Small hospitals in rural areas must use ingenuity and innovative perks to compete with big-city health care organizations for quality nurses.

"Larger hospitals have more bells and whistles to offer," said Mary Anderson, RN, MA, CNAA, chief nursing officer at East Georgia Regional Medical Center in Statesboro. "We, as smaller hospitals, rely on our personal touch and other ways to attract and retain nurses."

East Georgia Regional — a hospital with 150 beds and a staff of 700 — has several programs to help it rise above the competition for good nurses. It uses a shared governance model to involve staff in decision-making and improving processes. The organization's professional nurse leadership council, composed of nurses from all areas of the hospital, meets regularly to identify issues, recommend changes and make decisions on everything from delivery of care to internal communications.

"Empowering our nurses to be part of the process is very important to them," Anderson said. "Because we're a smaller facility, everyone knows everyone else and it's more of a community environment."

The hospital also sponsors staff parties, ice cream socials and activities that include family members.

"The administration comes in for both the day and night employees," Anderson said. "Throughout the year, we encourage a true sense of community within the hospital."

At least twice a week, East Georgia Regional's administration makes rounds to talk one-on-one with staff members who are on the front line of health care.

At nearby Candler County Hospital in Metter, Anderson's husband is vice president of nursing. James Anderson, RN, BSN, MHIA, says the 25-bed hospital's close-knit staff of 160 employees is an important factor in retaining workers.

"For Hospital Week in May, we had an employee picnic and gave out service awards for longevity," he said. "We have two employees who have been here for 45 years each."

Partnerships with other area hospitals provide ways to provide in-service education to staff members.

"Nursing education is important to the hospital and to our nurses," James Anderson said. "We often join with East Georgia Regional and Tattnall Memorial in Reidsville to pool our resources and offer in-service training, such as advance cardiac life support, or to address quality issues and measurement."

Another benefit of working at a small hospital is flexible scheduling. At Candler County Hospital, Anderson is a hands-on manager who can change schedules.

Working in a small community has benefits beyond the hospital grounds, Mary Anderson said.

"Staff is really a part of the community," she said. "They see patients in the grocery stores or post office, at ballgames with their kids and they go to church with them.

"Money can be a motivator... but it is truly our personal touch and their commitment to nursing that attracts employees to hospitals our size. The happier the employees, the more chance that they will stay longer."