March 30, 2023

Surgical leaders get creative to hold on to their top staff.

COMMON PURPOSE ASCs that maintain positive workplace cultures based on respect and inclusiveness are more likely to retain valuable employees. | Lehigh Valley Health Network

Retention of staff is an ongoing, intensifying problem for many outpatient surgery facilities. Recently, some administrators shared their ideas with Outpatient Surgery Magazine on how to maintain full, capable, productive staffs while competing with much larger and better-financed health systems for talent.

Correct your salary scale. One huge problem is longtime staff becoming resentful of new hires who receive bonuses and sometimes even higher salaries than they have. These professionals feel their earning prospects are being penalized due to their loyalty. To address these types of disparities, Administrator Norma Bacon at New England Surgery Center in Beverly, Mass., changed her ASC’s pay scale to be based on number of years as a nurse.

Per diem instead of salaried. Sani Eye Surgery Center in Templeton, Calif., has a solid team of nurses who have worked at the center long-term as well-paid per diem staff. “We pay an average of 20% more than other ASCs in the area,” says Administrator Dianna Reed, BA.

Better work/life balance. ASCs have long sold new hires on the more predictable nature of employment at a same-day surgery center, such as Monday through Friday regular working hours, weekends off and no call. However, staff are now asking for increased flexibility. “We have utilized more flexible schedules,” says Linda Nelson, MSN, RN-BC, CASC, administrator at North Pinellas Surgery Center in Dunedin, Fla. “Several of our nurses work 32 hours over four days, for example. It has helped with work/life balance, which aids in retention.”

Keep it stimulating.“I cross-train whoever I can so they keep learning and don’t get bored in their current roles,” says Cindy Novak, RN, BS, administrator at San Luis Obispo (Calif.) Surgery Center.

Workplace culture. The staff at Chugay Cosmetic Surgery in Long Beach, Calif., has been in place for more than a decade. How do they do it? “We have a team that works and has been treated as a family,” says Administrator Maria E. Pescasio, BS, who adds that the family vibe includes profit-sharing and bonuses.

“We have great people and a really good generational mix,” says Barb Draves, LPN, CASC, administrator at The Surgery Center in Middleburg Heights, Ohio. “Maternity leaves on the young ones and joint replacements on the older ones always create havoc for scheduling, but they all know that it all balances out in the end.”

Shane Ricks, RN, BSN, MHS, administrator at Millennium Surgery Center in Meridian, Idaho, kept his staff intact throughout the pandemic. “We have not had any significant issues due to staffing for the past two years,” he says. “I believe it is due to our excellent work culture.”

Stephen Gatesman, RN, clinical director/administrator at Executive Park Surgery Center in Fort Smith, Ark., shares a similar report. “We have been able to retain staff by maintaining a positive workplace culture.” Echoes Laurie Bailey, regional administrator at New Braunfels (Texas) Surgery Center, “We have excellent staffing and retention at my main location because of employee satisfaction and culture.”

Syracuse (N.Y.) Surgery Center is currently fully staffed with per diems for coverage. Additionally, says Andrea Sanders, RN, BSN, administrator/clinical director, “We gave across-the-board cost of living wages along with annual merit-based raises for all staff.” However, she says workplace culture ultimately keeps providers at the facility. “We have really nurtured a culture that is based in understanding, kindness and comradery,” she says.

The common thread at all of these facilities is leadership that not only appreciates the efforts of their employees, but also takes the time to understand what individuals are looking for in their career, and strives to deliver those benefits.

Take a closer look at communication, bonuses and onboarding.

THE WORK BEGINS Once a new staff member is hired, leadership must continue to give that provider reasons to stay on an ongoing basis.

You may be employing a number of creative recruiting efforts to staff your busy ASC, but if you haven’t also thought about how you will retain your new hires, you are missing an important piece of the staffing puzzle.

Ann Geier, MS, RN, CNOR(E), CASC, chief nursing officer with Ambulatory Healthcare Strategies, points to three retention strategies that work: communication, retention bonuses and excellent onboarding programs.

Communication. Ms. Geier says keeping a dialogue going is crucial for retaining employees. “I firmly believe the key to retention lies in honest, open communication between staff and facility leaders,” she says. “Most leaders will tell you they do this, but dig a little deeper and you’ll likely find they don’t or, as is often the case, they do it but only to a certain extent.”

Retention bonuses instead of sign-on bonuses. Many surgical facilities offer generous sign-on bonuses to hires, which seem like a good way to guarantee their loyalty down the road. “I fully understand why so many facilities are doling out sign-on bonuses,” says Ms. Geier. “Still, by nature, they entice people who are looking for upfront money and ultimately put the surgery center at a disadvantage. If the hire doesn’t work out, the employee still gets the money, and the ASC is left trying to determine how to terminate the person long after they’ve proved to be a poor fit.”

She instead recommends ASCs offer retention bonuses. “Instead of incentivizing people to come onboard and stay just long enough to grab that sign-on bonus, you’re sending the message that your culture is all about rewarding good, loyal workers,” she says.

Onboarding. Ms. Geier encourages surgery centers to spend the necessary time and effort on training and orienting new staff. “Do away with those cookie-cutter orientations, except for the general training where it’s unavoidable,” she says, adding that a mentoring program can be of great help when acclimating new hires.

Understanding an individual’s goals, preferences and skills is key to finding the best match.

In today’s challenging staffing climate, nurses and other healthcare professionals need to consider several factors when looking for the best job options for themselves and their families, including salary, benefits, location and work schedule. Whether they are looking for a job opportunity that becomes a permanent home, or a shorter assignment to test the waters, working with a staffing partner like Soliant can help them find the right fit.

As nurses seek new opportunities, it is important for them to understand their skills as well as personal goals, preferences and desired growth opportunities. Soliant uses these considerations to find the best position for a candidate.

Soliant works with you to ensure you are taken care of during every step of the process: from the initial meeting with you to the interview to contract negotiations. They take great pride in the fact that they listen to your every request and strive to accommodate you in every way possible.”

On the employer side, a win-win is hiring the right individuals for a role – and attracting people who will stay. The need to recruit and retain staff coincides with a growth in the ambulatory surgery market as new procedures have been introduced that cover a range of specialties from spinal to cardiology. Specialized skills are needed in the outpatient setting for these surgeries.

That is where a good staffing partner can assist because they have an extensive network of vetted candidates as well as valuable industry knowledge that allows them to find the highly specialized professionals that ambulatory and outpatient departments seek. With the help of a staffing partner for both employers and potential employees, there is a greater chance of finding successful and lasting matches.

Additionally, how facility leaders work with existing staff can predict retention and successful integration of new staff members.

According to expert Wayne M. Sotile, MD, who has studied leaders and staff dynamics in healthcare, “It’s important to impart the tactics and strategies of resilience before leaders and their teams get too far down the road of burnout, career dissatisfaction, interpersonal conflict, difficulty with retention, and a general erosion of attentiveness, detail and accountability that threatens not only quality and safety at work but also the quality of their own lives.”

Dr. Sotile is a strong proponent of cultivating the proper workplace culture to retain staff. He advises, “Rather than waiting until providers are coming apart at the seams, it’s important to incorporate resilience into the overall job experience and workplace culture to foster supportive environments and productive collaboration with the utmost professionalism. It’s not only about each individual provider, either. Resilience involves working together on how we work together in the OR or more broadly within the surgical facility.”

Dr. Sotile also points out how leaders can make a difference in workplace culture and staff retention and satisfaction. He says, “Leaders of stressed or depleted workforces need to be ambassadors of uplift. They need to show gratitude, energize people, orchestrate moments of joy, celebrate achievements.”

Soliant considers the individual needs of the healthcare professionals seeking a new opportunity to help guide them to the best job match – and once there, the organization’s continued attention to individual goals and preferences will keep them there.

For more information on staffing, please visit January 2023: Focus on Staffing | Outpatient Surgery Magazine (aorn.org).

Note: For more information on OR staffing with Soliant, please go to soliant.com/staffing-services/nurse-staffing-agency. For more information on OR jobs with Soliant, go to soliant.com/nursing-jobs/operating-room-nurse-jobs.