OR Manager - September 2019 - 6

Salary/Career Survey
Top challenge
Continued from page 1
from 35% last year. However, this question
was asked slightly differently this
year, so comparisons are tentative.
More survey highlights
Other key findings of the survey include:
* Adoption of new models of care
remains slow. In all, 31% of respondents
(compared with 33% last
year) reported that none of the care
model options listed in the survey,
including Enhanced Recovery After
Surgery (ERAS) and the Perioperative
Surgical Home (PSH), have been
implemented or are planned for implementation
in the next 6 months.
However, adoption of ERAS jumped
from 42% in 2018 to 53% this year.
* Data related to staff recruitment
indicate just how stubborn staffing
challenges have remained. More
than two-thirds (68%) of respondents
say it's more difficult to recruit experienced
OR nurses (similar to 66%
in 2018), and 51% say it's more difficult
to recruit STs (similar to 52% in
2018). Only new and inexperienced
OR nurses result in positive double
digits, with 28% of respondents saying
it is easier to recruit nurses at this
level compared with 12 months ago.
* Slightly less than one-fourth (24%)
of respondents plan to add ORs
within the next 12 months.
* Most respondents (59%) have a
preoperative optimization clinic.
Staff transitions
Turnover continues to trouble OR leaders,
with more than a third (34%) reporting
that the turnover rate for RNs has
increased in the past 12 months, and
only 16% reporting a decrease. The percentage
of RN turnover in the past 12
months ranged from 0 to 75%.
ST positions are slightly less troublesome,
with 29% of respondents report6
OR
Manager | September 2019
ing an increase in turnover. And there
was a glimmer of good news: 18% said
ST turnover has decreased, up from
11% last year. It will be interesting to
see if that trend holds.
For both RNs and STs, about half
(50% and 53%, respectively) of respondents
reported turnover has stayed the
same. The percentage of ST turnover
in the past 12 months ranged from 0
to 70%.
The percentage of open full-time
equivalent (FTE) positions for RNs in
the past 12 months again increased for
more than a third (37%) of participants.
This proportion is the same as last year
and comparable to the 33% reported in
2017, with only 21% (vs 17% in 2017)
reporting a decrease.
More than a quarter (27%) said they
have no open RN positions (the same
as last year), but nearly one-fourth (23%)
said they have five or more-similar to
the 21% reported in 2018.
The percentage of respondents reporting
an increase in ST open FTE positions
declined from 37% in 2018 to
34% this year. In all, 19% reported a
decrease, the same as in 2017 and
slightly higher than the 14% reported in
2018. Nearly a third (32%) of respondents
said they have no open ST positions,
essentially unchanged from 33%
in 2018. Only 10% said they have five
or more open ST positions, the same
as last year.
Staffing patterns
Given the frequency of staff transitions
and the number of open positions, it's
not surprising that 40% of respondents
hired more direct care staff in the past
year, up from 35% in 2018 and 34% in
2017. In addition, 20% reported using
more agency and travel staff, as was
the case in 2018.
At the same time, however, OR leaders
continue to address financial pressures
through staffing actions. More
than a third (34%) have reduced the use
of overtime, comparable to the 36% reported
in 2018, and 24% have reduced
the use of agency and travel staff, similar
to the 26% reported last year.
Other staffing actions include:
* Eliminating open positions. This
year, 19% of respondents said they
have had to do this, compared with
25% in 2018 and 31% in 2017.
Could this mean staff are so lean
that further cuts aren't feasible?
* Requiring staff to take time off
without pay. This trend is turning
downward, with just 14% of respondents
resorting to this strategy, compared
with 20% last year and 24% in
2017.
Filling positions
Finding staff hasn't gotten any easier
for OR leaders since the 2018 survey
results were reported. Only 5% of respondents
said it is easier to recruit
experienced OR nurses compared with
12 months ago, similar to last year's
6%, and up from 2% in 2017.
OR leaders have been focusing more
on recruiting new or inexperienced OR
nurses because experienced nurses are
so difficult to find. However,
it's also
challenging to find new or inexperienced
OR nurses; 26% of respondents said it
has been more difficult to recruit this
group compared to 12 months ago. In
2018, 25% reported difficulty, up from
16% in 2017.
When considering an applicant's
qualifications, 45% (comparable to 44%
last year) of OR leaders require a candidate
to have a baccalaureate degree in
nursing (BSN), and 59% (similar to 57%
last year) require an associate degree
in nursing (ADN). Only 12% require certification
(double the 2018 number), and
10% don't require either a degree or
certification.
More than half (51%) of OR leaders
said it has been more difficult to recruit
STs. That's about the same as the 52%
reported last year, and not surprising.
Only 9% said it has been easier vs 11%
in 2018.
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OR Manager - September 2019

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