Focus on workforce pays off for St. Mary's

When 81 percent of the employees who respond to a survey say they hope to stay in their current job until retirement, it's a sign that the employer is doing something right.

The number is all the more noteworthy if the same group of employees came within an eyelash of approving a union organizing effort less than five years ago.

The recent job-satisfaction rating from the 700 nurses in the St.

Mary's Health System is more than merely heartwarming for executives of the Reno-based organization.

It's also helping St.

Mary's deal effectively with an ever-increasing shortage of nurses nationwide.

But Norma Brown, associate administrator for patient care services at St.

Mary's, said last week the change in nurses' job satisfaction didn't come easily.

Some of the work was expensive; other tasks took patience and time for relationships between nurses and managers to develop.

Among the key steps that Brown and her management team took in the past four years:

* Listen and spend a lot of time with individual nurses on their shifts.

Early on, Brown and her team got an earful about the grievances that led to the strong prounion vote low salaries, unequal pay between nurses doing the same work with the same experience, the effects of vacant positions on the care of patients.

* Make sure that front-line management is adequate.

St.

Mary's created unit supervisor positions to cover nearly every shift on all floors of the hospital.

Supervisors mentor nurses and help deal with the day-to-day challenges an emotional family, a demanding physician faced by nurses.

"This has had a major impact," Brown said.

* Strive to reduce turnover in the management ranks.

"The staff began to realize that none of us were going anywhere," Brown said.

And that, in turn, helped develop relationships between nurses and managers.

* Deal with pay issues.

Nursing salaries are up 42 percent in four years at St.

Mary's.

Some nurses got even bigger raises after the health system conducted an extensive study to make sure that nurses with equal responsibilities and experience received equal pay.

* Allow flexible work schedules and job-sharing.

* Create a nursing council in which nursing professionals can present ways that their profession can be advanced.

The council meets regularly and includes members of the management team.

Among the upshots is that the vacancy rate on the St.

Mary's nursing staff is 5 percent.

(The national average is about 12 percent.)

At a time when nursing shortages are common, St.

Mary's has waiting lists for some positions.

"Our focus is more on retention than it is on recruiting," Brown said.

"We need to make the working environment good here so nurses never want to leave."

The researcher who conducts annual surveys of St.

Mary's employees said the most recent survey of the system's 2,500 employees was "the most positive I've ever seen." James Velghe, president of Work Dynamics Inc., noted that the commitment of St.

Mary's management to annual employee surveys keeps attention focused on employee relations.

"If you can't measure it, you can't accomplish it," Velghe said.

From the perspective of his company in Lee's Summit,Mo., Velghe said key steps taken by St.

Mary's management in recent years include complete overhaul of human-resources practices, a concerted effort to improve the training of first-line managers and stepped-up communication.

Along with traditional means of communications employees' brown-bag lunches with Chief Executive Officer Jeff Bills, an employee newsletter St.

Mary's has taken some unusual steps.

It offers, for instance, an employee hot-line and posts all the complaints and answers for everyone to see.