Is your salary keeping up with your staff's? - page 2

I'm wondering if all of the salary wars, bonuses, incentives, etc. that are offered to the bedside nurses these days is removing one of the long standing advantages (higher pay) of nurses moving into... Read More

  1. by   Glad2behere
    Oh ACNORN,

    Sorry to hear about the resignation of one of your better troops.
    That is one of the windows I am looking through that doesn't seem to change: total unawareness by upper levels of management that employee turnover is very costly, and I am sure you recognize this and must combat it daily. You are right about the shortage of staff nurses and management level nurses practicing, but is there really a shortage of nurses or a low supply of nurses willing to work within the current criteria? I suspect the latter. The common thought prevailing in this discussion is money.
    You and llg have both expressed some satisfaction with your duties, though not all the politics associated with it. The inability to make decisions you should be able to make because you are being restrained to do so. I know you wanted to keep that NM on board for several reasons, not least of all having to retrain and reorient someone and pay them more than you would have had to pay the one who resigned, and the interim distraction it caused by the influence it had on you by not being able to do something more productive than just maintaining status quo. I won't even mention the probability of nurses that will walk because they dislike the new personality or had loyalties to the previous NM. To me that is very bad management above you for not counting the dollars BEFORE instead of afterwards. The irony is you probably pleaded the case until you were blue, now there has been some dissatisfaction created in you....that didn't have to be there. AND if you leave, the one following you will be paid more! So futile the thinking of many management teams, that it is actually much more cost effective to keep your people on board and happy. It really does pay, but I don't think we will see the day.
  2. by   ACNORN
    I don't think my company is probably acting any differently than the others. I have to say we are very proactive with trying to retain staff RNs. And I have to compliment my company that the incentives for the staff get approved and implemented pretty darn quickly. All the time we are having to come up with more incentives to keep the staff nurses we have and new incentives to recruit new ones as we have vacancies. Everytime we have a meeting to discuss a new plan, it is quickly made clear that the exempt status RNs will not be eligible. Then I am seeing the big dollars they are throwing at the staff to keep the shifts covered, yet I am not allowed to work extra as staff (except for free) to make any extra money because they view me as RESPONSIBLE for the recruitment and retention - like I can compete with the travel nursing industry and the salary wars that are going on in our market. I asked for a secondary job class so I could work extra as staff when needed to make a few extra bucks, keep my skills up, help morale, and help out in my own facility. The answer was a firm NO because it is believed that it would add an incentive for me to purposefully leave staffing vacancies for myself rather than working on getting and keeping all the positions filled. Yet I am not supposed to work a PRN job anywhere else either in case I am needed at this facility.

    The staff nurses are viewed as being out of control and ever increasingly greedy and management is expected to have an attitude of being above all of that "show me the money" mentality. Yet we see the hourly rate of our staff exceeding our own and they get to go home at the end of a shift and forget about the place. I just don't see the facilities in our area maintaining the salary equities between staff and management (with mgmt rightly being significantly higher) to make it an attractive position to have/pursue.

    I guess I need to just give myself the old pep talk again and get over it.
  3. by   Glad2behere
    Wow ACNORN,

    I agree, that is sad and stupid to not let you work extra. Geez, who is it going to hurt? That is just plumb dumb. A golden opportunity for them to create cohesion and leadership and it costs nothing more than they would pay to an agency, if that much. They are stupid and in denial, and should be congratulating you for your efforts. I am sure they didn't offer to increase your salary to decrease your anxiety either, as an incentive to stay in management. So the tide rises....
  4. by   rstewart
    Nursing management can be extremely difficult----which is why I got out. There is no shortage of nurse managers. The shortage is at the bedside and that is where the attention is focused.

    You are fortunate in some respects although I do sympathize. At least you believe that your administration is making a genuine efforts to retain nurses----so there is hope. And with respect to the secondary job class, be careful what you wish for----I had one and then the expectation was that I do my management job and personally fill in all the holes in the schedule. That is a fast track to burnout.

    I don't expect the situation to change in the near future. The freedom from 24/7 responsability has become very attractive to me----And there is no shortage of patient, family and administration etc complaints.

    The fact is in many cases these jobs are impossible to do and financially not worth the headaches. They just grind you down.

    My advice: keep a good handle on how your personal life is going. If and when the job begins to interfere there---leave nursing management behind.
  5. by   Hellllllo Nurse
    I recently took a job as the nursing supervisor in a LTC facility. $22. / hr, full time, no medical benefits. Then, They told me they want me to be on-call 24 hrs a day?

    Uh...no. I quit.
    And... I only have an AAS degree, but the ADON is an LVN!
  6. by   llg
    Originally posted by ACNORN

    I guess I need to just give myself the old pep talk again and get over it.
    I think that is the position I have been in for the last month or so. After "that mess" with my eval in December, I got myself into a funk. But after talking with you all and a few friends, I seem to be coming out of it and getting back to my usual self. While I don't have the perfect answer for you, ACNORN, I suggest that you keep talking about your thoughts/feelings and working them through your system. We'll be here to listen.

    llg
  7. by   llg
    Originally posted by rstewart
    Nursing management can be extremely difficult----which is why I got out. There is no shortage of nurse managers. The shortage is at the bedside and that is where the attention is focused.
    That may be true where you live, but it is not totally true where I live. We do not have a shortage of nurses willing to work as staff nurses on our general care floors. Some of those units have no vacant positions. Our shortage is focused in the ICU's, ED, OR, Transport Team, and in nurses willing to take on leadership roles that are excluded from all the "goodies" that staff nurses are now receiving.

    Oh, there are some people willing to take those jobs, but they are often not very qualified for the positions. The "good ones" that we HOPE will apply for those positions are rarely pursuing careers in nursing management and/or nursing education.

    We are going to have to make such careers attractive if we want our leadership positions filled by the "best and the brightest" nurses. How can we market a profession in which doing a great job, earning a graduate degree, and getting a promotion results in more work, more politics, and less pay?

    llg
  8. by   Dr. Kate
    Great thread, and it has taken an interesting turn. I concur this discussion is needed.

    I work full time in Education, and per diem as a house supervisor in another faciltiy. I have never been a manager. The highest I ever got, and the highest I ever wanted to go, was charge nurse.

    Being a house supervisor is a distinctly different activity, and requires a distinctly different perspective and skill set than being a manager. Some people can do both well, but in my experience those people are very few and far between.

    The salary issues are difficult. Where I work FT is union. I am the only person working in education, other than the director, who is not part of the bargaining unit. Many of our nurse managers were unhappy when their latest increases were not the same as those negotiated by the union for the staff. For two of them, it was the straw that broke the camel's back, and they left the manager position. My boss made the comment that all of her staff got better raises than she did.
    On the whole I would say that salaries for nursing managers are running a bit better than those for staff nurses. Are they sufficient compensation for the work and responsibility, probably not. But, as in all of nursing, there is more to a job than the salary. Unfortunately salary issues can make it hard to get promising staff nuses with managerial talent to make the switch to management.

    Someone asked about education. The most valuable classes I ever took were three supervision classes at the community college level. I learned about various types of organizational structure, how organizations work, how people function in groups and organizations, and some of the fine points of dealing with people at work. I still remember the instructor telling us that even if we weren't supervisors it was important to take supervision so we would know what was going on in our organization. He was so very right.

    One thing that has and continues to distress me is the seeming reluctance to go out and get the education needed to do the job. I watch new managers, with no experience, wait for the institution to put them into classes, or teach them the things they need to know. And, I listen to them wail and gnash their teeth because they don't understand what is happening around them.
  9. by   llg
    Welcome to the thread, Dr. Kate! It's good to hear your perspective (with which I totally agree).

    About the reluctance to go out and get the education needed to do the job, I can only speculate that by the time many nurses reach the point in their career at which they start wanting that additional education, they have already "gone back to school" at least once already -- either because they delayed their original education, nursing was a 2nd career choice, or because their 1st degree was not a BSN to begin with. Combine that with the demands of doing the job and perhaps simultaneously raising a family and something's gotta give.

    Someone like me had the advantage of being "on the path to a leadership position" from the beginning. I knew before I started college that I would seek promotions, etc. and went to a school that assumed that would be the case and prepared us to do so. I graduated with my BSN at age 22, worked a couple of years as a staff nurse, and then graduated with my MSN at age 26. I had hoped to get my PhD by age 35, but delayed it a few years and didn't get that until I was 42. Also, being single and childless made it a lot easier to keep going back to school. It's not so much that I DECIDED not to marry and/or have children so that I could go to school, but I have always figured that those who DID CHOOSE to marry and/or have children made that choice that now limits some of their career options voluntarily.

    About money not being everything in a job. I certainly agree with that. I doubt I would ever take a job I hated just for the money (unless it was temporary and out of real necessary.) Because of that, part of me hates to complain about the fact that I make less money than many staff nurses at my hospital. On most days, I like my job and am happy with my career path. However, I think there is something dreadfully wrong with the compensation system of a profession that doesn't reward people for additional education and the additional skills that brings. And I worry that I don't see many people among the newer generation of nurses aspiring to in-patient hospital leadership roles (e.g. management, staff development, CNS, etc.).

    Finally, I won't be posting over the weekend because I use my computer at work for this. In spite of the fact I did my dissertation on nursing and information technology, I no longer keep a computer at home! I look for the thread on Monday to see if it has stayed alive over the weekend.

    Have a good weekend everyone,
    llg
  10. by   ACNORN
    I think there is something dreadfully wrong with the compensation system of a profession that doesn't reward people for additional education and the additional skills that brings. And I worry that I don't see many people among the newer generation of nurses aspiring to in-patient hospital leadership roles (e.g. management, staff development, CNS, etc.).
    My thoughts exactly.

    I appreciate all of the encouraging remarks. I took advantage of a discussion with our CEO about the nursing supervisor vacancies that we currently have to discuss the disincentives of nurses pursuing leadership positions. I have a feeling the message was heard loud and clear.
  11. by   Glad2behere
    Hey I applaud all of you posting here. I have learned a lot, this has been an interesting discussion. There must be some type of mechanism that can be activated to encourage nurses to enter leadership positions. Dr. Kate mentioned that potential candidates do not seek additional education until they are selected. That may be true, and I agree it often is. Maybe the primary reason is that nursing leadership is not that attractive financially, and consequently as llg and ACNORN have legitimate issues concerning those financial issues. Take a look here at what is happening and why. I have stated my desire to attend more formal education to succeed in nursing leadership, but the ambivalence I hear causes me to pause. $130-150K should not be a high mountain to climb. I have paid more than that in income taxes in one year! My son graduated from Texas A&M 1.5 years ago and yanks down over $90K, and he is still a grunt in his occupation. I will rattle everyone's cage here. It is no secret, you do not ask, and you do not receive. Now, stop following nursing school doctrine and engage in business doctrine, and get in there an get paid for what you are worth, and be able to show it on paper, spreadsheets and all. Show what you bring, not what you will settle for. That way when I get there some of it will already be done. :chuckle
  12. by   ACNORN
    I have paid more than that in income taxes in one year! My son graduated from Texas A&M 1.5 years ago and yanks down over $90K, and he is still a grunt in his occupation. I will rattle everyone's cage here. It is no secret, you do not ask, and you do not receive. Now, stop following nursing school doctrine and engage in business doctrine, and get in there an get paid for what you are worth, and be able to show it on paper, spreadsheets and all.
    I agree that we have to be assertive and make sure that we are paid what we are worth. The only problem with the comparison is that in other businesses you don't have the majority of revenues coming from the government with caps on the payments. Short term hospitals have DRGs, and all the post acute providers have PPS reimbursements. If consumers directly paid for their healthcare (which I'm not suggesting is the answer) and we didn't have built-in controls on the revenue side then we could operate more like the free market systems of many other industries where the harder and smarter you work the more money you can make. Since a major segment of the labor costs in a hospital comes from nursing care, if we all made major bucks, without the reimbursements of hospitals going up also, the hospital would go broke. I have seen the financial statements and know this to be true.

    Pharmacists in our area are demanding 75K to 100K as a starting salary because they changed their regulations of requiring a doctorate degree to be a pharmacist. I thought about whether nursing could do something like this, but there is a significant difference in the numbers of pharmacists employed versus nurses. I guess hospitals can afford to pay them the big bucks that the market demands because there are usually only a handful of pharmacists needed in the first place. The other factor that the pharmacists have that we don't is the influence of the retail drug store sector. Their salaries went up because the Walmarts and CVSs of the world are paying pharmacists 6 figure salaries.

    On the other hand, there are usually only a handful of nurse educators and nursing administrators.....If highly degreed and highly talented nurses could choose a job in the free-market sector, I bet our salaries would go up too. The bottom line is we need to create a situation where the hospitals feel they need to compete for the nursing leadership talent in their market as much as they already feel they need to compete for staff RNs and pharmacists. Hummm.......something to think about.

    I appreciate all the perspectives and comments of everyone. This is one of the more thought provoking discussions I've seen. Glad2behere, don't let this discussion dissuade you. You no doubt are just the type with spunk that we need to help make things better.
  13. by   Glad2behere
    ACNORN,

    Thank you for input, I have decided to initiate action and commence preparation for the GRE, I have to score about 1100 on the two parts that are accepted by the graduate school, surely I can get that done. I am not dissuaded one iota, but I did want to know some of the substance of what I am getting into from an internal perspective. All of you posting here have been very generous with your knowledge, and it is sincerely appreciated. I think you are correct about other avenues to pursue nursing leadership. This is a growth process and a learning curve, and to date, there has really been no need to accelerate or direct it. The roll call of individuals responding to this thread can be taken as evidence that that need is maturing and will be addressed. I feel I am in good company, will seek more education, and hope that I will be able to make contributions of significant caliber, adding to what has been done and what you are doing now.

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