'Paula Carynski, chief nursing officer at OSF St. Anthony Medical Center, scored a $1.2 million victory for her northern Illinois hospital by sharply curbing its use of temporary nurses in 2004.By analyzing employee overtime, sick days and leave, and the ebb and flow of admissions, the 238-bed hospital and a consultant slashed spending on temps-travel or per diem nurses-by adding 16 full-time nurses and another eight for on-call shifts.
True, Carynski's budget for nurses' salaries and wages rose 3%. But the Rockford hospital's expenses for agency nurses fell to $55,400 in 2004 from $1.87 million the previous year.
Carynski's triumph spells trouble for the nation's $6.5 billion nurse-staffing industry, which witnessed a modest rebound in early 2005 after two years of declining revenue. Backlash among hospitals and health systems, whose heavy use of temp nurses fueled a boom for agencies from 2000 through 2002, is widely blamed for the slump. Temporary nursing's decline eroded operating margins at the industry's largest agencies and reversed nine years of solid growth in overall healthcare staffing revenue, which peaked at $12.5 billion in 2002, according to Staffing Industry Analysts, a market research firm.
A recovery hinges on winning back nursing officers like Carynski and addressing concerns about agency nurses' quality and cost.
If the approach of a large for-profit hospital chain is any indication, a turnaround may be slow. Health Management Associates, with 56 hospitals, will "eliminate outside agency nurse staffing," said Joseph Vumbacco, president and chief executive officer, in an October 2004 statement. One year later, at least half of HMA's hospitals are "agency free," said John Merriwether, a company spokesman.'
