Nursing pay..Check this out!

  1. Why is nursing pay across the board not standardized? What I am referring to is, why do nurses get paid more or less according to the cost of living across the USA and not according to skills a nurse possess? I am not sure for other nurses but my quality of care does not fluctuate as our pay does across state lines etc. If a nurse was getting paid a lot more for the same job in a different city then moves to a city where the pay is much lower for the same job, are we allowed to decrease the quality of our care just like the pay decrease the nurse will receive?
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    About FrankRN2017

    Joined: Dec '17; Posts: 36; Likes: 34

    65 Comments

  3. by   SmilingBluEyes
    I dunno, but I'll take a stab. Because you won't get good, experienced, well-suited nurses, in say, San Francisco, if they are paid the same as in say, rural Oklahoma, where to cost of living is cheaper.

    People have to eat, house themselves/families and pay for food and other necessities, etc on their local economies. It's completely fair in my mind for a nurse on the California coast, where the cost of living is enormous, to make a lot more than one living where 30.00 (or more) an hour less will provide a good living.
  4. by   FrankRN2017
    The quality and quantity of nursing care does not change that I know of as I always strive to do my best wherever I am, BUT the pay changes. Does the cost of medications vary from one city to another?
  5. by   brownbook
    We are not economists. Maybe you understand economics better than us. But what SmilingBlueEyes said is all I understand and it makes perfectly good sense.

    I can't imagine how the cost of a drug has anything to do with a nurses income?
  6. by   FrankRN2017
    Does the cost of healthcare services vary between states?
  7. by   AceOfHearts<3
    The government takes cost of living into account when determining pay. Government employees living in the DC area receive a bump in pay because the area is so expensive.
  8. by   SmilingBluEyes
    Did you read my post? I said the COST OF LIVING varies. It's not about the cost of drugs or even health care. We don't have a very real stake in those. The doctors and pharmaceutical reps, do.

    I am earnest: Does it not register with you that the cost of living varies hugely in the USA and therefore, so should the amount a nurse is paid, if he or she lives either on the high or low end? It's not about how hard you work; it's about the market in which one practices.
  9. by   turtlesRcool
    The cost of health care can vary from the patient in the bed by the window and the patient in the bed by the door. It all depends on what's wrong with the patient, what insurance the patient has, how doctors chart for the coders to code, etc.

    A huge problem with healthcare in the US is the absolute lack of transparency. There is no way to get a price from Hospital A vs. Hospital B for the same procedure. In just about every other industry, cost comparison is possible, and consumers make choices accordingly. Health Insurance is such a labyrinth of codes, exceptions, and different deals struck by different insurers and policies that there's no way to figure out what anything will cost until you get a bill. Or several bills.

    And even with the biggest payers (medicare and medicaid) payments vary from state to state and even within states. Physician costs (which are often billed separately) also vary.
  10. by   cleback
    Maybe take an economics course and it will make more sense to you?

    Agree with the cost of living. Also patient populations (patterns of reimbursement) matter as well as supply/demand. It's like health. The quality of exercise may be the same between two individuals but their health can vary substantially. There are as many factors to pay as there are to health. Doesn't make it fair but it's just the way it is.
  11. by   SmilingBluEyes
    Also you are not even considering intangibles, such as benefits, corporate core values/norms/expected behaviors, etc. SOMETIMES the highest-paid job, or any job with a huge sign-on bonus(BEWARE)-----there are real reasons for those. It's cause the above suck and no one wants to work there.

    It's not just about money at the end of the day, but satisfactory personal happiness, fulfillment, opportunity to grow and accel/move up and being treated well and respectfully by management and administration. I took a lower paying job for those things more than once.
  12. by   TriciaJ
    Every job pays the lowest the market will bear. If you can attract competent nurses for $25/hr, why pay more? If you're hiring nurses in San Francisco and no one can live there on $25/hr, you aren't going to attract any to work in your facility. It's not about the quality of care that a nurse provides. Every employer has the right to expect a minimum standard of competence. This issue is: what does it cost to attract that in your geographic location?

    Does that make it any clearer for you?
  13. by   turtlesRcool
    This.

    Or think of it another way. It's not about making the same amount for each nurse regardless of location, it's about nurses enjoying roughly the same quality of life regardless of location.

    At this point, most nurses make enough to live middle-class lives. We're not rich, but we can generally afford decent housing, keep food on the table, have reliable transportation, pay for daycare/children's activities, and take modest vacations now and again.

    So imagine, we got rid of the outliers (high pay in HCOL areas and low pay in LCOL areas) and paid every nurse the same median wage.

    Well, the nurses living in MCOL areas would go on as before. The nurses in LCOL areas would get a nice little windfall. They could save more, go on more vacations, buy bigger houses, etc. The nurses in HCOL areas would be screwed. They'd be relegated to tiny apartments (and or ridiculously long, draining commutes), rarely get a chance to eat out, never vacation, and not even be able to afford daycare.

    So if they're all working just as hard, why should nurses in LCOL areas live the high life while nurses in HCOL areas barely scrape by?

    You know what happens in those HCOL areas, if conditions continue like that? Nurses quit. Hospitals can't attract or retain staff. Patient care is endangered. So, to attract the staffing they need, hospitals have to in crease pay so their nurses earn enough to live a moderately middle class life. It's really a simple case of supply and demand.
  14. by   ItsThatJenGirl
    This isn't just nursing, FYI. It's pretty much any skilled job out there. Check out police salaries in California vs. Texas for example, or physician salaries. My husband is a plumber and even his income varies state to state.

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