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No raise in bad economy for 1 in 4 EHPs
No one can escape the reverberations of this economic downturn. Yet while employee health professionals weather the realities of trying to do more with less, they also are more vital than ever to their hospital's operations.
After all, who is responsible for not one, but two influenza vaccination campaigns this fall? For screening employees who may become ill with H1N1? For responding to a growing range of regulatory requirements, including record-keeping rules and respiratory protection programs required by the U.S. Occupational Safety and Health Administration?
Add to that the link between employee safety and patient safety. Many hospitals now see the usefulness of safe patient handling as part of a strategy to reduce patient falls and pressure ulcers, which are quality issues monitored by the Joint Commission and Centers for Medicare & Medicaid Services.
"It takes work and energy, but I think the time is right [to enhance] the visibility of employee health and to show the value we have to organizations," says Sandra Domeracki Prickitt, RN, FNP, COHN-S, executive president of the Association of Occupational Health Professionals in Healthcare (AOHP) and coordinator of Employee Health Services at Marin General Hospital/Novato Community hospitals in California.
According to the 2009 Hospital Employee Health salary survey, employee health professionals have been significantly affected by the recession. About one in four (25.4% of 189 respondents) reported receiving no raise and 4% reported taking a salary decrease. In 2008, only 11.5% of 218 respondents said they received no raise and about 1% (just two respondents) reported a salary decrease. The most commonly reported pay range was $50,000 to $69,999 (43%), which is similar to 2008; another 14% of respondents said they earn from $70,000 to $79,999.
Although new people moved into the occupational health specialty (28% of respondents had worked in employee health for three or fewer years), it remains a field for seasoned health professionals. Two-thirds of respondents have worked in health care for 25 or more years.
Admittedly, this is a time of diminished resources. Some hospitals have held the line on compensation or reduced paid time off. "There are hospitals in the area that aren't giving any merit raises. You just get to keep your job," says Carolyn Amrich, RN, COHN, manager of Occupational Health & Wellness at Children's Medical Center Dallas and a regional director for AOHP.
"Frills," such as educational expenses, have been trimmed or even eliminated by some hospitals. AOHP saw the impact with lower attendance at its fall conference, says Prickitt, whose own hospital is no longer providing paid time off for education or professional development. "You either have to take [the time] unpaid or use your own personal time," she says.
"Every hospital is different in how they're being affected by bad debt [from uninsured patients]," she says. "California is being hit hard and every facility is making choices about what they're [spending]."
Clearly, this is not a favorable time to ask for more support staff or to expand the department. But employee health professionals are finding administrators are receptive to requests for help in responding to the H1N1 pandemic.
Amrich, for example, received help from PRN nurses when H1N1 flu vaccine arrived and she needed to administer it to employees as swiftly as possible. At the peak of a pandemic wave, 700-800 children a day were coming to the hospital with flu-like symptoms, and employees came to the occupational health department with symptoms that needed evaluation. Hospital leadership responded to the surge. "They just asked me what help I needed and they found it for me," she says.
Amrich received kudos from senior management for her part in responding to the pandemic. But some employee health professionals may need to be proactive to make sure hospital leadership is aware of their role.
"Really think about how you communicate the value you bring," says Charlene M. Gliniecki, RN, MS, vice president, human resources, at El Camino Hospital in Mountainview, CA, and a former employee health nurse. "Communication is important in terms of creating a sense of who you are, that you're part of the team."
Your role in vaccinating and screening employees may be apparent. Your efforts to reduce workers' compensation costs, reduce injuries and medical costs, and help employees be more productive may be less obvious to hospital leaders. But it's up to you to create partnerships and make it clear that you are supporting the hospital's work force their "human capital."
"Any time you can align what you're doing with patient safety and quality initiatives and goals, you are demonstrating your relevance to the core work your organization does," advises Gliniecki.
It may be intimidating to approach senior management, but you need to overcome any hesitance, says Prickitt. "You have to keep clear on the ultimate focus it's the patients you are treating in employee health and also the patients in the hospital."
State and federal regulations also have bolstered the role of employee health professionals. And in its National Occupational Research Agenda, the National Institute for Occupational Safety and Health laid out the issues facing health care workers: "[E]liminating hazards such as unassisted lifting and transfer of patients, contaminated equipment and surfaces, and even the mundane but still treacherous slippery floors protects both workers and patients. A safer, healthier, and focused caregiver will make better decisions and do a better job providing competent, compassionate care."
In the context of an aging work force and nursing shortage, keeping hospital workers healthy is more important than ever. "Facilities are seeing the value of having that [employee health] specialist in the work force," says MaryAnn Gruden, MSN, CRNP, NP-C, COHN-S/CM, employee health coordinator at Western Pennsylvania Hospital in Pittsburgh and AOHP community liaison.
As employee health professionals look beyond this current crisis mode, they need to maintain an interdisciplinary approach, says Barbara Burgel, RN, PhD, FAAN, ANP, COHN-S, clinical professor at the University of California San Francisco's Occupational and Environmental Health Nursing program.