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One agency even searches overseas for nurses
Finding home care nurses, aides, and other staff is a great deal more challenging these days and requires agencies to try some innovative strategies.
For example, Pro-Care Home Health Services in Sacramento, CA, has been working on recruiting skilled nurses from the Philippines. While there are considerable costs and many bureaucratic hoops through which to jump, international recruiting might be the best long-term solution for the agency, says David Dial, president and CEO.
The Visiting Nurses Association Inc. of New Orleans offers staff 12 paid holidays a year and rewards staff with bonuses according to their dependability and work quality, says Katherine France, RN, MN, executive director.
The home care agency at Henry Ford Health System in Detroit tracks its response to classified help-wanted ads to see which ads and placements are soliciting the desired response, says Greg Solecki, vice president for home health care.
Also, the agency is considering offering free training classes for home health aides, Solecki adds. Here are some of their strategies for recruiting staff:
• Finding staff who have a caring philosophy.
Henry Ford Health System’s home care agency has changed its employer image in recent years in an effort to attract not just any nurse, but the types of nurses who work in the field because they embrace the philosophy of home health care, Solecki says.
"We may not be attracting the numbers of nurses we had hoped to attract, but the nurses we’re attracting now embody the spirit of who we are and what we want to be and that has made a world of difference," Solecki says. "This is a way of recruiting nurses who view home health care as their mission, as opposed to coming to work because of the perks, flexibility, and getting home earlier in the day."
The agency encourages nurse recruits to follow a staff nurse on home visits before accepting a job. This way, the nurse can see if the home care environment is what he or she expected, and if it isn’t, then the nurse and agency can part company without having to go through a great deal of expense and energy, Solecki explains.
Long-term staff desirable
Another strategy is to send a Henry Ford home health care package to all nurses who call to inquire about employment with the agency. The packet includes information about the agency, newspaper clippings of agency nurses who have won awards, and a summary of benefits, Solecki says.
The idea behind carefully screening nursing candidates, even in these days of a nursing labor shortage, is that those who are hired will be more apt to stay at the job because they truly want to do that type of work, Solecki says.
• Entice nurses from hospitals by offering greater scheduling flexibility.
It has become harder for home care agencies to recruit nurses from hospitals because hospitals, also feeling the nursing pinch, have begun to offer sign-on bonuses and other incentives to staff, France says.
However, home care still has better hours than hospital shift work, and home care agencies can discuss that advantage when interviewing potential staff.
"My staff has rotating on-call duty, and they are only on-call once every two months. We rotate holidays-on-call so that the same person doesn’t always get the holiday work," France explains. "A lot of home care agencies don’t allow staff to take off any time at all during a holiday week because it’s difficult to staff those days."
At the Visiting Nurse Association in New Orleans, nurses may elect to have off one major holiday a year, and this way, they can go out of town to visit family, France says. "When someone comes in for an interview, those are the things I emphasize."
Consider hiring from overseas
Probably the most important recruiting strategy, however, is making the home care agency an enjoyable work setting so that when staff nurses meet with other nurses, they will boast about how much they like their jobs.
"I would like to have employees — if they have to leave our employment to be able to say, If you want to go work for a good place that’s very understanding, then you need to work at the Visiting Nurse Association,’" France says.
• Consider opening potential labor pool to include overseas nurses.
With a staff of 170 in one of the tightest health care markets in the country, Pro-Care Home Health Services is poised to take drastic measures to protect the agency’s future employment.
"We do a lot of shift nursing, and we need more LPNs than most," Dial says, adding that the agency’s employment is fine now, but likely will have difficulty keeping up with future need.
Keeping the long-term nursing shortage in mind, Dial has begun the lengthy process of recruiting nurses from the Philippines. This effort includes hiring an attorney who specializes in immigration and filing state and federal forms, including applications for H-1 visas for professionals.
The H-1 visa allows employers to hire workers from overseas in certain professions that have a demonstrated labor pool shortage among U.S. workers. However, all of the various professions, including engineering and various health care disciplines, must share the same set number of available visas, Dial explains.
Pro-Care Home Health Services also had to open an office in the Philippines and keep a full-time employee in the office. Then there is a waiting period before the recruit is permitted to enter the United States. After working on the process for more than two years, Dial finally was able to bring over two employees.
Once nurses are flown, at the company’s expense, to the United States, they are placed in temporary housing while they study and take their College Graduate of Foreign Nursing School test, which is a standardized test given to anyone who claims nursing education from a foreign school. The recruits also must meet LPN criteria and some may take an RN test, Dial says.
The immigrant nurses are asked to sign a two-year contract, which was designed to be fair to the nurses while still giving the agency enough employment time to recoup its recruitment expenses, Dial explains.
One of the advantages to hiring nurses from the Philippines is that they already speak English, so there are no language barriers to overcome, Dial adds.
• Tom Berg, General Manager, American Home Patient, Seattle Infusion Branch, 13035 Gateway Drive, Suite 131, Seattle, WA 98168. Telephone: (360) 377-3800.
• David Dial, President and CEO, Pro-Care Home Health Services, 7880 Alta Valley Way, Suite 103, Sacramento, CA 95823. Telephone: (916) 681-4949.
• Katherine France, RN, MN, Executive Director, Visiting Nurses Association Inc., 2475 Canal St., Suite 248, New Orleans, LA 70119. Telephone: (504) 822-1477.
• Melinda May, RRT, BHS, Director, Susan B. Allen Memorial Hospital Home Health, 119 Jones, El Dorado, KS 67042. Telephone: (316) 322-4540.
• Penny Rhein, BSN, RNC, Vice President, United Home Health Services, 2200 Canton Center, Suite 250, Canton, MI 48187. Telephone: (734) 981-8820.
• Phyllis Rizzo, RN, BS, CHCE, Director of Home Care Services, St. Elizabeth Home Care Services, 555 S. 70th St., Lincoln, NE 68510. Telephone: (402) 486-7043.
• Greg Solecki, Vice President for Home Health Care, Henry Ford Health System, Home Health Care, One Ford Place, 4-C, Detroit, MI 48202. Telephone: (313) 874-3135.
• Mary St. Pierre, RN, BSN, Vice President of Regulatory Affairs, National Association of Home Care, Washington, DC 20003. Telephone: (202) 547-7424.
• Rick Wade, Senior Vice President, American Hospital Association, 325 7th St. N.W., Washington, DC 20004. Telephone: (202) 626-2284.