Nursing Pay - Why So Low?

eltrip · Oct 23, 2003

Okay, I'll bite.

Yes, I agree with you on the multiple paths & gender theories. There's also the small problem that hospitals regard nursing care as an expense. The services that nurses provide aren't calculated individually but factored into the cost of supplies as well as the room charge. Thus, the value of nursing care is not well understood by hospital administration or the public.

Another thought is that society does not value its sick or infirm. As a result, the skilled care provided to them is also not valued. I suppose that this is why factory workers, carpenters, plumbers, machinists, etc., frequently without more than a high school education, earn more than nurses.

As for management, I've had both male & female supervisors. If they're good managers, it doesn't matter which gender they are. Ditto if they're not.

llg, PhD, RN · Oct 23, 2003

Adding to the previous ideas ....

A lot of people think of nursing as simply an extension to the "nursing care" that sick people receive from their families. Also, in a related view, nurses frequently became nurses as a result of a religious calling to serve the sick and did not demand wages comparable to other workers.

The above factors/attitudes have led to the development of a culture in which people don't really view nursing as something that they want to (or even should) pay for. It is often viewed as an activity that people perform out of a committment to others that is not related to earning a living.

Not that I agree with that ... :-)

llg

OC_An Khe · Oct 23, 2003

In addition to the above, Nurses income will only reach what is deserved by their responsibility until a vast majority of nurses demand appropriate wages, without regard to education. And if they don't receive what they feel is appropriate wages then refuse to stay at the bedside, or home health visit, or whatever.

You don't ask you don't get. Sadly to many RNs will complain but when the time comes for definitive action they just don't do anything.

flynrn · Oct 23, 2003

I think that the expense factor is major re RN salary. Unfortunately, the "bean counters" haven't figured out that they can't advertise "best hospital, etc" if they do not have qualified RNs to carry out the physician's orders, not to mention make sure he ordered the correct RX, tx or whatever. That is why I think managers are working with their hands tied so they end up just covering their ....to keep their (not hands on pt) jobs. It is surely a sad state of affairs for the RN and ultimately the patient. The public is kept unaware of this problem and think the only reason there is a nursing shortage is because there are not new ones entering the profession. If we had the RNs who had been trying to protect the pt, and reprimanded by the management, and the ones who just quit and gave up to work in Walmart - there would not be a shortage and their would be more money in the field.

maureeno · Oct 23, 2003

>>>In a study published in the September 24, 2003 issue of the Journal of the American Medical Association (JAMA), Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level. In hospitals, a 10 percent increase in the proportion of nurses holding BSN degrees decreased the risk of patient death and failure to rescue by 5 percent. The study authors further recommend that public financing of nursing education should aim at shaping a workforce best prepared to meet the needs of the population. They also call for renewed support and incentives from nurse employers to encourage registered nurses to pursue education at the baccalaureate and higher degree levels.

http://www.aacn.nche.edu/EdImpact/

I have experienced no significant difference between male or female managers...

I have no complaints about my own salary which is based on education and experience; I think nursing assistants [CNAs] are very poorly paid.

tntrn, ASN, RN · Oct 23, 2003

Regarding that study, I think I would have to disagree with that. You can prove anything you want with a study; just depends on how you set it up. My experience with BSN nurses, especially the ones just coming out of school, is that they are much more interested in looking at the numbers (lab values) that actually doing patient care. IF they know what I & ) is, they do not see the importance of keeping track of it, they are quite happy to use computer charting because it can be done at the desk and once again, the patient becomes secondary. Plus, many BSN programs offer fewer hours of actual clinical experience, so there you go. Since all nurses, hospital based, ADN and BSN, pass the same board exams in their respective states, to me that means something other than a BSN nurse is a better nurse. I just haven't had that demonstrated on a long-term basis, unless the nurse has had the benefit of many years of experience at the bedside.

eltrip · Oct 23, 2003

Please, let's not make this an education firestorm. This has been debated way too many times & does us no good.

Bottom line, if a hospital needs a nurse, they will hire the best nurse that they can get for the least amount of money. They may prefer one thing or another but let's face it; they need bodies (preferably with minds to go with it) to staff their hospitals.

Ned the Red · Oct 23, 2003

Originally posted by flynrn
I think that the expense factor is major re RN salary. Unfortunately, the "bean counters" haven't figured out that they can't advertise "best hospital, etc" if they do not have qualified RNs to carry out the physician's orders, not to mention make sure he ordered the correct RX, tx or whatever. That is why I think managers are working with their hands tied so they end up just covering their ....to keep their (not hands on pt) jobs. It is surely a sad state of affairs for the RN and ultimately the patient. The public is kept unaware of this problem and think the only reason there is a nursing shortage is because there are not new ones entering the profession. If we had the RNs who had been trying to protect the pt, and reprimanded by the management, and the ones who just quit and gave up to work in Walmart - there would not be a shortage and their would be more money in the field.

I'm not an RN. Hope you don't mind my two cents on this.

1) Seems to me a really big problem with healthcare is measuring results. Most pts only know that their doc wants them to go to hospital A. They con't have a clue how that hospital compares to others. So, you can deliver a substandard product for a long time and the public won't really know. When was the last time you heard of anyone shopping around to decide where they should have their operation performed? So, hospitals can get away with cutting corners in all sorts of ways. The pt doesn't know what the staffing levels are, the quality of care, the % of poor outcomes, etc.

2) It's not just RNs that face this problem. I've been in purchasing for 25 years. I have a BS in Business Administration and am a C.P.M. (Certified Purchasing Manager). I've given up trying to land a job in purchasing at a hospital because they don't seem to think you really need any experience/education/certification to do the job. Yet you'll routinely see job postings for purchasing openings where they expect the person negotiate, write contracts, write requests for proposals and quotes, evaluate suppliers, manage budgets, and spend SERIOUS money for the organization. And at the end of the job posting they'll say something like "high school degree and two years experience perferred." I have friend with better qualifications than I who was offered a job at a large university teaching hospital here in Dallas with a starting pay of $23,000.00 per year! They couldn't understand why he was laughing at them! Of course he turned them down and took a job making twice that amount. The result is that you get what you pay for. See the other thread discussing a medical transcriptionist in Pakistan who almost posted records on the internet. Could it be that the person who wrote the contract for the hospital had little or no experience in the law or writing contracts?

I once had a chance to interview for a purchasing position at a hospital. The simply could not understand how I could do the job without having RN behind my name. I tried to make them understand that I'd never dream of using my C.P.M. to be a nurse so why would an RN then they're qualified to do what I do! They just didn't get it.

So, until the folks with MD and CPA behind their names decide those initials don't qualify them to do anything other than be doctors and accountants I don't imagine things will change much or any salaries will go up much besides theirs!

On the bright side for nurses - y'all are in one of the few professions where you can ALWAYS get a job fast. It might not be a great job. It might not be the one you want. But, you can start work SOMEWHERE any time you feel like it.

Ned

Nurse2bSandy · Oct 23, 2003

I will be a BSN educated nurse and I can definitely say that my education is 'generalized'! I can't believe all that nurses have to know! Any other degree does not compare in my book... nurses not only have to generalize but specialize. And you can tell your friends I said so!

eak16 · Oct 23, 2003

tnrn-

you cannot "prove anything that you want with a study"

The Aiken study was large, credible, randomized, and peer reviewed by nurses and doctors.

Just because one doesn;t personally agree with the outcome of a research project doesn;t mean the project should be scrapped, we should LEARN from the research of our fellow nurses.

llg, PhD, RN · Oct 23, 2003

Originally posted by tntrn
Regarding that study, I think I would have to disagree with that. You can prove anything you want with a study; just depends on how you set it up.

Does that mean that you never use research to guide your practice? Does that mean you have no respect for researchers and do not support a researched body of knowledge as the basis for professional practice?

The fact that so many nurses do not fully appreciate research or know how to properly interpret and use research findings is one of the reasons we do not get the same respect as some other professions.

A lot of people are jumping to wrong conclusions based on the particular study in question -- and this is not the thread in which to discuss the study in detail. However, the fact that so many nurses seem unable to handle the results of this particular study without getting all emotional and defensive is part of our profession's problem -- and why we are not given as much respect (and pay) as we deserve.

llg