2008 Salary Survey Results

Recession-proof your job — How to thrive in tough economic times

SDS Survey results show more received no or small increases

Outpatient surgery managers are feeling the repercussions of the current difficult economy. With programs often performing fewer surgeries and some facilities being sold, careers seem less certain.

Some managers are even losing their jobs. Usually it's because a management company was brought in, says Jane Kusler-Jensen, RN, MBA, CNOR, BSN, director of perioperative services at River Woods and Ozaukee campuses, Columbia St. Mary's, Milwaukee. "They don't think financial margins are not where they should be, or there's been a change in partnership," Kusler-Jensen says. "Lots of times, the management company wants to put their own people in place," she says.

The 2008 Same-Day Surgery Salary Survey results indicate more people received no change in their salary (11.11%) than in 2007 (7.5%). Also, more (38.89%) received smaller increases of 1%-3%, compared to 31.25% who received raises of that size in 2007.

Two things are happening, Kusler-Jensen says. One is that, depending on where you're located, reimbursement levels have declined, she says. "Margins are tightening up," she says. "Any time that happens, the market starts changing, as far as wages go."

The SDS Salary Survey was sent with the July 2008 issue to 581 subscribers. There were 90 responses, for a 15.5% response rate.

Consider these steps to boost your job security:

• Know what a management organization is looking for, and assess whether current management will stay.

If a management company is going to come in, "work with them closely," Kusler-Jensen says. "Get an idea of their expectations for performance, both from an individual perspective and an organizational perspective."

• Sell yourself.

Be proactive in terms of keeping current in your knowledge of the organization and where in stands in terms of finances and quality, Kusler-Jensen advises.

Paula Graling, RN, MSN, CNOR, CNS, clinical nurse specialist of perioperative services, Inova Fairfax Hospital, Falls Church, VA, says, "I think the current managers must showcase their strengths and articulate what they can bring to the unit by having the historical perspective. They must utilize their intellectual capital, especially when it comes to dealing with the physician base." Intellectual capital might be knowledge of surgical procedures, the business, or quality outcomes, for example, she says. "I don't always know what the physician's need to consider, and they don't always know what I need to consider from the nursing aspect, but putting all of our viewpoints on the table and respect each other for their knowledge and opinion goes a long way to making sound decisions," Graling says.

• Obtain special training, education, and/or certification.

Surgery center managers should obtain their certified administrator surgery center (CASC) credentials, says Kusler-Jensen, who helped developed some of the coursework for the certification. It shows a commitment to wanting to stay current in your position, she says.

Identify areas for improvement, and get your skills up to speed, Kusler-Jensen says. "Health care is so complex, and so many skill sets are needed," she says. It's difficult to be strong in every area, Kusler-Jensen emphasizes. "Obviously accentuate your strengths, but make sure areas where you are a little weaker are fortified with CE."

For example, consider strengthening your business skills, says Laurie J. Wensink, RN, MBA, MSN, clinical director of perioperative services at Luther Midelfort Hospital in Eau Claire, WI. "I'm a firm believe in a master's program of some kind, especially on the business side," she says. "I learned a lot by taking those business courses and really understanding the clinical side as well as the fiscal side. A combination is where we should be."

• Know your options.

Find out who is looking to fill positions, Kusler-Jensen advises.

"I think just having options keeps you more focused in a positive direction," she says. "The grass isn't always greener, but if a management company comes in and you lose your job, you'll have the ability to still have income coming in."

Should you expect a big increase this year?

Will outpatient surgery managers be receiving large salary increases in 2009?

Probably not, says Kathy Bryant, president of the Ambulatory Surgery Center (ASC) Association. "I would expect increases not to be as robust as in previous years, particularly if hospitals are laying off people," she says. "Hospitals in a community often set wages that will be paid."

While the Same-Day Surgery 2008 Salary Survey results showed more people getting no raise or a low raise, it also indicates that managers at the high end of the wage scale were increasing:

  • 17.78% make $90,000-$99,999, compared to 13.92% in 2007;
  • 30% make $100,000-$129,999, compared to 22.78% in 2007;
  • 11.11% make $130,000 or more, compared to 7.59% in 2007.

The shift might be attributed to the fact that the salary survey responses showed more people have worked 25 or more years in the field (23.6% compared to 17.5% in 2007).

"The ambulatory surgery center market has matured," says Jane Kusler-Jensen, RN, MBA, CNOR, BSN, director of perioperative services at River Woods and Ozaukee campuses, Columbia St. Mary's, Milwaukee. "We're realizing that clinical expertise in hard-to-run ORs is critical knowledge you need to bring in."

Manage time with tips that some swear by

Outpatient surgery managers are increasingly facing larger workloads. The 2008 Same-Day Surgery Salary Survey results show that more than 92% of survey respondents work more than 40 hours a week. Almost 5% work 65 hours a week or more.

So how can you get it all done? The first key to better time management is to realize that the term actually is misleading, says Barry Izsak, a productivity expert in Austin, TX. You can't manage time, but you can manage yourself. "We all have time to accomplish our priorities if we identify them and then manage ourselves," he says.

Planning can be a bugaboo for managers, Izsak says. Planning is good, of course, but he says managers can not do it enough, or they can overdo it. Planning helps you become proactive with your time if it is done correctly, rather than simply being reactive running around putting out fires.

"At the end of the day, people should write down, while the day is fresh in their mind, the three big things you want to get done the next day," he says. "There still will be interruptions tomorrow, and maybe you'll only accomplish one or two of those things on your list, but even then you're far ahead of the game, better off than if you just came to work the next morning and started reacting to each new event."

A better solution

Remember that working longer rarely is the solution when you feel overburdened or behind in your work, Izsak says. Better organization and planning can help you accomplish more than simply staying late at the office, he says. Having specific goals for the day, the week, and the month can help you stay on track and get the important work done, even if you are periodically interrupted and thrown off track.

"When people work 10, 12, and 14 hours a day, they are just spreading their inefficiency over a long-time period," he says. "Focusing on those top things you want to do in the day are really key. Schedule them in your planner just like a doctor's appointment or a meeting with your colleagues. You make those things happen because you schedule them, and so you need to schedule your main goals, too, or they're not going to get done."

Sometimes you must "defend your calendar," says Pamela Dodd, PhD, productivity expert in Orlando, FL. That means sticking with your scheduled activities unless absolutely necessary to deviate, she says. That includes your personal and family time, which can be the most difficult to defend.

Dodd also recommends determining your own "peak time," the time of day when you are most efficient. If that is your best time, schedule your day accordingly so that interruptions are minimized. Block out that time for your most important or most challenging tasks.

Find a way to focus

Drew Stevens, PhD, a productivity expert in St. Louis, also emphasizes that a clear focus on the most important goals is key to making progress.

"If you're just staring at this huge pile of work that needs to be done, and the phone's ringing, and three people want your attention, nothing will ever be accomplished. You'll be overwhelmed and just respond to whoever's yelling the loudest at that moment," he says. "It is crucial that you seize control of your time and protect it. Don't make it available to just anyone. Keep your eye on the big picture, and apportion your most precious resource — time — wisely."

Stevens says there are four key steps to managing your time more effectively:

  1. Do not procrastinate. Sometimes it helps to do the things you hate to do first and get them off of the plate.
  2. Do little things first so that you can get to the large items and focus on them. It is easy to waste time thinking about the little items that are distracting you from the bigger tasks.
  3. Prioritize your tasks. Do the things that are most important that day, and do not try to do more than you know is possible. It is better to accomplish your most important tasks than to have done a little bit of work on everything.
  4. Make a "don't-do" list. These are the things that interrupt or waste your time. The list will vary for each person, but they might include web surfing, listening to the radio, or letting a co-worker sit down to chat.

Organization can help you feel more in control and minimize the time spent tracking down information or trying to remember what you're supposed to be doing. Tickler files can be especially helpful for an overburdened manager, Dodd says. There are things that you have to remember to do at a certain time or projects that you should check on periodically, so a tickler file can be a great way to make sure those things don't fall through the cracks, she says. Any calendar or electronic organizer will provide a way to plug in reminders, so be sure to fully use this option, she says.

Dodd also cautions about an overdependence on "organized piles." Sometimes even organized, neat people can become dependent on placing items in a pile here and another pile there, knowing all the time what the pile contains. But that just invites disaster, she says.

"Sooner or later, you're going to need something important, and you'll have to go tearing through those piles to find it. And you're probably the only one who has any idea what the piles are, so your assistant can't really help," she says. "Take the time to really organize and file things, even if it seems like another burden at the moment. You'll thank yourself later when you have to find that file in a hurry."

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