in a free market economy the price (in this case nursing services) of a good or service is determined by the complex interaction between supply, demand, and the availibility of substitutes. Thus, if the supply of Pepsi goes down we will see the price go up, but not nearly so much as if the supply of gasoline goes down. Why the difference? With Pepsi their are many substitutes (Coke, RC etc). However, with regard to gasoline the primary substitute is not driving something which most people cannot abide. How does this relate to nursing?
There is already a nursing shortage that's a good thing for nursing wages. However, the substitutes for health care facilities are still legion. They can simply go without nurses and live with the shortgage or they can hire more "quasi" nurse professionals such as medical technicians, nurses aids, and LPN's. In addition, they can "import" cheaper labor in the form of foreign nationals. So what steps can nurses take to enhance their long term compensenation?
I. Lobby state legislators to make the BSN the minimum requirement for entry level RN nursing. Existing ADN RN's and diploma RN's should be "grandfathered" into practice (as well as those currently in school) this will minimize resistence from current RN's to the idea (indeed ADN RN's and diploma RN's will benefit from the higher salaries generated from such legislation).
II. Seek to legislatively mandate holding an "RN" certification for as many aspects of patient care as possible. This reduces the "substitutes" availible for hospitals.
III. Support continued studies that show a correlation between hospital understaffing and negative patient outcomes. Furthermore, make sure that this information is easily availible to malpractice attorneys bringing suits against healthcare facilities. If hospitals see that understaffing results in more liability payments and higher malpractice premiums it will become relatively more expensive to maintain understaffed levels than to simply pay the wage necessary to retain sufficient nursing staff.
IV. Oppose ANY legislation which makes it easier for nurses from other countries to work here espcially if the educational levels from the originating country are substancially lowers in the nursing profession.
V. Work with nursing accredidation bodies to INCREASE the rigor of undergraduate BSN programs. Thus more classes like Organic Chemistry (at the majors level) and Pathophysiology should be required at the expense of classes like nutrition and educational psychology. In addition, push for a required one year internship after graduation before nurses can take board examinations (this requirement as been successfully implemented by professions ranging from accountents and electricians to pharmacists). Besides creating optimal restriction upon entry into the profession implementation of this reccomendaition will tend to increase the "prestige" associated with the profession.
VI. Use public relations and mass media techniques to heighten awareness among the public with regard to the potential ramifications of the nursing shortage for the health of their loved ones. In addition, the potential dangers of "undereducated" RN's should be accentuated.
VII. Long term there should be a concerted effort to make a master level education the minimum for RN practice. Consider that teachers have successfully implemented such a requirement (teachers must obtain a masters within five years in most states) and pharmacists have managed to raise the bar to SIX years of education.
Nurses don't necessarily need to unionize but THEY do need to pool a significant portion of their political clout to accomplish these objectives.