Nurses: Respect or Money? What Matters Most?

jeastridge, BSN, RN

While everyone’s situation and needs are different, at some basic level, there is a distinction for most of us. What matters the most to you?

Case 1

ED worked overtime again on a COVID-19 unit. He was exhausted and felt let-down by the management. He tried to make some suggestions that he felt would improve efficiency in meaningful ways and improve patient care, but sadly, his suggestions did not result in change. In addition to these difficulties, he felt the sting of being called down for what he perceived to be minor infractions. He was beginning to think of taking his five years of experience and moving to the cross-town hospital that reported high nursing satisfaction rates. His friend from nursing school that worked there gave him glowing reports of her floor’s structure and management. He realized, based on his friend’s reports that he would make slightly less than he was currently making.

Case 2

Shirley took a night job to make ends meet. The added money really helped with the bills she faced but she still found herself coming up short month-to-month. She enjoyed the job very much and liked the night pace on her med-surg unit. Her supervisor was simply the best, and her co-workers turned out to be friends. When she made suggestions that she felt would benefit patient outcomes, she felt like the management paid attention. If they didn’t implement them, they usually provided some feedback and at least some type of reasoning behind their decision. In spite of really loving her job, she recently applied for a position that had a slightly higher pay rate in addition to a sign-on bonus. She was seriously considering the switch even though she would hate leaving her group.

Depending on location, nurses’ salaries vary. The differences between California, New York and the Deep South are striking but the cost of living also has an impact. Statistics measure hourly wages but are less helpful in measuring quality of life. Cost of living calculators would show, for example, that it is considerably more expensive to live in Los Angeles than in Nashville. How do you decide where to work and live? Or whether to stay or move?

Nursing as a profession continues to evolve and command respect. Nurses of all levels of educational preparation have opportunities to pursue continuing education, as well as specialized certifications. As nurses pursue professionalization and join together to speak out locally and nationally, the profession continues to gain ground and prestige.

Although nursing has benefited from the public’s increased appreciation for their role, individual nurses continue in the struggle of maintaining a living wage and also being heard. Reimbursement is important, and so is respect. Nurses want to be able to survive and thrive on their earnings. Nurses also want to have a voice at the table and partner with management to have meaningful input on all aspects of patient care. Too many times, nurses end up feeling alienated from management that appears to disregard their input.

Many studies attempt to study the basic questions of “what makes nurses leave” their place of employment and also “what can we do to keep our nurses?” It is hard to answer these questions in a generic way since nursing practice encompasses myriad places of employment, skill levels, and working conditions. “Work-life interference and high workloads are major threats to nursing retention while challenge demands and higher levels of self-efficacy support better retention.”¹ The study goes on to point out that to retain nurses, organizations must look at both job demands, job resources, personal demands, and personal resources. “Solutions that address the anticipated nursing shortage should focus on reducing burnout and enhancing the engagement of Registered Nurses (RNs) to improve retention.”²

The pandemic has brought nursing as a profession into sharp relief. Simultaneously admired and vilified nursing as a profession presents more opportunities and options. The days of starting out at one hospital and staying there for an entire career seem anachronistic. Nurses are finding their skills to be portable. They have opportunities to seek out increased respect and increased pay as their particular situation demands.

What do you see as most important? Respect or reimbursement? How about at your job? Do you feel like your management listens? What about your pay? Do you struggle with wanting to leave and do something else so that you can enjoy a better quality of life? Or maybe just so you can get by? How do those two things weigh in your work-life balance? If you could speak frankly with your managers about your concerns in this arena, what would you say?

¹Factors predicting Registered Nurses' intentions to leave their organization and profession: A job demands-resources framework

² Ibid.

Nurses: Respect or Money? What Matters Most?

What matters most to you?

Case 1

Case 2

About jeastridge, BSN, RN

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