The COVID-19 pandemic has highlighted the underlying weaknesses of the US health care system. Large swathes of the country in rural areas lack hospitals. Long-term care facilities are centers of disease transmission, responsible for some 40 percent of the country’s 380,000 COVID-19 fatalities. Existing hospitals lack adequate personal protective equipment. And understaffing has emerged as a critical frailty in the country’s ability to handle the disease.

Understaffing and overwork among the country’s approximately three million registered nurses (RNs) — a problem even before the pandemic — is now an emergency. Privately owned facilities in particular tend to cut corners on staffing levels; lowering labor costs is a key strategy for boosting profit. Nurses, facing high stress and anxiety as well as exposure to the virus — according to the National Nurses Union, hundreds of RNs have died of COVID-19, with hundreds of thousands more infected — are under more pressure than ever before.

Hospitals are increasingly relying on traveling nurses, employed by staffing agencies, to fill in the gaps. Pay for these workers has skyrocketed — while median pay for an RN is around $73,000, some travel nurses can now make upward of $5,000 a week. (Rumors abound inside hospitals of $10,000-a-week travel-nurse jobs.) The result is a migration of nurses from stable but lower-paying work in a single hospital to contract work, a process only intensifying the problem of understaffing.