As the COVID-19 pandemic increases demand for specialized nurses in many parts of the country, it has also exposed long-running tensions over pay at Nashville's biggest hospital.

Vanderbilt University Medical Center last week set up a "manpower command center" to "recruit nurses and nursing students who can serve alongside or support our clinicians in a range of ways."

The pay? In some instances, up to $5,600 per week for temporary nurses, dwarfing the salaries of existing emergency room nurses who say they have been fighting for salary increases for more two years.

"My starting pay is less than $24 per hour," said one veteran nurse, who asked to remain anonymous because she feared losing her job after speaking out. The nurse said she relies on overtime, working 48-60 hours per week instead of the regular 36-hour work week to make ends meet. Otherwise, her standard take-home pay is less than $1,000 per week.

"We are nurses. We understand the risks. But we’re putting our family at risks too," the nurse said. "Kroger is offering their workers more pay right now. Other places are as well. I think financial compensation for how hard we are working would be a good way to say 'thank you. We appreciate you.'"

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Another nurse, who also asked her name not be used, said she had began working at Vanderbilt as a temporary nurse several years ago, then took a 60% salary cut to take a staff job to remain in Nashville.

"I hear people talking about hazard pay, and I kind of go back and forth about that," she said. "We knew what we signed up for when we became nurses. I think if I were working anywhere else where the pay was equitable, I don't think COVID should necessarily mean extra pay (for staff nurses) if we are already fairly paid. The problem is we are not."

The median salary for a hospital-based registered nurse is $37.37 per hour nationally, according to the Bureau of Labor Statistics. In Tennessee it is $29.48 per hour.

After inquiries from news organizations on Monday, the hospital issued a statement saying they planned to tell staff Tuesday that pay increases would take effect this month for all registered nurses involved in direct patient care and their nursing supervisor.

The news release did not specify the amount in pay increase, saying those decisions would be conveyed to individual nurses through their managers.

An email to one nurse on Tuesday shared with The Tennessean said nurses with three years of experience or less would receive a $2 per hour raise; nurses with more experience will receive a $3 per hour raise.

"We know that our nurses provide outstanding care and create remarkable patient experiences every day," the statement said.

The pandemic has forced hospitals to shift nurse staffing at all levels, as elective surgeries are cancelled and outpatient services temporarily suspended -- and the staff needed for those procedures sidelined.

Instead, ICU and ER nurses are in greatest demand.

Outbreak hotspots such as New York, Detroit, New Orleans and Seattle have all reported peak demands for those nurses, according to NurseFly, an industry information source for nurses and healthcare professionals.

Hospitals in New York City are paying $10,327.80 per week in addition to travel and housing stipends for ICU nurses willing to work immediately, according to NuWest Travel Nursing.

Average pay across the nation for temporary registered nurse jobs was $1,700 nationwide in January. By March, the average pay for COVID-19 related nursing jobs jumped to over $3,000 – with outbreak hotspots seeing pay increased of more than 100 percent, according to NurseFLy

At Ascension Saint Thomas, officials are also recruiting temporary full-time and on an as-needed basis, said spokeswoman Michelle Heard. Heard declined to provide pay figures for temporary staff.

The hospital is also cross-training existing nurses to provide support in departments that will need additional staffing to care for COVID patients, she said.

In response to questions about whether staff nurses would receive any additional pandemic pay, Heard said that the hospital established extra day care subsidies and hotel reimbursements for staff who treat COVID patients who may need to stay apart from family members.

HCA hospitals continue to recruit rapid response nurses on an as-needed basis, but does not disclose its contract pay agreements.

Spokesman Harlow Sumerford referred questions about additional staff compensation to a statement by HCA CEO Sam Hazen that he would contribute 100% of his compensation in April and May to an established relief fund that helps employees who have suffered an extended illness, injury or disaster.

Reach Anita Wadhwani at awadhwani@tennessean.com; 615-259-8092 or follow her on Twitter @AnitaWadhwani