years working in the emergency department at Olympic Medical Center in Port Angeles, Higgs now employs a staff of 17 travel nurses at North Coast Nomad with contracts at three hospitals. He said he recruits local nurses to work at nearby facilities, keeping them rooted in their home communities.
Nursing is already a tough job, he said, without dealing with the resource shortages and politics of a hospital. The culture of most hospitals is that nurses will do anything for their patients, based on their compassion and feelings of duty or service.
“Do it all with nothing,” he said, “build mansions out of twigs and shrubbery.”
Higgs was reluctant to share his story publicly because travel nurses and agencies get negative press — unfairly he thinks. In his experience, North Coast Nomad allows health care workers to continue their passion on their terms.
It isn’t just the money that entices people to do travel work, he said. Some want more control over their schedules or different experiences to build their skill set. Some are just tired of hospitals’ internal politics. Travel work allows a type of gig-worker autonomy and detachment. And, if the traveler keeps their housing back home, the pay covers double rent or mortgage. Ultimately, he thinks his business has “allowed us to take pride again in what we’re doing.”
He said his business is different from the big national staffing agencies in transparency, flexibility and staff quality. North Coast Nomad strives for low overhead and pays out a larger share of its bill-to-fill rate to employees. About 75% goes directly to workers as wages, he said, a percentage he contends is meaningfully higher than that of other agencies working in the region. Several recent job postings for an RN in an Aberdeen emergency room advertise a pay and benefits package equivalent to 61% to 73% of a $130 bill rate.
“We try to give the best rate possible,” he said, “but also if [the hospitals] need staff, we have to attract nurses.”
Higgs said he discloses those rates and profit margins with his staff, a policy he says is unique. Other travel staff he has worked alongside told him they had no idea what the bill-to-fill rate is.
(According to Foley and a public records request, North Coast Nomad’s bill-to-fill rate for ER nurses was similar to that of another larger staffing agency, about $125-$135 an hour in 2021. Favorite Healthcare Staffing, a national agency based in Kansas, was billing $130 as a “crisis” rate — the market rate Harbor Regional has paid since late 2020.)
Higgs said he aims to have staff more readily available to fill shifts at these isolated hospitals. Because his team is local, North Coast Nomad can fill short-notice, single shifts for hospitals. And hospitals deal directly with him — not a recruiter — as the owner and a practicing nurse.
He also knows the quality of his team first-hand, often working directly alongside them.
“I’m not out just trying to fill a hole,” he said, “I’m trying to deliver a good product.”
