Nursing shortage: Here is what some Hospitals are doing

Nursing shortage has been an issue for sometime nowRoom).
in the country. The causes are varied and have been.
discussed in many articles in the recent past.•Dental Insurance.
The purpose of this article is to explore the strategies•Vision care.
US Hospitals are employing to overcome the nurse•Life/AD&D/Dependent Life.
shortage.•Short and Long Term Disability.
The remedy of a problem is dependent on its cause.•Flexible Spending Accounts.
This is no different here. Since the causes of shortageWellness Program
of nurses are varied the possible solutions proposed•Employee Health Services
are many too. Nurse shortage stems from lesser•On-Site Fitness Centers
number of students choosing nursing as profession ,•Lectures, Training & Workshops
Uncertainty created by a wrong research report in•Massage Therapy
1988 by a reputable organization predicting impendingVacation, Leave & Time Off
nurse oversupply (resulting in students deciding not to•Paid Time Off (personal, sick, holidays) with annual
chose nursing), more nurses choosing to work in outcash-out option
patient setting creating a mal distribution of nurses in•Extended Illness Bank
some areas of the country , dissatisfaction among•Family & Medical Leaves
nurses because of shift work, mandatory overtime,•Personal Leaves
insufficient pay, lack of a career ladder are some of•Bereavement Leave
the common causes.•Paid Military Leave
Many nurses are choosing Temp. work as it pays•Sunshine Fund (no interest loan & donations to
more money and allows some control over workemployees in need)
hours and benefits.•Pension Plan with Employer Matching Contributions
In the private sector the turnover is higher then in the•Adoption Benefit (up to $4,000)
govt. sector.•Credit Union (free checking, low cost loans)
Hospitals are doing all sorts of things to recruit andTraditional benefit packages are not always sufficiently
retain the nurses.alluring to nurses. It is possible that employee benefits
Financial incentives to recruit nurses are temporary fixcould be used more effectively to retain nurses and
in general. These do not guarantee retention of thereduce costly staff turnovers
nurse in the same facility.One example is payroll reduction program commonly
Long term planning for this national problem isknown as 125 Reimbursement Plan. Using this plan the
addressed by federal as well as state level. These willemployee can allocate a pre tax dollar amount per
have effect though not in very near future.year which is anticipated as potential expense to
A serious effort by the hospitals, nurses themselvescover health and welfare expense.
as well as the government and the nursingThe employer avoids having to match FICA tax and
organizations will be needed. Image building , making theworkman compensation expense by reducing the
profession attractive are the sort of things which willamount of income upon which these figures are
take time but will have lasting effects.calculated.
For the short term it is the hospitals which have to dealNot only does the employee net take home pay
with the nursing shortage.increases but the employers matching FICA taxes and
The latest news is that some nurses who are in armyrelated pay roll expenses are reduced (consult your
reserves are now being called in for active duty andtax advisor for more details on this program).
sent to Germany (3 from our institution).Employee’s Voice
There are not many innovative strategies available to•Annual Employee Survey
hospitals to deal with the shortage of nursing staff.•Roundtables with CEO, VPs
Here are some ways different health care•System and Divisional Townhall Meetings
organizations and hospitals are dealing with this nursing•Staff Meetings & Committees
emergency:•Reward & Recognition Task Force
(These strategies are for recruitment of new nurses,•Roving Cart (suggestion box)
new graduates as well for retention of existing•Nurse Week Activities
workforce. Some strategies are short term and some•VP Rounds on Nursing Units (all shifts) during
are long term. Your institution or hospital may alreadyWeeks On-Call and for Special
be employing many of these methods.)•Employee of the Month and Year Awards
Commonly employed strategies to attract and retain•Employee Service Awards
nurses in the organization include:•5&10 year plaques
•Signing referral bonuses•15 year dinner
•Salary incentives•20+ year banquet
•Flexible hours.•Special Performance Awards - Recognition at
•Lower eligibility threshold for benefits.Annual Employee Service Awards
•Improvement in working conditions.Dinner
•Increase recruitment in training programs.•Celebrate, Motivate and Decorate Task Force
•Recruitment outside of prime age.Collaborative efforts between health care
•Identify cost effective and quality based practiceorganizations, societies, hospitals , private sector.
models that promote quality patient outcomes and jobSome examples:
satisfaction.•In San Diego, six hospital systems have committed
•Accommodate aging nurse force.$1.3 million to support a program called, "Nurses Now",
•Image building of nursing staff.which will add faculty and additional student slots to
•Assign responsibilities and challenges for motivatedSan Diego University.
members of nursing staff .•The American Hospital Association News reports
•Create role models for junior nursing staffthat in Laredo, Texas, a hospital CEO worked with
members.Texas A&M University to develop a four-year
•Promote leadership development programs.bachelor's program and is providing $425,000 in
Baptist Hospital of Miami, Florida is employing followingscholarships to local students over the next five years.
strategies for some time with good success.•In Morris County, New Jersey, the Board of
•Sign-on Bonuses offered to all RNs andFreeholders offered scholarships to students who
Out-of-Area Applicants ($5,000 andagreed to work in a long term care facility.
$2,500)•The Dallas-Fort Worth Hospital Council raised
•On-Campus Recruitment Twice a Year at each of$600,000 to expand student enrollment at local
Four Local Nursing Schoolsschools.
•System-Wide Posting of all Job OpeningsMagnet Hospitals: This elite class of hospitals generally
•On-site Child Care Center.do not have problem with high nurse turn over and
•Post Office.recruitment. These classes of hospital (only 1-2 % of all
•Choice of multiple health plansUS Hospitals) attain and keep this designation only if
•Group Legal Insurance.they meet stringent standards and ongoing 4 yearly
•Leave Sharing (PTO donations to employees inevaluations.
need)"The label 'Magnet hospitals' originally was given to a
•Larger and more frequent advertising in Localgroup of U.S. hospitals that were able to successfully
Newspaper and Nursing Journalsrecruit and retain professional nurses during a national
•Special Annual Ads (i.e. Florida Hospital Associationnursing shortage in the early 1980s. Studies of Magnet
Guide, RN Magazine, AJN).hospitals highlight the leadership characteristics and
•Commercial Internet Postings.professional practice attributes of nurses within these
•Special Nursing Limited-Time Offer ($5,000 andorganizations... Hospitals selected met the following
$2,500)criteria: 1) nurses within the hospitals considered them
•Nursing Recruitment & Retention Committeegood places to practice nursing, 2) the hospitals had
•Birthday Cards from Human Resources with 2low turnover and vacancy rates, and 3) the hospitals
Movie Ticketswere located in areas where there was significant
•Employee Activity Committee Eventsregional competition for nursing services." (JONA,
•Regular Bonuses of $1,000 and $500January 1999). Magnet designated health care
•Year-end Raffle for "Trip for Two"organizations consistently outperform their peers in
•Stepped-Up Publicity of the vacancies (posters,recruiting and retaining nurses, resulting in increased
brochures, raffle boxes)stability in patient care systems across the
• Employees Referrals program (RN Hires throughorganization.
employees referral program increased from 28% toForeign nurses/Importing nurses.
31% afterPhilippines is the largest source of foreign nurses.
Introduction of Program).Nurses from many other countries including Europe
•Relocation Assistance offeredhave come recently and in last many years to work in
•Extra Pay Option (in lieu of benefits).the US.
•Staffing Incentive Bonus Programs (including $25is a US based agency that has the authority currently
gift certificates)to screen foreign nurses for eligibility for state licensing
•Special Weekend Scheduling Option ($7/hr diff)boards and work visas.
•Supplemental Weekend Plan ($3/hr diff)Acquiring the services of foreign nurses is not new in
•Increased Base Rates and Per Diem Ratesthe US. Recently the number of non-US origin nurses
•Guaranteed Overtimehas increased significantly.
•Preceptor Honorarium ($200)A number of hospitals are using programs to hire
•Special Call Back Pay (%20 or time and a half)foreign nurses. This is not an easy task as the process
•Thanksgiving, Christmas & New Years Holiday Payis tedious and takes months and may be years.
(time and a half)CGFNS (Commission on graduates of foreign nursing
•Annual Spring Luncheon for Graduating Nurses (allschools) is one source of information for this process.
colleges)Hospitals generally use recruiters specializing in thisarea
•Pay for NCLEX Review Courseand immigration lawyers to hire foreign nurses. Foreign
•Nursing Student Clinical Rotations and Practicums atnurses have to show that their training is adequate,
Hospital.they are proficient in English language and are eligible
•Students Hired as Nurse Care Techs at Top offor visa otherwise
Pay Scale until GraduationTo summarize it seems that the major influences on
•Nurse Care Techs Recruited into New Graduaterecruitment and retention are salary and raises,
Training Programbenefits, shift rotations and scheduling flexibility , staff
•Professional Advancement Process (Clinicalcommunications , tuition reimbursements, type of
Ladder).nursing care delivery system, nursing leadership,
•Leadership Development Programreputation of the hospital and responsive management.
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•Tuition AssistanceAuthor: Sam Khan, For more career -related info,
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