Jane Crowley, a nurse for 15 years, had just settled into a new public health job with Arlington County when she quit to do the same work for Alexandria.
Alexandria, she explained, would pay her $1,640 more a year.
"As much as I liked working in Arlington," where she has lived for a long time, Crowley said, "economically, I just could not turn it down."
Public health nurses in the county, citing a growing number of examples such as Crowley's and an annual turnover rate approaching 40 percent, gathered en masse before the Arlington Civil Service Commission last week to protest a salary scale they say will drive away experienced nurses.
"I get the feeling that there is a policy in Arlington that retention isn't all that important," Dr. Raymond Schwartz, deputy director of the county Department of Human Resources, told the commission. "I've heard it said that Arlington trains nurses to go off to Fairfax -- and they do."
Added public health nurse Suzanne Dorick: "In effect, Arlington becomes the apprenticeship source for surrounding counties."
The nurses wanted the commission to raise salaries at the top of the scale to equal the proposed maximum pay for social workers and mental health therapists, with whom they had shared a maximum pay grade since 1973.
The commission voted, however, to accept the pay package proposed. It gives nurses a higher starting salary than their social worker/therapist counterparts, but places the highest-paid nurses one pay grade and more than $1,000 below those workers -- and below their counterparts in neighboring Fairfax County and Alexandria. In Alexandria, public health nurses at the highest pay level earn $871 a year more than Arlington nurses; in Fairfax, they earn $295 more.
This salary discrepancy will make it hard to keep experienced nurses, the nurses maintained.
At least 10 of the county's 21 public health nurses said later that they have applied for jobs elsewhere.
But Arlington's top health official believes the nurses will be content with the new scale, since most of them will receive a raise.
"There will not be a loss of professionalism among the nurses, and they will not resign," said Dr. Martin Wasserman, director of the county Department of Human Resources. "When the pay plan is put into effect, over 90 percent of the staff will be affected positively."
Discontent among the county's public health nurses surfaced in a position paper they issued last week. Citing shifting caseloads caused by a high turnover rate, it said "the public health nurse is overburdened with an unrealistic caseload and is frequently asked to compromise the quality of care provided. . . . There is a crisis in public health nursing care delivery in Arlington, largely due to noncompetitive salaries."
In stressing the importance of the county's public health nurses, the nurses' report emphasized that they have been charged with trying to control the incidence of tuberculosis in Arlington. The report said the nurses currently monitor 1,528 persons infected with tuberculosis, 84 percent more cases than they handled last year. Most of the TB cases have occurred among the county's large immigrant population, Schwartz said.
"There has been no spread of tuberculosis from the immigrant population to the indigenous population in Arlington, due to the efforts of the public health nurses," nurse spokeswoman Ann Howland told the commission.
"The questions is," added another nurse, "Do you want to keep your nurses or do you want them to go away? I really feel the administration doesn't care."
Fairfax County's assistant director of nursing said she recently received several transfer inquiries from Arlington public health nurses. "We are certainly aware that their salary scales are different from other jurisdictions," Jo Anne Jorgenson said. "I'm sure it is exacerbated now." Fairfax currently has no openings on its staff of 99 public health nurses, she said.
A spokeswoman in Alexandria said she too has been contacted by Arlington nurses, but they have no openings on their 25-nurse staff.
Arlington, in contrast, has had a full-strength, public health nursing staff for only two weeks of the past 2 1/2 years, the nurses said -- a fact Wasserman does not dispute. They also said it costs the county more than $5,000 to train a new public health nurse.
The nurses say the shuffling of cases due to the rapid turnover also makes it more difficult to deal with patients, who often must confide intimate family and medical problems to them.
"You get to the point where you feel like you're sitting on quicksand," said Howland.