Keep a full staff: Make your hospice attractive to mature nurses
Flexible schedules, input in job are keys to keeping experienced staff
An aging workforce and a nursing shortage might seem like the perfect storm for the health care industry, but all areas of health care, including hospice organizations, have found ways to attract, retain, and make the best use of experience that comes with age. Not only are hospices implementing programs that are attractive to mature workers, but according to the AARP's list of the nation's 50 "Best Employers of People over 50" earlier this year, half of the organizations were health-care related.
"Schedule flexibility is one thing that all mature workers want, and hospice is perfect because our schedules offer flexibility for all employees, regardless of age," says Jill Roby-Snyder, RN, operations director of the hospice and home medical equipment divisions of MidMichigan Medical Center in Midland, MI, one of the organizations recognized by AARP. MidMichigan's hospice offers a variety of employment options including full-time, part-time, weekend, and per-diem, she says. "We call our per-diem positions 'casual,' and these employees can choose to work one day a week, or they can pick up one or two visits a week on different days," she says.
The casual employee positions are attractive to retirees who want to return to work on a limited basis, says Roby-Snyder. "They may want to stay up to date on their skills and maintain some patient contact, but they don't want work to interfere with retirement activities," she explains. By allowing employees to pick up a few days or a few visits, the hospice is able to cover vacations and sick days for employees by using experienced nurses, she adds.
Part-time employees have a more predictable schedule with their own caseload, but they do receive benefits and still have a lot of flexibility, says Roby-Snyder. "Even our full-time employees have the opportunity to see their child's program at school during the day or visit the doctor for their own appointments, as long as we know that their visits are being made," she says.
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Issues Important to Older Nurses
Source: Hatcher BJ, Bleich MR, Connolly C, et. al. Wisdom at Work: The Importance of the Older and Experienced Nurse in the Workplace. 2006. Princeton, NJ: Robert Wood Johnson Foundation. |
To alleviate concerns about covering weekends and after hours, Roby-Snyder's hospice has employees who work those hours as their primary job. "Our weekday employees do rotate weekend and after hours call, but only as backup for times that the primary nurse is on a lengthy visit to a patient's home," she says. Knowing that they won't have evening and weekend call regularly is a big attraction for most employees who prefer to work during the week, she says.
Give opportunities for input
It makes sense that hospice would attract more mature employees anyway, says Roy Hoxworth, SPHR, director of human resources for Hospice of Marion County in Ocala, FL. His hospice, which was included on the AARP list of best employers, not only promotes flexible hours, but also promotes employee involvement on performance improvement teams.
"We give people a chance to contribute their ideas and help us solve problems," he says. Employees see the results of their input in protocols that are developed or changes in practice that are put into place, he explains. "We only hire employees with at least two years of experience, and we have employees with many more years of experienced, so we want the organization to benefit from their knowledge," he says. In fact, Hoxworth says that the hospice has many employees with 15 or more years of experience, and most employees have 6-10 years of experience.
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You hired them once Why not hire them again? Retiree rehires provide extra, experienced help Is there a better way to ensure that you are hiring a well-trained, experienced, dependable employee than by hiring one of your own retired employees? MidMichigan Health System has just started a new program that applies to all employees, including hospice nurses, that offers retirees an opportunity to come back to work while continuing to receive their retirement payments. "Changes in our organization's pension rule now make it possible for retirees to work more hours without affecting their pension checks," says Lynn Bruchhof, vice president of human resources for MidMichigan Medical Center in Midland, MI. Previously, our retired employees were capped at 800 hours but that has been expanded, she says. Be sure to check your pension plan rules as well as federal regulations as you design your program, she suggests. "We've developed a web-based resource center that retirees can use to see what positions are available for short-term work," says Bruchhof. Positions listed might include teaching a few inservices periodically; acting as a preceptor for new employees; or filling in for a nurse on maternity leave, illness, or vacation, she explains. Nurses especially like the opportunity to keep their nursing skills current but they like to do so in a way that allows them to travel, spend time with grandchildren, or just relax, points out Bruchhof. At Bon Secours Richmond Health System in Richmond, VA, a phased retirement program enables employees who have reached retirement age to continue working for 16 hours per week, receive full benefits such as health care coverage, a paycheck for part-time work, and a partial retirement check for which they qualify, says Dawn Malone, administrative director of human resources for the health system. "Nurses may not be ready to retire, but because their spouse is retired or because their children need their help caring for their children, they leave because they don't have options," she says. By enabling nurses to reduce their work hours without reducing benefits and to also receive a pension check, the hospice and other departments in the health system can keep experienced nurses, she explains. To address the nurses' needs for childcare or eldercare, the health system offers access to onsite childcare centers for employees' children or grandchildren, says Malone. "We also offer up to 10 days of respite care per year at a discounted rate in our assisted living facility for employees who have elderly family members who need care," she adds. The focus on programs that will retain older employees is a positive step, says Bruchhof. "It is especially important for hospice, which requires a specially trained, experienced nurse," she says. |
In Wisdom at Work: The Importance of the Older and Experienced Nurse in the Workplace,1 a 2006 report by the Robert Wood Johnson Foundation, several issues were identified as important to older nurses. "Control over the work setting" and "favorable work schedules" are two issues that Hoxworth's hospice addresses with job sharing. Although all hiring and employment policies must apply to every employee, regardless of age, the opportunity to job share appeals to older workers, says Hoxworth.
"Job sharing is an option for almost all positions, with the exclusion of management," he says. "Two employees can present a proposal on how they will cover bi-weekly team meetings, illness of the other employee, or vacations," he says.
As long as the two employees have addressed the issues that might arise, the job share option is approved, he adds. Sometimes an older employee shares with a younger employee because their schedule needs compliment each other, he says.
"They can design their work weeks to fit their schedules and know that all patients will be seen," he adds.
Because nursing can be physically challenging, it is important to recognize the risks associated with lifting or repositioning patients, warns Roby-Snyder. Education and assistive equipment such as Hoya lifts can help older workers with the physical demands of nursing, she says.
Although developing hiring, benefits, and incentive programs to attract and retain older workers takes time, it is one way to address potential shortages, says Hoxworth. "People of all ages want to work in a good environment, but hospices that demonstrate their appreciation for mature workers will stand out and attract good experienced employees."
Reference
1. Hatcher BJ, Bleich MR, Connolly C, et. al. Wisdom at Work: The Importance of the Older and Experienced Nurse in the Workplace. 2006. Princeton, NJ: Robert Wood Johnson Foundation. Available at www.rwjf.org/files/publications/other/wisdomatwork.pdf.
Sources
For more information on personal health records, contact:
- Roy Hoxworth SPHR, Director of Human Resources, Hospice of Marion County, 3231 SW 34th Ave., Ocala, FL 34474. Telephone: (352) 873-7400. E-mail: [email protected].
- Dawn Malone, Administrative Director of Human Resources, Bon Secours Richmond Health System, 1403 Maple Ave., Richmond, VA 23226. Telephone: (252) 267-5270. E-mail: [email protected].
- Jill Roby-Snyder, RN, Operations Director for Hospice and Home Medical Equipment, MidMichigan Medical Center, 4005 Orchard Drive, Midland, MI 48670. Telephone: (989) 839-3646. E-mail: [email protected].
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