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Imagine that you’re a same-day surgery manager with a busy operating schedule, a full staff, no turnover, and a stack of applications from experienced surgical nurses who want to work in your program.
Carol Hiatt, RN, nurse manager at Ocala (FL) Eye Surgery, doesn’t have to imagine this scenario. She does have a busy surgery program and a list of people who want to work in her program. Most of these nurses will be called by Hiatt only if she expands the program and needs additional staff because, as she says, "I have no turnover."
About one-third (30.5%) of the respondents to the 2001 Same-Day Surgery salary survey indicated that they also experienced no change in the number of their employees. Of the remaining respondents, 52% reported an increase in the number of employees and 16% reported a decrease. Same-Day Surgery sent the annual survey to 1,035 subscribers. A total of 190 readers responded, for a response rate of 18.36%.
Enabling employees to participate in decisions may be the best way to ensure employee satisfaction, says Hiatt. "We have switched from a supervisory to a team-based management structure," she says. There are pre-op, post-op and operating room teams that work within each other to identify areas for improvement and solve problems, Hiatt explains. "The teams are empowered to make changes within their areas if the changes are in the best interest of patient care and the surgery center," she says.
In one case, the operating room team decided that turnover could be better handled if three circulators were assigned to two rooms that a single surgeon was working. Then the nurse who brought the patient into the room could accompany the patient to recovery and another would be setting up the room to be ready for the surgeon. "This was an ideal solution because it kept the surgeon working and maintained a continuity of care with the patient," says Hiatt.
Another way to increase employee satisfaction and reduce turnover is to find out what daily activities may be keeping them from concentrating on patient care, says Mary K. Ryan, BSN, CNOR , ambulatory surgery center manager at Tri-State Surgery Center in Dubuque, IA. An employee satisfaction survey identified a need for a new position to help relieve nurses of the frustrating task of tracking and ordering supplies. "Our different specialty teams had been responsible for ordering their supplies and equipment but the nurses were increasingly frustrated by the amount of time this task required," says Ryan.
The center posted a new position of inventory specialist. "We wanted a person that had a clinical background so he or she would be familiar with the needs of a surgery program," she explains. A surgical technologist already at the center applied for the job and spends half of her time as inventory specialist and half of her time in the operating rooms. "Our nursing teams still prepare a weekly order from our item master list, but they now submit it to the inventory specialist," Ryan says.
The specialist reviews the lists, makes sure there are no duplicate orders, ensures that extras of some items are ordered if needed, and places the orders. "The best thing about this person is that she has the time to research new items, review prices, and look at the overall picture," adds Ryan.
Another secret to Hiatt’s success is her ability to offer salaries commensurate with experience, she says. "I’m paying at the top of the scale, but it is more cost-efficient for me to do so," she says. It takes her one and one-half years to train a nurse with no ophthalmology experience to become an ophthalmic circulator. It is less expensive for her to pay one experienced nurse at the top of the pay scale rather than pay two nurses during the training process. "I’m able to offer salaries and annual increases that attract nurses with the best experience, but when I compare my overall payroll to national averages, my program’s payroll is within the norm," says Hiatt.
Salary increases for survey respondents have improved slightly over increases reported in the 2000 survey. (See table, above.) An increase of 1% to 3% was reported by 34% of the 2000 survey respondents and by 32.63% of this year’s respondents. There was, however, an increase in the number of respondents receiving 4% to 10% increases. The percentage went from 38.8% in 2000 to 42.63% in 2001.
A flexible work schedule is important or very important, according to 63.68% of the survey respondents; however, 20% of the respondents indicated that flexible work schedules are not available in their programs. "It’s important to offer some flexibility in the work schedule," says Hiatt. In addition to her full-time staff, Hiatt has a group of per diem nurses that can be called upon if the schedule is unusually busy or if a nurse needs a day off, she explains. Hiatt also cross-trains employees to other areas to help avoid burnout. "I have no turnover because my staff members know that they and their expertise is appreciated and valued," she says.
[Editor’s note: Do you have success or failure stories for retaining or recruiting staff? Please send your ideas to: Joy Daughtery Dickinson, Senior Managing Editor. E-mail: firstname.lastname@example.org. Telephone: (229) 377-8044.]
For more information about team management and employee satisfaction surveys, contact:
• Mary K. Ryan, BSN, CNOR, Ambulatory Surgery Center Manager, Tri-State Surgery Center, 1500 Associates Drive, Dubuque, IA. Telephone: (800) 648-6868, ext. 4500 or (563) 584-4500.
• Carol Hiatt RN, Nurse Manager, Ocala Eye Surgery, 3330 S.W. 33rd Road, Ocala, FL 34474. Telephone: (352) 873-9311. Fax: (352) 873-9652. E-mail: email@example.com.