For years, the way for a nurse to get a raise at Erlanger Health System was to put in the time.
Length of service was the key factor in how much Erlanger's 1,280 nurses were paid.
But Erlanger, which is Hamilton County's fourth-largest employer, is changing that system.
Instead of basing pay decisions just on the number of years worked, nurses will be evaluated for raises on a "tiered" system that also considers competency and level of education, said Jan Keys, chief nursing officer at the public hospital.
Keys said the new system follows "an evidence-based research model" that is growing more common throughout the country and was devised to help avoid salary compression - what happens when employees have only small differences in pay regardless of experience or skill.
While Keys and other Erlanger officials say the new system will elevate "professionalism" among the nursing staff, some nurses are frustrated by what they see as a betrayal of decades of loyalty.
Several nurses with more than 30 years of experience say they've been placed in the middle of the four-tier system - meaning their salaries are "topped out" and they won't be seeing market adjustment raises that will go to other nurses in their tier with less experience.
Even nurses who have been approved for a raise say they're disappointed the hospital is planning to phase in raises instead of implementing them by the end of this month as they had expected. Some may not see raises until sometime next year.
Hospital officials said they decided to stagger the $5.4 million implementation to conserve for expected "headwinds" this year in the form of additional reimbursement cuts, said Gregg Gentry, Erlanger's chief administration officer
"We know we have the best nursing staff," Gentry said, "and we want to pay them market rate."
Keys said the new model is meant to create "equitable pay" for nurses who have worked for varying spans, while better accounting for their differing roles and duties.
She said an across-the-board 3 percent raise for nurses in January did not address problems with compression and the four-tier system does.
"In the past it has only been based on years of experience," she said. "Now you have to bring something of value back into the organization, which is something we are very passionate about."
But one nurse, who did not want her name used because it might affect her job, said she's on tier 2 despite 30-plus years at the hospital - meaning she has "topped out" her salary and will not receive a market adjustment anytime soon.
To get into another tier, she was told, would take getting a degree like a bachelor's of science in nursing - something she said she does not see as a possibility at her age.
Contact staff writer Kate Harrison at email@example.com or 423-757-6673.