Short staffing incentive ideas???

BSN16 · Jun 7, 2016

From experience I can tell you that call in incentives are a terrible idea (financially for the hospital) I was a prn staff and would frequently get alerts for short staffing. First it would just ask for volunteers at regular incentive, then it would progress to like 200 dollar bonus, as far as triple incentive plus a bonus. And my thought process literally started to become "wow only a $200 bonus? I'm not going in unless they offer triple". I mean I would go in often without any incentive, but once you have a policy like this it creates a new set of problems

malamud69, BSN, RN · Jun 7, 2016

Hmmmm...could the answer be have enough staff to begin with? No...that's crazy talk

middleagedRN · Jun 7, 2016

We were offered bonus packages. For example three extra shifts you get 750 dollars. 8 extra shifts you get 2000 dollars. 3 weekend shifts 1000 dollars. Each shift 250 dollars. I cleaned up last summer working incentive shifts.

Holy cow! My family would never see me again if my facility offered those kinds of bonuses!

nrsang97, BSN, RN · Jun 7, 2016

They need to hire more staff and not expect you to pick up so much extra time.

Conqueror+, BSN, RN · Jun 7, 2016

How much does management actually care about short staffing? Reverse bidding for shifts. I hate hate hate to work extra shifts, but I do have a price!!
Reverse bidding would likely quickly determine that there is someone else that would be willing to work for much less. And the shift would get covered. There are purely web based systems that are easily accessible. Heck, there may even be an app for that!
Reverse bidding allows nurses to bid on a needy shift and the lowest bid wins. So say nurse A (who makes $35/hr normally), bids to work for $45/hr for that unwanted Saturday shift. Nurse B (who makes $30/hr normally), bids to work that same shift for $40/hr. Nurse B gets the shift, at a nice bonus, and the hospital saves at least $5/hr. Or possibly more if they have to use their on call nurse, who happens to be topped out and now is going to make time and a half.

The last thing we need is a system that lets the facility pay as little as possible. Moreover, the nurse who always got the shifts was known to have undercut everyone else and became most hated. Reverse bidding hurts the nurses and benfits the facility.

Conqueror+, BSN, RN · Jun 7, 2016

From experience I can tell you that call in incentives are a terrible idea (financially for the hospital) I was a prn staff and would frequently get alerts for short staffing. First it would just ask for volunteers at regular incentive, then it would progress to like 200 dollar bonus, as far as triple incentive plus a bonus. And my thought process literally started to become "wow only a $200 bonus? I'm not going in unless they offer triple". I mean I would go in often without any incentive, but once you have a policy like this it creates a new set of problems

What problem? The facility has far more money than they want us to think. My old manager knew not to call me until it was $250 for an 8 hour shift. There were times that I was the only nurse getting that much working alongside someone getting $100 or $150 for the same shift.

JerseyTomatoMDCrab, BSN · Jun 7, 2016

When I read the title of this thread, my first thought was "Duh! More money!" but it seems your facility already thought of that. Those are pretty good cash incentives. My first hospital job SOMETIMES offered an incentive, usually a non-taxed $250, which was nice but they only offered when times were really tight. My most recent hospital job didn't offer anything. I never went in when they called.

Chronic understaffing plagues hospital nurses all over the place. It's an epidemic. I don't think management understands that hiring and retaining quality staff will eventually be cheaper than hiring travelers, paying incentives and overtime for staff that is already exhausted from poor staffing.

A non-cash incentive might be an extra vacation day earned for x hours of overtime worked.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Jun 7, 2016

I was a traveler. Costs the facility approximately 4 times the $$ of obtaining PRN staff.

True! But it appears that PRN employers either do not exist at the OP's facility, or are no longer willing to rise to the occasion. In the past month with trying to find a caregiver for my mom after her behavior got her thrown out of the nursing home, I've finally convinced my siblings that you cannot pay those that won't accept the job, which means you might be paying dearly for those that will.

The powers-that-be might have to empty out their pockets on this one in order to paint a more appealing portrait for potential employees. Otherwise, the few remaining employees may quickly become former employees.

Just my opinion;)

Here.I.Stand, BSN, RN · Jun 7, 2016

What problem? The facility has far more money than they want us to think. My old manager knew not to call me until it was $250 for an 8 hour shift. There were times that I was the only nurse getting that much working alongside someone getting $100 or $150 for the same shift.

Right...forget about setting up high expectations with bonuses. Staff aren't willing to come in for extra $$$ anymore. Why would they come in for a regular rate?

My hospital gives -- wait for this -- a meal ticket. Worth $4, which isn't enough for a full meal. My husband always points out that I pay more than that for parking.

The first poster was spot on. A short staff is a finite resource.

llg, PhD, RN · Jun 7, 2016

Demonstrate to your staff that the short staffing is temporary and you may get better response. People are less likely to volunteer if they see light at the end of the tunnel. If the short staffing is routine, they figure out that their extra effort isn't helping in the long run. It gives them some extra cash in the short term, but burns them out in the long run. Take care of their "long run" and they are more likely to help you with your "short term" problem.

What are you doing to recruit and retain staff for the long term? Does your staff see and approve of those efforts? Are they optimistic that their long-term interests are being addressed adequately?

cjcsoon2bnp, MSN, RN, NP · Jun 7, 2016

If your unit is that short that people need to be offered time and a half (1.5X), double time (2X) and on-call (or any combination of those) and you're still not getting people consistently (and this still remains a regular issue) then the management team needs to get some more bodies in there ASAP.

Yes, this could mean contact nurses/travelers as a short-term, quick fix for this issue but as other users have mentioned it is very costly and the quality of travelers is extremely varied. I have worked with some travelers who are nice people and good teammates while others are cold and distant (likely because of the time limits of their position and wanting to avoid drama, company politics or close relationships). I have also found some travelers to be completely incompetent (not a word I throw around lightly) and others are extremely skilled clinicians with a lot of experience.

I think that an even better option would be (a) cross train some nurses from other departments if possible and allow them to pick up shifts AND (b) hire some per-diem nurses (PRN) but make sure you find the right people who are willing to work with some regularity and make sure you have a strong policy regarding the work commitment of per-diem staff. As a former manager, nothing irked me more than investing in a per-diem nurse only to find out that they "only do days" or only can work "once a week" after they made a big point of saying during the first interview that they were "willing to work any shift" so they could "pick up plenty of hours". I wasn't unreasonable and didn't expect per-diems to work 40 hours/week on any available shift (1st/2nd/3rd) but don't say you are looking to work a lot or will work any shift just so that you can get a job, it's not helpful to you or to the management and you will be taking the place of someone who is looking to work.

If you work at a facility that doesn't hire for per-diem positions but allows currently employed nurses to transition from a benefitted position to per-diem (some VA facilities operate under this kind of policy) then I would consider asking if some current staff wish to transition to per diem once their position has been posted and someone hired into it. This can be a good way to get per-diems that might not otherwise be approved but you need to establish with senior leadership that the position being vacated is a need and be assured that it will be re-posted for hiring ASAP. I used this method previously and found that it resulted in some experienced per-diem nurses who knew the unit and helped to keep some nurses who might have left anyway (people near retirement, stay-at-home moms etc.) and allowed their benefitted positions to bring in some fresh candidates (transfers from other units and new grads. etc.)

Of course, if you review your staffing model and identify that you have a need for benefitted positions (FT or PT) because you are short staff regardless of call outs, LOA, PTO, or temp. vacancies then you would need to speak with senior management and get approved to post requisitions for such positions (and consider posting them as flex/rotating positions as well).

Best of luck to the OP! Just out of curiosity, are you a staff member on this unit or a member of its management?

!Chris :specs:

meanmaryjean, DNP, RN · Jun 7, 2016

In addition to all the excellent suggestions here (most importantly HIRING ENOUGH STAFF) - I think contracting with a cleaning/ yard service. I would be likely to turn down extra work because I had stuff to do at home. But knowing when I get home my house will be clean and my yard mowed? Watch how fast I take extra work!