2004 Salary Survey Results

Fight rising costs of hiring by keeping current staff

Good communication and support for staff efforts improve retention

The good news for respondents to the 2004 Same-Day Surgery Salary Survey is that more than 68% of survey respondents saw their salary increase between 1% and 6% in 2004.

Even better news for almost 11% of survey respondents was the 7% to 10% they reported. In 2003, only 5.44% of respondents received a 7% to 10% increase. (See chart on how much salaries have changed.) The SDS salary survey was mailed in July to 944 subscribers and had 115 responses, for a response rate of 12.2%.

The bad news is that same-day surgery managers are having to face increasing salaries at the same time they try to attract new employees and deal with shrinking reimbursement.

Experts interviewed by Same-Day Surgery point out that there are ways to recruit and retain employees without resorting to salary wars.

"Our challenge is that we are competing with larger, urban institutions for nurses," says Mary Jane Sutton, RN, MSN, director of The Surgical Center at Lake Norman in Mooresville, NC.

Sutton’s facility is a freestanding center affiliated with a hospital, as were almost 16% of survey respondents, but she says that geographically and size-wise, her hospital and location present a challenge in recruitment. (See chart on work setting.)

"Not only do the larger hospitals pay more, but nurses who live closer to Charlotte [NC] do not want to commute 30 miles one way to work," she adds.

"We do have an advantage over hospital-based programs because we don’t have weekend, holiday, or evening coverage."

In addition to the attractive hours, there also is a family atmosphere, Sutton adds. "Because we are a small staff, we have a chance to get to know everyone, and we all get along well," she says.

Because a good relationship between administration and staff reduces turnover rates and increases word-of-mouth promotion of the center as a good place to work, the managers of El Camino Surgery Center in Mountain View, CA, have developed a range of methods to communicate among the 70 staff members, says Julie Butner, RN, BSN, MS, executive director of the center.

"We delay the start of procedures one Friday each month to enable all staff members to attend a staff meeting," she says. The delay in the start of the workday is worth the effort and potential lost revenue because it gives Butner and other managers a chance to communicate directly with all staff members at one time, she adds.

In addition to the monthly staff meeting, teams meet weekly to address issues the employees face, clinical programs are provided for clinical staff once each month, newsletters are inserted in paychecks twice each month, and the leadership team of managers and supervisors meets twice each month, Butner points out.

"We also have a bulletin board in the employee lounge that has an area titled Must Read’ so that all employees can quickly check for timely announcements," she adds.

One of the perks offered by El Camino that does not cost the surgery center anything, other than a little unused space, is discounted massages offered to staff members by a local masseuse, says Lisa Cooper, RN, BSN, clinical director of the center. "We keep a sign-up sheet for massages on our bulletin board, and employees can schedule a massage at the end of the day on the one or two days each month that the masseuse visits," she explains.

Employees can relieve stress with a massage at a deeply discounted rate of about $40 for an hour, and the masseuse charges the surgery program nothing, she adds.

"Staff members love this extra benefit because it is easy to use and shows that we do realize that they have stressful jobs," she adds.

Offer advancement opportunities

One of the reasons that The Surgical Center at Lake Norman lost employees in the last year was the need to move elsewhere to receive a promotion, says Sutton. "With a small staff, we don’t have a lot of room for movement," she says.

While most SDS salary survey respondents represented administration — with more than 45% holding the title of chief executive officer, director, or administrator and almost 60% making more than $70,000 per year — all of the experts interviewed by Same-Day Surgery admit that the ability to be promoted or be eligible for a higher salary bracket is key to retention. (See chart with respondents titles, and see gross incomes.)

"We have an advantage when it comes to recruiting nurses because we have a large pool of hospital-based nurses who want to move to the freestanding center," says Meaghan Reshoft, RN, MBA, CASC, director of the Day Surgery Center at Northwest Community Healthcare in Arlington Heights, IL.

Unfortunately, most of the nurses are not operating room nurses, Reshoft adds. "We do pay hospital-level salaries, but we don’t require weekend and evening hours, so we can attract operating room nurses from outside the hospital system," she explains.

Once Reshoft has hired nurses, they do have a number of ways to increase their responsibilities and pay level without leaving the surgery center.

"Nurses who want to take on additional responsibility can apply to become a clinical resource nurse and add $1 per hour to their salary," she says.

"Clinical resource nurses take part in quality improvement activities and staff education and become experts to whom other staff members can go to for help," she adds.

Another education program that will boost nurses’ salaries when they complete their degree and position them for more responsibility is a BSN completion program, Reshoft notes.

"We’ve contracted with a local university to provide courses for nurses who want to complete their BSN on the hospital’s campus," she explains. This program is scheduled to begin in January 2005, she adds.

It is important to offer competitive salaries to attract employees, Cooper points out.

"We don’t offer the highest salary in the area, but it is competitive; and we make sure that job applicants understand that benefits such as no weekend work, corporate 401K match, and an outstanding work environment make up for any differences in our salary levels and the salary levels of other surgery centers," she says.

Most importantly for retention of current nurses, Cooper doesn’t pay top dollar to hire specific people, she says. "The salaries we offer new applicants are the same salaries current employees earn. We don’t want to make current employees appear to be valued less than new employees," she adds.

Almost 42% of survey respondents saw the number of employees in their same-day surgery program increase in the past year. In the 2003 salary survey results, 56% reported increases.

Cooper reminds other managers to work on retention activities so that they don’t have to constantly be hiring new employees. (See graph on how number of employees has changed.)

One way to keep good employees is to make sure they know you are there to support them as they do their job, she says.

El Camino’s management is very responsive to requests for instruments or other items that staff members say will help them do their job better, Cooper explains.

"I received a request from our orthopedic nurses for a third ACL [anterior cruciate ligament] instrument set so that they would not spend as much time sterilizing and setting up for cases," she says.

"Although two ACL sets is probably enough, purchasing a $7,000 instrument set to show my support of the nurses’ efforts is far less than the $55,000 that I have read is the cost to replace an operating nurse who leaves," Cooper admits.

El Camino’s efforts to retain nurses have been successful, with a 30% turnover rate in 2002 cut in half by 2004, she points out.

Retention of employees means retaining the experience and skills that have helped your same-day surgery program grow, Sutton adds.

More than 53% of salary survey respondents report 10 or more years of experience, with more than 19% of those respondents reporting more than 25 years of experience. (See chart.)

"The average age of our operating room nurse is 53 years old, so my challenge is finding younger nurses willing to join us and stay with us long enough to give us the same level of experience when my other nurses retire," she says.

Sutton is optimistic. "I have filled three of my four vacancies, and I only need one more to have a full staff," she says.


For more information on retention and recruitment activities, contact:

Julie Butner, RN, BSN, MS, Executive Director, El Camino Surgery Center, 2480 Grant Road, Mountain View, CA 94040. Phone: (650) 961-1200. Fax: (650) 961-7041. Web: www.ecsc.com.

  • Mary Jane Sutton, RN, MSN, Director, The Surgical Center at Lake Norman, 131 Medical Park Road, Mooresville, NC 28117. Phone: (704) 660-4572. Fax: (704) 660-4501. E-mail: mary.sutton@inrmc.hma-corp.com.
  • Meaghan Reshoft, RN, MBA, Director, Day Surgery Center at Northwest Community Healthcare, 675 W. Kirchoff Road, Arlington Heights, IL 60005. Phone: (847) 618-7075. Fax: (847) 618-7069. E-mail: mreshoft@nch.org.