Nursing as a service industry

ZootRN · Feb 21, 2007

You all may be aware that the service industry has the lowest paid jobs...with all the emphasis being placed on Press Gainey scores and customer service, I fear we are migrating to that end of the career spectrum.
We all like to think of ourselves as professionals and having a license seems to validate that, but if employers stop thinking of nursing in that light and instead see more of a service line, would you still be happy being a nurse?
How would/do you feel being considered in the same occupational class as housekeeper and waitress?
I think that's what a lot of dissatisfaction is coming from, only we haven't quite identified it as such.

In my personal opinion, when nursing workforce will shrink enough to interfere with hospital operations and their money-making strategies, all this BS, pressured by corporations onto health care to devalue nurses, will be thrown out of the window. When baby boomers will retire (and many of them are nurses), there are won't be many eager to take their spot, because nursing as it is stressful, physically demanding and not highly paying job. Younger people seems to be less apt to put up with bad conditions, and will continue quit profession as they do now. Nursing shortage will continue to worsen until much needed big changes that our profession yet to see will be brought about.

Hmm, I must be day-dreaming:lol2:

UM Review RN, ASN, RN · Feb 21, 2007

You might not know this, but in Florida the biggest union (we're pretty much non-unionized here) is the SEIU--Service Employees International.

Nurses are lumped in with everyone in the healthcare field (doctors too) along with bus drivers, security officers, and office workers.

So we're already considered "service" type employees.

TheCommuter, BSN, RN · Feb 21, 2007

Many degreed professionals are "public servants". In my honest opinion, there should be absolutely no shame whatsoever regarding public service.

Social workers, schoolteachers, professors, traffic engineers, legal aid attorneys, and other highly-educated professionals all serve members of the public in some capacity to a greater or lesser extent. Therefore, these people are members of the so-called 'service industry'. They are simply being paid more money for their services than cashiers, housecleaners, bus drivers, and cafeteria workers.

jjjoy, LPN · Feb 21, 2007

It's less about 'service' and more about 1) how much training you need and 2) how much responsibility you have

For housekeeping, most people can learn the basics on the job in not much time and the responsibility in terms of human life is low. Bus driving shouldn't take too long to master either, though there's much more responsibility involved.

Learning to start IVs, to do basic wound care, and even learning CPR doesn't take too long. Learning the underlying pathophys, common treatments, potential adverse effects, signs of complications, nursing care and emergency care, prioritizing!!!... this takes much more time to learn. And there's major responsibility involved.

It looks like a person only needs 1-2 years of training to become a nurse. That doesn't look like much. Yes, there are pre-reqs but I'm talking about nursing coursework. We know how rigorous nursing school is, but most people don't.

Most people also don't know the great responsibility of nurses. They assume that because nurses "follow orders" that they don't need to understand them and aren't expected to know as much nurses actually need to. Acute care nursing these days is like the critical care of the past. Today's critical care was just sci-fi before. Yet, acute care nursing still has the image to outsiders of being watching over basically well patients, handing out pills and giving bed baths.

lindarn · Feb 21, 2007

It's less about 'service' and more about 1) how much training you need and 2) how much responsibility you have
For housekeeping, most people can learn the basics on the job in not much time and the responsibility in terms of human life is low. Bus driving shouldn't take too long to master either, though there's much more responsibility involved.
Learning to start IVs, to do basic wound care, and even learning CPR doesn't take too long. Learning the underlying pathophys, common treatments, potential adverse effects, signs of complications, nursing care and emergency care, prioritizing!!!... this takes much more time to learn. And there's major responsibility involved.
It looks like a person only needs 1-2 years of training to become a nurse. That doesn't look like much. Yes, there are pre-reqs but I'm talking about nursing coursework. We know how rigorous nursing school is, but most people don't.
Most people also don't know the great responsibility of nurses. They assume that because nurses "follow orders" that they don't need to understand them and aren't expected to know as much nurses actually need to. Acute care nursing these days is like the critical care of the past. Today's critical care was just sci-fi before. Yet, acute care nursing still has the image to outsiders of being watching over basically well patients, handing out pills and giving bed baths.

I have said it before and I will say it again. Nurses are shooting themselves in the foot by refusing/fighting increasing the educational leval for entry into practice. We are lumped in with minimally trained individuals, because THE PUBLIC CANNOT SEE WHAT ARE EDUCATION CONSISTED OF, AND THE RESPONSIBILITY AND ACCOUNTABILITY THAT WE HAVE. The public looks at how long we are in school, and they see LPN/LVNs coming out of school after just one year of post HS education, and most RNs coming out of school after a two year ADN. While I know that most ADNs end up in school longer than that with pre-requisites, what matters at the end of the day is the Associates Degree, which is only considered a two year degree, regardless of how long it took you to accomplish it. THAT IS WHAT THE PUBLIC SEES, AND WHAT HOSPITALS THROW AT US (what do you girls expect? You only went to school for two years?)!!

When hospitals look to cut $$$, we look like an easy mark and career to de-skill. What is the difference between a nurses aide with six weeks of OJT, and an LPN/LVN with just a few months more. The public doesn't know or care what kind of classes you took, they look at the finished product.

Same with ADNs. Most careers that are community college based, are blue collar non professional careers.

We will always be a a line- item on the balance sheet, because we don't bill for or services like other departments. We will alway be thrown in with the room rate, housekeeping, and the complimentary roll of toilet paper.

Lindarn, RN, BSN, CCRN

Spokane, Washington

RunningWithScissors · Feb 21, 2007

You gals are right; if all it takes to be a nurse in a hospital is 9 months at a career center, no wonder the public sees us as just "public servants"...they can't distinguish between LPN and RN, esp. when you introduce yourself as their nurse for the day...they never ask what kind of nurse.

I do disagree with the previous poster who said traffic engineers and teachers are considered public servants. They are definitly (esp. teachers) held to more respect....plus teachers have a heck of a union!!!

SuesquatchRN, BSN, RN · Feb 21, 2007

I've never seen myself as being anything but service. And I'm proud to be considered essential personnel, and privy to travel in states of emergency.

TheCommuter, BSN, RN · Feb 21, 2007

I do disagree with the previous poster who said traffic engineers and teachers are considered public servants. They are definitly (esp. teachers) held to more respect....plus teachers have a heck of a union!!!

According to my sociology textbook, high school teachers and registered nurses possess an equal prestige rating of 66/100 in the United States. Physicians, of course, receive the highest prestige ranking year after year.

In addition, you'd probably be surprised at the sheer amount of people who still do not realize that schoolteachers are required to have a minimum of a BA degree. Many parents do not think highly of their childrens' teachers.

clee1 · Feb 21, 2007

I have said it before and I will say it again. Nurses are shooting themselves in the foot by refusing/fighting increasing the educational leval for entry into practice. We are lumped in with minimally trained individuals, because THE PUBLIC CANNOT SEE WHAT ARE EDUCATION CONSISTED OF, AND THE RESPONSIBILITY AND ACCOUNTABILITY THAT WE HAVE. The public looks at how long we are in school, and they see LPN/LVNs coming out of school after just one year of post HS education, and most RNs coming out of school after a two year ADN. While I know that most ADNs end up in school longer than that with pre-requisites, what matters at the end of the day is the Associates Degree, which is only considered a two year degree, regardless of how long it took you to accomplish it. THAT IS WHAT THE PUBLIC SEES, AND WHAT HOSPITALS THROW AT US (what do you girls expect? You only went to school for two years?)!!
When hospitals look to cut $$$, we look like an easy mark and career to de-skill. What is the difference between a nurses aide with six weeks of OJT, and an LPN/LVN with just a few months more. The public doesn't know or care what kind of classes you took, they look at the finished product.
Same with ADNs. Most careers that are community college based, are blue collar non professional careers.
We will always be a a line- item on the balance sheet, because we don't bill for or services like other departments. We will alway be thrown in with the room rate, housekeeping, and the complimentary roll of toilet paper.
Lindarn, RN, BSN, CCRN
Spokane, Washington

I just KNEW you'd chime in with this POV, Lindarn.

Theoretically, I agree with you. However, until there are enough BSN programs to supply the current and projected need for nurses, I have toi disagree with you as a practical/logistical matter. (For the record, I intend to continue my education at least to the BSN level)

To the OP: I have no problem being in a "service industry". If you don't manufacture or sell a physical product, you are by definition selling a service. This category includes doctors, lawyers, accountants, etc. etc.

The reason nursing is underpaid and disrespected is that we, as nurses, permit it to continue - by accepting substandard wages and conditions.

lindarn · Feb 21, 2007

I just KNEW you'd chime in with this POV, Lindarn.
Theoretically, I agree with you. However, until there are enough BSN programs to supply the current and projected need for nurses, I have toi disagree with you as a practical/logistical matter. (For the record, I intend to continue my education at least to the BSN level)
To the OP: I have no problem being in a "service industry". If you don't manufacture or sell a physical product, you are by definition selling a service. This category includes doctors, lawyers, accountants, etc. etc.
The reason nursing is underpaid and disrespected is that we, as nurses, permit it to continue - by accepting substandard wages and conditions.

There are plenty of nurses to satisfy the need for nurses. They just leave within two years of graduation because of job burn out. With "ABC Community College" churning out new grads every six monhs, there is no incentive to work at retaining the nurses they already have. There is also no incentive on the part of nurses to remain at bedside nursing due to workign considions, pay, lack of respect, etc. The short amount of time it takes to become a nurses also fuels the exodus. Nurses look at it as just, "well, I only went to school for two years, I will just look for something outside of the hospital (that only pays less than half of what I make at the bedside), but that's OK. I only went to school for two years".

Tell me that isn't the case. If nurses were forced to earn a BSN, or higher, they would fight a little harder to make the workplace better, pay more, and fight the de-skilling that the hospitals are continuously attempting (with a little help from the BON). The whole charade fuels a non existent nursing shortage.

And yes, we allow it to continue because we are forever apologizing and making excuses for our lack of education, compared to other health care professionals, who not only have always had a Bachelors degree as entry into practice, but now have graduate levels of education for entry into practice.

The public may say that we are wonderful, but ask them if they would be willing to go along with a 25-50% pay increase, bringing us in line with PT, OT, Pharmacists, etc. What do you think the reaction would be?

We don't think/believe that we are worth, and we know deep down, we are not the professsional equals to other health care professionals. And we are not taught in school business skills, worth in the workplace, etc like other health care professionals are in their programs. Just mention this to nurses, and they roll their eyes and say, "we don't need that to take care of patients. Those classes are just fluff that you take in the BSN programs". Need I say more? That is the reaction from all of the nurses who are ADN graduates. All they want is the technical classes to "make them a better bedside nurse". What is really needed is a mandatory 6 month to one year internship to ease the transition to working after school. That is what other health care professionals have to help newbies to become confident after they graduation. Nurses continue to insist that new grads must be able to "hit the ground running" the day after graduation. This completes our Blue collar image to the public- nursing as an unskilled OJT, blue collar profession. Just ask the public yourself. See what kind of reaction you get.

Lindarn, RN, BSN, CCRN

Spokane, Washington

jjjoy, LPN · Feb 21, 2007

While I agree that nursing education and the public image of nursing needs a good overhaul, I don't have confidence that increasing RN entry to BSN would increase wages.

Where I am, nursing wages are great compared to a lot of alternatives. This is especially true for those without any bachelor's degrees. Yet, facilities still have a hard time recruiting enough nurses. Why? Because the facilities can't or won't afford more nurses on staff thus creating a miserable environment that many people choose to leave. If facilities can't/won't afford to hire enough nurses to provide a good work environment and high quality care, why would they just roll over and pay more for BSNs?

I think LPNs would become the primary caregiver in hospitals and the number of RN-BSNs/unit would drop. The RN-BSN would then be "supervising" the nursing care, not giving the nursing care - like in some LTC settings. And again, health facilities would cry about not being able to hire enough nurses and look to overseas to find nurses.

I don't know what the answer is. There are so many factors!!