nabeepchen

The solution to the nursing shortage is simple–pay instructors more money. How is it that no one thought of that before?

That is one of the politically correct responses to the late great shortage of nurses, that it is merely a matter of not enough slots in school and a lack of instructors.

This article appeared in October 2007, and I never got around to linking to it. But it is from Health Care blog, which says that it will tell you everything you ever wanted to know about healthcare but were afraid to ask. This particular article was penned by Maggie Mahar, and it is entitled: HOSPITALS: Why We Don‘t Have Enough Nurses (It’s Not Low Wages)

Consider this: In the San Francisco area, a nurse with a bachelor’s degree can hope to start out with a salary of $104,000. The salary for a nursing professor with a Ph.D. at University of California San Francisco starts at about $60,000.

This goes a long way toward explaining why nursing schools turned away 42,000 qualified applications in 2006-2007—even as U.S. hospitals scramble to find nurses. We don’t have enough teachers in nursing schools and the fact that the average nursing professor is nearly 59 while the average assistant professor is about 52 suggests that, as they retire, the shortage could turn into a crisis. The most recent issue of JAMA (October 10, 1007) reports that in 2005 we had 218,800 fewer nurses than we needed and by 2012, it’s estimated that we’ll be short some 1 million nurses.

So according to Mahar’s report, nurses are now all making 6 figure salaries when they are fresh out of school, and the only reason that there is a nursing shortage is that there just aren’t enough teachers or schools to train them.

There are a few hospitals in the Bay Area, notably Kaiser facilities, that are organized by the CNA and pay high wages. Although, someone fresh out of school is not going to get top dollar instantaneously. Even at Kaiser, which is probably the highest paying, a new grad may earn $40/hour, which is good money to be sure, but doesn’t translate to $104,000 (where on earth did she get that figure from?) It’s more like $80,000.

And that’s Kaiser. Small hospitals don’t come near that figure, and once you leave the heart of the Bay Area, wages vary considerably. So Mahar is using a small sliver of very high paying facilities in one small section of the U.S. (and still overinflating the amount for new grads) and using that as a basis for her argument–that salary is not a reason for the nursing shortage.

Hospitals have had to raise nursing salaries (as well they should), not just because nurses are scarce but because, in our chaotic hospital system, the work can be extraordinarily stressful.

I hate to break this to Mahar, but nursing has always been stressful. And chaotic. And nurses have always been for the most part, treated poorly. This is nothing new, and most hospitals are not jumping on the bandwagon to improve either salaries or working conditions. Perhaps Mahar might remove her blinders and look at the salary stats in other part of the country, or even in California. For example, new grads in Florida (and this reported from a recent new grad) are making $16/ hour. Now isn’t that a stimulus to go into nursing. The average nursing salary nationwide is about $50,000–that’s averaging out the very high and the very low.

Mahar is also ignoring the fact that isn’t just money which keeps nurses out of teaching. The climate of academia can be just as stressful as working in a hospital, albeit in a different manner. There’s the pressure to publish, to kiss ass, to deal with students and university politics, etc. Universities also want their nursing professors to have a PhD, and many nurses just aren’t interested in going to school for that long, just to teach. If they do get a PhD, they can get a more interesting job. An advanced degree in nursing can open the door to a lot of different opportunities, and teaching just isn’t high on the list of being either well paid, or all that enticing.

Many of the nursing programs that have these huge lists of applicants are state funded universities or community colleges. The schools are cheaper, so people apply there first. I wonder if private universities have long lists to get into their nursing programs. It has always been harder to get into state schools, even back in the early 80s when I was attending. So this really isn’t anything new, although this small part of the nursing shortage is being targeted and highlighted.

Mahar also didn’t mention nurses leaving the profession, or hospital jobs, another source of the chronic vacancies. She also didn’t mention how some hospitals have very low turnover and vacancy rates, despite the nursing shortage.

All in all, its a rather myopic little ditty of trying to explain the nursing shortage in 10 words or less.