Community College Selection Process-What A Joke!

Anthony Heyes, from the Univ. of London, issued a statistics paper a few years ago stating that a low paid nurse is a good nurse. There are a few threads about that paper here at all nurses.

https://allnurses.com/forums/f195/does-better-pay-better-care-170851.html

His points were RIGHT ON THE MONEY, pun intended. All things being equal, if the value of being 'called' is factored into our salaries, it will naturally exclude those that don't hold the value in being called.

All things being equal . . .

However, healthcare became 'cost centered' as opposed to 'patient centered' in the '80's. Rooted out of the equation was the time necessary for the average nurse to fulfill their 'calling'. And so, this vocational view of nursing became inadequate to meet the needs of nursing.

That being the case, and it is, the usual rules apply: higher salaries equal better nursing because it draws more candidates into the profession and allows for competition to create a higher quality student, ultimately leading to a higher quality nurse.

If you are an administrator and have some control over how community colleges recruit (you are on their boards, or on the board of nursing), AND, you are worried about the changing nature of nursing, slowly moving from a vocation (low pay) to a profession (commensurate pay), then it is vital to continue to cast nursing as a vocation.

In order to do that, if you can't (or won't) fix the problems in the trenches that is serving to make nurses take a much closer look at the concept of vocational loyalty, then the solution is to tip the balance back towards vocationalism at the training level.

In order to do that, you have to change the equation so that the schools themselves do not add to professionalism by recruiting only the top notch candidates for entry to the profession. A 'lottery' is the perfect tool to accomplish that goal.

Lottery systems are merely another attempt to keep nursing vocational in nature and there is real value at stake in that: the ability to continue to pay 'vocational' type wages instead of professional wages.

Denying opportunity for the best qualified candidates to move forward, in favor of a lottery of minimally qualified candidates, is an attempt to field a caste of nurses grateful for entry at all, and not nearly as committed to the science of nursing that will make our salaries rise.

The selection process isn't a joke: it's an attempt to keep well qualified candidates, like the OP, out of the process, or at least, randomly subject to the process, in order to keep the balance in nursing AWAY from rising scientific qualifications that would lead to rising salaries, and with it, rising respect. In short, it's a direct attack on the professionalism of nursing.

That's the bottom line, pun intended.

The fact that nurses, as education adminstrators, buy into this reasoning either shows their leftest leanings (by instituting a socialism system of recruitment), or they are severely deluded about the rationale for implementing such a system (It's certainly not about 'fairness'). That, in my opinion, calls their very ability and aptitude to teach nursing into doubt. Why they aren't actively resisting and subverting such a system is beyond me except to say, whatever the Ivory Tower is smoking, it's a good thing they aren't subject to random drug testing, like the rest of us.

~faith,

Timothy.

Sit down boys and girls cause I'm going to enlighten you on something. I have come to the realization that the nursing shortage in the US is a manufactured shortage. There's several reasons why I have derived this conclusion. This is all based on my observations, people I have discussions with (including members of the California BON), and two retired hospital administrators. I'm sure the same applies all around the country.

The first thing we must recognize is that hospitals in the US are a business. Hospitals make money by taking care of patients which provide a service and collect $$$$. OK nothing wrong with that basic idea, however it goes far beyond that.

Ever wonder why it is so difficult to enter any nursing program in the US? What is the logical reason? To keep the number of nurses down? I think it is just that.

On average, it takes 2 to 3 years to get all the prerequsites done before one is allowed to apply to nursing school. Then one is put on a waiting list or even worse, a lottery. Either system will cause one to wait an additional 2 to 3 years before being accepted. If accepted, then an ADN program is an additional 2 years. Wow! That makes on the average 6 years before one can become an RN! Who would wait that long? Well, most don't when they realise that one can get a BS or BA in another field in 4 years instead of an ADN in a minimum of 6 years. Who decides the rules governing the education level of nursing programs? The California BON.

Now who are members of the California BON? Well I found out that they all are senior administration members of various hospitals within the state who volunteer to be on the state board. Wait! Can that be? The same people who are responsible to assure that the hospital they work for earns the most $$$$ for the service they provide? Hmmmm ...

What about the rules and regulations for the level of education and how many can enroll for the various nursing school in the state? Well those are made by the members of the BON. Hmmmm ...

So, since there is a "shortage" of nurses, where do they find some? Well some come from the local nursing school, yes, but most are recruited from overseas. God love 'em, these recruited off shore nurses want to be good nurses, work hard so they can help provide family back home.

The next statement most likely will not apply to California because of the recent (2 year old) ratio law, however it will apply for the other states. "Because of the nursing shortage", you nurses will just have to take care of 8 - 10 patients.

Do you see the pattern?

I HAVE BEEN SAYING THAT FOR YEARS AND YOU ARE ABSOLUTELY CORRECT!

Anthony Heyes, from the Univ. of London, issued a statistics paper a few years ago stating that a low paid nurse is a good nurse. There are a few threads about that paper here at all nurses.

https://allnurses.com/forums/f195/does-better-pay-better-care-170851.html

His points were RIGHT ON THE MONEY, pun intended. All things being equal, if the value of being 'called' is factored into our salaries, it will naturally exclude those that don't hold the value in being called.

All things being equal . . .

However, healthcare became 'cost centered' as opposed to 'patient centered' in the '80's. Rooted out of the equation was the time necessary for the average nurse to fulfill their 'calling'. And so, this vocational view of nursing became inadequate to meet the needs of nursing.

That being the case, and it is, the usual rules apply: higher salaries equal better nursing because it draws more candidates into the profession and allows for competition to create a higher quality student, ultimately leading to a higher quality nurse.

If you are an administrator and have some control over how community colleges recruit (you are on their boards, or on the board of nursing), AND, you are worried about the changing nature of nursing, slowly moving from a vocation (low pay) to a profession (commensurate pay), then it is vital to continue to cast nursing as a vocation.

In order to do that, if you can't (or won't) fix the problems in the trenches that is serving to make nurses take a much closer look at the concept of vocational loyalty, then the solution is to tip the balance back towards vocationalism at the training level.

In order to do that, you have to change the equation so that the schools themselves do not add to professionalism by recruiting only the top notch candidates for entry to the profession. A 'lottery' is the perfect tool to accomplish that goal.

Lottery systems are merely another attempt to keep nursing vocational in nature and there is real value at stake in that: the ability to continue to pay 'vocational' type wages instead of professional wages.

Denying opportunity for the best qualified candidates to move forward, in favor of a lottery of minimally qualified candidates, is an attempt to field a caste of nurses grateful for entry at all, and not nearly as committed to the science of nursing that will make our salaries rise.

The selection process isn't a joke: it's an attempt to keep well qualified candidates, like the OP, out of the process, or at least, randomly subject to the process, in order to keep the balance in nursing AWAY from rising scientific qualifications that would lead to rising salaries, and with it, rising respect. In short, it's a direct attack on the professionalism of nursing.

That's the bottom line, pun intended.

The fact that nurses, as education adminstrators, buy into this reasoning either shows their leftest leanings (by instituting a socialism system of recruitment), or they are severely deluded about the rationale for implementing such a system (It's certainly not about 'fairness'). That, in my opinion, calls their very ability and aptitude to teach nursing into doubt. Why they aren't actively resisting and subverting such a system is beyond me except to say, whatever the Ivory Tower is smoking, it's a good thing they aren't subject to random drug testing, like the rest of us.

~faith,

Timothy.

I don't believe nursing is a vocation and they don't get paid vocational wages. It is a skilled profession that requires critical thinking and analysis, and you can't pull everyone off the street and teach them to be a nurse.

I don't want to hijack the thread into turning it into a "are nurses paid enough" war, however, Nursing is one of the highest paying jobs with an Associate Degree, and Associate Degree nurses even get paid more than the majority of those with Bachelor degrees, especially the first year out.

That is a cold, hard fact.

We don't live in a society where you get paid based on merit, we live in a society where education and highly skilled positions, especially where there is a marked shortage, get paid the most, and Nursing does fit that bill.

Same with computer Geeks...they are few and far between, and the highly skilled ones make the money, and in that industry, they don't really care if you have a degree or not as long as you can do the work. The schools can't crank them out fast enough.

If I thought nursing was a low-paying job, there is no way I would be uprooting my life and putting it on hold for 3 years whlie I finish school only to get a low-paying job.

Same with computer Geeks...they are few and far between, and the highly skilled ones make the money, and in that industry, they don't really care if you have a degree or not as long as you can do the work. The schools can't crank them out fast enough.

I guess you missed the tech crash. Computer geeks don't have great job opportunities ... far from it.

A lot of those jobs went to India where there are plenty of computer geeks who will work for only ten bucks an hour.

That's why a lot of computer geeks in the U.S. are now going to nursing school.

I want to thank everybody for your kind words. I am doing my best to deal. I do have support from family and close friends. Maybe, I can regroup. All of you are helping even though you are distance voices.

Hey Tim, hang in there! I can't imagine what you are dealing with but try to keep at it. Don't give up.

I'm not sure where you are located but I'm in a wonderful ADN program at Mendocino College here in Ukiah that does not use a lottery system, they use a formula that is based on grades.

PM me if you want more information...the program is expanding, too!

Regards,

Ken

Yes, but in order to be a valid candidate within the California ADN lottery pool, don't you need at least a 2.5 GPA (in some cases it's 3.0) in all the hard-core science pre-reqs micobiology, chemistry, anatomy, phiso (in some cases, in all your college level course work)? So, doesn't this sort of preclude the whole idea of nursing as just a low paid vocation and not a profession.

Don't you think those students have got to be pretty committed bunch to make those grades so that they can become a candidate in the lottery pool? Not to mention the determination it takes to even gain a seat in anatomy or physio--the most impacted classes in the universe here in the Bay Area. All new graduates are college educated...how can anyone view these people as "vocational workers" and thereby justify low wages.

Also, While you make a very compeling argument, do you really think those people in those ivory towers give it this much subversive thought?...keep in mind I am a person who used to rub shoulders with ivory tower types in my prior profession....they are just people who usually want a good balance between what is best for the industry and what is best for the workers. They are usually very smart and pretty capable leaders at that.

Of course, I worked in a traditional top 10 company that was headquartered in San Francisco--very liberal company in a very liberal town. I may have rose colored glasses on; but, I am open to hearing and learning from your interpretation that Tim did not get a seat in nursing school because of some conspiracy to maintain nursing as a low paid vocation. But I just can't buy it from where I am sitting (hoping to get into a BSN nursing program that just added seats becuase the major hospital in my town made a large grant in order to ensure high quality nurses).

This industry of health care is a twisted new game for me. I guess I need to make a commitment to dig deeper on the issues that affect this industry and on the key industry players.

...but after finals! I need to get back to studing.

Also, While you make a very compeling argument, do you really think those people in those ivory towers give it this much subversive thought?...keep in mind I am a person who used to rub shoulders with ivory tower types in my prior profession....they are just people who usually want a good balance between what is best for the industry and what is best for the workers. They are usually very smart and pretty capable leaders at that.

Warning - very long answer:

It's not that I think it's an all-fired 'conspiracy'. But, the leaders of healthcare generally are well aware of the concept that, using vocational standards, a 'low paid' nurse is a better nurse. Anthony Heyes, whom I quoted earlier, didn't invent this concept; it's been the modus operendi of setting nursing salaries for decades.

Even through to the early 80's, you really had to be motivated to be a nurse, because you certainly would not make enough money at it to support a family. This is the key reason why men haven't been in nursing in any number until very recently. In many family dynamics, especially in the past, women can be '2nd income' earners, but men have been traditionally conditioned to be 'primary breadwinners'. And nursing - nursing wasn't a job that could accomplish that. Ask those that have been in the field for 30 yrs and many will tell you that their starting salaries way back then were not much more than minimum wage. Even in the mid-90's, my starting RN salary was 13 dollars an hour.

The dynamic, as I discussed, is changing. Because nursing is no longer a job where someone that is 'called' can actually meet that calling on our busy units, pay has had to go up to create the supply of nurses willing to work 'in the trenches'.

THAT is why schools are full now. It's enough to draw candidates in, but still not enough to keep nurses in the profession. The physical demands and moral distress of being a nurse is enough to tax the strongest person. It is a job that exacts a heavy toll. Those on the outside looking in generally think: wow! what a salary for the level of education! Those of us IN the trenches normally think: I'm not being paid nearly enough for what I do.

But don't doubt that those that set salaries are greatly concerned about how to keep them in check. Employee salaries are traditionally the largest expense of any company and when your largest group of employees start to earn in the 50-70k range, that is cause for alarm, especially if YOUR salary and bonuses are dependent upon keeping such expenses in check.

There have been mulitple attempts to keep salaries low over the years.

Look at the ADN/BSN debate. NO, I don't want to get it started, but I just want to make a point. In any rational economic theory, higher education should equal higher pay. In reality in nursing, those degrees get paid almost identical salaries. Why? Management simply doesn't want a concept that would allow a convenient way for nurses to transition to educational degrees that would command a higher salary. Once you stratisfy such salaries, the result is to go down the road of ever increasing salaries as nurses catch on that more education equals more money. So, there is almost a nationwide collusion to refrain from acknowledging the economic value of such degrees. If hospitals had paid for such a difference in education over the years, that whole debate would be moot by now: the economic benefit of such a degree would not only cause movement to transition towards such degrees, it would affect the choice of programs, in the first place.

Look at the concept of magnet hospitals: IN EXCHANGE for decent work environments (something that should have been provided all along), nurses will be 'drawn like a magnet' to environments and job situations not expressed in the bottom line. I'm not opposed to the concept of spending a few hundred thousand dollars on work environments. I am opposed to it when the concept seems to be that, by doing so, hospitals can save a few million in salaries.

Look at turnover rates. Depending on which study you look at, the annual turnover rate for nurses nationwide is 15-21%! If you employ 300 nurses, that means, EVERY YEAR, you are looking to replace 45-60 of them! Why would hospitals allow such attrition? Because most administrators believe that it's simply cheaper than paying a salary that would keep attrition at a normal 5-7%. (Another argument here is that, by allowing such turnover rates, hospitals can keep replacing higher paid, more experienced nurses with new nurses on the lowest salary rungs.) I could argue that this isn't the case, that such strategies aren't cost efficient, but that's another debate. Bottom line, retention is poor because administrators BELIEVE that such is the cost of doing business at the price they are willing to pay.

Now, look at Anthony Heye's theory: low pay equals better nurses. Management is certainly aware of this concept - they've been depending upon it for decades. At it's heart this is a question of vocation vs. profession. This formula works for a vocation, and works well. But for a profession, the usual economics apply: higher pay equals better candidates. But the reverse is true as well: better candidates demand higher pay.

It's not that there is some conspiracy at work so much as employers are seeing their long used economic advantages over hiring nurses slip away. When you are talking about millions of dollars in play, there is ample incentive to attempt to turn the tide. Once that tide fully rolls in, the economic free for all that results in the creation of commensurate salaries will be huge.

Hospitals don't worry about paying doctors commensurate wages: the formula is in place for them to bill themselves. That was a necessary result to ensure that hospitals and doctors both got a decent piece of the pie. What hospitals are very concerned about is that nursing will cost so much that the economics will turn to nurses becoming independent contractors in order to command truly commensurate salaries, salaries that employers will never pay in their own right.

Ask any hospital administrator what they think about paying 'agency' salaries. Most administrators think of such salaries as practical extortion and shun having to deal with them whenever they can.

If a small hospital that hires 300 nurses gave each nurse a dollar an hour raise, that translates to more than half a million a year in extra salaries. Now, mulitiply that by much larger hospitals and much larger pay increases.

No, this is about money. Big money. And when you are talking about motivations in the millions of dollars, hospitals are very keen to control such costs, by any means necessary.

Disarming nursing from becoming a more qualified force to contend with at the bargaining table (increasingly becoming more qualified to demand higher salaries) is but ONE way - out of many stratigies being employed - to control costs. It's simple economics: the best and the brightest also tend to have a much higher valuation of their worth.

Bottom line: higher pay equals better nurses is the exact reverse of the formula that hospitals have used for years to employ nurses on the cheap. Since, under this formula, one equals the other, the solution to control ONE of these variables (salary) is to control the other.

Answer me this: what other economic benefit could be involved with a lottery system? Don't tell me that it's about altruism to students - full programs mean full tuition fees regardless of the actual body in the program. In any case, such a system is inherently unfair and creates MORE hassles than would be the case with a straight competition system. Why create such hassles? The answer to such questions is normally this: follow the money.

~faith,

Timothy.

wow good post

"If doctors, like airline pilots, died with their clients they would take a lot more care with the orders they issued." That quote right there reminds me of how I got over my fear of flying! The pilot doesn't want the plane to crash JUST as much as you don't! Sorry kind of off topic, but I really liked that quote!