Giving staff a schedule they can count on helps 'magnet' hospital achieve low vacancy rate
This article first appeared in the September 2001 issue of Hospitals & Health Networks
by Terese Hudson Thrall
Across the country, hospitals struggle to find enough nurses. It's happening at Poudre Valley Health System, Fort Collins, Colo., where the vacancy rate is monitored by Margo Karsten, R.N., chief operating officer and chief nursing officer. "We hope this is the worst it's going to get," she says.
Most hospitals would blush to have Poudre Valley's problems. Its current vacancy rate: 4.6 percent out of 650 nursing positions. That's about half the national average, even though the system must compete with hospitals in neighboring Denver and Greeley.
Poudre Valley has accomplished the relatively low rate while avoiding the enticements some competitors offer. Don't look for signing bonuses or extra pay for weekend shifts at the system. Instead, it spends money liberally where hospital executives think it will do the most good.
This year the board earmarked an additional $1 million annually to bolster the nurse staffing ranks. It's a small price to pay--total payroll is $67 million--to stabilize staffing, Karsten says.
Typically, when hospitals have high admissions, they order nurses to work overtime and augment their ranks with agency nurses. Then, when patient census drops, hospitals send nurses home. But having a low patient-to-nurse ratio--about two to three medical-surgical patients per nurse during the day--Poudre Valley minimizes its need to make sudden personnel shifts. "The nurses have a schedule they can count on," Karsten says. "They are in control of their personal lives." Also, having more nurses helps keep length of stay low, she adds.
Another way the hospital hopes to attract nurses is by promoting last year's selection as a "magnet hospital" by the American Nurses Association's credentialing center. The ANA program recognizes what it deems excellence in nursing management philosophy and practices. "Seeking that status shows an administrative commitment to keep the bar high," Karsten says.
Poudre Valley will get lots of company on the magnet list soon. The ANA has named 36 hospitals as magnet facilities since the program's inception in 1994. Last year it certified seven new hospitals, and this year that figure will double. "The emphasis on improving quality and the impending labor shortage have generated interest," says Kammie Monarch, the program's director.
Sixty-five percent of applicants are granted magnet status. And it's not merely a device to honor unionized hospitals: just 26 percent of magnet hospitals have collective bargaining for nurses. Monarch says magnet hospitals usually have a chief nursing officer who is a key member of high-level decision-making bodies. Also, doctors and nurses at magnet hospitals usually treat each other as colleagues, she says.
Many nurses don't know about the program. But that's changing. Two recent hires said Poudre Valley's designation was a factor. "We are just beginning to see the program's impact on recruitment," Monarch says.
How Poudre Valley Retains its Nurses
Uses $1 million a year to support low patient-to-nurse ratio--two to three medical-surgical patients during day shifts, up to six patients per nurse at night.
Donates $350,000 a year to a nearby nursing school for scholarships in an accelerated program in which students with a B.A. can become nurses in 18 months. In return, the system gets 10 new nurses a year.
CEO and board support to discourage disruptive doctor behavior.
Extra pay for nurses who help orient new hires for three months.
Higher pay rates for nurses who serve as clinical coordinators or patient coordinators.
Source: Poudre Valley Health System, 2001
This hospital appears to be on track. Too bad across the country from my home and unable move!