Hire a nurse? In Twin Cities, that's the $10,000 question

[NRSKarenRN, BSN, RN]

Carl Hinson, chief recruiter for the Minnesota-based Fairview Health System, sent a team to Tulsa this spring with one goal: to lure nurses to Minneapolis. So far, 10 nurses have made the move. Hospitals in Minnesota are so desperate to hire nurses that they are raiding other parts of the country.

Maura Lerner

Minneapolis Star Tribune, June 17, 2002

http://www.startribune.com/stories/462/2908979.html

When Carl Hinson sent a team of recruiters to Tulsa this spring, he had one goal in mind: to see how many nurses he could entice to Minnesota.

The result? He hit the jackpot. "We've hired 10 so far," said Hinson, chief recruiter for the Fairview Health System in Minneapolis. And more are in the pipeline.

For Hinson, it's just the first step in a campaign to send Fairview recruiters around the country in search of one of the most precious commodities in health care: registered nurses.

These days, hospitals in the Twin Cities are so desperate to fill nursing jobs that they're raiding other countries, other states and even each other with tempting offers of more money and better perks.

In the process, they've ruffled some feathers and raised fears of a bidding war that some say will drive up health costs without solving the growing nursing shortage.

Since April, Regions Hospital in St. Paul has hired about 60 nurses -- mostly from other Twin Cities hospitals -- by offering signing bonuses of up to $10,000.

Fairview, with seven hospitals, has set its sights on nurses in as many as 10 other cities -- including Tulsa and Des Moines -- where salaries are lower.

Allina Hospitals & Clinics, meanwhile, is recruiting in Canada, said Kendra Calhoun, vice president for communications. Allina's 16 hospitals also offer bonuses to new recruits (though nowhere near Regions' $10,000 bonus, she said), and incentives for employees who refer new hires.

And one group of four hospitals, HealthEast, has spent two years trying to hire 70 nurses from the Philippines, spending thousands of dollars per person in immigration and other fees.

"Unfortunately, I think this is the new world," said Hinson, who has pushed for more aggressive recruiting efforts. "I don't see a whole lot of light at the end of the tunnel. They're talking about this [as] a 20-year shortage minimally."

Some, though, see the strategy as a shortsighted. "First of all, for consumers it's going to raise prices," said Tom Gilliam, a nurse and director of the Center for Health and Medical Affairs at the University of St. Thomas in Minneapolis.

Beyond the cost, he said, it does nothing to solve the underlying problem. "Somebody might leave Abbott and go over to Regions or someplace like that, but what does that solve, except for Regions' very short-term problem?"

Nor does it sit well with some folks in, say, Oklahoma, where Fairview sent its recruiters. "Do we like it? No. Can we prevent it? No," said Sheryl McLain, vice president of the Oklahoma Hospital Association, which is struggling with a nursing shortage like everyone else.

Of course, she said, they have plenty of arguments to fend off unwanted suitors from Minnesota. "We don't have horrendously cold winters," she said politely. In fact, she says, Minnesotans might want to check out Oklahoma's recruitment Web site (http://www.okhealthcareers.com ).

At Fairview, Hinson shrugs off the notion that he's trying to raid the competition. "We're going to go convince people in other parts of the country that Minnesota is a great place to live," he said. "A lot of times we want to keep it a well-kept secret. This time we don't."

'Sky high' bonuses

It's easy to see why hospital recruiters are feeling desperate.

Nationally, there are at least 100,000 openings for registered nurses. On average, about 13 percent of hospital nursing jobs are unfilled, a recent study for hospital groups found. Minnesota has 3,260 job openings for nurses, a state survey shows.

And the shortage is only expected to get worse. Rampant burnout and retirements are expected to deplete nurse staffs dramatically, as demand for care goes up.

Just last week, the University of Minnesota approved plans to expand its nursing programs in Minneapolis and Rochester, to train more nurses. Yet that expansion will add only a few dozen nurses a year. The number of new nurses seeking state licenses in the United States declined 29 percent since 1995 to 68,759 last year, according to the National Council of State Boards of Nursing.

In the face of those bleak numbers, hospitals are getting creative.

In April, Regions launched its "Sky High Bonus Days" with a goal of hiring 70 nurses in 90 days. The bait: bonuses of $3,000 to $10,000 per person, plus offers to pay off student loans.

With two weeks to go, they've hired 60 nurses -- and enticed an equal number of current employees to work more hours, said Ruth Bremer, recruitment manager at Regions.

Many hospitals are offering bonuses, but the size of this one made national news. "It's opening eyes," admitted Bremer. The top-dollar bonus only goes to nurses in certain high-demand fields, such as critical care.

It caught Michael Saunders' eye. Saunders, a critical-care nurse from South St. Paul, joined Regions last month after two years at nearby United Hospital. "This was not the deciding factor," he said of the bonus. "But it did pique my interest."

Saunders, a nurse for 20 years, said he got a steady stream of recruitment fliers in the mail from other hospitals. At Regions, he said, he was able to pick the job and shift he wanted. The bonus, he said, was icing on the cake.

Bremer acknowledges that most of the new hires came from other Twin Cities hospitals. "I wouldn't call it raiding," she said. "I'm sure that this has had an effect on other hospitals." But, she said, "the intent wasn't to address the nursing shortage in the nation. It was intended to recruit nurses to Regions Hospital."

A global search

In the meantime, recruiters at HealthEast turned to a country that has become a major recruitment spot for U.S. hospitals: the Philippines.

"They look to us still as the land of milk and honey," said Trudy Knoepke-Campbell, HealthEast's workforce planning director. They started recruiting in Manila in March 2000 and eventually hired 70 registered nurses. But because of immigration delays, only 11 have arrived so far. Most are working as nursing assistants until they pass the state nursing board exams.

Michael and Elizabeth Devera are among them. The couple, who married last September, arrived in Minneapolis in January, two years after they were hired in Manila. For them, both registered nurses, it was a simple decision -- "a greener-pasture thing," said Michael Devera, 30. "If you get to compare realistically our gross salary . . . one month gross here in the U.S. would take us about seven months of work." HealthEast is paying most of their immigration and legal fees; in return they promise to work for 40 months.

"It has been a lengthy process," admits Knoepke-Campbell. In the end, she said, they will have added 70 full-time nurses to the Twin Cities workforce.

For Fairview, the immigration battle seemed too costly and time-consuming, Hinson said. Instead, he picked Tulsa and launched an ad campaign in April. One featured a "beautiful snow scene" with the tag line: "Move to Minnesota, you'll be surrounded by flakes."

"It got great response," he said. The biggest selling point, he said, was the wage difference -- nurses making $14 to $18 an hour in Tulsa would earn $22 to $32 here. Even though the cost of living is higher, they come out ahead, he said.

In the meantime, Fairview has also hired about 100 nurses in Minnesota since April, with signing bonuses of $500 to $6,000. But that trend makes him nervous. "I pray that in our marketplace not everybody has to jump on the sky-high bonus days bandwagon," he said. "We won't be able to sustain that as a health care industry."

-- Maura Lerner is at [email protected] .

[eltrip]

And one day, the bonus, pay & benefits will be better than they are in Minneapolis...and these hospitals will lose their nurses...because they went for the quick fix rather than try to ehlp be a part of the long-tem solution.

It figures.

[Jenny P]

Well, I read this article in the paper and it does sound so desparate, doesn't it? There are some hospitals here that don't need to resort to this behavior, they treat their employees as if we DO have brains and with some respect (after all, I want LOTS of respect, so I may never be fully satisfied for a long while!) :) I don't believe in this type of bonus either, Eltrip, for precisely the reason you stated! FIX the problems and we wouldn't have to worry about retentionand recruiting!

[TopazStone]

I love how they keep saying that better bennies and salaries will drive up the cost of health care. If you pay well and appreciate your employees-- how much better will staff retention be? The cost of training new nurses and using agency to cover costs a lot more than just giving us the pay we deserve and improving conditions . . .

[Jenny P]

You are so right, TopazStone. I believe I read somewhere that it costs something like $50,000 to orient a new nurse for the first year they are at a new facility in a new position. I bet that $$$ would be better spent on retaining the nurses they already have (and this quote was from several years ago, before most nurses were earning that kind of $$$).