2007 Salary Survey Results

Tackle nursing shortage by attracting, keeping senior nurses

Attractive employment options encourage nurses to put off retirement

With almost 49% of the respondents to the 2007 Same-Day Surgery Salary Survey reporting that their staff sizes have increased during the past year, the challenge of recruiting new employees and retaining experienced employees grows and is exacerbated by the nursing shortage and the aging of the work force.

Salary survey respondents are representative of the aging work force, with more than 58% of respondents over the age of 50. (See chart, below.) One tactic to address the nursing shortage and the increasing work force age is to offer employment programs that provide senior employees a reason to continue working past the age they might retire, or to return to work after retiring, according to experts interviewed by Same-Day Surgery.

Lee Memorial Health System in Fort Myers, FL doesn't just claim to be a good place to work for employees older than the age of 50, the health system has been recognized three years in a row by the American Association of Retired Persons (AARP) as one of the best employers for workers older than of 50 due to innovative programs that address the needs of senior workers. Lee Memorial is one of five hospitals or health systems included in the AARP's top 10 best employers for mature workers for 2007. "We make a special effort to recruit senior nurses throughout the health system, including our outpatient surgery departments," admits Kristy Rigot, system director of human resources for Lee Memorial.

The recruitment begins with a specially designed brochure for distribution to the 3,000 volunteers throughout the health system, Rigot says. "We have found that our volunteers are an excellent source of referrals of new employees," she says. Not only have volunteers referred friends or family to Lee Memorial but many times, volunteers with health care backgrounds will decide to re-enter the work force when they see the variety of flexible employment plans offered by the health system, Rigot says. Lee Memorial also uses senior placement agencies to recruit mature workers or retirees, she adds.

Flexibility is a key concern for working seniors, so Lee Memorial offers job-share positions, flex pools for nurses who want to select the number of hours they work, and 36-hour weeks that pay 40 hours of salary, points out Rigot. "If a nurse is physically unable to work three 12-hour days to make up the 36 hours, we adjust the schedule to include six- to eight-hour shifts that total 36 hours," she says.

About 35% of Lee Memorial's work force is over the age of 50, "primarily because we are located in an area that attracts seniors because of our weather and our quality of life," Rigot says.

To appeal to snowbirds who live in the area only six months of the year or seniors who don't want to work full time the entire year, two seasonal employment options enable employees to work full time during the health system's busiest months for six months, then either take six months off to return to their homes in the north or just reduce hours for up to six months to enjoy vacations, gardening, or other hobbies, she says. Both options offer employees a chance to continue receiving full benefits at the same cost as employees working full time throughout the year, Rigot adds.

The ability to attract senior nurses or other employees might be related to your location, admits Kathy Harris, vice president of human resources at Mercy Health System in Janesville, WI. Salary survey respondents represent all regions of the country as well as different types of locations such as urban and rural.

"Our geographic area is somewhat rural, and many of our clinics are located in small communities in the southern Wisconsin and northern Illinois areas," she says. "We do compete with Madison and Milwaukee and some of the Chicago suburbs for work force talent."

Because Mercy Health System is a large organization, there are several approaches to attract or keep mature nurses, she says. One key approach to the needs of older nurses is the Low Lift Program, in which nurses' work areas and equipment are redesigned so that there is less physical lifting, Harris says. "We offer specific education opportunities for nurses to learn about the special lifting equipment and safe patient handling," she adds.

Another key program is the work-to-retire program, in which longer-term nurses can reduce hours and transition into retirement, while staying eligible for benefits, says Harris. The program allows employees age 50 and older with five years of service the opportunity to work reduced, pool, or work-at-home schedules, she says. It also allows employees ages 55 and older with 15 years of service to work seasonally, for 1,000 hours in a year at their discretion, while maintaining full part-time benefits such as health and dental insurance for the entire year, she explains. (See charts below.)

Offer senior staff a chance to affect workplace

Freestanding surgery programs or smaller hospital systems may not have the resources or flexibility of a large number of employees to be able to offer formal reduced hour programs, but there are benefits to working in a surgery center that do attract senior nurses, says Pam Neiderer, RN, BSN, clinical service manager at Surgical Center of York (PA).

"Surgery centers don't have weekend or evening hours, and the schedule is fairly predictable," she says.

The small staff also give every nurse an opportunity to participate in committees that present recommendations that can affect everyone's job, says Neiderer. "We don't have many standing committees other than quality improvement or infection control, but we do put together committees to study issues as they arise," she says.

Nurses can volunteer for issues that interest them and participate in decision making that affects their jobs, Neiderer says. The addition of new equipment or services, studies of different performance improvement areas, or evaluation of educational opportunities are a few examples of special committees that can be convened. "We also promote a family-oriented philosophy at our center, so if an employee needs a few hours to go to a child's activity at school or a doctor's appointment, we work with the staff person to cover their job for a few hours," she says.

With 14 years experience in outpatient surgery, Neiderer is typical of most survey respondents, of whom more than 57% have worked in outpatient surgery for 15 or less years (See charts, below.) "I did, however, have 14 years of experience in a hospital setting before I moved to outpatient," she says. Neiderer's staff nurses also have many years of experience before they move to outpatient because she does not hire new graduates. "We are a busy, small center with no time to train people for surgery," she says. "For that reason, I only hire experienced surgical nurses."

Because administrators want to find out what is important to employees before developing retention strategies, Lee Memorial conducts both a health systemwide annual employee survey and monthly surveys with employees chosen at random.

"Results of both types of employee surveys show that, regardless of age or experience, salary levels are not an indicator as to whether an employee will stay at Lee or not," says Rigot.

"Salary levels do attract new employees, but our employees say that input into decisions affecting their jobs, resources that enable them to do their job effectively, and the opportunity to grow and develop are the reasons they choose to stay," says Rigot. To address the interest in furthering their education or developing new skills, Lee Memorial offers three types of educational assistance that appeal to senior workers, she points out. "We reimburse tuition for nurses who are going back to school to earn another degree, we also pay for a nurse refresher course for nurses who want to re-enter the work force after time off, and we offer educational grants for one-time courses," she explains.

Senior nurses also like to fill the role of teacher for less experienced staff, Neiderer says. "We have a mentor program that matches an experienced nurse with a nurse who is new to our center or new to a surgical specialty," she says. The mentor works with the new employee to make sure that the new employee is comfortable asking questions and learning a new job, she explains. A mentor program is a great way to tap into the knowledge of senior employees as well as demonstrate respect for their experience, she adds.

As you evaluate your employment options for senior employees, be sure to keep their specific needs in mind, suggests Rigot. "Our senior nurses want meaningful work, the ability to set their own schedules, a position that matches their lifestyle, and the opportunity to maintain benefits," she says. In fact, managers work with senior nurses to ensure that they don't lose Social Security benefits while they work, Rigot says. "We have nurses who are job sharing and must keep track of their hours so that they don't work over the limit allowed for retention of Social Security benefits," she says. "When one of the employees gets close to the limit, managers rearrange schedules to help the employee avoid going over the limit."

It isn't difficult to develop employment options that are attractive to experienced employees, Harris says. "One very important tip is to ask the staff what kind of programs would help them stay in the work force longer," she says. "The answers to this will give you a great foundation to design programs that meet the needs of your staff."

While it is important to look at best practices and identify many different options that are being used by other employers, pick the ones that fit your organization, Harris suggests. "Not all best practices work in all settings," she says. "Always ask employees what is important to them."


To learn more about recruiting older employees, contact senior placement agencies such as:

  • Experience Works, an Arlington, VA-based national agency that pairs low-income seniors with employers. Phone (866) 387-9757. E-mail: info@experienceworks.org. Web: www.experienceworks.org.
  • Operation ABLE: Coaching and referral service; provides counseling to employers interested in retaining and attracting older workers, Boston. Phone: (617) 542-4180. E-mail: able@operationable.net. Web: www.operationable.net.
  • Senior Community Service Employment Program (SCSEP), part of the AARP Foundation, helps financially eligible individuals 55 and older remain in or re-enter the work force. Provides training for workers and referrals for employers. National office phone: (202) 434-2020; state SCSEP offices located nationwide. To find a local office, visit the AARP SCSEP web site at www.aarp.org/scsep.

For a free complete listing of AARP Best Employees for Workers Over 50 as well as descriptions of innovative programs, go to:

  • www.aarp.org. Under "Best Employers for Workers Over 50," click on "Honored in 2007."

For more information on low-lift products, contact the following manufacturers:

  • Hovermatt patient repositioning products. Manufactured by HoverTech International, D.T. Davis Enterprises, Bethlehem, PA. Phone: (800) 471-2776. E-mail: hovermatt@earthlink.com. Web: www.hovermatt.com.
  • Ergo Slide no-lift patient transfer systems. Manufactured by ErgoSafe Products, St. Louis. Phone: (866) 891-6502. Web: www.ergosafe-products.com.
  • EZ Lift battery/electric patient lifting systems. Manufactured by Kinetic Concepts, San Antonio. Phone: (800) 275-4524. Web: www.kc1.com. For information on EZ Lift, select "bariatric support" in the left navigational bar.