Last month, Eddie Davis worked 213 hours at Howard County General Hospital - that's about 7 hours per day, every day - and he didn't get paid a dime.
He filed documents, consoled emergency room patients and punched away at a computer keyboard, but his only compensation came in the form of a big old "thank you," which Davis says is payment enough.
"I worked a regular job for most of my life, and I just didn't like the way employees were treated," said Davis, 63. "But here they really appreciate you and treat you with a lot of respect."
Davis is a hospital volunteer, one of 458 at Howard County General who, in fiscal year 2002, donated nearly 33,000 hours of work and saved the hospital $492,956 - what it would have cost to pay them for their labor.
Volunteers have always been a big part of hospital operations, but with a third of the nation's hospitals running in the red and with increasing worker shortages at medical centers across the country, unpaid helpers are becoming more integral.
"Hospitals are permeated with volunteers," said Rick Wade, senior vice president of the American Hospital Association. "They couldn't survive without them on several levels."
The first level, he says, is economic. Only a third of the nation's medical centers are profitable. The other two-thirds are either losing money or just hanging on.
Another way hospitals would suffer, if there were no volunteers, would be in the area of customer service.
"All those warm fuzzies you get at a hospital? They're coming from volunteers," said Barbara Swann, director of volunteers at Howard County General. "They're the icing on the cake."
They work in many areas - filing, photocopying, running errands, transporting patients, fund-raising, answering phones, making beds. But the most significant service they provide is personal.
"Hospitals are intense places, and volunteers can put people at ease," Wade said. "That's what they do best."
They usually live in the communities they serve and transfer that familiarity to patients, helping them relax. They're also less intimidating to talk to than medical staff because they're regular Joes and Janes.
"Volunteers can certainly do and say things the staff can't," said W. Fred Hitchcock, director of volunteer services for the Maryland Department of Health and Mental Hygiene, which oversees 11,000 volunteers at its 17 state-operated hospitals. "They're a real balancing factor between the medical staff and administration and the patients, acting as a bridge from and back to the community."
And they free up time for hospital employees to concentrate more on their jobs.
For the third consecutive year, nursing vacancies have increased in the state, according to a survey by the Maryland Hospital Association. There are more than 2,000 unfilled nursing positions in Maryland, and 126,000 unfilled in the United States.
Extra hands are appreciated because they can take over many of the unskilled tasks that nurses and other medical personnel are called on to perform.
But the volunteers make out in the deal, too, in personal rewards.
"The biggest gift I get is when a patient says `thank you' or offers a handshake," said Davis, who works in six departments at Howard County General. "I'm on top of the world then, because I know I'm making a difference."
Howard County General also offers free flu shots, free meals, a cell phone contract after 100 hours of service and a lot of real-life work experience.
"The acceptance process mirrors that of a human resources department," Swann said. "We do background checks and interviews, and once they're here, they need to show commitment. It's just like having a job."
At St. Joseph Medical Center in Towson, volunteer coordinators have created the Paver Program, which enables people returning to the work force or just entering it to check out areas of potential employment.
"People use the volunteer positions to test out whether they like health care careers," said Vivienne Stearns-Elliot, the hospital's spokeswoman.
Moonah Mohamed, a junior at Wild Lake High School in Columbia, wants to be a nurse. She volunteered twice a week during the summer at Howard County General "to get experience."
Others might want computer or clerical skills, and recruiters say hospitals offer those, using them as a selling point to draw a more varied volunteer force.
"It takes a lot of creativity to come up with programs that are going to attract people and make a real difference," said Susan Kern, a founding member of Health Care Directors of Volunteer Services, a group that brainstorms new ways to attract volunteers. "It's more challenging than it has been in the past because people in general have so many things going on at one time."