I've been up to no good since my last entry :-)
I have been discussing matters of compensation with hospitals in the north Phoenix and Scottsdale areas, and I can not believe how hard it is to figure out how much annual compensation I would get if I quit my present job and took a similar (full- time night shift telemetry/step-down registered nurse) position within 5 miles of my home.
Everyone wants to talk about the hourly wage, but when I ask specific $$ questions about health benefits, 401(k), 403(b), and incentive pay, no one is able to hold any kind of intelligent conversation.
The problem is my methodology of comparing one job to another. It's foolish to only consider the hourly wage. I always crank up Excel, and I do an annual income comparison, which includes a full year of the following:
- base pay
- shift differential pay
- weekend differential (since I prefer to work weekends)
- incentive pay (most hospitals pay a flat rate for any hours a nurse works in excess of contract/scheduled hours) -- Incentive pay comes and goes depending on market conditions.
- 401k / 403b corporate match (and how long I have to stay to become vested)
- Accrual of earned leave as a dollar amount
- Sign-on Bonuses (I only consider them if I can keep the cash for <=1 year of employment.)
Then I take that annual income, and subtract the following:
- The cost of 10 office visits (via copay, as a deductible, etc.)
- Worst case scenario of a long hopitalization with lots of lab tests and diagnostic tests
These last two are realistic since I pass kidney stones and have various other health issues.
I have already received three firm offers for new jobs, but getting the additional information needed to process the other costs and benefits has been a challenge. I guess the point is that most nurses don't do much planning when it comes to figuring out where to work. Most nurses are interested only in the hourly wage, and don't think about the cost/benefit of their benefits package.
Most of my co-workers do not contribute to their 401k, even though our employer will match 4% of income. Most recruiters can't speak knowledgeably about retirement planning. One headhunter proudly proclaimed "we match 50% of your 401k contributions." When I balked at this, he finally read the fine print -- 50% of 6%. He wasn't trying to be deceptive. I don't think anyone has asked him for all of the data I asked of him.
The silliness at work continues. We still are not really doing geographical staffing. We are still giving face-to-face reports to too many different people (the main advantage to geographical staffing is that one nurse gives all his/her patients to one oncoming nurse regardless of what the assignment was yesterday). Instead, we continue to combine the worst aspects of geographical staffing with the worst aspects of "continuity" staffing (where nurses get their patients back from yesterday even if that means a lot of walking.) The support staff of CNAs and PCTs are still not nurse-directed during the first part of their shift (and that is going to kill someone any time now). Most of my friends from work have either left or are trying to leave before the upcoming Holiday season.
As usual, I blame my leaders. And worry about my patients.