By Tim Bonfield
The Cincinnati Enquirer

Become a home-health nurse. Get free housekeeping services for a year.

As nursing agencies, hospitals and nursing homes struggle to maintain staffs in a nationwide nursing shortage, this latest wrinkle in the recruiting war comes from the nonprofit Visiting Nurses Association, the largest home nursing agency in town.

The VNA plans to start advertising Sunday to fill six of its 30 full-time nursing jobs by offering a choice between a $2,000 sign-on bonus (twice as much as last year) or a year of free housekeeping services - two four-hour sessions per month. The agency also plans to use a similar promotion, with larger cash bonuses, to recruit three coordinators.

"We interviewed a lot of nurses. And over and over again we heard that nurses struggle with how to keep house and hearth together and still work full time," said Warren Falberg, the agency's president and chief executive. "This is our way of addressing that concern."

The VNA's recruiting offer comes about eight months after the Health Alliance of Greater Cincinnati raised eyebrows nationwide by offering $30,000 sign-on bonuses for nurses and technicians who commit to work at least three years in special cardiac-care units.

Most Tristate hospitals - the biggest employer of nurses - have struggled in recent years to fill open jobs. In December 2001 - the most recent local figures available - the average hospital nurse vacancy rate was 15 percent, according to the Greater Cincinnati Health Council. The national average was 13 percent at that time, according to the American Hospital Association.

While the local report has not been updated, there are some signs that the nursing shortage may be starting to ease.

A weakened economy has reduced turnover rates because some nurses are hanging onto jobs they previously considered quitting for family reasons, other career options, or over frustration with increasing workloads.

Meanwhile, enrollment increased last fall at most local and regional nursing schools, with some reporting waiting lists.

But at best, those signs are viewed by health-care executives as just a start.

"The May graduating class will still be short of overall demand for the area," said Debbe Endres, vice president of human resources for the Health Alliance.

The Visiting Nurse Association can offer free housekeeping service because it already has a staff that provides such services for the elderly and medically needy, Mr. Falberg said. Like a regular client, the four-hour sessions can be used however the nurse's family needs them, be it meal preparation, laundry service or other housekeeping chores.

"That's an interesting idea. I definitely think you'll see this kind of benefit expand in the Greater Cincinnati health-care system," said Lisa Blank, director of the Health Care Workforce Center, an organization created last year by the Greater Cincinnati Health Council.

The workforce center has been negotiating a contract that would provide a wide range of concierge services to participating health-care organizations, from dry cleaning pick-up to errand running to arranging pet care during vacations, Ms. Blank said.

Short term, many health organizations are offering signing bonuses, tuition reimbursement and a variety of flexible scheduling options to attract nurses. But many of those efforts simply shuffle nurses from one employer to another.

Long term, many in the hospital industry say, more effort is needed to attract health-care workers from out of town and to increase the overall number of local residents choosing health careers.

The Health Alliance surprised many in the field last year by offering the $30,000 signing bonus to fill a dozen specialty jobs in cardiac care. But even though the bonus helped the Health Alliance fill the jobs in about a month, the program was a disappointment.

There were only slightly more resumes than job openings from people who actually had the expertise the Health Alliance wanted. Also, of the jobs that were filled, only two hires were from out of town, Ms. Endres said.

Since then, the Health Alliance has assembled a "Welcome to Cincinnati" package of perks to offer to out-of-town job candidates.

The program includes expanded help with relocation expenses, including temporary housing and furniture allowances. New hires also can select a free membership from a list of area museums, arts organizations and other attractions.

Meanwhile, health-care employers are working with area chambers of commerce and other groups on better ways to promote Greater Cincinnati to out-of-town markets, Ms. Blank said. Among the ideas is hiring a recruiter to market Cincinnati as a health-care job destination.

E-mail tbonfield@enquirer.com