Flexestaff News & Events

Name Your Price—Staff Nurses Bid Online for Open Shifts

NURSING SPECTRUM
By Heather World
Published April 18 , 2004

Not long ago when Valerie Ward, RN, wanted to pick up shifts outside her regular schedule at Mount Sinai Hospital in Chicago , she went to a nurse staffing agency. Now she goes online to bid for extra shifts at Sinai itself.

“The bidding has been fun,” says the surgical ICU nurse. She and her colleagues have found a lot to like about eShift, one of a handful of electronic shift-bidding systems designed to cut down on the use of expensive agency nurses while maintaining continuity of patient care. “Nurses are able to take care of patients they already know, which makes it easier for the rest of the staff,” Ward says.

Used by a small but growing number of healthcare providers, shift bidding has become the latest incentive to recruit nurses in a tight labor market and a way to cut costs. Some nurses say the system gives them more control over their schedules. Executives say it saves money spent on agency nurses and the supplemental pay meant to entice employees to fill last-minute open shifts.

Critics, on the other hand, call the system a Band-Aid® approach that fails to address the growing nursing shortage.

Mount Sinai started the program in its medical/surgical unit in February and is now rolling it out to the rest of the hospital and to its sister hospital across the street, Schwab Rehabilitation Hospital . In a typical shift-bidding setup, pre-qualified nurses who log on to Mount Sinai 's system through the Internet can peruse open shifts. Nurses may bid on any unfilled shift if they have the required credentials. Although they are not limited to shifts within their own units, nurses are asked to bid on them first.

The top rate of pay is set at a price less than the total cost of an agency nurse but near the rate an agency nurse would earn. Hours worked through the bidding system do not count toward an employee's benefits.

Bids are taken within a posted time frame, much like bids on the online auctioneer eBay®. But in a reverse of the standard auction, nurses bid down in multiples of 50 cents. The lowest bidder wins the shift and is notified through e-mail. Managers have the discretion to override the bidding process if an unqualified nurse has won the shift.

Evangeline Asuncion, RN, BSN, unit director of the hematology/oncology unit and general medicine, says she will cancel a winning bid to her unit if the bid-winning nurse is not chemotherapy-certified, though the situation has not happened yet. She believes the simple and flexible system will improve the quality of patient care.

“If you get agency nurses from outside, they don't know our system,” Asuncion says. “I would rather use my eShift staff because they know Mount Sinai ; they know the policy.”

Jackie Conrad, RN, vice president of patient care at Mount Sinai , says agency use in the medical/surgical unit has dropped by 42% since the launch of the eShift system, a drop that amounts to about two full-time- equivalent agency nurses.

“That's not a huge reduction, but it's still early,” Conrad says.

Mary Healey, RN, a medical/surgical unit director, says she is pleased with eShift so far.

“We can pay anywhere between $55 and $75 an hour for an agency nurse, and that's if we're lucky,” she says. The eShift bids start at $43.50 and are then bid down.

Money Saver ...
Mount Sinai bought eShift from Flexestaff, a web-based software company that partnered with the program's developer, Spartanburg Regional Healthcare System in South Carolina .

Spartanburg developed the system to encourage its own nurses to cover extra shifts rather than pick up hours at other hospitals and to reduce use of agency nurses, says Darby Douglas, RN, Spartanburg 's RN staffing coordinator.

Offering extra shifts to in-house nurses saves an average of $10,000 per week, says Douglas . The average winning bid, between $35 and $39 an hour, costs $14 to $20 an hour less than the fee for an agency nurse. The system fills more than 300 shifts per two-week pay period, she says.

“Since we started a newer version [of eShift], we've done without crisis pay and double crisis pay,” says Douglas, referring to the additional money she must offer to entice Spartanburg nurses to work extra shifts.

Jim Hardin, RN, says Spartanburg 's system not only gives him more control over his schedule, it also makes work more exciting.

“You never get bored,” says Hardin, who had spent the past week going from the hospital's pediatrics unit to neurology to its heart center in five days. “I'm developing my skills in the manner I want.”

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