<i> Times Medical Writer </i>

There was a time when the people who hired nurses for Desert Hospital in Palm Springs could sit back and wait for the phone to ring. But the nation’s worst nursing shortage in memory has changed all that. Desperate times, after all, call for extraordinary measures.

These days, Judy Carpenter does her nurse recruiting in Bermuda shorts. She wears a T-shirt bearing her slogan, “Ahhhh, Palm Springs.” She hands out shoelaces printed with her toll-free number and small, pink and turquoise packets of palm tree seeds.

“Plant one on us,” the packet cajoles a reluctant job prospect. “We’ll grow on you.”

“This is a marketing strategy, a marketing campaign,” explained Carpenter, a 47-year-old nurse with a decade of experience in medical marketing and public relations. “You could take any product and do it. Our product happens to be a hospital.”


What does it take to snare a nurse in a seller’s market? What does it take when nursing schools are closing down and interest in the profession is at a worrisome low?

Shoelaces, palm tree seeds and billboards to catch a nurse’s eye. Raffles for bicycles and microwave ovens to snag a name and address. Then sign-on bonuses, relocation allowances, tuition reductions and child care to persuade a nurse to come to work.

“That’s one of the hardest challenges there is in a crowded marketplace--making your hospital stand out,” said Arthur Sponseller of the Hospital Council of Southern California. “You try to find any distinguishing characteristic and make the most of it.”

At a time large hospitals may have as many as 100 openings, and changes in health-care financing have cinched the economics of hospitals, nurse recruiters have become in some ways the air traffic controllers of the health-care job market.


They work under extraordinary pressures, in part because hospital staffs are leaner and patients sicker than in the past. Vacant nursing positions mean more stress, overtime, even burnout among remaining nurses. Too many vacancies can mean a hospital must close down beds.

Nearly every large hospital now has at least one full-time recruiter. Some have as many as four. They spend their time, recruiters say, not enticing nurses away from other hospitals but winning over, and holding on to, those looking for a change.

The marketplace is intensely competitive. At some job fairs, the ratio of hospitals to nurses is dropping toward 1 to 1. Nurses are calling the shots in job negotiations. And recruiters, with less to work with, are forced to be creative.

“It still is life-and-death work in many ways,” said Valerie Martin, recruitment manager for Memorial Medical Center of Long Beach, of the business of filling nursing vacancies. “You worry about the patients being taken care of properly.”


The trick, many believe, is to find a gimmick.

Professional conferences, job fairs and career days are a recruiter’s element. Some spend a third of their time traveling cross-country and abroad, lugging with them their displays, gizmos and giveaways to plant their hospital’s name in nurses’ consciousness.

Although many conservative recruiters find the hoo-ha distasteful, job fairs are nevertheless taking on a kind of carnival atmosphere. Texas recruiters have turned up with bales of hay and in Western wear. At one confab the Louisiana hospitals joined forces in a miniature Mardi Gras, their booths decked in lanterns, crepe paper and souvenirs.

Recruiters have been spotted popping popcorn at booths to draw attention. Others hand out pocket protectors, gym bags, appointment calendars, mugs. Some say they have seen raffles for stethoscopes, microwave ovens, even the chance to win a leased car.


“I think I read somewhere that you have eight seconds to get somebody over to your booth,” said Karen Hart, executive director of the National Assn. of Health Care Recruiters. “It’s very, very competitive. A lot of it is the quality of your display.”

At Memorial Medical Center of Long Beach, a 1,000-bed hospital with just one nurse recruiter, Valerie Martin forgoes heavy traveling. Instead, she concentrates on the Southern California job market, devoting most of her budget to local newspaper advertising.

Earlier this year, she helped develop a widely admired ad. Designed like a “Wanted” poster, it showed many of the top hospital brass dressed like cowboys. With them ran the slogan, “Wanted! Nurses who aren’t afraid to love their work.”

Congratulatory calls came in from Universal Studios. At least 80 nurses responded in the first week alone. The ad’s genius, Martin and others say, was its novelty as well as the suggestion that top hospital officials were keenly interested in good nurses. Recruiters who believe that their hospitals boast “better than average” relations between doctors and nurses say they always stress that in their pitch.


“You have to be willing to change your direction at any time,” said Linda Wendt, coordinator of nurse recruitment and retention at El Camino Hospital in Mountain View. “I don’t close my mind to any idea or any thought or any anything at any time.”

UCLA Medical Center stresses its strong points, such as its reputation and its big names. Recruiter Bud Bednarski talks up the campus and a two-thirds reduction in tuition for hospital staff, and emphasizes specialties such as heart and bone marrow transplantation.

Some recruiters have turned to the international job market, often working with firms that match employer and employee like dating services. Until recently, they have relied on Great Britain and Canada, where there is no language barrier and comparable training.

But now some say the well may be running dry. A few have explored Scandinavia, the Netherlands and Australia (even though Australians, in turn, are also recruiting in Great Britain). Said Hart, “I think single-handedly American recruiters have created a shortage in the British Isles.”


There are other frustrations, too.

Martin Cregg, director of human resources at Santa Monica Hospital Medical Center, has watched several Los Angeles-area hospitals in recent months advertise nursing salaries of up to $50,000--upping the ante by 25%, he says, in an act that would be difficult to follow.

“We’re all playing the same game. They chose to play a chip,” said Cregg. “There’s a big part of me as a professional personnel guy that says I wish they hadn’t done that. It invites a money war at a time when a lot of people can’t afford a money war.”

Burnout may be rising among recruiters, some suspect. The average tenure among the members of Hart’s association dropped this year from 59 to 43 months. Salaries appear to have climbed only slightly, reaching an association average of $34,526 in Western states.


Few recruiters believe that the nursing shortage will blow over quickly, so many have embarked upon some long-range planning. Recruiters from Los Angeles County-USC Medical Center are actively involved in encouraging nursing as a career--in junior high schools.

Some also want to correct what they believe is stereotyping of nurses in the media. Weary of situation-comedy nurses pursued by predatory doctors, they recently began offering their services as consultants on television shows--an offer that has yet to be accepted.

“I think nurses are realizing that this shortage is here to stay,” Bednarski said. “What we’re seeing is a real concern in the profession that we have to do something to the image of nursing, to show what a nurse is and the contribution they make to health care.”