By Debra Wood, RN, contributor
Nov. 6, 2009 - While pay and benefits remain important to nurses, they may not hold the sway they once had, with some employers finding nurses more interested in good places to practice, participation in decision making and opportunities for career growth.
Joni Sperry and Tracy Coleman of Southwest General Health Center report nurses now show a greater interest in work environment and having a say in their practice.
“In recent times, we’ve seen a shift to them focusing on the work environment rather than financial incentives,” said Joni Sperry, employment manager at Southwest General Health Center in Middleburg Heights, Ohio. “The financial incentives help get the nurses here, but that’s not what keeps them here.”
Southwest General has introduced a shared governance model of practice; online and flexible scheduling with 12-hour and 8-hour shifts, no shift rotations and weekend options; seasonal staffing assistance; and electronic recordkeeping, which has decreased paperwork and allowed nurses more time to spend with patients.
“They want to work somewhere where care is the number one concern and the employer is doing its best to provide an environment where they can provide the best care,” Sperry said.
Janice Buehler, MBA, CHCR, director of recruitment and workforce planning at Cedars-Sinai Health System in Los Angeles and president of the National Association for Health Care Recruitment, also indicated that nurse applicants are asking more about management styles and codes of conduct. Cedars-Sinai has an established shared-governance model and a formal code of conduct.
“Job applicants are more savvy because of the Internet. They know your reputation,” Buehler said.
Deborah Rowe, MS, RN, PHR, CHCR, regional director of Genesis Health Care in Towson, Md., and secretary of the National Association for Health Care Recruitment, reported nurses have an increased emphasis on career planning and educational opportunities.
“A career path, more than money, is a satisfier,” Rowe said. Genesis is helping employees create career maps, identifying education and qualifications needed to advance, so they can set realistic goals.
Nurses also care about the physical attributes of the environment in which they work. A Kaiser Permanente team confirmed this when soliciting nurses’ feedback about priorities when rebuilding aging facilities to meet seismic codes. The new Kaiser Permanente Downey Medical Center features more natural light, environmentally friendly paints and adhesives, and a food and nutrition services department that offers healthy choices.
As another way to enhance the working environment, Southwest General established a Tokens of Appreciation program for their staff this year. New clinical employees receive a booklet with tokens valued at $1 each, which they can give to individual co-workers who have been helpful to them. Sperry said it helps break the ice and creates bonds between staff.
“It’s a more enjoyable environment when you have teamwork, coaching and mentoring going on,” Sperry said. Despite the recent economic downturn, Southwest General has not cut back on employment benefits and has even retained its concierge services.
Cedars-Sinai also continues to offer a wide variety of benefits including pet insurance and on-campus coursework that allow staff members to earn a bachelor’s and master’s degree.
“We’re focusing on how to retain nurses when the economy turns around,” Buehler said.
Southwest General has implemented a Wisdom Works program, enabling experienced nurses to work part time but retain their benefits. Tracy Coleman, a human resources generalist at the hospital, added that flexible scheduling, allowing nurses to better balance home and career commitments, is very appealing.
Reports of Benefit Changes Due to the Economy
RN Magazine’s 2009 Nurse Benefits Survey found that benefits packages have remained strong during the recession. The 685 nurses responding to the online survey indicated greater access to health insurance, vacation days and defined-contribution retirement plans. And part-time nurses found their odds of receiving benefits increased. However, more nurses, 35 percent, reported dissatisfaction with their benefits plans than in years past, and only 10 percent reported improved quality.
While some hospitals have maintained their benefits packages, others have scaled back.
“Nurses still care about the same things they’ve always cared about, but employers are feeling a pinch overall,” said Greg Zoch, a partner with Kaye/Bassman International Corp., an executive search and recruitment firm in Plano, Texas.
Zoch reported some hospitals offering lower or no sign-on bonuses, reducing or eliminating retirement account matching funds, increasing the amount the employee must contribute to health insurance, and lowering education allowances, such as paying for one conference per year instead of two.
“These are incremental savings that may not be that great for one individual,” Zoch says. “But it can add up.”
Rowe also indicated hearing about cost containment in regard to retirement accounts and leadership salary freezes and focusing more on front-line employees. However, Genesis has been able to add 100 full-time nurses while decreased the amount of overtime it authorizes.
Susan Erickson, RN, MNSc, BC, CHCR, nurse recruiter at the University of Arkansas for Medical Sciences Medical Center in Little Rock and the southern regional chairperson of the National Association for Health Care Recruitment, added that her facility has not cut back on benefits but also is watching overtime expenses. She reports that facilities in rural areas of the state have cut back on retirement matches and are reviewing health benefits.
While cuts may help the bottom line, Zoch called it a risky proposition.
“It’s a dangerous game for employer to play, because people talk,” Zoch said. “Employers will find themselves in a battle to retain good employees at the cost of a few hundred dollars a year in savings. Plus they will have to advertise to replace those employees, and those employees might not be as good as the ones they lost.”
Zoch reported the demand for nurses continues to grow, because of the aging population and the increased technology and ability to get noninvasive care. He expects employers will again be searching for nurses within the next two years.
“Don’t make long-term decisions based on short-term circumstances,” Zoch said. “It can cost more than they realize.”
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