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Cheryl Johnson, RN, president of the 100,000-member
union United American Nurses, said she wishes
hospitals would focus the same amount of innovation
and attention to improving workers’ health
and safety or staffing ratios rather than paying
nurses as little as possible.
“Sometimes these things sound wonderful
but they don’t play out,” Johnson
said, though she said she would withhold final
judgment on the system for now. “We really
do have to look at all kinds of solutions.”
Mark Genovese, spokesman for the New York State
Nurses Association, said bidding systems do not
get to the root of the nursing shortage and can
harm nurses in the long run.
“It devalues the work a nurse does and
undermines the gains we try to make through collective
bargaining,” he said. “They need to
focus on the root of the problem: creating a work
environment that will attract registered nurses
to full-time staff positions.”
Some in the health care industry hope the flexibility
of shift bidding will lure nurses back to the
workforce. Kim Job, RN, JD, works as an attorney
in private practice and as a per diem nurse for
Sharp HealthCare in San Diego. Before, Job found
she could rarely adjust her legal calendar to
work the last-minute shifts offered by supervisors.
Since Sharp started its shift bidding system called
BidShift in May 2003, Job is picking up many shifts.
“I think this is perfect for people who
work per diem who have other jobs,” she
said. Shift bidding allows a nurse to plan her
schedule without having to commit to times a month
in advance, she said.
Comfortable and convenient
Convenient Internet technology also may lure
much-in-demand nursing school graduates, said
Bonnie Clipper Salzberg, RN, MA, MBA, chief nursing
officer at St. David’s Medical Center in
Austin, Texas.
“It helps to reduce the phone interactions
they don’t want to make,” Salzberg
said. “If we make this easy, they can sit
in their pajamas at home and look through available
shifts.”
St. David’s is seeking to implement a shift
bidding system developed by Decision Critical,
a company that creates Web-based systems to support
the work processes of health care organizations.
Kenneth Dion, RN, MSN, MBA, founder and CEO of
Decision Critical, said his company already offers
an education data repository, which allows organizations
to deliver and track nursing education.
“We always knew an extension of that would
be scheduling nurses,” he said.
Qualified nurses using Decision Critical’s
StaffBid system are notified by e-mail, pager
or Web-enabled cellular phone that a shift is
open. Nurses who have been outbid and winners
are then notified, freeing nurse managers from
finding emergency staff. of making 50 phone calls,
you’re making one Internet posting,”
Dion said.
Like its cousins, StaffBid requires no hardware
or software, nor does it need a connection to
the education data repository. An organization
need only have a Web browser and access to the
Internet. Managers can customize the system to
limit the number of shifts in a row worked, or
the number of shifts taken by one employee, for
example.
Furthermore, Dion said, the potential for continuity
of patient care by inhouse nurses is consistent
with better patient outcomes.
Glori Civitello, LPN, staffing coordinator at
St. Clare’s Hospital in Schenectady, N.Y.,
agreed that shift bidding has reduced the chance
for nursing errors. Not only is the hospital staffing
its open shifts with nurses familiar with its
procedures, physicians and patients, but it also
no longer requires nurses to cover second “mandated”
shifts on the heels of a
regular shift.
The national Institute of Medicine issued a report
in November advising state regulatory bodies to
limit nursing shifts to 12 hours a day and 60
hours a week. Working longer hours poses one of
the most serious threats to patient safety because
fatigue slows reaction time, decreases energy,
diminishes attention to detail and otherwise contributes
to errors, the report said.
“When I first came here, every other day
people were staying on,” Civitello said.
“Now they get to go home on time and they
get to have their days off.”
St. Clare’s based its shift bidding system,
which is open to the hospital’s 250 nurses,
on one at nearby St. Peter’s Hospital. St.
Clare’s still uses agency nurses, who cost
between $49 and $60 an hour, but the majority
of empty shifts are filled through bidding, capped
at $35 an hour on weekdays and $45 an hour on
weekends. In January, for example, the hospital
paid for 68 agency nurse hours and 2,304 bidded
hours to fill shifts.
Civitello said she also has anecdotal evidence
that physicians are happier working with familiar
nurses.
“I get a lot of phone calls from people
saying, ‘They’re not going to get
rid of this, are they?’ ” she said.
Contact
Heather World at h_world@yahoo.com.
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