2003 Salary Survey Results

Good managers are secret to retaining experienced nurses

Being supportive, approachable, and fair are vital traits

Home health agency managers have looked at every aspect of their new employee recruitment programs to identify how to best attract good nurses. Competitive salaries, ongoing educational opportunities, and a strong benefits package are a few ways to attract new nurses, but how do you keep them satisfied with the job and happy with you as an employer?

Staff are too hard to replace

As home health programs get busier, it is more important than ever to be able to keep good employees because it is too hard to replace them, says Karen A. Hart, RN, BSN, senior vice president of the health care division of the Bernard Hodes Group, a human resource communications company in New York City. While salaries and benefits are important to recruitment of new nurses, they are not key reasons that nurses leave their employers, according to a survey recently conducted by Bernard Hodes Group, Hart says. (For a copy of the survey report, go to www.hodes.com/hcrecruiting.)

Staff need to feel valued, respected

The reasons nurses leave include not feeling valued (39%), lack of growth potential (33%), lack of confidence in management (31%), and lack of professional respect (30%), she adds. Because respondents to Hospital Home Health’s 2003 salary survey represent a range of different types of locations, rural to urban (see chart), they often find themselves facing different problems or needing different solutions, but Hart points out that the importance of a manager’s relationship with employees does not differ with location.

"We find that a manager or supervisor is the key to retention of a quality nursing staff," says Hart. "There are people who are natural managers, and you can see it immediately as they talk with staff members and walk around their departments," she says. "Other people may need training because they don’t instinctively know what is necessary to manage people," Hart adds.

Communication challenges

Ongoing communications with staff members in a home health agency is more difficult because you have field staff who do not come into one central area every day, says Frances A. Johnson, RN, BSN, manager of clinical services for Duke Health Community Care in Durham, NC. "This makes it necessary for managers to find ways to communicate at staff meetings, e-mail notes, and voicemail messages," she says.

Manager traits that are important to employees can differ according to generational differences, says Ann Warner, RN, MS, CCRN, assistant professor, College of Nursing at McNeese State University in Lake Charles, LA.

Are you a team player?

"In a study that we conducted to compare the traits nursing students considered important to manager traits that experienced nurses considered important, we found a number of interesting differences," she says.1 "Of the top three traits identified by both groups, only team player’ and receptive to people and ideas’ are mentioned as a top-10 trait by both groups," Warner says.

Even with these two traits, the groups ranked them differently, she points out. "Experienced nurses identified receptive to people and ideas’ as third most important while students rank it ninth. Team player’ is ranked first by students, while experienced nurses rank it ninth. Clearly, these two groups value different traits," she adds.

Generational differences

The differences in traits valued in a manager are generational, says Warner. "This is important to understand because many managers, and many entrenched nurses, are members of the baby boomer generation who are having to learn how to supervise members of Generation X," she explains.

All are hard workers

Respondents to the 2003 Hospital Home Health salary survey are representative of the baby boomer generation, with 48% of respondents born between 1946 and 1961. Generation X, ages 26 to 40, is represented by only 8% of survey respondents. (See chart.) The majority of respondents, 60%, have worked in home health between 10 and 18 years. (See chart.) "Nurses tend to be workaholics, but there are generational differences so managers need to understand that while baby-boomers will put in long hours, Generation X nurses want to finish the task, then move on to their personal life," Hart says.

Salary survey respondents also point out that home health managers are workaholics as well, with slightly more than 76% of the respondents working more than 46 hours each week. (See chart.) With the extra work hours, the good news for survey respondents is that although 12% experienced no pay increase in 2003, almost 80% experienced an increase that ranged between 1% and 6%. (See chart.) Sixty-four percent of survey respondents earn between $60,000 and $89,999 annually. (See chart.)

Prioritizing staff’s workload is important

With increasing workloads for managers, it is more important than ever that managers be able to prioritize their work, Hart points out. "Being able to prioritize your staff’s work also is an important trait for a manager because employees want to know that the manager has them doing the most important work when time is limited," she adds. In addition to addressing generational differences, it is essential that managers understand the difference between management and leadership, Johnson says.

Create a vision for your agency

"A leader creates a vision for the agency and develops an atmosphere that makes change possible. A manager makes the vision a reality and can see what needs to be done on a day-to-day basis to create the vision," she explains. "The ideal manager knows that it is necessary to be a leader sometimes, and a manager other times," Johnson adds.

Experience is the best teacher

While you can teach management and leadership skills in a classroom, the best way to learn is the school of hard knocks, she says. "I like to see supervisors and managers get a chance to learn while they are doing, and at the same time, have a mentor to whom they can go to with questions or problems," Johnson explains. "I always tell my staff that they can make mistakes as long as they learn from them," she stresses.

If you want to evaluate your own management style, Hart suggests that you think back to all the years of your work experience. "I always tell managers that it is helpful to think about the manager who made the biggest difference in their careers. What qualities possessed by that manager can you emulate?" she asks. "When you encounter a difficult situation, ask yourself what that manager would have said or done," Johnson advises.

For more information, contact:

Karen A. Hart, RN, BSN, Senior Vice President, Health Care Division, Bernard Hodes Group, 220 E. 42nd St., 16th Floor, New York, NY 10017. Telephone: (330) 865-5988. Fax: (330) 865-5989. E-mail: khart@ny.hodes.com.

Ann Warner, RN, MSN, CCRN, Assistant Professor, College of Nursing, McNeese State University, P.O. Box 90415, Lake Charles, LA 70609. E-mail: awarner@mail.mcneese.edu.

Frances A. Johnson, RN, BSN, Manager, Clinical Services, Duke Health Community Care, 4321 Medical Park Drive, Durham, NC 27704. Tele-phone: (919) 620-3853. E-mail: frances.johnson@duke.edu


1. Thompson J, Wieck L, Warner A. What perioperative and emerging workforce nurses want in a manager. AORN J 2001; 78 246-261.