Wage Deflation In Nursing

Some nurses who have been in the profession for many years have observed deflationary forces and downward pressure on nursing wages during the past few years. The intended purpose of this article is to explore wage deflation in the nursing profession. Nurses Announcements Archive Article

While recently conducting a Google search on the topic of stagnating and deflating wages in the healthcare sector, I honestly did not unearth much scholarly information on the topic. However, many nurses and other healthcare workers in the U.S. have certainly been impacted by wages that have either flattened or outright decreased during the past few years.

Therefore, I believe that wage deflation in the nursing profession is a very real phenomenon that has been taking place for quite some time, even if a lack of formal data exists to help bolster my claims. Wage deflation is defined as an overall decrease in pay rates, whereas wage stagnation would be described as a general lack of growth in pay rates. Although some nurses and healthcare workers have been fortunate enough to have been shielded from downward pressure on their earnings, others have not been so lucky.

Several things have been happening that have placed downward pressure on nursing wages over the past four or five years. First of all, a surplus of nurses now exists in many job markets across the U.S., so many healthcare facilities now have the upper hand when negotiating wages. After all, if the nurse who has been unemployed for nine months does not accept the pay rate that HR is offering him or her, many others will take the job without hesitation even if the wage is not really competitive. The job candidate is not in a favorable position to negotiate for a higher pay rate if HR has several hundred applications submitted per job opening.

Second of all, schools of nursing have been graduating new nurses into local employment markets at a rate much faster than new job openings are being created. Many nursing schools have been created in recent years; in addition, some existing nursing programs have expanded to allow the admission of many more students.

The end result is that more new nurses are graduating than ever, while fewer nursing positions are becoming available due to people who are delaying retirement out of necessity or clinging to their jobs to support unemployed spouses.

Third, some middle-aged nurses with decades of experience have reported that their workplaces had terminated their employment to replace them with cheaper labor. In this economic climate, hospitals and other healthcare facilities are now able to hire nurses with less than five years of experience to replace employees with many years of experience who have topped out on the pay grid.

A hospital can save money by laying off 25 experienced nurses who had been earning more than $40 hourly and fill the job openings with 25 less-experienced nurses who will work for less than $30 hourly.

Some nurses who have been in the profession for many years have observed deflationary forces on wages during the past few years. Is this downward pressure on nursing pay rates going to become a 'new normal' to which we must become accustomed?

I do not know, nor do I pretend, to offer any solutions to what appears to be a complex issue.

The area I relocated from for a nursing job was/is one of the largest metro areas in the US. Many new grads left that area for jobs and some hospitals were closing at that time or at least closing some of their units. Some were on hiring/raise freezes for years. One place, with a union, agreed to a 10% pay cut for all employees, the alternative was massive layoffs so the union went with the choice that would be better off economically for most. Most of their veteran employees would have a harder time completely relocating their lives compared to a young new grad. And there wouldn't be anywhere else for them to find jobs in that area as other hospitals were facing similar issues. There are PLENTY of new grads pumped out each year there. No problem finding an employee. Employers know that. Where I am now, there aren't many nursing schools but there aren't many hospitals either and the hospitals know that too. "Lucky to have a job" is one of our managments favorite lines. Raises here are 0-75 cents. Most people get around a quarter.

I think every area has stayed the same or had wages decrease, not just nursing.

Specializes in Med Surg, PCU, Travel.

I have had quite afew nurse's with their MSN 's tell me- why do you think I got an MSN, or I didn't get an MSN to wipe butt.

Word at the University I'm applying to is that beginning in 2014 MSN programs are going to be phased out and DNP well be the new standard reqiurement, so get your MSN while you can so you can be "gran-fathered in"...else one would be a DNP wiping butt.

What I don't understand is why students are being asked to spend more on education to come out of nursing school to make less money than their grandmothers made in the same field?

and this quote

"That's what we get for abandoning the RN/LPN team nursing model. Having a RN only primary nurse model was NEVER economically viable. That's why hospitals are crawling with various "techs" now. Mark my words, we're gonna see the creation of such titles as "wound techs", "admission/discharge specialists", "IV techs", UAPs who are "trained" to pass meds. All unlicensed and all working under the RN resulting in the RN taking a much larger pt load in med surg. Have fun.... "

is a scary thought. Just adding "tech" to someone job title could give employers the right to pay like $10/hr

Word at the University I'm applying to is that beginning in 2014 MSN programs are going to be phased out and DNP well be the new standard reqiurement, so get your MSN while you can so you can be "gran-fathered in"...else one would be a DNP wiping butt.

What I don't understand is why students are being asked to spend more on education to come out of nursing school to make less money than their grandmothers made in the same field? . . .

This is still only a recommendation, the same as the one made years ago by the ANA for the BSN to become the minimum credential for RN's. My bet is that this will boil down to a power struggle between health care corporations and the nursing establishment - and my money will be on the former.

The hospital and health care corporations kind of like the way things are evolving. Right now, there's a glut of nurses, so they save on pay and benefits, increase their profits and get BSN's to boot. With increasing enrollment in MSN programs, they will likely see the same thing: An oversupply of NPs and APRN's, leading to wage and benefit rollbacks and higher profits. It seems to me unlikely they would want to upset that by pushing for DNP's, which increases profits for educational institutions but would decrease the numbers of NP's available in the short run, leading to upward wage pressure and decreased profits. So right now, they will lobby furiously and probably successfully, against the DNP recommendation.

Once wages and benefits for NP's and APRN's come down though (when there's a glut of MSNs), leading more the new MSN nurses who have to scramble for jobs to pursue the DNP, the corporations can do what they are doing now with new hire RN's and the BSN: They will simply require the DNP as the minimum educational credential for their NP's.

The free market is a thing of beauty sometimes, ain't it?

chuckster and man to be-

I totally get what your saying and can see that happening. I know for a clinical NP- the standard by 2014 will be the DNP.

I know for the Doctorate of Nursing Practice there are 2 tracks- the clinical doctorate, who will see the patients and the research doctorate track, who don't do patient contact. One of the NP's I worked with- Family Practice, she was going for herdoctorate of clinical practice.

I can see the corporate mongrels of healthcare making these NP's and DNP's wipe butt- it's almost like they want to degrade them, us nurses in general and rub our noses in it. it's like they are making a mockery of nursing= abuse. Why else would they demean such educated professional to tasks that are so far below their educational preparation? Medical residents don't even wipe butt!! neither do medical students- I have worked around enough of them to know what they do and don't do.

I certainly hope some one in the nursing PTB wakes up and does something fast to stop this before it starts. These ladies and gentlemen with their NP's know as much and put in as much time as any MD or DO and when they get their doctorate they will be the EXACT same level as any MD, or DO. The Doctorally prepared NP will have the exact same amount of formal education as any MD or DO. I think the doctorate of nursing Np's should have 1 more year of formal education- to learn how to physically beat the crap out these corporate administrators- take them out in the parking lot and beat them to a pulp!!

The push for the NP was due to the vast shortage of physicians, especially now that the ACA act had come into fruicion. The NP's are proving they can give just as good if not better, and more cost effective care as the physicians. The corporate mongrels of healthcare are taking avantage of the NP's. First - Think back to how many neighborhood clinics there were approx 2-3 yrs ago. Not many and they were in the poor, undesirable, dangerous underserved neighborhoods. Now all I see around our area is a clinic attached to every hospital there is, staffed by the providers hired by that healthcare institution! These healthcare systmes around me are buying out the private practices of the physicans- family practice and surgeons. One around me had it's tenicles/testicles( because it's CEO is a male the old sod) in the speciality practices also- cardio, ortho, neuro.

Corporate healthcare has barged it's way into the primary care and community health sector. realizing that acute care is now frowned upon by the federal Health and Human Services Dept. who did not lavish federal funding on hospitals for acute care back in April 2010. Obama gave $122million or billion to primary care.

JBudd- I totally hear you also. The RN unionized hospital I worked at for 18yr was bought out by this bunch of corporate trash and did the same thing back in 2002. Only our union went out on strike and in came the strike nurses who stay for all most- 2 years and worked at the stike nurse pay for that long. Bought $200-$300,000 homes in cash! The unionized nurses were told they would be paid the same and would keep their jobs, no changes and were invited to cross the picket line. Not many did. The healthcare corporation succeded in breaking the union. Now the hospital is a hell hole- can't keep staff, high, high, high turn over!! all newer nurses, the care has gone down hill because they can keep a nurse, some oldies stayed, close to retirement are being pushed out or covertly intisted into quitting to save corporate spending money- by being micromanaged, nit picked at such as they are too slow, daily calls into the manager office over dumb non nursing stuff- "You didn't greet that patient!" or Manager to nse: I want you over here. Why are you over there". Nse to manger: the assignment says I to be here". Manager to nse: " No, I want you over here now, I changed my mind". Ok!! My favoite: Manager to patient" Is this nurse treating you like a king? They better!!!" That is NOT nursing. manager heard 2 nurses planing dinner to gether after work and invites herself- she's standing at the restaurant when the 2 nurse walk in. Isn't it a shame when corporate admisntration has made one loose all their own dignity, pride and self respect!!!!!!!!!!!! to show up some where not invited. Is there really a price on a nurse manager's self esteem? My advise- write every time down and keep your eyes and ears open.

These last few posts are right on the money. It is all corporate now. And the funny thing too is that groundwork has been laid to do this same screw to physicians. I read physician blogs and it is the exact same raw deal in the works. I do believe that physicians are pretty easy targets and have dug their own hole so to speak. They refuse to see their own reality because the ego always gets in the way for them. In my area they pretty much must work for the hospital networks. When you are a network doc, you must refer all to others in your network or get fired. This keeps any MD on his/her own struggling unless known as the very best in their field. Almost all practices are owned by Hospital networks. Physicians are just another employee now. Lots of moaning on about being hauled into a "review" and told to make numbers next month and being shown the numbers of the guys on the other side of town that you should aspire to, etc. Also about specialists just out of residency being refused. The corporation that runs every practice doesn't need any more of you guys, they don't want another employee on payroll, thanks. Just like us.

Our deal is that the corporation hates nurses and wants us gone as much as possible. There will be many "techs" hired to replace us, or duties given to others eg common in my area to have PT do wound care... This too is happening to physicians. When it comes down to it the corporation will rather hire NPs in numbers greater than MDs. It's a money thing. And all you NPs to be, you might see good times for the time being, but your salary will go down too because alas you are ONLY an NP, thus even though you will do more in future years, you still are ONLY an NP and do not qualify for decent salaries according to the corporation. This is the future.

Listen to it, they are already bemoaning a "phyisican shortage" LOL, and LOL again. There are cries for more residencies, more students to enter the medical track! Have we heard that one somewhere else? Local community colleges already offer premed classes only for those with an established premed intention! You can forget the whole worries about rural areas and the "need". There ain't nobody in the corporation who gives a damn about poor rural folks who cannot pay the big bills. Why bring them healthcare? Remember it is not about caring for people. No benevolence involved here at all. It is only about the money.

Specializes in FNP, ONP.
chuckster and man to be-

I totally get what your saying and can see that happening. I know for a clinical NP- the standard by 2014 will be the DNP.

I know for the Doctorate of Nursing Practice there are 2 tracks- the clinical doctorate, who will see the patients and the research doctorate track, who don't do patient contact. One of the NP's I worked with- Family Practice, she was going for herdoctorate [sic] of clinical practice.

Two grossly inaccurate statements were prefaced with the phrase "I know."

#1. The DNP mandate by 2014 or 2015 (the date changes depending on how hysterical the poster is) is an urban legend. It is a recommendation only.

#2. The DNP is by it's very definition a clinical or practice doctorate (the argument about Nurse educators and administrators obtaining DNPs will be saved for another venue). The "research doctorate track," does not exist within the DNP as defined by the is otherwise known as a PhD.

The best source for clarification on these issues is the American Association of Colleges of Nursing's Essentials of Doctoral Education for Advanced Nursing Practice.

Two grossly inaccurate statements were prefaced with the phrase "I know."

#1. The DNP mandate by 2014 or 2015 (the date changes depending on how hysterical the poster is) is an urban legend. It is a recommendation only.

#2. The DNP is by it's very definition a clinical or practice doctorate (the argument about Nurse educators and administrators obtaining DNPs will be saved for another venue). The "research doctorate track," does not exist within the DNP as defined by the is otherwise known as a PhD.

The best source for clarification on these issues is the American Association of Colleges of Nursing's Essentials of Doctoral Education for Advanced Nursing Practice.

Blue devil- all I can do is tell what the NP I worked with told me and what I SAW her do- studing for her doctoral degree , with her books in the office and studing on her down time between patients. There's no need to get your panties or shots in a bunch and start name calling.

There are 2 tracts for the doctoral degree level in nursing: One is research and the Other is clinincal. Take it up with academia.

Specializes in FNP, ONP.

I am simply correcting misinformation and leading interested readers to the best source to obtain factful information for future reference. I certainly did not call anyone any names or even imply anything of the kind. You are correct that there is a research doctoral track. I simply clarified the serious misunderstading; that track is called a PhD. These are important distinctions to those of us that hold one of said degrees and to those seeking same. It is probably of little consequence to anyone else, but accuracy is important to some.

Regards.

Nursing is a disease- it requires a 12 step program to gewt out

Specializes in geriatrics.

While not everyone can relocate, wage issues and better working conditions are the main reasons why I won't work in my home Province (I'm Canadian). Back home, nurses have had their wages frozen for two years, and they are unionized. Unions are great, but they only go so far. At the moment, governments and hospitals have the upper hand. It will be interesting to see how things unfold over the next decade.

Blue devil- all I can do is tell what the NP I worked with told me and what I SAW her do- studing for her doctoral degree , with her books in the office and studing on her down time between patients. There's no need to get your panties or shots in a bunch and start name calling.

There are 2 tracts for the doctoral degree level in nursing: One is research and the Other is clinincal. Take it up with academia.

kcmylorn -- I think you may be taking offense where none was intended. Regardless of what the NP that you work with may have stated, the DNP requirement for NP's remains a recommendation only. Health care institutions, such as the one you may work in, are free to follow that recommendation, but the point is that they are not required to. This may change, and the AACN recommendation may become a requirement but many, including me, believe this is unlikely.

You are correct that there are two tracks for nurses at the doctoral level: The DNP for those interested in clinical practice and the PhD or DNSc for others interested in education or research. I think Blue Devils point was that the Doctor of Nursing Practice is just that - an advanced degree oriented toward clinical practice (hence the name).

Regardless, this has strayed from the original topic of the thread, which was wage deflation in nursing. I believe that this is real and that it will quickly expand to the NP, APRN, CNS and CNA as more BSNs enroll and complete MSN programs. Wage deflation is already occurring in many parts of the country - those regions with high numbers of nurses - and the situation will only worsen until either nursing school enrollment falls or demand for nurses increases. In my view, neither is likely in the short run.

At the moment, due in no small part to continuing misinformation about a nursing "shortage", nursing school enrollment continues to increase. While I do not believe that there is some kind of dark conspiracy behind this, it is clearly in the best economic interest of benefiting parties, such as hospital and health care corporations, to encourage the nursing oversupply. I believe that a similar situation with respect to the MSN and by extension, NPs, APRNS, etc, is in the early stages of occurring. Time will tell if I am right.

Specializes in Rehab.

This is true, I hear stories about this at work all the time, as a new grad lpn with 3 months experience I would not know what to do without Ms. Shirley or Ms. Wanda who each has 20-30 years experience as nurses, they are my backbone and they school me on things I never knew, I had a pt that needed to be sent out and I did not recognize this but as soon as they saw her they did, I can personally attest to experience saving lives, cuz who knows what could of happened, these big folks on top does not realize that you cannot put a price on this type of expertise