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The demand for full-time RNs throughout all areas of health care will exceed the supply by the year 2010 if nothing is done to promote the retention of older, experienced nurses and attract more people to the nursing profession, according to a report from the Bureau of Health Professions in Rockville, MD.1
While same-day surgery managers usually have been able to attract experienced nurses from inpatient surgery programs by offering more attractive hours and no required call for evenings and weekends, it is becoming increasingly harder to find nurses, says Kay Ball, RN, MSA, CNOR, perioperative consultant for K&D Medical, a surgical consulting and educational firm in Lewis Center, OH. "We need to work with colleges and high schools to promote nursing as an exciting career," says Ball. Encouraging more young people to pursue nursing as a career will help all areas of health care, including surgery, she adds.
Because the pool of experienced nurses is shrinking, same-day surgery managers have to look at recruiting nurses directly out of school, says Kathy Bryant, executive director of the Federated Ambulatory Surgery Association (FASA) in Alexandria, VA. This means developing training programs within your facility, she explains. "We need to look at training as an investment rather than a drain on our resources," she says. "Training new nurses can be a good experience for everyone because it is uplifting to see people starting a new career with youthful enthusiasm." Training programs also will expand the pool of nurses from which you can hire because you won’t be limited to experienced surgical nurses, she points out.
Training within a same-day surgery program can be costly for a single facility, says Beth Derby, RN, MBA, executive vice president for Health Resources International, a West Hartford, CT-based management and consulting firm for ambulatory surgery centers. Not only are you paying the nurse who is mentoring or training another staff member, but you also are paying the trainee, she says.
"I think we will see some unusual partnerships between surgery centers, hospital-based programs, and nursing schools develop in order to provide quality training," Derby suggests. By sharing resources such as sites, staff, and time with each other, same-day surgery managers can make sure nurses learn the skills needed for same-day surgery without placing an unmanageable burden on any one program, she adds.
"We also need to make sure salaries and benefits are competitive with a nurse’s other opportunities," adds MaryAnn Edwards, RN, MSA, supervisor of ambulatory surgery at Henry Ford Health System in West Bloomfield, MI. "Sometimes same-day surgery programs have offered lower salaries because the hours and work environment are more attractive than inpatient surgery programs, but we can’t expect experienced nurses to accept lower wages any longer," she explains.
Freestanding center managers should remember that they are not only competing with inpatient programs with unattractive hours but also with office-based programs with attractive hours for nurses, she adds. Staffing shortages might not be limited to nurses alone, so be sure to evaluate all of your staffing needs when developing a training program, Edwards points out. "We have trouble hiring reprocessor technicians because we need experienced people, since we don’t have time or resources to train them on the job either," she says.
1. Health Resources and Services Administration. Bureau of Health Professions. Division of Nursing. Report to the Secretary of the Department of Health and Human Services on the Basic Registered Nurse Workforce. Rockville, MD; 1996.