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Susan Pitoscia, Chief Nursing Officer

In an effort to fill the nursing shortage, New Orleans hospitals are ponying up bonuses, helping new graduates repay student loans and recruiting workers from overseas.

Touro Infirmary in New Orleans recently kicked off a program to hire 60 nurses in 60 days, chief nursing officer Susan Pitoscia said. Nursing recruits who agree to work at Touro for two years receive $12,000; $6,000 for each year.

"I think what's unique about this program is we're offering the same program and payment to staff that are working here in an effort to retain them," Pitoscia said. "If they commit to working here the next 24 months, we would pay them $6,000 now and $6,000 next year."

The incentives are boosting Touro's costs, but are still less than paying temp agencies or contract firms anywhere from $60 an hour to the high $80s for each nurse, Pitoscia said. Either way the cost is significant for Touro, which is short some 60 nurses, but the bonus incentive solution might be a better way to both finding and keeping nurses.

"By nature many of them [temps] are transient, so they don't make a commitment really to the organization, to our values and our culture, and what we're trying to do in terms of providing good patient care," Pitoscia said.

The bonuses are just one way healthcare providers are expanding their nursing staffs.

Ochsner Health System is looking at ways to share nurses among its facilities and is offering extra pay for doing so, said Lisa Colletti, vice president of nursing at Ochsner-West Bank.

"We're trying to start cross training some of our staff for some of our other facilities," she said. "If we don't need some people at the main campus, then they can be shifted to the West Bank."

The shortage of nursing is more pronounced on the West Bank, Colletti said. For that reason, Ochsner-West Bank is paying an additional dollar an hour for nurses.

"Part of the issue is that people just don't know about this facility, and West Bankers like to stay on the West Bank and East Bankers like to stay on the East Bank," Colletti said. "So the pool of nurses (on the West Bank) is smaller."

Ochsner is also taking a look at special pay programs, such as additional pay for working weekends.

Ochsner has also made a major recruiting effort in the Philippines, interviewing 250 nurses in October and selecting 100 to hire, Colletti said.

Getting the new hires to the hospital is an arduous process that takes at least a year. The nurses, already licensed by the Filipino government, must also pass an English competency exam and the United States nursing exam. After that the nurses must apply for a visa and be cleared to work stateside.

Touro and for the first time Ochsner are also offering student-loan repayment programs. Touro also offers a graduation gift of $700, which covers the cost of a nursing board exam and covers the day's pay lost in taking the boards.

All of these steps and others are necessary because the conditions that led to a pre-Katrina nursing shortage still remain, Colletti said.

Two years ago, a shortage of instructors prevented healthcare providers from enrolling enough students into nursing schools, Colletti said. The pay scale for most instructors was very low, which meant those qualified to teach could make more money in other settings, and many chose to do so.

In addition, a lot of nurses are not working in hospitals, Colletti said. Some are working for private practices; some are working for insurers or large employers.

"The amount of opportunities that nurses have now in all kinds of different settings really presents a challenge for the hospital that's open 24 hours a day, seven days a week, plus weekends and holidays and all that," Colletti said.

Hospitals face another major challenge in the post-Katrina environment, Colletti said. Many of the providers' employees have relocated. Ochsner probably lost three-quarters of its staff after the storm, Colletti said. Most of those people were ancillary staff but a good portion of those who left were nurses.

Some left because they lost everything. Others left because they were afraid to stay. Some didn't know what was going to happen to their homes. Still others left because their husbands were able to get transferred to another city.

A lot of that shuffling took place last year, Colletti said. "Now what we're finding is the repopulation of the city has not occurred at the rate we would expect, yet the suburbs are still repopulating so they're requiring healthcare," Colletti said. "And we just do not have the nurses that are staying in this area available enough to meet the demand."

The shortage persists despite good performance from Louisiana nursing schools, Colletti said. Overall, the state's schools produced enough graduates to put a dent in the nursing shortage, but not all of those graduates are coming to the New Orleans area.

The hurricane closed the schools during the fall semester. But when campuses reopened, the schools doubled their course loads in the spring semester so students could graduate in May, Colletti said. Unfortunately a large percentage of those graduates did not pass the state board of nursing exam.

"So then we thought we had nurses that were out that we thought that we could count on, but we couldn't use them as nurses because they weren't licensed," Colletti said. "So it created another level of complexity."

Recruiting has also been hurt by the continuing media focus on New Orleans' crime rate.

"A lot of people just have this fear that if they come here they could get killed any minute," Colletti said. The reality is that many of the crimes taking place are in the inner city and not in the suburbs.

"It's a problem. I'm not trying to discount that, but it needs to be put in perspective," Colletti said.


June 2007

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