“Good news! We need to hire more staff for our ASC!” said no one, ever. Even when the need to add staff is the result of an increase in business, with more cases and new surgeons coming on board, the hiring process can be tedious and fraught with pitfalls. Yet, finding a good fit is imperative to keep an ASC running smoothly.

We spoke with representatives of ASC management and an industry consultant to gather their recommendations for hiring right.

Updating the Job Description

Once you’ve identified the need for additional staff, a good first step is to create, update, or polish a job description for that position.

“Job descriptions for nurses need to encompass every task and responsibility that someone with their specific licensure is permitted to perform in a surgery center,” says Nikki Hurley, director of Key-Whitman Eye Center in Dallas. “For example, in addition to registered nurses (RNs), we employ licensed vocational nurses who aren’t permitted to administer narcotics, so that restriction must be specified in our job descriptions.”

In addition, remember to include basic tasks that are required but may not be top of mind, such as helping to keep storage areas clean and the ability to lift a specific weight to unload boxes and materials.

Creating an Ad

When advertising for an open staff position, Vanessa Sindell, MSN, BSN, RN, senior consultant with Progressive Surgical Solutions, recommends not just cutting and pasting an entire job description into a website.

“Keep it simple,” she says. “You don’t necessarily need to go into a lot of detail, particularly if you’re looking for a staff nurse.”

Do be specific that you’re hiring for an ambulatory surgery center. “Some nurses and surgical technicians are not necessarily familiar with ASCs,” says Sindell, who recommends emphasizing the benefits of working in an ASC. “Many people appreciate not having to work 12-hour shifts, which is common in a hospital, and everybody likes the idea of having weekends and holidays off. Also, emphasize the small, intimate environment of an ASC, which greatly differs from a large hospital. I think it’s fair to say that everything is more efficient in an ASC, particularly a single-specialty ASC, than it is in a hospital OR.”

Candidates with experience in ophthalmology or an ASC are desirable but rarely found, these experts say.

“My general goal is to hire people with good attitudes, who work hard and have the desire to learn, grow, and succeed,” says John Blanck, senior vice president of operations for Surgery Partners in Kansas City, MO. “Those attributes are as important as specific experience to date.”

Sindell agrees, noting that focusing on experience may hinder your chances of from finding a great candidate. (See “Finding Good Candidates in Unexpected Places”)

“Hospital outpatient departments, intensive care units, and even medical-surgical floors provide great experience for nurses and scrub techs,” Sindell says. “Nurses who work anywhere in a hospital have great assessment skills, which is what we want. As long as you’re willing to provide thorough orientation, training, and education on basic eye procedures and eye anatomy, you should consider anyone with a strong clinical background.”

It’s also important to consider the culture of your ASC. What qualities do your current employees possess that contribute to the surgery center’s success? In addition to specific credentials for a nurse or certifications for a surgical technician, keep in mind other desirable traits, such as attention to detail, ability to multitask, appreciation for teamwork, and a focus on patient care and safety. While some of these qualities will be revealed in a resumé, plan on exploring them more thoroughly in your interviews.

Getting the Word Out

Once you’ve sketched a profile of your ideal candidate, it’s time to get the word out. Websites, such as Indeed (indeed.com ), Monster (monster.com ), and Craigslist (craigslist.org ) are well-known for attracting job-seekers, but their effectiveness may vary by region and the types of positions you wish to fill.

“Monster is good for basic job postings,” Sindell says. “I believe Indeed generates more traffic and a higher caliber of candidates; and many people use Craigslist for nonlicensed personnel. Some ASCs in rural or remote areas may still use the local newspaper to advertise.”

Other options for job postings include Facebook, which may attract people who are already fans of your surgery center, and LinkedIn, which may be useful for management-level positions. You also may want to tap your state ASC association, the county medical society, and the American Academy of Ophthalmology.

A Word About Word-of-Mouth Recruiting

Toni Camarata Jansson, administrative director of Humboldt Physicians Surgery and Laser Center in Eureka, CA, says she rarely has to advertise employment opportunities. The surgery center’s nurses, most of whom work per diem, are her best recruiters.

“Basically, our nurses are our advertisements,” she says. “They are good judges of character, and, typically, the people they recommend are on staff at a hospital and have been thoroughly vetted there. We review their applications, check their references, and bring them in for interviews, but we consider recommendations from our staff to be strong endorsements.”

Hurley agrees.

“We’ve used all sorts of other techniques, including placement agencies and employment websites, but we don’t find them quite as effective as word-of-mouth references from our existing personnel,” she says.

Having a desirable work environment is also attractive to job seekers.

“We’ve been lucky to have been selected several times as one of the top 100 work places in the Dallas-Ft. Worth area,” Hurley says. “As such, I believe we have a somewhat better chance of attracting people who want to be part of a popular organization that’s well recognized with a good reputation. I think that’s a feather in our cap in trying to attract potential employees.” (See “Is Yours a ‘Spa’ ASC?”)

Consider Online Screening Tools

Large employers, such as Walmart and McDonald’s, often use online employment screening tools, but employers in smaller markets who may not have the resources to screen dozens of resumés and job applications may also find them useful, as Hurley can attest.

“When a person wants to apply for a position at Key-Whitman Eye Center, even if they know someone who works here, they must apply through the online portal on our website,” explains Hurley. “After uploading their resumé and any supporting documentation, they complete an application and are directed to online testing by Wonderlic.”

Hurley explains that Wonderlic (wonderlic.com ) is a pre-employment screening service that tests mental aptitude, personality, and skills. Any candidate who scores well, shows high potential, and appears to be a good match for the open position is invited for an interview.

Ace the Interview

Interview preparation is just as important for potential employers as it is for job seekers.

“I review work histories before applicants arrive, so I know as much about them on paper as I can, and that prepares me to ask specific questions,” Hurley says. The questions run the gamut from what a person liked or disliked about a previous job to the reasons for gaps in a work history. All the while, Hurley is assessing the person’s communication skills.

“If someone can’t carry a good conversation, make eye contact with me, and be engaging, then I doubt that person can handle face-to-face patient care appropriately,” she says. “If I’m hiring someone to work alone in a sterile processing room, that might be okay, but if I’m hiring a nurse or technician who will be helping in patient care areas, then no.”

Sindell focuses on the skills and attributes required for a specific position during the interview.

“For example, organizational skills and the ability to multitask efficiently are important qualities for surgery schedulers and receptionists, and being able to work well under pressure in a fast-paced environment is particularly important for surgical technicians,” she says. “When interviewing nurses, I want to know what drives them, what their priorities are when providing care. I want nurses who are focused on safety and following procedures.”

Jansson has a strong interest in interpersonal relationships. “I look at a person’s overall attitude, tone, and body language, particularly when I ask probing questions, such as, ‘Have you been let go in the past where you feel as though it was unfair or not your fault? Tell me about that.’ The answer to that question can be quite revealing. I also listen for absolute statements, such as, ‘I never do this,’ or ‘People are always this way.’ These statements may indicate inflexibility that could interfere with smooth team operations.”

As for red flags in an interview, Hurley may be skeptical of someone who says he or she has no weaknesses. “I feel that’s not being honest,” she says. “I want to know where you feel you can improve.”

When Sindell asks nurses about prioritizing, she expects patient safety to be at the top of the list, and if it’s not, she considers that a red flag. She also takes note of how job-seekers say they deal with conflict, whether they’re comfortable dealing with it themselves or if they tend to go straight to management. “While not necessarily a red flag, their answer provides insight into their personality,” she says.

The interview is an opportunity to set expectations for potential employees and to gauge their work ethic. “It’s important to describe your work environment and the pace and efficiency level that you expect,” Sindell says.

While including your surgeon or surgeons in an interview is optional, Sindell recommends having a second person present, perhaps a charge nurse or your business manager, to provide additional insights on a candidate.

Some final tips from Sindell: A confident demeanor and professional attire are expected at the interview, and no-shows do not get a second chance.

The “Working” Interview

Hurley invites potential employees to participate in what she calls a working interview to help both the job-seeker and surgery center management and staff determine whether or not the candidate will be a good fit.

“If I’m expecting to make an offer, I usually suggest that the person spend an hour or two in the surgery center,” she explains. “After signing a confidentiality agreement, they can observe, talk to the staff and surgeons, and get a feel for the environment. For the last year or so, every person I’ve hired has done that and really enjoyed that process.”

Hurley continues: “In ophthalmology in particular, it’s difficult to find people who are already certified and have the skills that we want, so we seek out good people to train,” Hurley says. “Our goal is to start with the right people in the right positions, continually grow their potential, and keep them for decades.”

Making an Offer

Making a job offer is typically straightforward. After the working interview at Key-Whitman Eye Center and before leaving for the day, the candidate and Hurley discuss the details, such as hourly wages and benefits, if applicable. Most ASCs require a 90-day probationary period before new employees are eligible for benefits.

Sindell notes that surgery centers should aim to be competitive, but this may be difficult for small, independently owned ASCs. She recommends they emphasize the positive aspects of working in a surgery center, not the least of which are the shorter hours and weekends and holidays off.

She also suggests that some negotiations may be advisable in certain situations. “If you find a surgical tech with 10 years of eye experience who wants $5 more than you were planning to offer, you may need to negotiate with that person,” she says. “Having a technician who already knows eyes and has experience is obviously a great find and not someone you come across very often. So, maybe you make an exception for that person.”

The Ideal Candidate

How can you identify the ideal candidate for your surgery center? “Clearly, you want someone who can meet the demands and requirements of the position,” Blanck says. “If the candidate has appropriate training and skill sets, that is a plus, but if he or she has the right underlying work ethic, integrity, and drive, that’s a critical predictor of a long-term, mutually beneficial employment relationship.”

In short, says Hurley, “I want someone who is meticulous, kind, and engaging.” ■