Brother, can you spare a dime?

If we want to get paid what we feel is fair and equitable for the skills and training we posses, then we’re going to have to establish a mutual understanding as a profession that we expect nothing less. It’s not personal, it’s just business.

So I decided to refresh an older article that I wrote when I happend upon a post over at the Linked In Group Working Nurse about the overall decline in salaries for nurses. Now I realize that we’re coming out of a recession here, and for some it may feel like we’re still in it, but I have to say that many of the salaries posted in that forum are pretty atrocious. This isn’t really news to me, but it is a reminder about one of the reasons why I chose to go into business for myself. I set a fair rate that provides my clients with a valuable service, and I get to make a good living for the work that I do. It’s a win-win situation.

I’ll speak from both a nurse’s point of view and as an employer. This may sting a bit, but my intentions are to elevate the profession and to actually help this compromised and archaic system. I feel more than adequately qualified to give my opinion on both sides because I’m involved in each of these roles mentioned above.

To my fellow nurses I feel that we’re diluting the profession and selling ourselves short.

The mentality of nursing as “shift work” needs to end. Let me say that I realize nurses at the bedside in a hospital do work shifts, I did, but what is up with this “clocking in” mentality (all due respect if you clock in somewhere). It’s just that I view nurses as highly trained and skilled professionals. I haven’t clocked in since I was in high school washing dishes for extra money. I believe I’ve mentioned that I wasn’t always a nurse, so my frame of reference is from past experiences as a salaried employee in other industries.

In my previous careers I was paid pretty well (most of the time), and lives weren’t on the line. Sure, you may be thinking that this would be common if I worked for a fairly large corporation, but have you had the opportunity to take a look at the Forbes top 500 list? You may or may not be surprised to find a few companies in there that provide some type of service in the healthcare industry. It’s not really a surprise I know, but at the very least a pretty compelling visual.

You can do your own research out there on about starting, median, and high ranges for your particular location and specialty, but I don’t mind saying that some of the results are just shocking. Now, we nurses are probably aware that employee retention is a hot topic in most work environments, but I want to talk about hospitals in particular. Again, I know that the overall financial health of this country needs a shot in the arm, but this idea builds on the point of this post, so stick with me here.

Approximately 60% of RN’s work in a hospital/surgical environment. This is out of about 3 million of us here in the United States.

Keep this in mind for later. 

Let’s dive into the retention part. According to several organizations’ HR departments and various online journals, hiring and training a full-time nurse can cost a facility anywhere from 75-100% of an RN’s salary. In some specialty areas the costs can double. As staggering as those numbers are you’d think an employer would have their finger on the pulse, but apparently they claim they do. Otherwise I suppose we wouldn’t have those statistics, and there’s quite a bit of research on this subject.

So, if employers seem to have this knowledge, and you’d expect them to have some type of business savvy about dollars just flying out the door every time a nurse quits, then why haven’t they figured out a better way to stop the hemorrhaging?

Now I’m not insinuating that we gouge the system here, but what about raising the standards of pay, and stopping this assembly line mentality? Remember that I’m also an employer, so to all of you organizations out there giving me the stink eye, I get it! It’s not just the dollars and cents when it comes to employee investment, but I think it certainly starts there. The investment on the part of the system will promote employee satisfaction and retention, encourage increased involvement with clinical research, and provide an environment for healthy self-promotion.

So, if approximately 1.8 million RNs who work in a hospital or surgical center felt adequately paid, would retention go up? How about cutting that number in half as I’m sure there are some RNs who do feel adequately compensated. I mean there’s got to be a few of you, right?

Ultimately this standard could save the system millions. Sure, the upfront investment is more, but whether you like it or not, this is a business. The return on investment (ROI) would be huge for the system in the long term.

Let me circle back to the entrepreneurial piece here and say that if more of us are providing services under a small business model, then this will also help raise the standards of pay as I assume that if you’re self-employed then you’ve decided to pay yourself a reasonable salary. If not, then stop what you’re doing immediately and call me so that I can help you fix it.

By paying ourselves a wage that is commensurate with our training and skills, we’re able to affect these overall salary calculations. Nurses are very well positioned to make the necessary investment in patient populations that are at a much higher risk of bouncing in and out of hospitals with preventable diseases. It’s time for the monster system to start seeing us as an investment instead of a liability.

So nurses, are you ready to take that next leap up?

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  1. […] as always, has a thoughtful discussion of nurses and wages going on at Innovative […]

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