So, you're the administrator of the new surgical facility. Let me be the first to welcome you to our industry and to let you in on a little secret: Hiring a great clinical staff is absolutely critical to your success. Here are some tips.

Start looking early. In many parts of the country, nurses are in short supply. So start looking now. Nurses are known to peruse the Sunday want ads, even if they're not looking for a job. Consider advertising in the local and neighboring newspapers. You might also post a free ad on your state ASC society's e-mail listserv or Web site. Who knows, you may attract interest from nurses in your state who want to relocate. Classified ads in trade journals and clinical journals are good outlets to attract executive-level people to your staff.

Stagger the start dates. I believe in hiring just a few nurses at first. Your surgery schedule won't be busy for several months as you wait to secure your Medicare number and payer contracts. Hire only enough nursing staff to allow coverage for pre-op, PACU/stepdown and the OR. No more.

It may seem like it's cutting it close, but wait until a few weeks before opening to officially add nurses and techs to the payroll. Rarely will your project follow the timeline you developed during planning. Translation: construction delays. Even if the project is an upfit of an existing building, something always seems to come up. You won't see revenue for several weeks after cases begin; you can't afford to spend money on employees who can't even work in the building until you get the certificate of occupancy. That doesn't always happen until a week or two before the projected opening.

Don't hire full-time at first. This can be controversial, but I suggest that you compress your OR schedule to get the most from your skeletal staff. This may mean working two days a week at first instead of five days. Early on, hire part-time nurses or even PRNs. Encourage nurses to keep their current jobs while working at your facility one or two days a week (besides being kind to your human resources budget, this lets you try each other out). When interviewing potential nurses, don't promise what you can't deliver. If full-time shifts and benefits aren't available at the outset, tell them that it will come, but that they'll need to hang in there and help the center build the business.

Cast a wide net. Word of mouth is the best recruiting tool for a new surgery center. Depending on the location, it will be no secret that a new facility is being built. In fact, there will be lots of speculation about the new entity. If you're local, you'll know a lot of people at other facilities. Nurses might call you out of curiosity. Be prepared to answer questions honestly. Invite them in to talk. Caution: Know what you're looking for before you begin the interview process.

Talk with nurses from your past. You might not be recruiting them, but let them know what you're looking for, and they'll help you look for nurses. They may know someone who's ready to move on, and they'll tell you about the nurse's strong points. Once you've got a few nurses on board, they'll often recruit friends. They realize the potential at the ASC and they're happy, so it's easy for them to be excited about telling their friends.

Ask your docs. Your physician-owners will gladly recommend their favorites from the local hospital; nurses they love to work with and without whom they say they can't possibly perform their cases efficiently. A word of caution here: These nurses might have seniority and top pay, and there may be a lot of baggage attached. The physicians may have already promised them the moon - top pay, great hours, full time and "you'll only have to work in your specialty area." Whoa. If you're pressured to hire such a nurse, she becomes a protected individual in the eyes of others on staff, and this can negatively affect morale. I've also seen this result in nurses who don't have the ASC mentality, and they pressure the center to buy supplies, equipment and instruments for their doc because he had it at the hospital and can't work without it.

No looking back
Staffing can be a challenge. Take your time. Interview carefully. Make sure that the nurses you hire reflect your work ethic and your facility's mentality, and share your emphasis on customer service.