Community v. Hospital RNs... what's the difference?

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Hi,

I am a recent graduate who has worked in both the hospital and community settings since graduating. Recently I have relocated to Ontario from Alberta and have secured a full-time job as a community RN. I am just wondering if anyone else has noticed that here in Ontario community-based RNs are paid quite less than RNs based within a hospital. Does anyone know why this is so? I mean both professionals attended university for their BSCNs, both work very closely with patients, families and other disciplines to provide optimum care, and both are considered to be within the same profession-- so I ask why the pay difference?

I can anticipate people will respond with acute care v. homecare but I interject that within my practice I have dealt with very acute clients and am required on a daily basis to not only provide cardiac care, chemo and wound-care, but also be skilled in many basic and complex skills such as PICC care, Ostomies, Iv insertions, VACs, Port-a-cath accessing/deaccessing that all RNs working in hospitals would not be required to.

To clarify in no way am I saying that community nurses are in anyway superior to hospital nurses or vice versa; I am just saying that as professionals with the same level of knowledge and skill, why are community nurses paid less? Any thoughts or observations form your practice would be appreciated!

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Specializes in SICU, trauma, neuro.

I've never worked in the community so admittedly am clueless about it. The difference that comes to mind is while a home health nurse has to utilize skills and nursing judgment, it's more one thing at a time...vs. a floor nurse in the hospital might have to juggle lots of thinking and tasks for seven pts. But then I hear from colleagues in home care that they take a lot of work home with them in the form of unfinished documentation. Can't chart and drive, ya know. :blackeye: :dead:

But there are wage disparities everywhere, and not all of them are right. LTC comes to mind. LTC nurses do a boatload of really, REALLY important work with very little help and are generally not compensated accordingly. As a straight night shift RN, I get paid $4/hour more than the day shift RNs to work at a more relaxed pace.

It would be nice if life were fair, huh? :yes:

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Specializes in SICU, trauma, neuro.

Oops I saw this post in the healthcare politics forum... I'm not in Canada. :o

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Specializes in AC, LTC, Community, Northern Nursing.

Community nurses tend not to be unionized also the budget for community is waaaaaaay less than the hospital. Supposedly the push is for age at home trying to alleviate ALC's from acute care beds but i have yet to see this pay increase they talk because of more funding

I used to work in community and miss it...

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Specializes in Home Care.

Are you Union or non-union?

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I know that community nurses aren't unionized and the budget is unrealistically low- but I don't understand how this hasn't been brought up or pressed further. As you said the push is to keep people out of the hospital as it costs thousands of dollars a day to support hospital stays; yet they won't increase pay or funding for community healthcare. Many nurses would probably come to the community if the rates were the same as the hospital and this would not only provide better care to and improve health status of clients, but also allow nurses to work freely within the areas they love without having to factor in paychecks.

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Specializes in Acute Care, Rehab, Palliative.
I know that community nurses aren't unionized and the budget is unrealistically low- but I don't understand how this hasn't been brought up or pressed further. As you said the push is to keep people out of the hospital as it costs thousands of dollars a day to support hospital stays; yet they won't increase pay or funding for community healthcare. Many nurses would probably come to the community if the rates were the same as the hospital and this would not only provide better care to and improve health status of clients, but also allow nurses to work freely within the areas they love without having to factor in paychecks.

You are right but it's not exactly something that is in our power to change.

Trish is right. No union and a low budget adds up to low pay.

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Specializes in Home Care.

I work community and love my job.

I see all kinds of problems related to lack of funding, not just my lower pay.

Our elderly citizens suffer the most from poor funding. We have clients waiting far too long for LTC beds. We have hospitals bouncing out people who are incapable of being mostly independent.

Every day I do my best to better their lives.

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Oh I completely agree. I love my job too but its just so discouraging to see how under funded community care is. As you said the elderly citizens suffer much more that us nurses with people being sent home too early or with limited care allotted. I also work with children and although their funding is quite better than the elderly, Its far from enough. I believe everyday nurses enrich and better the lives of all our clients. Its that knowledge that makes us all stay in our profession. However I do feel that it is within out power to change it- I mean how did the other nurses in our profession get hospital funding? We are supposed to be client and care advocates and I feel that we too often sell ourselves short thinking we cant make a change. Is there some way to increase community support and funding so that the system could be better for our clients and professionals?

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