Do we get paid enough?
Nurses—the hospital, bedside sort of nurses—usually get paid pretty well. Nursing is competitive in that there are less spots to fill than there are people to fill them. If you can’t find a job where you are, and you’re able to relocate, there’s a good chance you can get a decent gig somewhere, and even get your moving expenses paid.
Most hospital staff (and I’m concentrating on those people because that’s all I know) have access to insurance plans and 401K plans and disability insurance and all that good stuff, mostly subsidized in one way or another by their employers. Most of us get paid vacation time and at least decent sick leave.
Looking at things that way, in the simple “effort in, money back” way, we get paid plenty. There are things that we’re missing as a profession, though, that would go a longer way than money toward assuring that nurses are happy with their jobs and that we get more young folks coming into the field.
1. The first thing that’s missing is respect for the profession.
I don’t mean public respect; most folks will respond positively if you say you’re a nurse. Isn’t nursing the most trusted profession year after year in surveys that measure those things? In the larger healthcare system, though, nursing is often given lip service that isn’t matched by actions.
One simple example: My employer is implementing a standardized patient education system throughout the entire system. From clinics to bedside to home care, there will be a continuous flow of information for patients about chronic conditions like diabetes and hypertension and stroke. The various committees that will write the brochures and develop the education standards are already meeting—but there wasn’t a single bedside or clinic nurse on any of them until Your Faithful Correspondent made a fuss. Those in charge figured they knew better than we did about how we educated our patients, and how to change things.
We need people in charge of nurses to step up and ask us how they can make it possible for us to do our jobs better.
2. The second thing that’s missing is acknowledgement of how hard a job nursing is physically, mentally, emotionally and ethically.
From talking to nurses all over the country, I gather that employee-assistance programs and ethics advisory committees are often a joke. Safety initiatives are often implemented only after something goes badly wrong—one of those “Never Events” that results in a bad outcome for the patient. Mandatory overtime sounds relatively benign. After all, you’re only working one extra day every two weeks, right?—until you figure in the sheer physical toll of working in a unit with too many heavy patients and not enough bodies.
We need people in charge of nurses to understand that, as our patients have gotten more complex, sicker and physically larger, we have emerging concerns that aren’t like the ones nurses had 20 or even 10 years ago.
3. The third thing we need is recognition that support staff, like patient care aides and transport teams, are vital to us doing our jobs well.
This parallels but isn’t the same as “not enough bodies.” What we need are enough—and good enough—techs and aides and folks to move patients when we’re doing something only a nurse can do. A good support staff can save a nurse’s bacon when the chips are down. We need people in charge of nurses to understand that good support people are rare and deserve to be treated with the same sort of respect and care that we’d expect ourselves.
Will all of this happen? Probably not anytime soon. We can force changes, though, by demanding that respect for the profession (and for us as individual nurses), safe working conditions and enough resources are on the table whenever some bright person starts reworking something in our workplace.
Agatha Lellis is a nurse whose coffee is brought to her every morning by a chipmunk. Bluebirds help her to dress, and small woodland creatures sing her to sleep each night. She writes a monthly advice column, "Ask Aunt Agatha," here on Scrubs; you can send her questions to be answered at email@example.com.
By Agatha Lellis