Hospitals Try Tea, Raises, Status to Refill Thinning Ranks of Nurses

Next month, Western Medical Center will start an unprecedented--and expensive--advertising campaign on television to persuade nurses to join the staffs of its three hospitals in central Orange County.

At Mission Hospital Regional Medical Center, nurses are feted at lavish recruitment teas to entice them into working for the Mission Viejo hospital.

To make salaries more attractive, St. Joseph Hospital in Orange pays 35% more to nurses who give up health insurance and other fringe benefits--an offer too good to refuse for 25% of the staff.

Hoag Memorial Hospital recently hired its first nurse recruiter, an administrator who spends all her time attending job fairs and college career days and coordinating other efforts to lure nurses to the Newport Beach hospital.

Plagued by the acute shortage of nurses that is prevalent throughout the nation, Orange County’s 42 hospitals are resorting to innovative measures to keep nurses on staff and to recruit new ones.

There are no exact figures on the number of unfilled nursing positions in Orange County. However, hospitals in the county lose about 20% of their nurses every year, said Arthur Sponseller, who has studied the nursing shortage for the Hospital Council of Southern California, a hospital trade group with headquarters in Los Angeles.

To replace these nurses and to fill additional slots created by the growing demand for nurses, hospitals are actively bringing nurses on board. About a third of their staffs each year consist of new employees, Sponseller said.

Nurse recruiters acknowledge that the most obvious way to increase the supply of nurses would be to pay them more.

Noting that the salary for an entry-level nurse is $12 an hour, Jane Coyne, vice president for patient care services at Hoag, said: “Most nurses are unhappy with their salaries. Years ago the only professions for women were teaching and nursing, but today the high-paying fields of medicine and law have opened up for women.

“The salaries over the years have been increasing, but the wages were so low to begin with that there has been a lot of catching up to do.”

John Gilwee, director of the Hospital Council’s Orange County office, said hospitals in the county would like to increase nurses’ pay more than they already have, but are unable to do so because of reduced fees coming in from government and private medical insurance programs. Those programs are concerned about holding down rising hospital costs.

Lucille Winklepleck, nurse recruiter for Western Medical Center, said nursing salaries this year are up 6% to $12 an hour for entry-level nurses and $18.50 an hour for experienced nurses.

Even these increased salaries haven’t attracted enough nurses. As a result, a growing number of hospitals are hiring nurses under a plan that gives them 20% to 40% more in cash, in exchange for giving up health insurance and other fringe benefits.

At Anaheim Memorial Hospital, about 30% of new employees participate in this cash-in-lieu-of-benefits program, said Diane Griffiths-Westcott, the hospital’s nurse recruiter.

Try Merit Systems

To retain nurses, hospitals increasingly are turning to merit systems, in which nurses receive additional pay based on their education, experience and evaluations of their job performance. At Hoag Hospital, nurses can receive 5% a year more in pay for each leg they advance on these clinical pay ladders.

At Mission Hospital, this program translates into as much as $400 a month more in pay for nurses who are nationally certified to work in such specialties as trauma, emergency room and intensive care, said Lynda Whitehouse, director of nursing. But Anaheim Memorial’s Griffiths-Westcott acknowledged: “It’s tough for us to increase salaries much because funding is being cut for hospitals.”

As a result, hospitals give as much emphasis, Griffiths-Westcott said, “to making the work environment more pleasant.”

“We want to avoid burnout, give recognition, provide upward mobility, education and innovative scheduling to nurses so they don’t have to deal with all the hardships that conventional scheduling provides.”

Programs variously known as “physician-nurse relations” and “inter-disciplinary practices” have sprung up to put nurses on a more equal footing with doctors. “We want to upgrade the stature of nurses in the hospital and to give them the feeling that they are being heard,” Griffiths-Westcott said.

Popular Program

At Hoag, most critical-care nurses work 12-hour shifts three days a week, spokeswoman Coyne said. The 12-hour shift has proven so popular that the hospital is considering offering the schedule to all nurses.

To attract nurses who have rusty skills because they have not worked in hospitals for several years, the Mission center helped organize a program where nurses who take refresher courses at Saddleback College get their clinical training at the Mission Viejo hospital. The hope, director of nursing Whitehouse said, is that they will end up working at the hospital at the end of their studies.

The shortage is particularly acute in specialized fields. Because Anaheim Memorial Hospital could not find enough operating-room and critical-care nurses, two years ago it began its own in-house training program for these fields, Griffiths-Westcott said.

Humana Hospital in Anaheim offers similar training to prepare nurses to work in surgery and critical care, nursing director Connie Oetting said.

U.S.hospitals need thousands of nurses. Part I, Page 1.