Skip to main content

Health System's Internal Travel Agency Program Gives Nurses What They Want: Flexibility and Options

Analysis  |  By Carol Davis  
   July 25, 2022

Bon Secours Mercy Health's Nursing Flex Team gives nurses 'an opportunity to take advantage of the geography, size, and complexity of our health system,' CNO says. 

A unique nurse staffing program at Bon Secours Mercy Health (BSMH) serves as an internal travel agency program, of sorts, providing nurses more flexibility and choices about how and where they advance and progress across the health system.

The Nursing Flex Team is divided into three tiers, says Andrea Mazzoccoli, RN, PhD, FAAN, the Cincinnati, Ohio, health system’s chief nurse and quality officer. Tier 1 is the most traditional, where nurses stay within their facility or a single geographic area and flex by either staying within their specialty or learning new specialties.

Tier 2, which was added about 18 months ago, gives nurses more flexibility in region and geography.

“If a nurse is enjoying our Richmond [Virginia] market, they are able to have concentrated and assigned intervals in different kinds of units across all of the facilities within that market,” Mazzoccoli says.

Tier 3, introduced just within the past few months, allows nurses to take assignments across the health system’s 13 markets in five states: Ohio, Virginia, South Carolina, Florida, and Kentucky.

“We’re most excited about our Tier 3 program, because it’s a way that we afford nurses an opportunity to take advantage of the geography, size, and complexity of our health system, Mazzoccoli says. “They now have the opportunity to have assignments across our ministry in any of the markets and in any of the facilities. Those assignments range much like you see in traditional traveler programs, where it goes for eight, 12, and 16 weeks, and where they talk to us about their career pathway progression and choices, where they’d like to have assignments, and what kinds of things they're looking to experience within our ministry.”

BSMH targeted about 100 nurses to start the program and about 75 are currently in the program, she said.

Mazzoccoli spoke with HealthLeaders about how the Nursing Flex Team is working at BSMH.

This transcript has been lightly edited for length and clarity.

HealthLeaders: How does the flex program benefit the nurses?

Andrea Mazzoccoli: It allows our nurses to stay inside our ministry of a faith-based community setting. It also allows the nurses to maintain their compensation, tenure, and service within the ministry.

Nurses have the opportunity to choose whether they want to stay in the unit or department they came from, or travel. They can take a break and say, “Over the next year for 12 weeks, I'd really like to go to Greenville, South Carolina, where we have a bone marrow transplant unit and see what that might be like to work there.”

Our nurses aren't necessarily constrained by what kind of experience they already have, because we help nurses in building their experience. They may try different specialties, or they may stay in their specialty and try different kinds of clinical areas.

Perhaps, for example, we have ED nurses who have never worked in a trauma ED but with the flex program, they can go and experience assignments in Toledo [Ohio] where there's a level-one trauma ED and see how that fits in terms of their career path and progression.

HL: What do the nurses think about the program?

Mazzoccoli: One of the most exciting things is their opportunity to stay within in our ministry and have lots of different kinds of experience based on their choice and their time. At one time, if they wanted to have these kinds of experiences, they would have to choose to leave the ministry to travel. Now they have that opportunity as part of our own portfolio.

The other part is that introduction of external traveling and agency [nurses] is sensitive and sometimes difficult in terms of the acculturation that happens. Nurses see [the flex program] as a way in which they're supported by our own nurses—nurses who come committed to our mission and our vision and our values, who already know what it's like and what it means to be a Bon Secours Mercy Health nurse.

HL: What kind of results are you seeing from the flex staffing program?

Mazzoccoli: We’ve had our external agency nurses opt to join our own internal traveling program. That’s a huge step in and of itself.

We certainly are seeing, thankfully, a downward trend in our resignations and our turnover. There are certainly lots of things that we're working on, so I wouldn't say that this program is necessarily the one single thing, but in our portfolio what we're looking at, particularly for recruitment and retention, are things that afford nurses mobility and flexibility and lots of choice in their own design of their staffing and scheduling.

HL: New nurse turnover is a particular challenge, with newly licensed RN turnover rates reaching 30% their first year and nearly 60% by their second year, according to studies. Is the flex program helping BSMH hold onto its new nurses?

Mazzoccoli: This is one of the ways that we're affording them with opportunities. If some other new nurses can opt to do this, perhaps in a smaller geographic area just to get a taste of different kinds of experiences, either within a facility or market before they make a choice, that will help new nurses get a real-life lived experience before they make the choice.

Often what we hear from the new nurses that choose a unit is, “That’s not really what I thought it was going to be.” It’s not been long enough yet for us to truly say that it’s helping us to hold onto new nurses, but it will continue to be a factor in where nurses choose to work for us and the options they have.


“One of the most exciting things is their opportunity to stay within in our ministry and have lots of different kinds of experience based on their choice and their time.”

Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.


Bon Secours Mercy Health (BSMH) has implemented the Nursing Flex Team, an internal travel agency program for nurses.

The program allows nurses flexibility to practice within a small geographic area, or throughout the health system’s 13 markets in five states.

Some of BSMH’s external agency nurses have opted to join its internal traveling program.

Get the latest on healthcare leadership in your inbox.