The Sampson County Health Department said goodbye to 11 employees last year alone, including nine due to resignation. The department’s director cited lack of competitive salaries as a primary reason for the turnover, and pay rates back that up.
A salary survey shows Sampson County has one of the lowest hiring pay rates in the region for key positions when compared to a number of other counties. That has hurt recruitment and retention of professional staff, notably nurses and nutritionists, said Health Director Wanda Robinson.
“Recruitment of staff is continuing to be an issue for the Health Department,” said Robinson. “We are training staff and, just as soon as they reach permanent status, they are accepting employment in other counties.”
Robinson said she looked back at recent staff turnover.
“I have so many concerns about recruitment and retention,” she said. “We had nine resignations and two retirements in 2012.”
Of those, there were four nurses, as well as nutritionists, health specialists, health educators and others. Of the nine who left, only two had been there for more than six years. However, each one of the employees who departed were experienced, because Sampson County ensured they received the requisite training.
“That’s a lot of staff if you think about the experience walking out the door,” Robinson said.
She pointed to two positions, Public Health Nurse (PHN) II and Nutritionist III. Sampson County starts PHN II at $38,736 up to $58,128, while the Nutritionist III position starts at $32,000 up to $48,000.
To train the nutritionist at a salary of $45,000, it would essentially equate to three months pay, at $11,000, and the training cost to the department, at about $5,000.
“To train that nutritionist is about $16,376, and that includes 16 days out of the office and three months’ orientation,” said Robinson. “My (last) nutritionist stayed with me 11 months and was recruited by Tri-County and Johnston County. She left us at a salary of $45,000 and went to Johnston County for about $60,000.”
That employee was a registered dietitian from the private sector who the county was “lucky” to get, Robinson said, but Sampson was not able to keep her because the pay was not anywhere near competitive.
“In 11 months with us, she got her training, walked out of our building and walked into another building and went right to work without any difficulty whatsoever,” said Robinson. “That was my supervisor position in the Health Department, but the same is true for my nurses. I have turnover with my nurses and PHN II is the main one I have a lot of difficulty with.”
To get that PHN II position trained, the same three-month window applies. In that three months, the PHN II trainee would be paid a salary of $10,000, on par with a starting annual salary of around $40,000, and the department would incur a training cost of $2,700.
“It’s about $12,000 to train a nurse in the first six months,” said Robinson. “And I have to train them. You can’t just walk in off the street and come into the Health Department and start working. So I have two or three nurses resign each year while I’m paying out of my budget for training and orientation. They can leave our Health Department and walk into Wayne or Duplin or anywhere else as a trained nurse, and get a (pay) increase.”
Robinson said Sampson brings them in at a bottom scale, but other counties who already offer better starting salaries, can bring them in further up the scale because they are trained.
“It’s going to be very difficult for em to hire a registered nurse with a year of experience at $37,000,” said Robinson, alluding to the requirements for the PHN II position. “Very difficult. If you look at some of the counties — I know some are larger — everybody else’s starting PHN II salaries are at least $40,000 to $42,000. That makes a big difference when you’re trying to compete.”
Similarly it would be a “very difficult” prospect to find a registered dietitian for the Nutritionist III position.
According to the salary survey, Sampson’s starting salary range for PHN II, at $38,736 up to $58,128, and Nutritionist III, at $32,000 up to $48,000, fall far below ranges for other surrounding counties.
For the PHN II position, Bladen offers a range that starts at $40,472, Duplin offers a minimum of $42,000, Pender offers $42,402, Harnett $44,972, Cumberland $46,394 and New Hanover and Brunswick offer minimum salaries in the $49,400 range. The high end of the salaries range from Bladen’s $51,267 to Brunswick’s $77,598.
Cumberland, Duplin and Harnett fall at $62,238, $66,631 and $69,705, respectively.
As far as the Nutritionist III position — not all counties have them — all minimum salaries and high-end ranges again exceed Sampson’s.
Brunswick offers its Nutritionist III a minimum salary of $41,332 up to $66,131; Cumberland offers $38,734 up to $65,189; Duplin is at $40,612 up to $72,122; and New Hanover offers $58,675 up to $89,977.
Illustrating just how large the salary gap is, Robinson said one of her staff came up to her just last week and said she had interviewed for a job in another county because the offer was just too good to pass up.
“She said ‘I love my job, I wasn’t looking for a job, but a friend called me and said there was a job opening,’” said Robinson.
That employee currently earns $56,000.
“If she leaves Sampson for the other county, they are going to start her at $77,000, the mid-point for the job,” said Robinson. “The market rate for physician’s assistant, I can’t compete. If they offer her the job, she is going to leave. I want qualified people to work in public health, but the only way we can recruit and retain is (competitive pay). We have a very good benefits package that helps me sometimes.”
The Health Department’s employee recruitment and retention problem is a microcosm of the one affecting many departments countywide.
Assistant county manager Susan Holder recently pointed to the large number of recent county retirees, noting 26 in just a one-year span from January 2012 to January 2013. She used those numbers as a way of touting the importance of a proposed Career Path Salary Plan, which would reward “above average” employees with raises as they progress in the county.
“Those 26 employees represented 521 years of service,” Holder said. “You can’t buy that back. We have no plan for holding onto employees, unless we show them some promise that the longer you stay here, the more promise you have of earning a higher wage.”
Otherwise, those trained people will leave and the untrained employee that takes their place will demand more time from the existing employees, Holder said. As the economy improves, county officials said, more employees will likely retire or “job-hop” to the highest bidder, something that Robinson is seeing firsthand.
“We have a problem that is going to repeat itself and get worse instead of better,” said Holder, “unless we think about succession planning.”
Robinson is still looking to fill needed positions, including a nurse practitioner, but recruiting is difficult — and the lack of competitive starting salaries is a dilemma that impacts several areas of operations.
“This is costing the Health Department additional training revenue, impacting clinical services and causing low morale among the remaining staff.”
Chris Berendt can be reached at 910-592-8137 ext. 121 or via email at firstname.lastname@example.org.