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"Do they deserve this six-figure salary for what they do?"

October 26, 2006 -- Today The Boston Globe posted a poll on its web site in the wake of a successful nurses' strike at the University of Massachusetts Memorial Medical Center in Worcester. The poll appeared in the site's business section. The introductory text said that the strike was about a plan to reduce what were, according to the hospital, "excessively generous" contracts under which the "average nurse...working a 40-hour week makes $107,000 a year." The site then asked if the nurses were "right to strike," and whether "they deserve this six-figure salary for what they do." The Massachusetts Nurses Association (MNA) said that these descriptions of the strike issues and the average nurse pay were inaccurate. The union urged nurses to respond to the "insulting" poll by explaining that they were indeed worth that kind of money for their important work. We think the poll's most basic flaws are that it wrongly assumes that everyone knows "what [these nurses] do," and that it clearly suggests that it's nothing very important or difficult. We doubt the paper would have run such a poll about a "six-figure salary" for a given employer's lawyers, accountants, ad executives, or newspaper editors. But the idea that a nurse would make such a salary evidently suggests to the Globe that our society has its priorities all wrong.

Here is the complete text of the poll posted on the "Message Boards" part of the business section on the Globe's site:

After striking for several hours yesterday morning, nurses at UMass Memorial Medical Center in Worcester were successful in contract negotiations over salary and health benefits. The dispute concerned the management's plan to reduce what they called excessively generous nursing contracts. The average nurse, according to the hospital, working a 40-hour week makes $107,000 a year.

In your opinion, were the nurses right to strike? Do they deserve this six-figure salary for what they do?

This short poll text has many problems. The text carefully phrases the account of the strike issues in terms of what the hospital says--which it does not explicitly endorse--but it deftly slides away from that hedge when it comes time to ask the questions. The hospital says this is the story, and based solely on that, were the nurses "right" to strike? Do they "deserve" that kind of money? Thus, while avoiding a specific adoption of the hospital's claims about the "excessively generous" salaries, the poll has effectively invited readers to take those claims as facts, and then to make sweeping moral and policy judgments on that basis alone. There is no mention of whether the nurses agree with this characterization of the strike issues, or indeed, any mention of their position at all. According to the MNA (which is a Center supporter), the average full-time salary for the striking nurses was about $82,000, and the key issues were hospital efforts to reduce the nurses' retirement and health benefits and union rights.

Moreover, how does the average reader know what the striking nurses "do," or indeed what any nurses do? Does the average Globe reader understand how much college-level training nurses have, what they actually do every day for patients, the exhaustion and abuse they endure, how many lives they save or improve through their advanced skills? In recent years the Globe has been one of the best mainstream U.S. press sources for accurate information about nursing. But that's not saying much. No one should imagine that the Globe's readers are immune from the handmaiden stereotypes that have dominated social and media understanding of nursing for decades, particularly on television, which remains the most powerful medium.

Of course, even if a reader were inclined to think nursing is valuable, this poll is clearly pushing the other way. The phrasing is exquisite: "Do they deserve this six-figure salary for what they do?" It seems factual and neutral, but the use of "deserve" and "for what they do" subtly calls for a negative response. Few readers will not at least consider interpreting the question with the following emphasis: Do nurses deserve such a high salary for what they do? Bedpans and pillow-fluffing? Of course not! Consider the effect if the poll had chosen different seemingly neutral words: "Is that a fair salary for the nurses' work?" Or if it had framed the issue in terms of the hospital's action, rather than the nurses' reaction: "Did the nurses deserve to have their benefits cut?" Of course, the very fact that the poll is raising the issue suggests that it favors a negative response. We can't imagine the paper running such a poll about a job that it felt required advanced skills and had great social value--would it ask such a question about physicians?

The import of the poll was not lost on the MNA. The union released a statement to members describing the poll as an "insulting twist" on the UMass nurses' victory, and as reflecting a "bias against the value of nurses." The MNA went on:

Putting aside the fact that the Globe's characterization of the issues and nurses' actual average salary at UMass is wrong, the question exposes a bias against the value of nurses and the role you play in health care. You are worth every penny you make and more. You work in one of the most dangerous professions (you're injured as much as construction workers, you're assaulted more than prison guards), you deal with deadly infectious diseases; you hold life and death in your hands every minute of every shift. We urge every nurse and family member to respond to this poll and tell them why you are indeed worth $100,000 per year. Tell them what you do on a daily basis; tell them about the patients you care for, and the role you play.

This is good advice. Without taking any position on whether the UMass nurses were "right to strike," nurses do deserve good salaries because of the threats and stress they face every day, and even more, because of the constant "life and death" nursing role that the MNA mentions. Nurses use their years of college-level education and experience to save lives and improve outcomes in a practically endless variety of settings. Of course, the stress nurses endure is also considerable. One 2003 study found that 20% of ED nurses surveyed met symptom criteria for post-traumatic stress disorder. And rampant short-staffing has driven many desperate nurses from bedside, as Suzanne Gordon explained in Nursing Against the Odds.

We hope that, in the future, the Globe will think more carefully before it presents a poll question that so clearly suggests that nursing lacks value.

See the article: "Chaotic but brief UMass strike: Nurses blame hospital for 5-hour action over contract language row" by Christopher Rowland from the October 27, 2006 edition of the Boston Globe.

The Boston Globe Poll on the Question on the Worth of Nurses appears to no longer be available.

See the MNA press release on the UMass Strike and Settlement.