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Where's the Money in Sterile Processing?

Over the course of the last couple of years, more and more dissension has occurred in the sterile processing field over the pay structure. Whether you view professional websites or social media sites, you can find someone writing about the earnings of sterile processing staff. Some writers have even taken up discord with professional associations. There seems to be more finger-pointing than solutions to the problem, low pay. So, where is the money in sterile processing?

Low pay within the field is driving an increase in the travelers (temporary staff) market. Sterile processing technicians can increase their pay substantially if they enter the temp market. This swing in employment creates a shortage of staff in the market for permanent employment, driving incentives like sign-on bonuses and referral bonuses. I recently was privy to a sign-on bonus of $5k for a sterile processing technician. This hiring practice is not uncommon in the nursing field, but for me, this is rather new for hiring sterile processing technicians. The staff I have worked with continue to question that "if hospitals can afford to spend money on temporary staff, why don't they just give us a raise to keep us employed"? I see that as a fair question; however, what drives the temp market is usually temporary. In the long term, it should be less costly than annual raises. It is a financial balancing act.

How do we increase the pay for permanent sterile processing staff? The early consensus was to utilize education to help drive pay. At this point, certifications for sterile processing technicians are only mandated in five states (NJ, NY, CT, PA, & TN). The push for mandated certification has largely failed, considering NJ required certification for sterile processing managers as far back as 1990. Please understand me; I believe in certification and have supported enhancing educational offerings for decades. The truth is that the hospital and nursing associations have not supported the process. Hospitals fear increased costs and other professional associations feared upsetting the hierarchy, which is still prevalent in today's healthcare field, even to the dismay of patient care. Personally, I would like to see a degree developed for the sterile processing field; there is so much knowledge to learn about the craft that would help support better patient care. Also, increased education usually equates to increase income. Unfortunately, it is a numbers game, as is everything in life. Schools have to know enough about the trade to support it, and there has to be a viable number of positions to fill to make it profitable. On a large enough scale, neither is happening. Enrollment in baccalaureate nursing programs increased nearly 6% in 2020, to 250,856, according to preliminary results from an annual survey of 900 nursing schools; nursing is also the nation's largest healthcare profession, with more than 3.8 million registered nurses (RNs) nationwide, as stated by the American Association of Colleges of Nursing. Conversely, the U.S. Bureau of Labor and Statistics lists Medical Equipment Preparers, which includes staff who prepare, sterilize, install, or clean laboratory or healthcare equipment, as 53,920 individuals.

As an added distractor, sterile processing technicians are not being placed in a favorable light. Negative articles play a role in the perception of the staff in the field. Articles regarding ethics for the reprocessing of medical devices are not uncommon. These articles develop a theme of uncaring technicians who put themselves first and the patients last. When poorly reprocessed instruments are used, patients get hurt and sometimes die. Is this a failure of the technician or a systematic issue? In most cases, the issue is systematic. A failure to hire trained staff, continually educate staff, and have the basic foundations in the workplace for the sterile processing department are legitimate issues that aren't found as much in other medical professions. I can even say the understanding of what is being accomplished within the sterile processing department is misunderstood by the "C" Suite and many managers who have direct oversite for the department. There is even consistency with the misunderstanding of productivity targets leading upper-level management to believe that faster is better when it comes to the production of instrumentation. I digress; that is a topic for another day. The point is that the field is not supported well by management and is most often misunderstood. A comparison to dishwashers comes to mind, and I have heard it stated more that I would like to count.

Where do we go from here? That isn't easy to answer. Economic outcries for better pay are heard on every corner for many jobs and have reached a fever pitch. It has come true with the median pay hovering around $17 per hour in the sterile processing field; the current economic structure for better pay has created more competition for these workers. With temporary staff taking a larger chunk and jobs that require much less rigor for staff to stay current within their field climbing ever so close to the pay structure in sterile processing, we may see a larger gap develop for this essential position. That may help increase pay as it did in the nursing shortages of the past. We still need to highlight the contributions of this workgroup positively. They are indeed frontline healthcare workers and have a direct patient care impact. Whether you like it or not, infection prevention starts here more often than not. We need more science-backed research to show the impact this group has on patient care, which at the moment is hard to find. We need to continue to educate those in the dark. We need to continue to find allies in the healthcare field to help our cause. In large, we need to continue to support each other.

Lastly, we need to take our stories public. We need to develop a dialogue with the general public, who don't know who we are for the most part. It is hard to create a need for something that no one knows about or understands. On a recent flight, I had a conversation with a passenger next to me who said, " I thought the instruments were thrown away after each surgery." To my dismay, the general public has latched on to a need to raise pay for fast-food workers and others but has no voice for sterile processing technicians. We drive the message to our fellow workers within our field: do your job as if your family was on the operating room table. How do you think the public would react if they knew that the lives of their family members were left to workers who compete for the same pay they already champion for others?

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