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By
Christina Sponselli When hospitals and other healthcare workplaces tighten their finances and go through mergers and acquisitions, what happens to the nurses and allied health professionals working there? Chances are your salaries and hourly wages are reflecting the tightening, too. There’s a lot of talk of shortages lately, and that’s often good news for healthcare professionals’ pay. But while it’s true that some areas of the country are having problems recruiting health professionals, the pocket shortages are for experienced workers with specialty training or advanced education. So if you’re looking for a hefty sign-on bonus or bountiful pay, you’ll probably need to move or have the kind of clinical experience desperately in demand. Salary range Here are the numbers: The average salary for staff RNs this year is $41,800; nurse managers, $56,000; and LPNs, $31,040, according to WageWeb, a Web site that conducts salary surveys. PTs’ average salary is $51,540; RTs’, $37,386; and social workers’, $33,900. But that’s only part of the picture. Compared with salaries in many other employment sectors, salaries in nursing are high. But current annual salary increases for nurses seem paltry when compared with increases during the peak of the nursing shortage 10 years ago. For example, CRNAs could count on a 5 to 6 percent pay increase; now they are receiving 1.5 to 2 percent, according to Gregg Revak, director of membership and information services at the American Association of Nurse Anesthetists. Based on the group’s 1997 national membership survey, the average salary for a CRNA was $87,500, a 1.5 percent increase over the previous year. Texas CRNAs reported an average annual salary of $101,900. [California CRNAs reported an average annual salary of $98,500.] In other professions, annual raises seem to be on track. "Anecdotally, we’re hearing members are getting their regular, expected increases in pay," said Sherry Milligan, associate executive director at the American Association for Respiratory Care (AARC). The rules of supply and demand prevail. Acute problems Acute care in particular is experiencing shortages. Facilities are begging for experienced RTs, for example. Milligan attributes the robust job market to the need to treat sicker patients and to backfill RT jobs that had been cut. In fact, an AARC survey found the largest percentage increase in advertised full-time jobs was in acute care. This is where RTs will find steady pay increases and even sign-on bonuses in some parts of the country, she said. The American Association of Critical-Care Nurses is also hearing anecdotal evidence of nursing shortages. "There is a shortage of skilled, experienced nurses in some areas—such as critical care, recovery, and cath labs—and this is fueling creative incentives, including sign-on bonuses. New grad training programs are also back in vogue," said Michele Wolff, MSN, RN, the association’s clinical practice specialist. In addition, she is hearing of shortages of nurses with BSNs and beyond. Wolff is seeing a resurgence of clinical nurse specialist positions that hospitals axed a few years ago —and the difficulty hospitals have in filling them. Rural scramble Attend a meeting of healthcare recruiters and you’re sure to hear tales of woe about recruiting nurses and allied health professionals in rural areas. Health workers living in the country are choosing to commute a couple of hours to a hospital in the city three days a week and work 12-hour shifts to bring home $15,000 more a year with better benefits and more educational opportunities. Shortages of OTs are cropping up in rural areas in the South and West, according to Brynda Pappas, spokesperson at the American Occupational Therapy Association. But even some suburban areas are feeling the shortage. St. Joseph Mercy Hospital in Ann Arbor, Mich., has been forced to aggressively recruit nurses to stay competitive with neighboring facilities. Recently the hospital began offering employees a bonus for recruiting nurses. An employee who recruits a nurse is paid $750 after six months and another $750 after another six months if both employees are still working at the hospital, said Francie Wolgin, MSN, RN, director of operations support and practice development. Trouble at home While many hospitals are offering health professionals a rosy employment scenario, home healthcare’s financial resources are dwindling. Faced with the upcoming prospective payment system (which will force home health agencies to assume financial risks and make do with smaller budgets), allied health workers and nurses are seeing fewer reimbursement dollars, lower salary increases, and decreasing jobs. "Home health agencies are cutting costs by cutting their labor costs," said Anna Gilmore-Hall, director of labor relations and workplace advocacy at the American Nurses Association (ANA). But while staffing cuts save money, they can also increase injuries to workers, Gilmore-Hall said. She cites a 1997 survey, conducted by the Minnesota Nurses Association, that found that when the healthcare staffing is cut, the number of injuries reported to the Occupational Health and Safety Administration goes up. Among the injuries that increase are needlesticks and back injuries, she said. And it is not just hospitals and health systems in managed care markets that are cutting costs, Gilmore-Hall said. She is hearing about facilities outside of managed care markets that are reducing costs and increasing profits in anticipation of managed care’s arrival. Hidden squeeze Nurses and allied health professionals are continuing to feel the sting of cost cutting. Some of them, especially in skilled nursing facilities and home health agencies, are being told to crank up their "productivity." There are anecdotal reports of allied health workers being pressured to spend up to 85 percent of their time with patients. Many professionals claim such productivity goals don’t factor in time needed for paperwork, screenings, or team meetings. For nurses, cost-cutting pressure is seen in the growing popularity of pay-for-performance compensation systems, Gilmore-Hall said. There are many kinds of pay for performance, sometimes called merit pay, depending on where you work. Sometimes nurses work for a base pay and receive a bonus for meeting specific goals. Jose Pagoaga, a national healthcare specialist at benefits consulting firm William M. Mercer, says these systems grew out of employers’ need to reward employees, while not exceeding their evaporating salary budget. They’ve worked around the problem by increasing productivity and sharing some of the wealth with employees. Although Pagoaga has not heard of merit pay being structured around meeting supply or time quotas, that’s what Gilmore-Hall is hearing from ANA members. She stresses that the ANA doesn’t see such incentives as inherently problematic, but it is concerned when the compensation system is tied to quotas on the time spent with patients and the supplies used on patients. "It appears that compensation systems may encourage the misuse of nursing services, thus compromising patient care," Gilmore-Hall said. So, rather than being paid for the nursing care you give, you may be rewarded for the time and supplies you don’t give. |
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Related
Sites Wage Web’s healthcare salary data |
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