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nursing shortage

Are Nurses Underpaid?

Most people have no idea how massive the nursing shortage already is, how much worse it will get, or how it will impact them.      

I always assumed nurses were reasonably well paid, given the importance of the work they do, but they really aren’t.  As the shortage of nurses continues to worsen, I also assumed nursing salaries would be skyrocketing, but they’re not.  

This is a highly complex issue, and I’m admittedly out of my lane commenting on it, but I’m genuinely curious – what’s going on here?  

For the past year, I’ve been documenting the myriad of proposed causes and solutions to the issue.  Proposed solutions vary widely as nursing schools, hospitals and state governments scramble to implement a wide range of strategies in an attempt to address shortages.  Time will tell if they work.  

However, one solution I almost never find is to pay nurses more.  

You can verify this for yourself pretty easily by setting a Google Alert for “nursing shortage,” and you’ll see the flood of proposals from states, schools, and hospitals, but nobody is suggesting that we pay nurses more.  

You can read the first 50 articles you find on the nursing shortage, but you almost certainly won’t be reading anything about increasing nursing wages or improving workplace conditions in a truly meaningful way.  

I’m told that travel nurses are doing pretty well these days pay-wise, and maybe this ends up being part of the solution?  Some kind of ‘Uber for Nursing’ gig economy for nursing?  I’m not necessarily convinced this would be a good thing for patients or nurses in the long run, but we’ll find out soon enough.  

Here are summaries of the most common solutions I’ve read about: 

  • Financial support for students entering nursing programs (discounted or free tuition)
  • Safe Staffing mandates
  • Fast-tracking nursing education
  • Hire more travel nurses
  • Align nursing school with real world through hybrid lecture programs with more clinical time in person 
  • Integrate more clinicals throughout school, not just at the end
  • Nurse Licensure Compacts 
  • Hire foreign nurses (p.s. the countries they’re coming from have devastating shortages too…)
  • More funding to nursing schools
  • Increase nursing instructor pay (hey, this is a start..)  
  • Require those with bachelors degrees to become an RN 
  • Requires those with an associate’s degree to become an LPN
  • BSN in 10
  • Diploma nursing
  • Increase nursing school enrollment
  • Increase the use of non-acute facilities for practical training
  • Industry partnerships: Health systems provide tuition, pay for books, and living stipend for students 
  • Streamline and Speed Up Nurse Licensure Exam Process
  • Create a one-year mentoring program to help first-time educators transition to the classroom
  • Create an innovative and affordable way to earn bachelor’s degrees in nursing
  • Seamless opportunities for nurses with associate degrees to complete their Bachelor of Science in nursing (BSN) on community college campuses.   
  • Community colleges partner with a four-year college or university and design a BSN completion program with input from local employers and local workforce development agencies.
  • Increase access and affordability of Bachelor of Science in Nursing programs for students who completed their Associate Degree in Nursing
  • Help students get their RN degrees, send them to 4-year to receive BSN or MSN degrees, then retain them to either work at local healthcare facilities or to teach nursing. 
  • Hire a “Success Coach” to help students at both schools persevere through the challenging nursing curriculum and make it to graduation

The initiatives being proposed combined approach billions of dollars of investment, yet there’s almost no mention of increasing nursing wages or meaningful measures for improving working conditions.

Maybe as I continue studying this problem, I’ll find something that gives me an “aha!” moment that helps me understand why nurses aren’t paid more. 

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