May 10, 2021


travel, Always a step ahead

Far from home: Traveling nurse fills the gaps at hard-hit nursing home

6 min read

Traveling nurse Freddie Miller hasn’t been home for more than a month.

He spent Thanksgiving working a contract at a Santa Clara County facility. And he provided care to nursing home residents at Escondido Post Acute Rehab on Christmas Day, New Year’s Eve and New Year’s Day before his two-week contract ended and his employer — Aya Healthcare, which is a traveling nurse staffing agency — sent him to yet another facility on a new contract.

Despite missing his family and friends back in Naples, Fla., getting to work with nursing home residents and novel coronavirus patients throughout the holiday season has been emotionally fulfilling for the 23-year-old nurse.

“I enjoyed it because I got to make my patients’ day brighter,” Miller said. “They are away from loved ones and can’t see them, just like me, so to be able to make them smile or to just be able to tell them happy holidays was a blessing. We never realize how the little things in life like that are important.”

Miller was hired to temporarily work at Escondido Post Acute last month as the largest local outbreak in a skilled nursing facility raged through its hallways, infecting dozens of staff in its wake.

According to California Department of Public Health data, a total of 150 residents and 89 health care workers have tested positive there since the beginning of the pandemic. This includes 11 new resident and eight new staff cases that have been reported since Dec. 23, when Escondido Post Acute broke the previous record for novel coronavirus resident cases in the county.

Freddie Miller, a 23 year old traveling nurse from Florida, just arrived at his hotel

Freddie Miller, a 23 year old traveling nurse from Florida, just arrived at his hotel after finishing another 12 hour shift at an Escondido health facility with a major Coronavirus outbreak. He’s working 12 hour shifts at Escondido Post Acute Rehab five days a week during his two-week contract there.

(Charlie Neuman / For The San Diego Union-Tribune)

Miller has worked in health care since he became a certified nursing assistant at 16 while taking classes at a technical high school. It wasn’t until this year that he began working as a traveling nurse to help others during the pandemic.

“I like working my COVID assignments,” Miller said. “I like to work and I like to make a difference in these people’s lives, because I know they don’t get to see their family and it’s not like what they’re used to. They’re not having a lot of social interaction.”

Traveling between coronavirus hotspots is easier in some ways for him than it might be for others, he said, as he is a young, single man without any children.

But being thousands of miles away for months on end does take its toll. Instead of living in this grandfather’s house, and down the street from his family, Miller returns to an empty hotel room in Vista when he leaves work, then calls his family every night.

Despite the ongoing outbreak, Miller said the quality of care at Escondido Post Acute is superior to the facilities where he worked in Florida and Texas earlier in the pandemic.

While in Texas, he said, he ended a contract working at a hospital early because of inadequate infection control precautions.

“Here, they actually care about their job and the work that they do, and that’s what makes it even better for me because I’m that same type of person,” Miller said. “When you’re surrounded with those types of people, it makes the day go by fast. It makes working all these 12-hour shifts even greater.”

Although he has worked with coronavirus-positive patients at various facilities while traveling back and forth across the country, Miller has not yet contracted the virus. He plans to delay receiving any vaccination for at least a year or two because he is worried about how quickly it was developed, and he believes the safety protocols he has taken over the course of the pandemic will continue to protect him.

“I want to let it play out for at least like a year or two and continue to do my precautionary measures of washing my hands, wearing my mask when I go out and constantly taking my showers,” Miller said.

On his current contract, Miller makes $2,300 base pay for a 40-hour work week, which includes a housing and food stipend, plus the overtime he earns working five 12-hour shifts per week. In addition to paying for his hotel in Vista, he uses the money to pay the taxes and utility bills at his grandfather’s house in Florida, where he lives between contracts or while working closer to home.

Because of the heightened need for traveling nurses due to the rapid spread of the virus, Miller won’t be home again until at least February. This is the longest he has been away from home for work since he became a licensed practical nurse at 18.

The San Diego Union-Tribune confirmed through the National Council of State Boards of Nursing that Miller has a multistate, practical nurse license in Florida, as well as practical nurse licenses in Oregon and New York. Miller said he is currently working in California under a temporary license applied for by his employer while he works to earn his license in this state.

The 180-bed facility where he is working, which became home to the greatest number novel coronavirus infections among residents and staff last week, continues to top the list of infections for both demographics in San Diego County.

The second largest outbreak is at The Shores Post-Acute in San Diego, which reported 75 new resident and 22 new staff cases between Dec. 23 and Dec. 30. This brings the cumulative totals at the 305-bed capacity facility up to 133 and 72, respectively.

A continuation of rising cases within San Diego County facilities mirrors what nursing homes are experiencing nationwide as CVS Pharmacy continues to administer the first round of vaccines to staff and residents.

The Centers for Medicare and Medicaid Services reported this week that as of Dec. 20, there had been 471,953 confirmed cases of COVID-19 among nursing home residents and 402,956 cases among staff throughout the country. That’s up from last week’s CMS report for Dec. 13, 441,473 resident and 377,228 staff cases.

Thus far, novel coronavirus infections have caused 92,373 resident and 1,268 health care worker deaths, up from the previous totals of 86,775 and 1,258 deaths, respectively.

California’s health care system continues to be impacted by the virus as the state experiences an “unprecedented and exponential surge in COVID-19 cases” that is straining both staffing and other resources, according to a letter from the California Department of Public Health on Monday.

CMS reports that 35,710 nursing home residents have contracted the virus in California, which is an 11.2 percent increase from the previous week’s total of 32,123. There have been 5,326 nursing home residents who have died from the novel coronavirus throughout California, up from last week’s report of 5,014.

San Diego County is currently experiencing the greatest number of concurrent outbreaks since the pandemic began.

County health officials reported Wednesday that there are currently 55 active outbreaks in skilled nursing facilities, which includes seven newly announced ones, bringing the total of novel coronavirus outbreaks to 140. Last week, there were 48 active outbreaks out of the 133 that have occurred since the beginning of the pandemic.

Unlike outbreaks in community settings, which are defined as three or more related cases from separate households, outbreaks at skilled nursing facilities are deemed active when one resident or health care worker from the facility tests positive for the novel coronavirus. An outbreak is deemed inactive once no one has tested positive for at least two weeks.

The county reported that a total of 2,259 skilled nursing residents and 1,413 staff in San Diego County have tested positive for the virus since the pandemic began, up from last week’s report of 2,044 and 1,301, respectively.

According to California Department of Public Health data, Monte Vista Lodge in Lemon Grove is still the only facility that has not yet reported a single case of the virus among either a resident or a health care worker.

There were also 16 new deaths connected to skilled nursing facility outbreaks reported by the county this week, bringing the total over the course of the pandemic to 255. Last week, 239 skilled nursing facility residents and staff were reported to have died from the virus. Deaths related to skilled nursing facility outbreaks account for 17.77 percent of the the total number of novel coronavirus deaths in the county.

For the online version of this story with novel coronavirus details for all 86 skilled nursing facilities, visit

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