Transcript Exemplary Professional Practice

Created & presented by Cindy S. Krivoshik
Exemplary Professional Practice
ICU Salary Model
Hunterdon Medical Center
Intensive Care Unit
ICU Magnet Champions
Cindy S. Krivoshik, RN, BSN, CCRN
Maureen Moran, RN, BSN, CCRN
ICU Director
Pureza L. Ruiz, RN, MSM, CCRN
PURPOSE
 The HMC ICU professional nursing staff adopted a unit
based system of shared decision making and group practice
called the ICU Salary Model.
 This agreement between the ICU RNs and the HMC
Administration provides quality nursing care 24 hours a day
for the 12 bed ICU, in exchange for self-management and
salary compensation.
 This Model provides improved patient care along with
increased RN staff autonomy, professional development,
job satisfaction and professional accountability.
MEMBERSHIP
 All Registered Nurses in the HMC ICU who work
at least forty hours per pay period commit to be
Members of the ICU Salary Model.
 New RNs become Members after the successful
completion of their ICU orientation program.
 Per-diem, agency and float pool RN staff are not
eligible.
SALARY COMPENSATION
 Members are salaried which includes a base salary plus an
additional component for on-call work, holidays, PTO coverage,
required staff meetings and in-services, as well as an advanced
degree and shift differential.
 Current employee benefits (PTO, medical/dental, disability, life
insurance, tuition reimbursement, pension plan, etc.) are
unchanged.
 The clinical ladder and market analysis for all salary adjustments
and bonuses remains unaffected.
 Merit increases are calculated according to an individual’s salary.
COMMITTEE
 The Committee consists of an RN from each shift. They coordinate the ICU Salary
Model, suggestions for revisions, evaluate staff compliance and review the On-Call
Book of flex-up/flex-down hours based on patient census. Members are elected
annually by the ICU RNs in March for a 1 year term which starts on April 1st
 The ICU Nurse Director, Clinical Coordinator and Scheduling Coordinator are ad
hoc committee members.
 The Committee refers Members to the Nurse Director and/or Clinical Coordinator
for noncompliance issues.
 The Committee meets quarterly and as needed.
 The Model and corresponding guidelines are reviewed annually by the Members.
 Changes are made only by an absolute majority vote (not a simple consensus).
STAFFING & SCHEDULING
 Utilizing a self-scheduling model Members sign up for
their regular shifts and back up on-call shifts utilizing
the hospital approved computerized scheduling
system.
 A Member is elected Scheduling Coordinator in March
for a 2 year term which starts on April 1st.
 The Scheduling Coordinator with the Nurse Director
and / or Clinical Coordinator coordinate scheduling,
staffing, back up on-call time, announce dates for
monthly self-scheduling and corresponding guidelines.
ON-CALL BOOK
 The On-Call Book, which does not leave the ICU, is a
simple internal documentation system where Members
log their actual hours worked over or under their
scheduled salary hours.
 Recorded hours consist of both patient care time
(based on patient census) and authorized meeting
time.
 Recorded hours are designated as flex-up time
(positive hours) and flex-down time (negative hours).
ADVANTAGES
Members do not float outside of the ICU.
PTO time does not have to be used when the
ICU census is low to even out compensation.
ICU budgeting is easier to plan with stable
professional staff compensation levels.
POTENTIAL DISADVANTAGES
Members are required to sign up for 12 hours
of unpaid on-call time each schedule.
(This remains unpaid time even
when Members are called in).
There is no additional overtime pay or holiday
pay as this is built into the salary when the ICU
Salary Model was started.
CONCLUSION
 Overall the Model has been mutually successful for the ICU
nursing staff and HMC Administration.
 Most staff strongly favor the Model.
turnover and is a strong hiring incentive.
It has reduced
 New nursing staff are reminded that the pros and cons of
the program do balance out over time.
 During prolonged periods of high patient census morale
drifts down, however when the census dips, enabling RNs
to take their earned on-call time back, morale turns right
around.