km rn

I think what we can do about it is educate ourselves and others about the stagnation of wages issue in nursing. Yes the starting wage in many areas seems comparable...but a nurse's wage will quickly stagnate. My non-nursing friends were shocked to hear how much I made compared to a new nurse. They assumed if new nurses received such a good wage..it meant I must really be making big bucks. Although this may not be the biggest issue regarding retention of nurses...it is one factor that should be addressed. It is cheaper for hospitals to keep hiring new nurses and importing nurses than trying to keep existing nurses - Why? Health insurance costs vary significantly dependent on the ages of your employees as well as the costs of benefits for someone who has over 5 years of employment. I believe most hospitals see it as a cheaper alternative to keep hiring nurses (money on recruitment) rather than focus on retention. I have also found that most non-acute hospital employeers expect you to take significant wage cuts yet they want you to bring the experience and knowledge base earned by working in an acute care setting. They don't want to pay you for your experience and knowledge but mandate that you bring them.

Government statistics regarding nursing salaries. October 2002 Nursing salaries overall have remained STAGNANT in the past 10 years. Nurse's actual earnings have increased steadily from 1983 - 2002 BUT "real earnings" have been FLAT since 1991. (real earnings = money available after adjusting for inflation) Average Annual Salaries of RNs versus "Real Earnings" 1984 annual salary = 25, 064 Real Earnings = 22, 063 1990 annual salary = 29, 588 Real Earnings = 23,861 1995 annual salary = 35,146 Real Earnings = 23,711 2001 annual salary = 41, 060 Real Earnings = 23, 409. Futhermore....much of a nurse's wage growth takes place early and TAPERS off with time. New grad Nurse 5 years experience: makes 15 to 17% more than newgrad. Nurse 15 - 20 years experience: 16 to 20% more than new grad. Secretary Thompson points out that nurses' salaries are actually BEHIND those of another perceived low income group - elementary school teachers. Nurses' salaries are falling futher behind each survey period. 1984 Elementary school teacher = 25,000 1984 Nurse = 19,000 (4,400 less per year) 2001 Elementary school teacher = 54,800 2001 Nurse = 41,000 (13,800 less per year) Now please don't make this into a teachers versus nurse war - both groups have difficult jobs. However, I believe the teachers have done a much better job educating the public about their salary issues. Source: Government Statistics regarding Nursing Salaries October 2002 Contemporary Long Term Care In addition, the salary for a nurse varies significantly dependent on area of country and area of practice (hospital versus non-acute). I get very frustrated when I hear that nurse get very high wages - it needs to put into the right context.

It is not so much the starting wage in nursing that is horrible - it is the fact that your salary will stagnate and you will forever be making within 1000 - 3000 dollars more than a new graduate. The starting salary seems reasonable - I started at the same wage as many of my friends in non-nursing jobs...however now 19 years later - their wages are double to triple mine and their benefits have also increased. Any 1 - 2% pay raise I make is eaten up by my having to spend more money on my health insurance etc. During this last year, congress discussed the stagnation of nursing pay and compared it to teacher's pay. Both are predominately still female professions, yet the teachers did not have the same stagnation of salary issues. Teachers have received a lot of media attention towards their salary woes and it has done some good - less stagnation...yet neither teachers or nurses receive adequate compensation. I'll try to find the web link to the study...it was fascinating and helped educate me regarding stagnation of salary issues.

The information was in an article in Contemporary Long Term Care Magazine from 10/02. However, it was Secretary Thompson of HHS who made most of the comments and it might carry more clout if you could get it from the Congressional Record. I believe Secretary Thompson has testified re: nursing shortage and salary issues r/t it. Senator Cliniton has also shared the stagnation of nursing salaries as one problem with retainment of nurses. I can't remember the name of the article but I know it was Oct 2002 Contemporary Long Term Care - the article had to due with retention of nurses and the nursing shortage. Good luck with your negociations - I believe that we can more effectively educate the public about the salary stagnation!

Actually it wasn't meant to start a teacher/nursing war. Secretary Thompson was pointing out that most people are aware of the inequity of teacher's wages...however, very few people are aware that nurses are struggline also. I agree with should make comparisons with engineers, and other 4 year male wage professions. We have to make the public aware of the wage stagnation - most people I've run into think nurses are highly paid. I think it is vital that we become aware of what our wages/benefits are compared to other professions. It was an eye opener for my brothers to learn how my wages have basically plateaued (?sp) where their wages continue to increase as their experience increases. Both my brothers are engineers - civil and geological. My hope is that we will effectively be able to advocate for our profession.

The following are government statistics from October 2002 Contemporary Long Term Care. They represent average national salaries. Nursing salaries overall have remained stagnant in the past 10 years. Nurse's actual earnings have increased steadily from 1983 - 2002. However, "real" earnings have been flat since 1991. (Real earnings = money available after adjusting for inflation). Secretary Thompson points out that nurses' salaries are actually behind thos of another perceived low income group - elementary school teachers. In addition, nurses' salaries are falling further behind each survey period. 1984 Elementary school teacher average salary = 25,000. 1984 Nurse average salary = 19,000. Nurses averaged 4,400 less per year. 2002 Elementary teacher average salary = 54,800 2002 Nurse average salary = 41,000 Nurses averaged 13,800 less per year. Furthermore much of a nurses' wage growth takes place early and tapers off quickly. A nurse with 5 years experience makes about 15% more than a new graduate but only 1 - 3% less than a nurse with 15 - 20 years experience. 1984 -- annual salary for nurse = 25,064 1984 -- "real" salary for nurse = 22,063 1990 -- annual salary for nurse = 29,588 1990 -- "real salary for nurse = 23,861 1995 -- annual salary for a nurse = 35,146 1995 -- "real" salary for a nurse = 23,711 2001 -- annual salary for a nurse = 41,060 2001 -- "real" salary for anurse = 23,409. A lot of the public I run into believe that nurses are very high paid - they have no concept of the stagnation of salaries that we live with. Teachers have effectively educated the public regarding their low pay but as nurses we have been less effective. Notice how your "real" salary has been 23,000 since 1990. The stagnation of wages has a lot to do with retention of nurses. I always inform people considering nursing of the salary issues - I continue to be amazed how my friends in non-nursing have greatly surpassed my income - but they are in business, engineering and accounting ...mostly traditional male roles whereas nursing/teaching is still considered a female profession. Please comment - are you surprised by these numbers?

I've only refused to float to a specific unit once. Instead of forcing me to go to that unit - I was pulled to another. I was working SICU and they wanted to pull me to the Bone Marrow Transplant Unit where I would have a full patient assignment. I found out from one of the hospital's pool nurses that pool nurses couldn't float there until they had orientation to that unit so I refused based on that. At that same hospital I was floated to Neuro floors, ER, Rehab Unit, Cardiac Step down, Urology, etc... One of my friends got floated to Labor and Delivery. Unfortunately, where ever you went you were expected to take a full patient assignment and sometimes got the worst assignment because you were the ICU nurse and should be used to very sick people. We also never had anyone float to our unit but critical care float pool nurses and on a couple of occasions a Medical ICU nurse got pulled. We always gave those nurses the easiest patients and kept checking to see if things were okay. So...I would refuse to float to certain areas espicially if the expectation is you take a full patient load OR if you know float pool nurses in that hospital receive additional trainging before floating to that unit. Good luck! It usually can't be considered patient abdonment unless you have accepted the assignment.

Please check into why the catheter is being changed every month. We no longer change catheters every month - it increases the risk of infection. We change catheters if we need to get a urine culture, if the catheter feels granuley or it there are any concerns with blockage, etc. Frequently patients and families are taught to self-cath or catherize using a "clean" technique. Overall these patients seem to do quite well. There would be a different standard of care expected from a licensed professional than a lay person. Call the agency and discuss your concerns with the DON.

Actually it sounds like you are doing well - we usually have 1 nurse for 24 residents and 3 aides. So you are carrying a heavier load then we are.

We need to get the stagnation of pay issues out to the forefront of the nursing shortage issue. It is not unusual or surprising to find nurses who have worked at a facility for years to be making slightly more or the same wage of a newly hired, inexperienced nurse.

1400 every 2 weeks, I am an RN working in a nursing facility as a QI Nurse/Nurse Manager. I have been a nurse for 18 years. Believe me - you pay stagnates the longer you've been a nurse and the longer you've been out of the hospital. Wage stagnation coupled with not retirement fund like police officers and fire fighters are two additional reason to not become a nurse.

Our staffing is as follows: Days: 2 nurses and 6 CNAs for 48 residents PMs: 2 nurses and 6 CNAs for 48 residents Nights: 1 nurse and 2 CNAs for 48 residents.

How about looking at the 6am meds and weeding out the ones that should be given at a later time. I agree that it is very hard to get resident awake and in proper positioning for swallowing pills. So....I would ask that everyone focus on getting rid of some of the 6am meds, discontinuing some, etc. Good luck.

Thanks for your kind replies! Our state survey agency believes that every regulation demands perfection. As such, they cite anything they see regardless of what you can show them from a QI perspective. They say that although you will be cited, the severity will be low, hence...you shouldn't care. However, they narrow the population to increase the scope of the problem whenever they can. It is frustrating to live in a border city and know that the facility 5 miles away in another state would not be cited for the same issues. Our state believes that they are doing everything correct and the other states are under-citing.

I agree Hepatitis presents a bigger threat than AIDS, etc. However, also look at disability issues - neck, back, shoulder, etc. injuries disable many nurses every year. Recognize the risks and do what you can to protect yourself - standard precautions, pre-shift stretching exercises, etc.