Stable Staffing in an Unstable Economy

Karen Haller

When this year’s graduating class first entered nursing school, confidence was high. The chronic global nursing shortage promised jobs, flexibility, competitive salaries, and benefits to newly minted RNs. Then the recession hit.

In my 21 years at The Johns Hopkins Hospital, I have never seen turnover as low as it has been this year: Less than seven percent in the first nine months of fiscal year 2009, compared to 12 percent the previous year. For the month of May alone, the turnover was less than one percent.

Though the numbers are stunning, they illustrate a familiar pattern: When the economy contracts, nurses stay put to offset household income losses. When the economy is flush, nurses are apt to work fewer hours, accept promotions, or relocate when a spouse takes a new job.

Faced with these new economic challenges, nursing leadership and nurse managers throughout the hospital are devising thrifty and creative ways to avert layoffs and employ as many new nurses as possible.

We have curtailed several premium-pay programs for a savings of $6 million—that translates to 60 nurses who were able to keep their jobs this year. A similar program at the Johns Hopkins Bayview Medical Center saved $3 million and 30 nursing jobs. Neither I nor the nursing directors will receive pay raises this year. The goal, of course, is to hit that balance between saving money right now and preserving what programs we need when the economy improves.

This period of recession and retrenchment offers us opportunities. We’re fully staffed, and can now re-direct the energy we’ve been pouring into recruitment these past years. We can shift our resources into stabilizing programs, making quality improvements, and developing new leadership among our ranks. It’s a welcome time of stable staffing.

Karen Haller, PhD, RN, FAAN
VP of Nursing and Patient Care Services, Johns Hopkins Hospital

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