Nursing News:
Palomar nurse turnover rate far below California state average

By BOOYEON LEE, Union-Tribune Staff Writer

The Palomar Pomerado Health district is touting a turnover rate for nurses that it says is less than half the average rate at other California hospitals. Among about 1,000 registered nurses in the hospital district, 6.7 percent left their jobs in 2004, according to district officials.

The statewide average was 15 percent to 18 percent, which varies depending on the region, said Jim Lott, executive vice president of the Hospital Association of Southern California. The turnover rate in Southern California was closer to 18 percent, Lott said.

Lorie Shoemaker, chief nurse executive for Palomar Pomerado, said the district's turnover among registered nurses has dropped dramatically in the past two years.

In 2001, about 23 percent of the district's registered nurses quit. In the third quarter of 2004, less than 1 percent left. That compares with an average of 4.8 percent during the same period for hospitals south of San Luis Obispo County, according to the Hospital Association of Southern California. A shortage of nurses is a major problem across the country. It costs as much as $60,000 to replace a registered nurse, Shoemaker said, not including salary. For every one percent decrease in turnover, the district saves about $250,000. Shoemaker attributed the district's low turnover rate in part to a management-training program that began about 18 months ago, after the arrival of Michael Covert, the district's CEO and president.

"People don't leave jobs, they leave their managers," Shoemaker said. "To focus on our retention, we needed to get our leaders trained."

In a recent survey, employees were asked what type of retention incentives they wanted. About 65 percent of the respondents wanted "simple thank yous" for their work, Shoemaker said. Covert frequently writes thank you notes to the staff.

"Money wears off after two pay periods. You have to give another reason to stay, which is a positive working environment," Shoemaker said. But pay may also be a factor. In May 2003, after months of labor strife, Palomar Pomerado signed a contract with its nurses that gave them a 30 percent increase in salary over three years, and an average 22 percent increase the first year, making its nurses among the highest paid in the county at the time. Carrie Gerdik, a registered nurse for four years at Palomar Medical Center, said she has received several of Covert's letters but would prefer something else. "A bonus would always be nicer," Gerdik said.

But Gerdik, who worked at the hospital as a nursing assistant for five years before becoming a registered nurse, said she chose to stay with Palomar Pomerado because of her managers. "My bosses have been wonderful. They're my mentors," Gerdik said. "I just really like the environment, the people I work with." Shoemaker said Palomar Pomerado also has launched several programs to qualify it for a "magnet recognition program" awarded by American Nurses Credentialing Center to health care organizations with excellent nursing care.

For example, nurses sit alongside doctors on hospital committees to make decisions about medical procedures. Shoemaker said the district is working toward qualifying for the program, because most magnet hospitals keep their nurses longer. The 800-square-mile district, which has a seven-member elected board, extends from Poway north to the Riverside County line, east to Borrego Springs and west through San Marcos. The district hired about 250 nurses last year, including 31 recruited from the Philippines.