Nursing News:
Increase in Float Pools nationwide

With the aim of savings millions of dollars each year, Milwaukee, Wis. area hospitals are increasingly using their own ³float pools² instead of staffing agencies to supplement nursing staffs. The shift is the latest in a series of steps taken by local hospital systems to cut costs. The Milwaukee area is home to some of the highest health care costs in the nation and is also in the midst of a nursing shortage.
In the past six months, the Covenant Health Care hospital system has saved $500,000 by using an internal squad of 145 nurses to fill staffing holes at its four hospitals. Covenantıs nursing pool has expanded from 33 nurses, said Jill Schwieters, regional vice president of human resources at Covenant. While hospitals pay nurses in their internal pools more than other staff nurses, Covenant still estimates that it saves about $10 for each hour an internal pool nurse works compared to what it typically pays an agency for an outside nurse.
Nurses earn an average of $28 an hour at Covenant. Internal pool nurses can receive $5 to $8 more than that, but that is less than the $40 to $70 an hour Covenant pays for an agency nurse, Schwieters said. ³Everyone wants to get out of paying for agency nurses or traveler nurses,² said Sally Brenner, human resources director of employment at Columbia St. Maryıs. Many hospital systems throughout the country are developing their own pools of staff nurses to cut agency costs, she said.
Aurora Health Care estimates it is saving $1 million a year by using its own pool nurses to plug staffing gaps in the Milwaukee area. Columbia St. Maryıs will have an expanded internal nurse pool up and running this spring in hopes of reducing the need for outside temporary staff.
Hospitals have long complained that nursing shortages force them to pay significant amounts of money to agencies for supplemental staffing. Agency owners dispute the claim that it is more expensive to hire their nurses. They also say they fear hospitals are cutting back on nurse staffing to save money, a claim disputed by hospital executives. Nurse staffing agency executives say their revenue has dropped dramatically as a result of hospitals cutting back on hiring temporary nurses.
Agency nurses typically work one or two shifts a week in hospitals. Other agency nurses, called ³travelers² because they come from other areas of the country, can be assigned to hospitals for months. Mike Hayden, president of BestNurseUSA, a Milwaukee temporary nurse service, said his companyıs revenue was down by $1 million last year as a result of hospitals expanding their internal nursing pools. ³Our business has been crushed. It was a horrendous year. We had been growing by 10% to 15% a year, and we had expected to continue growing,² he said.
³We were one of the biggest providers to Covenant and Aurora. Those two large systems have gotten together and are trying to eliminate us from the market place.² Mark Knight, a California-based hospital consultant, said it was ³hard to develop sympathy for temporary agencies.² A trend developing among the nationıs hospitals is to form their own internal agencies, he said. ³Thatıs competition, and hopefully competition will result in lowered health care costs, which is what everybody wants to see,² Knight said.
He said he could envision a day when Aurora and Covenant would agree to plug each otherıs staffing gaps to cut out the agencies altogether.
Mary Krueger, owner of the SDC Healthcare nurse staffing agency in Wauwatosa, said expanded hospital-owned pools have been hiring nurses away from local agencies. ³They are predatory on our employees. Thereıs been a shift in the market. Agencies have gone out of business, but the strong will survive,² she said.
Many former agency nurses are joining hospital staffs as full-time employees because their spouses may be out of work or have taken lower-paying jobs and the nurses want more hours and better benefits, said Kimberly Noon, chief operations officer for the Guardian Healthstaff agency in Milwaukee. Mary Cieslak-Duchek, regional director for nursing operations for the Milwaukee region of Aurora Health Care, said Aurora has cut its use of agency nurses by 40% using its own pool of 200 nurses. Nurses are attracted to the internal pools because of higher pay and the flexibility of their schedules, nurses and hospital executive said.
Elizabeth Sohnle, a Covenant nurse for 20 years, recently joined Covenant's internal pool. "I absolutely love it," she said. "It gives me flexibility to set my own schedule. I get to work with different people and expand my knowledge base," she said. She works primarily as an emergency room nurse or in intensive care units, and she appreciates the flexible hours. "It's a wonderful opportunity," she said. "It's a good deal if you are the right person."
Reprinted from the Milwaukee Journal Sentinel