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Why is there a type of mythology that exists in health care that minimizes the impact of money on nurses? Why is it that hospitals are willing to spend huge amounts of money on traveling nurses, agency nurses, and overtime rather that simply pay more for those shifts and units that are most difficult to staff? There are so many examples of the fact that increasing salaries increases nurses' willingness to work. The so-called "Baylor Plan" proved that when hospitals paid significantly more for nurses to work weekend shifts, significantly more nurses were willing to work those shifts.
There is ample evidence that significant differentials for night shifts result in significant increases in nurses who are willing to work nights. How can hospitals justify spending enormous amounts of money on advertisements, job fairs, recruiters, and legions of human resource types for the purposes of increasing their nurse employees rather than simply using that money to increase the salaries of the hard to fill positions?
Research by Peter Buerhaus and colleagues indicates that increasing salaries leads to increased labor participation (see related articles in this issue). Further their research reveals that nurses feel that salaries and benefits are a major cause of the shortage. The nurses also believe that salary increases and bonuses are effective in stimulating nurses to increase their amount of work.
Same Old, Same Old
Year after year, employee satisfaction surveys reveal nurses' dissatisfaction with their salaries and benefits. In this issue, Buerhaus and co-authors provide evidence of the persistent, national dissatisfaction nurses have with their salaries and benefits. Just over a quarter of the nurses described their salary and benefits as very good or excellent.
Yet, few organizations attempt to respond to this dissatisfaction in creative and meaningful ways. One hospital that I know of recently released the results of their employee satisfaction survey that indicated profound nursing dissatisfaction with salaries and benefits. Two days later that same hospital announced a set of initiatives that provided a very meager allowance to nurses who served as a nursing preceptor, if the new employee stayed with the organization for at least a year. What about the preceptor who successfully transitioned a new nurse out of a situation where she was not successful? Is that not worth something? One of the senior nurses laughed at the fact that the hospital was paying less than 50 cents an hour additional for all of the responsibilities and time required of a preceptor. What kind of message does that type of human resource policy send regarding the value of experience, mentoring, and retention? What other senior group of employees would agree to assume this added responsibility for less than 50 cents an hour?
Save the Nurses Campaign
Soon the annual hospital executive salary survey will be released and the chief nursing officer will again be the lowest paid senior executive. The survey will indicate that the CEO, COO, CIO, and CFO all earn substantially more than the CNO. No one will marvel at the fact that the position with the largest number of employees, and the largest budget is paid the least. It will be viewed as the "same old, same old." What justifies these practices? The research indicates that increasing salaries increases hours worked, retention, and recruitment. Perhaps it is time for hospitals to use research related to nursing labor market participation in the same manner that they are attempting to use research to increase safe practices and save patient lives. We need a campaign to save the lives of our nurse employees.
Isn't it time to significantly increase the chief nurse's salary so the nursing directors and managers can also have a substantial salary increase? Isn't time to stop paying the price for outdated compensation plans? Isn't it time to stop wasting time and acknowledge the facts? Money matters!
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