Resurrecting the Baylor Plan

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

 

 

 

 

 

 

 

There is a saying that everything old is new again.  There is truth to that as there are few truly original new ideas or initiatives.  Right now, health systems are looking for ways to accommodate nurses with scheduling and focus on well-being. Some are considering resurrecting the Baylor Plan.

The Baylor plan started at Baylor University Medical Center in the early 1980s during a severe nursing shortage. After noting that the weekend work plan that was used at an Ohio rubber plant, the administration decided to try the same idea at BUMC and found great success.  Different variations of the Baylor plan developed across the country but most used a similar formula – nurses worked two 12 hour tours on the weekend and were paid for 36 while also receiving full-time benefits. Nurses who worked the Baylor plan worked almost every weekend while the rest of the staff rarely worked weekends. Units with the Baylor plan in place developed very stable teams of nurses working on the weekends. New graduates were usually not eligible to work the Baylor plan until they had at least one year of experience.

So why think about the Baylor plan now as a strategy to help stabilize RN staffing. As was true in the 1980s (when the Baby Boomers were in their peak childbearing years), the Baylor plan worked especially for certain groups of nurses:

• Moms or Dads with very young or school-age kids who had a spouse or relative who could do childcare on the weekend.
• Nurses who returned to graduate school for advanced practice roles that required availability during the week for practicums.
• Nurse faculty who teach in colleges of nursing but want to maintain their clinical skills and supplement their salaries.
• Nurses who love to travel and wanted five days off together.
• Nurses who lived in areas where the pay/benefits were not good but took positions in hospitals who offered Baylor and made weekend arrangements.

As the nursing shortage in the 1980s subsided, many hospitals stopped using Baylor because it is more expensive than traditional staffing. I do think piloting the Baylor program again is worth talking about. We know that many Millennial nurses are in their peak childbearing years and have either cut their hours or stopped working because of the childcare crisis. Anecdotally, nurse leaders tell me that their younger staff want to work fewer hours to attain better work-life balance and mental health. Nurses who return to graduate school full-time would still be eligible for tuition reimbursement and other benefits – and avoid student loan debt. Other nurses want their weekends off to spend with their families and friends.

The Baylor plan could be a win-win in some settings especially when the cost of travelers has skyrocketed and the ROI on the Baylor plan might not be hard to achieve. In times like this, every idea is worth thinking about. There is no silver bullet for this nurse staffing crisis. What it will take are some small bets like the Baylor plan – some of which may work and others that won’t