2007 Salary Survey Results

Rx for your career: Strategies to get the salary you deserve

Most EHPs get small annual raise

You have many years of experience in nursing, special training in occupational health, responsibilities that impact the hospital's bottom line. When it comes to compensation, are you getting what you deserve?

A majority of employee health professionals (56%) received an annual salary increase of 1% to 3%, according to the 2007 Hospital Employee Health salary survey. About 16% received no raise. Most of the respondents also had a long tenure — 80% had 22 years or more in health care and almost half (49%) had 10 years or more in occupational health.

There were 202 respondents to the survey. They were most likely to work in a nonprofit hospital with 300 or fewer beds. The predominant salary ranges were $50,000 to $59,999 (26%) and $60,000 to $69,999 (25%), although another 20% earned from $70,000 to $89,999. Most (60%) have a bachelor's or master's degree.

"To the degree to which you are mature in your career life, you are at the top of your range," Charlene M. Gliniecki, RN, MS, vice president, human resources, at El Camino Hospital in Mountainview, CA. "The market may not bear more. If you get the cost of living or a little bump, you are the lucky person."

Yet there may be some ways to increase your earning potential — by qualifying for performance bonuses, seeking pay equity, or even altering your job description and title.

Before you make the case that you should receive more compensation, make sure you are displaying professional leadership and following best practices in your field, advises Ann R. Cox, CAE, executive director of the American Association of Occupational Health Nurses (AAOHN) in Atlanta. For example, you need to have a broad scope that includes injury and illness prevention and you should have input into your hospital's safety program and disaster planning.

"It really comes down to what a person wants professionally for themselves," she says. "If they want to contribute and be rewarded for that contribution, then they need to be looking where the optimal practice opportunities are for the future."

Go for a performance bonus

If you are ready and willing to prove your worth to the organization, find out more about your hospital's compensation philosophy. Are you eligible for incentive pay? This may involve setting specific goals that correspond with the hospital's goals or bottom line. For example, you may set a goal of reducing workers' compensation costs by reducing injuries, or improving return to work rates.

"This is usually paid for by stretching beyond what you're been doing or taking your performance beyond [the routine], — an increase in productivity or effectiveness that you can demonstrate with metrics," says Gliniecki.

You may even partner with another manager who has a performance goal that includes reducing turnover or absenteeism, or reducing bloodborne pathogen exposures and patient handling injuries, she suggests.

Additional training or involvement with professional organizations may give you leadership skills. For example, in November, AAOHN will publish a revised self-assessment tool that occupational health nurses can use to evaluate their competencies. According to the AAOHN, the occupational health nurse's responsibilities and areas of opportunity have expanded into such areas as case management, counseling and crisis intervention, health promotion, legal and regulatory compliance, worker and workplace hazard detection, and business leadership. (See the AAOHN Journal at www.aaohn.org for more information.) AAOHN also holds an annual Conference for Leadership Advancement. The 2007 course, held in September, focused on communication skills.

If you're too overwhelmed with day-to-day functions, such as providing TB screens or giving flu vaccinations, consider ways to gain extra help, advises Cox. For example, nurses on light duty in the workers' compensation program may be available to help administer vaccines, freeing you up to take on other responsibilities.

Check out your pay equity

If your hospital doesn't offer incentive pay, or you're not eligible because you're not a manager, you still may have other avenues for improving your compensation. One is to insure that you have pay equity.

"Sometimes if you're in your job for quite a while you might fall behind the market," says Gliniecki. "If you left the job and they were recruiting for someone, would they have to revise the range to be successful in recruiting for that person? It might be that you need a wage range adjustment."

You can find out about pay equity, both external and internal (for positions similar to yours) through the compensation manager in human resources, she says. Local chapters of AAOHN or the Association of Occupational Health Professionals in Healthcare (AOHP) or a union also may be able to share local compensation information for employee health nurses.

At El Camino Hospital, employee health nurses are aligned with other clinical nurses in the hospital, says Gliniecki. If nursing pay rises due to a nursing shortage, the employee health nurse will receive the raise, she says.

However, that is not always the case. At Saint Francis Medical Center in Peoria, IL, inpatient nurses at the bedside receive financial incentives that are not available to "ambulatory care" nurses who work in other areas, says Denise Knoblauch, RN, BSN, COHN-S/CM, clinical case manager in the Center for Occupational Health and president emeritus of AOHP.

"The hospitals are trying to keep the nurses at the bedside. Financial incentives are very striking there," she says.

In some cases, employee health nurses still may be eligible for a career ladder program, which provides financial incentives for obtaining additional education or certification or participating in hospital committees.

Consider your job duties and review your job description, advises Knoblauch. You may find that the current description doesn't fully address the scope of your responsibilities, and you may be able to revise it in a way that creates a new career path. For example, when Knoblauch became a "clinical case manager," she moved into a higher pay range.

"Pick up on the pieces of what you're doing and put the puzzle together in a different way," she says. "Maximize who you are."

Something better than money?

After you've analyzed your job responsibilities and performance, you may decide that pushing for a little more money isn't what's most important to you. Instead, you'd rather push for some additional help in employee health. Or, as Gliniecki says, "Maybe what you really want is not to be working 12-hour days or 10-hour days."

Again, you'll have to make the case that you don't have enough resources — and that you can do more for the organization to raise productivity and lower workers' compensation costs. It's hard to find benchmarks for the "right" number of employee health nurses to number of employees. Employee health services differ greatly in the scope of their practice; some include other duties such as infection control or health promotion.

You can do your own informal survey with colleagues at hospitals that you know are similar to your own. You also need to articulate what you would do differently if you had assistance, and how it would save the hospital money, says Gliniecki. Try to quantify a return on investment — such as how root-cause analysis of injuries or a stronger patient handling program would save money through reduced injuries.

"At the end of the day, it probably comes down to how good a salesperson you are," says Gliniecki.