Hospital Sees Improvements After Increasing Nurse Pay

Erlanger Health System in Chattanooga, TN recently gave a 10% raise to all 1,500 of its hospital-based registered nurses and 300 on-call nurses, and good things have been happening ever since.

The company says it has seen a dramatic decrease in the number of nurses calling out sick since the wage increases were implemented on February 5.

In a recent meeting with Erlanger’s board of trustees, Rachel Harris, chief nursing executive, said the call-out reduction was an unexpected benefit of the pay raises. The board approved the wage gains during a January meeting in an effort to recruit and retain more nurses. 

“We recognize that it is time to implement a more permanent solution so that we can re-establish our bed capacity closer to pre-pandemic levels and fully meet the health care needs of our community,” Harris said after the board announced its decision.

Many hospitals used high-cost travel nurses to reduce staff shortages during the pandemic, but Erlanger never subscribed to that model. Instead, they used incentives and overtime pay to leverage existing internal contracts.

During the recent board meeting, Harris said the incentives and overtime pay were not sustainable, which is why the 10% raise was needed. She also attributed the call-out reductions to the hospital’s decreasing reliance on contracts that force staff to work four or five days per week with incentives for overtime that made it difficult for nurses to refuse work. The wage increases allow nurses to make the same amount of money without having to work overtime, which reduces the strain on their mental and physical health.

“They would come, and they were tired, and so four or five shifts in, they would call in. They’re exhausted,” Harris explained. “I think it’s giving them a chance to build back their resilience. And I think we’re getting more quality care out of the staff, because you just can’t continuously work for 2 1/2 to three years this amount of hours. They’ve done it, and they’ve done a fantastic job, but I think it’s given them a chance to take a breath.”

She also noted that the hospital’s nurse retention rate has improved now that nurses have a better work-life balance. It seems the company is finally taking the latest statistics to heart.

According to a survey from the American Nurses Foundation conducted in November, 84% of the nearly 12,600 nurses surveyed reported feeling stressed or dealing with burnout. Of the nurses surveyed, 19% said they intend to leave their position in the next six months, and 27% are considering leaving. Participants reported that the leading contributors to burnout were not enough staff to adequately do their job (38%) followed by lack of respect from their employer (14%), too many administrative tasks (10%) and low compensation (9%).

Jessica Holladay, nurse director of trauma and surgical critical care at Erlanger, said that the recent pay increase is meant to help prevent feelings of burnout and increase job satisfaction.

“We are setting up our nurses to have the ability to be clinical nurses for long, healthy careers,” Holladay said, “instead of getting burned out quickly and leaving the nursing profession.”

Like many hospitals, Erlanger is still facing a large number of job openings. The company is looking to hire 100 inpatient nurses, including nurses able to care for patients with chronic conditions and those recovering from surgery.

Dr. Mitch Mutter, a board trustee, said he supports the wage increases but believes the retention problem can’t be solved with money alone. “We now have babies teaching babies in terms of nursing staff,” Mutter said. “We don’t have the seasoned people that we used to have.”

Harris mirrored his concerns. She said the wage increases are meant to not only retain existing staff members but to convince former Erlanger employees to come back on. “The best recruitment tool is our alumni and talking to those nurses that have been here before,” she said. “And we hope to be able to capture some of those nurses that work in a temporary status that will commit to us full-time.”