Hospitals auction nursing shifts online

Hill, who works with heart patients at St. Peter's Hospital, always bids on the early shift so she can take her 11-year-old autistic son to therapy in the afternoon. Her asking price is $30 an hour, and she has yet to be rejected.

"It works really well for me as far as keeping my flexibility," she said.

Shift bidding is among the newest tools that hospitals are using to attract nurses. Already, hospitals are hiring more foreign nurses and offering ever-larger signing bonuses and other incentives.

Traditionally, hospitals have trouble filling overnight and weekend slots and rely on traveling nurses or those from temporary agencies to fill the gap. Through bidding, hospitals save labor costs by using fewer outside nurses while letting their own staff members control when they work and how much they earn.

"It has helped us keep our own staff and give them the opportunity to fill shifts that might not have been attractive to them before because of price," said Christine McCarthy, a nurse recruiter at St. Peter's.

Since 2001, St. Peter's has filled more than 127,000 hours and saved more than $1.7 million through online bidding. Its overall nurse vacancy rate dropped from 11 percent to 5 percent.

Other hospitals have followed suit, from Pittsburgh to Miami, with similar results.

In shift bidding, nurses log on to a hospital's website, view all empty shifts in units such as cardiac, intensive, or critical care, and make an offer to work for a rate within a specified range posted by the hospital. The lowest bidder, with skill level and other factors being equal, wins.

The average bid at St. Peter's is $37 an hour, about 30 percent higher than the base rate paid to registered nurses, but less than the average $49 an hour agency nurses get.

About two-thirds of the bidding comes from St. Peter's employees seeking more work. Part-time nurses are the main bidders, and salaried nurses who bid are paid overtime. Nonhospital nurses must pass orientation first before they are added to the payroll as bidders.

The American Nurses Association, which represents 2.6 million registered nurses, supports programs that give them control and flexibility over schedules and wages. But it says the shortage cannot be solved with the click of a mouse.

Hospitals "may use this as a short-term way to fill their slots and maybe save some money, but in terms of long-term patient care and the nursing shortage, I'm not sure that's the direction we need to be going in," said an association spokeswoman, Carol Cooke.

Hospital administrators agree that online bidding alone will not reverse the nursing shortage, but say it does help.

More than 30 states are grappling with a shortage estimated at 136,000 nurses. If the trend continues, the deficit could be more than 800,000 nurses nationwide by 2020, according to federal projections.

The national vacancy rate for registered nurse jobs is 13 percent on average, but many health specialists expect the shortage to grow as nurses reach retirement age or take less-demanding, higher-paying jobs at health maintenance organizations or pharmaceutical companies.

Last year, Spartanburg Regional Healthcare System in South Carolina created a bidding site after learning about St. Peter's success. Spartanburg's three hospitals allow registered nurses and licensed practical nurses to bid, and will expand the program to other staff.