Salary Survery Results-Shortage of experienced nurses? Readers share solutions
Salary Survery Results-Shortage of experienced nurses? Readers share solutions
The nursing shortage has affected most same-day surgery programs across the country, and they are developing innovative ways to find nurses and keep them once they find them.
"I think [the nursing shortage] is pretty pervasive around country," says Janet A. Lewis, RN, MA, CNOR, administrative director of surgical services at Integris Baptist Medical Center in Oklahoma City. "My colleagues speak of it everywhere I go."
The shortage of nurses could be one factor in the decrease in the number of employees reported by 14.7% of respondents to the 2000 Same-Day Surgery salary survey. In comparison, only 8.8% of respondents reported a decrease in the number of employees in the 1999 SDS survey.
Same-Day Surgery sent its annual salary survey to 1,076 subscribers. There were 103 responses, for a response rate of 10%.
Trained nurses evade burnout
Same-day surgery managers report a shortage of experienced nurses. In the OR, specific training and educational opportunities are critical to recruiting and retaining nurses. Most new graduates don't have prior experience in surgical areas.
"Going straight from educational programs to clinical roles is difficult. The term 'burnout' comes from that frustration," says Nancy Jo Vinson, RN, vice president of West Virginia Surgery Center in Charleston and chairwoman of the Nurses Committee for the Federated Ambulatory Surgery Association in Alexandria, VA.
"Their lack of clinical preparedness impacts the ORs and the ASCs and other facilities financially, because you have to take the time to expose those same nurses to the clinical areas and provide them orientation programs in areas you're training them in," Vinson says.
In response to the nursing shortage, sign-on bonuses are getting much bigger, Vinson says. Some facilities in North Carolina are offering $2,000 to $5,000 bonuses for OR nurses, she says.
Here's some other suggestions on how to address the nursing shortage.
• Offer flexible scheduling and case extension pay.
In the SDS salary survey, 38.6% of respondents said some freedom to choose work schedule was extremely important. More than one-fourth (25.7%) ranked that benefit as "important, and 15.8% said the benefit is "somewhat important." Almost one in five respondents (18.8%) said that benefit isn't provided to them.
West Virginia Surgery Center offers a tremendous amount of flexible schedule in order to accommodate needs of nurses, as long as the nurse's needs meet the needs of the facility, Vinson says. For example a nurse might work two 11-hour days, a 10-hour day, and an eight-hour day.
"I think flexible scheduling is an asset to a facility as well as employee," Vinson says.
It has to be understood that patient care coverage is the primary need, she emphasizes. "Secondarily, it has to be employees who are available to work a normal schedule, regardless of what that schedule is," Vinson says. "Sometimes that schedule will be overridden by the needs of the facility."
Outpatient surgery staff typically don't want to work late, Lewis says. "They want their family life," she says. Those concerns can be addressed with staggered shift staffing and case extension pay, "so if someone has to stay over to finish care past their shift, there's a monetary incentive," she adds.
• Identify nurses who would work well in outpatient surgery.
Nurses who are self-directed, function independently, and who were flexible in their previous positions make the best outpatient surgery nurses, Vinson says.
"Most RNs have to be able to function in pre-op, post-op, and in the OR, whether scrubbing or circulating," she says. "They have to be able to function in multiple roles and multiple areas."
Critical care nurses, ED nurses, and dialysis nurses often have flexible backgrounds that adapt well to outpatient surgery, Vinson says. "When they walk in, they're usually more adaptable in different areas."
• Offer on-site day care and sick day care.
According to the results of the SDS survey, 69% of respondents don't have child care as a benefit.
And a "sick season" can wipe out an entire nursing staff, Vinson says. Consider on-site day care and sick day care as a way to keep nurses on the job, she suggests. Christus St. Joseph Hospital in Houston offers a Kids on the Mend Program that provides a place for staff to take their sick children so they can continue to work.
• Provide educational programs.
Integris is offering educational programs in the OR for RNs from other parts of the facility, technicians, and recent graduates. The program lasts four months. It starts with a core curriculum. "Then they have actual precepted experience in the OR," Lewis says.
After completing the program, the nurses are hired into a specialty area depending on their interests and the needs of the facility. "That's how we have been able to refuel ourselves with the openings that we have," Lewis says. "We've been able to open up more rooms, because we have more staff."
Integris is very aggressive about ending one course and starting another, depending on the facility's needs, Lewis says. "We expect we will continue, be-cause you always have the normal attrition rate of people who move or are recruited away," she says.
Once you have nurses, the challenge is to keep them, Lewis emphasizes.
If you are part of a health care system, the problem needs to be examined from the system perspective, she says.
"Department heads and administration have to get together and determine what are satisfiers for the nursing staff related to retention," Lewis advises.
For more information, contact:
• Janet A. Lewis, RN, MA, CNOR, Administrative Director of Surgical Services, Integris Baptist Medical Center, 3300 N.W. Expressway, Oklahoma City, OK 73112-4481. Telephone: (405) 949-3661. Fax: (405) 951-2797. E-mail: [email protected].
• Nancy Jo Vinson, RN, Vice President, West Virginia Surgery Center, 425 Greenway Ave., Charleston, WV 25309. Telephone: (304) 768-7310. Fax: (304) 768-8211. E-mail: [email protected].
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