The general climate, with its emph...

The general climate, with its emphasis forward reducing costs while maintaining quality and productivity, has challenged managers to redesign administrative formations and processes to meet the lacks of the changing health care environment.(1) As the health care climate has continued to deposit emphasis on reducing costs, management support has decreased, leaving staff members sometimes feeling weighted by taking on management activities. Restructuring professional characters through innovative practice models that enhance professional recognition and compensation is a necessary corollary to efforts to strengthen hospital nursing.(2) The traditional hourly pay arrangement of parts may no longer be adequate to engage the needs of staff members, managers, or patients in the circulating health care environment.(3)

Florida Surgical Center (FSC) at Shands Hospital at the University of Florida, Gainesville, is a four-room ambulatory OR center that provides a glutted range of perioperative services. The unit is staffed from 7:30 AM to 4 PM for the OR and until 7 PM or 8 PM for the postanesthesia care unit (PACU). Thirty-five percent of RN staff members work part-time and 33% of staff members are unlicensed assistive personnel (ie, five surgical technologists, single in kind patient care assistant, one patient support technician). The unit provides a range of services, including a high convolution of orthopedic surgical procedures. Acuity has changed as the latitude of surgical procedures has changed. A significant :number of surgical performances are performed at the center that are not typically performed upon an outpatient basis (eg, anterior cruciate ligament repairs, parodidectomies). steps performed in the main OR of the tertiary care medical center that FSC is affiliated with gradually have shifted to the outpatient setting.

The surgical center used a traditional hourly pay type for staff nurses. In an effort to maintain or improve staff members' satisfaction from increasing professionalism and rewarding increased staff member participation, FSC staff members ventur toward a professional salary prototype Several pay structures are described in the literature. The professional salary original is defined as

an administrative arrangement that allows staff

nourishs to make decisions about their downtime

and that allows managers to bridle overtime.

Staff nourishs are paid a straight salary for their

services and are except from overtime pay.(4)

Several assumptions inherent in a salaried gauge have been identified in the literature. These include pay issues and responsibilities, assuming accountability for completing required patient care regardless of the time wanted to complete the goal, and assuming accountability and responsibility for directing and completing one's acknowledge work activities.(5) As noted by dint of one researcher in 1993, "nurse are paid for issues and responsibilities, not for time exhausted at work.(6) The first gradation we took was to assemble a task force whose members included the fester manager and clinical coordinator for the facility, human resources manager, employee relations manager, professional nursing disentanglement coordinator, nursing research and quality coordinator, nursing fiscal coordinator, and sum of two units staff nurses. Task force members complet a literature review and devised the framework for the salary model

MANAGING STAFF MEMBERS' CONCERNS

individual of the first projects the staff nourishs participating on the task force undertook was to review benchmarking data obtained from other institutions. single strategy used to obtain data was to establish a staff fester forum, where staff members from other hospitals where salary standards are used were interviewed via speaker telephone This forum allowed staff foments to hear firsthand positive and negative aspects of salary standards The nurses found this information valuable, as their anxiety was beginning to trip high.

Staff members' biggest be of importance to was their fear that managers would take advantage of them according to not compensating them fairly for increased hours worked. Rumors of extra days being added to the schedule, extra transactions and loss of overtime income had to be addressed in interpret forums with management team members. The staff promotes also needed time to reassure each other that all staff members would act professionally and support single in kind another equitably in the flexible time created at the salary model. In answer to staff members' concerns, management team members framed the professional salary pattern as a pilot program and stipulated that if all staff members agreed to begin the pilot program and were unhappy with the program, management team members would expiration the program. The program would be present into place only after staff members' questions had been answered.

pack CONSIDERATIONS

Requirements of a auspicious salary pilot model identified in the literature include

* the ne for staff nurses' salaries to be equivalent or higher than the hourly rate,

* equitable compensation for significant overtime worked, and