Home > Career Resources > Going Once, Going Twice, Sold! Nursing shifts hit the auction block

Going Once, Going Twice, Sold! Nursing shifts hit the auction block

The latest solution to the nursing shortage is causing quite a buzz in and outside the industry. Some view it as a creative alternative, others say it's only a quick fix and it makes nursing look like a casual labor. It's called shift auctions and it's got people talking.

Shift auctions work much like a regular auction would - the only difference is, it's not the highest bidder who wins. Under this system, the hospital posts the shifts they need to fill along with the highest pay rate they are willing to pay per hour. The nurse who bids the lowest wins the shift.

Getting Creative.

It's a well-publicized, well-recognized fact that the nursing shortage isn't getting any better. The patient load is increasing yet our hospitals' pool of working nurses is dwindling. The time has come for the healthcare facilities that want to survive to think "out-of-the-box" for their staffing needs.

One large west coast healthcare system states that although they have seen positive results from implementing their own recruitment and retention strategies, the daily reality of filling open shifts remains one their biggest concerns. Even using common industry incentive programs, such as sign-on bonuses, competitive pay rates, relocation assistance and referral bonuses, have done little to alleviate the problem.

After examining the situation, the healthcare system realized that there were certain noticeable patterns that would leave them needing a new alternative to filling shifts.

• Nurses were turning to temporary staffing agencies when they wanted to work extra shifts because they could earn more money.
• And nurses were unaware that they could work extra shifts outside their unit.

One creative answer seemed to address all of the issues - shift bidding.

Hospitals Adapt an Age-Old Process

Shift bidding is among the newest tools hospitals across the country are using to attract nurses. Customarily, overnight and weekend shifts are the hardest to fill. Hospitals often have to turn to travel nurses from staffing agencies to fill these difficult slots. Bidding changes this situation. Now, with shift auctions, hospitals are giving their own staff the opportunity to fill these shifts that might not have been attractive to them before because of the pay rate.

Here's how shift bidding typically works: Prequalified nurses log onto a hospital's website and view all empty shifts in units like cardiac, intensive care, ER, etc. Nurses can bid only on shifts offered by their facility, but they may bid on any unfilled shift if they have the credentials, which are spelled out in detail next to the bid. Hospitals may ask nurses to bid on shifts in their own units first. The lowest bidder wins with the skill level and other factors being equal.

In a rather simple transaction the hospital saves more money, while the nurse makes more money. One southeast hospital explains that offering up shifts to in-house nurses through shift auctions has saved them, on average $10,000 per week. The average winning bid , between $35 and $39 an hour, costs $14 to $20 an hour less per shift than the fee for an agency nurse.

Is Bidding the Best Bet?

Hospitals that have put into practice shift auctions are raving about the results they are seeing. One facility notes that their nursing vacancy rate drop from 11% to 5% while the southeast facility we mentioned earlier boasts a dramatic drop from a 20% vacancy rate to just 7%.

Hospitals are saying that the technology is fast and easy to implement. And nurses are expressing that the software is really user-friendly stating, "it takes three clicks on the computer from start of login until nurses bid on shifts."

But nursing organizations and unions are singing a different tune about the practice of bidding for shifts. According to an article featured in the Chicago Tribune, The American Nurses Association, which represents 2.6 million RNs, supports programs that give nurses control and flexibility over schedules and wages. But it does not think the nursing shortage can be solved with the click of a mouse. Spokeswoman Carole Cooke goes on to say that, "hospitals may use this as a short-term way to fill their slots and maybe even save money, but in terms of long-term patient care and the nursing shortage, I'm not sure this is the direction we need to be going in." * 1 This is only a stopgap approach to staffing.

Meanwhile in an article published in the New York Times, the executive director of the California Nurses Association denounced shift bidding by pay as a threat to patient care and continuity and to the image of nurses as professionals. The executive director goes on to explain that auctions are essentially turning nurses into a commodity, stating that, "it's outrageous and predatory. It might be good for the bottom line but not for patients. It treats patients like a widget on an assembly line and nursing as casual labor." * 2

Many nurses' unions strongly oppose the practice, saying it has an enormous potential for abuse. Almost none of the hospitals that use pay-based bidding for shifts have unions. Several union officials have said that improved wages and better working conditions would be a better long-term solution to the nursing shortage. Shift auctions are not producing new nurses. The same nurses are now just working harder.

Every Little Bit Helps.

Many hospitals understand that bidding systems are not the answer to the nursing shortage, but implementation may address some of the more looming issues and can have significant potential. Healthcare facilities are viewing it as a way to bring more savings to their organizations, increase nurse satisfaction and consistency in care delivery, and ultimately enhance the quality of patient care.

* 1 - Chang A. Hospitals try online staffing. Available at: http://www.flexstaff.com/ChicagoTribune.htm

Cited February 11, 2004

* 2 - Koeppel D. Nurses bid with their pay in auctions for extra work. Available at: http://www.nytimes.com/2004/06/06/jobs/06jmar.html?ex=1099022400&en=1d461c12d578ecd7&ei=5070&oref=login&pagewanted=all&position

Cited February 11, 2004