Here is an interesting article that merits posting here:
B.Nurses using temp agencies to find more job freedom
FONT=century gothic]By SHERRY JACOBSON
Copyright 2002 The Dallas Morning News
DALLAS -- Not long ago, Linda Brent was exhausted. After nearly 30 years as a registered nurse on nights, weekends and extra shifts, coupled with backbreaking physical labor, she decided it was time to give it up, to find something else to do.
So she got a real estate license and started selling other people's property.
"I was doing fine," she recalled. "But something was missing. Something just didn't feel right about it."
As tough as her old job was, she had to admit to herself that she actually enjoyed working in a busy hospital. It was always interesting; no two days were the same. She always thrived on the professional camaraderie with other nurses, she says. She could always count on them to do whatever they said they would do. And then there were the patients; it really felt good helping sick people to feel better.
Wasn't that reason enough to be a nurse, Brent asked herself? The answer was a qualified yes. So after about a year of selling houses in Kaufman, she put away her real estate license and went back to nursing. But this time on her own terms.
Instead of working for a hospital, she joined a growing number of nurses and turned to an agency that finds jobs for them in whatever medical setting they choose. Brent, 52, has decided that being a temp or agency nurse is the only way to handle being a nurse anymore. It gives her some measure of control by allowing her to pick the setting of her employment -- in this case, the hospital and even the floor where she wants to work as well as the days of the week and the number of hours.
"You can ask for whatever you want," Brent said, sounding a bit like a kid in a candy store. And she gets such free rein of choices because her skills are in great demand.
U.S. hospitals are struggling to operate while short 126,000 nurses, according to the American Hospital Association. By 2010, the shortage will grow to 1 million nurses.
From the smile on her face, it's clear that she's found something she likes in her current placement on the 14th floor of Roberts Hospital at the Baylor University Medical Center in Dallas.
"I like it because I can go in, do my time, take care of my patients and not get caught up in office politics," she said. "The staff has been very accepting of me. They're all very nice. I can go home at night and feel good about my day."
Her days typically include managing the details involved in the care of four or more patients, from monitoring medication to challenging doctors' orders when she feels it's necessary. She enjoys the intensity and intimacy of caring for often critically ill patients and their families.
"Hospitals used to have more staff, so now it's harder work," she said of the career she chose in 1971. "The bottom line in the hospital now is that the care is not so much on the doctors' shoulders as on the nurses' shoulders. It's a lot of responsibility."
Of course, there are a number of trade-offs in working as a nursing temp.
Although she does the same job as RNs employed by a hospital, the agency that placed her in the job pays her about 25 percent more for doing it. However, she gets no health coverage, vacation pay or other job benefits. But Brent is covered by her husband's insurance plan.
Typically, she now works three 12-hour shifts during the week, which is considered a full week's work for a hospital nurse. But she takes another eight-hour shift during the winter because the hospital needs her.
"I'm loyal to the hospital I work for," she said. "But I do like to have more time off in the summer when my grandchildren are out of school."
There is a downside, however.
Sometimes, temp or agency nurses can struggle to find their way around on strange assignments. They sometimes complain of being ignored by other staffers or even of being assigned more patients than they can possibly handle. Still, when an assignment goes bad, the nurse can request not to be sent there again.
"There used to be a lot of resentment because agency nurses are paid about 20 to 25 percent more than staff nurses, depending on the specialty and the hours worked," said Scott Reid, president of CliniCall Staffing, a Dallas agency that employs Brent and 200 other nurses. "Now, there's more of an attitude that 'we're all in this together.' Plus, there are more agency nurses out there now."
Nationally, more than 110,000 nurses are working as temps, a 66 percent increase from 1996. More than 40 temp agencies find jobs locally for nurses, offering a variety of perks that include cash bonuses, health insurance and other benefits. Reid's company offers a profit-sharing plan that returns 15 percent of a nurse's salary, up to $15,000 per year, to those who stay with the agency for five years.
"This is a very competitive business," he said. "Other agencies may pay their nurses more, but we have a good track record for finding them good assignments. We have very few cancellations."
After trying a variety of temporary assignments, Brent says she has found a comfortable spot at Baylor, caring mainly for organ transplant patients.
"I seem to fit in with this group of nurses," she said of the 14th floor staff. "There are some floors I've worked on that I haven't felt that. But not at this hospital."
In fact, her services are much in demand these days, says nursing supervisor Cindy Clayton, who starts her day juggling 20-some patients among the eight nurses assigned to the floor that shift. One nurse will be leaving at 1 p.m., requiring further patient shifts.
"Losing a nurse when we're close to being full is not good," said Clayton, sitting at her cluttered desk in a closet-sized office. "I'm short two nurses today and I'm refusing new patients right now because there's not enough nurses to distribute them to."
Clayton, who has worked at Baylor for 10 years, places a high priority on striking the proper balance between the number of nurses and the number of patients they handle because transplant patients tend to be much sicker than the average hospital patient, she says.
Whenever the floor has "fresh transplants," Clayton tries to hold the ratio down to three or four patients per nurse. Some nurses are assigned up to five patients if they are not complicated cases. The floor's reputation for good care stems from maintaining good ratios, Clayton notes.
Which is why she is thankful to have Brent's services. "She rarely makes mistakes and gets along with everyone. She does more shifts than the average nurse up here," Clayton said.
But there are financial realities to face about hiring a temp. "She costs the floor more money than any other nurse working here," the supervisor explained. "She's worth every penny of it, but we have to justify it. I will hate to say goodbye to her."
In fact, Clayton has been working pretty hard these days to replace Brent and several other temp nurses who work on the 14th floor. By the end of the summer, eight recent nursing school graduates will be sufficiently oriented to take over their work.
"As we get fully staffed, the agency people will be canceled," Clayton explained. "This is a business. A hospital has to be competitive, and it's for a good reason. The bottom line is part of the job."
Brent says she's not too concerned that the day will arrive soon when her services will no longer be needed on the 14th floor. Baylor is a big hospital, she says; surely they'll need her somewhere.
"It would be nice if I could stay at Baylor," she said. "But they're always trying to hire their own staff, and I know that. I just roll with the punches."
Until then, Brent will just keep taking care of patients, 12 hours at a time.
"It can be very rewarding," she said. "They have such interesting patients on this floor. At the end of the day, I feel like I've really done something worthwhile."