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Washington Post: "Study Links Nurse Shortage to Pay That Lags Behind Inflation"

March 15, 2006 -- Today The Washington Post ran a short item linking fluctuations in the number of U.S. nurses to whether nursing wage increases had kept pace with inflation. Marc Kaufman's piece suggests that making sure the wage increases do keep pace is the key to resolving the nursing shortage. The story relies on a new report written by the Institute for Women's Policy Research (IWPR), funded by the Service Employees International Union, and based on data from the Bureau of Labor Statistics. We have no doubt that wages are a factor in the nursing crisis, especially in developing nations. But we doubt small wage increases in the U.S. will make much difference in resolving the shortage. Instead, it seems clear that that will require serious, long-term improvements in staffing, working conditions, health system reform, educational resources, and basic social respect.

The Post piece begins by asking how hospitals can "attract and keep much-needed nurses," and saying that the "answer is simple," according to the new study: "[i]ncrease nurses' wages at a rate that keeps them from falling behind inflation." The piece notes that the study found that between 1996 and 2000, when hospitals "began to complain" about the shortage, average nursing pay dropped 1.5 per cent, accounting for inflation. But the apparent 2.1 percent increase in inflation-adjusted wages in 2001 reportedly "result[ed in] a flood of job applications--with staff size increasing by 9.2 percent." The piece says that salaries continued to increase until 2003, "when wages and the number of practicing nurses began to decline again." The IWPR analysis reportedly also found that studies addressing how to attract more bedside nurses often ignore the pay issue, with only 11 of 49 recent studies examined concluding that raising wages at a rate above inflation would help solve the nurse shortage.

No doubt wages are an important factor for many nurses, especially in parts of the nation and the world where pay remains low relative to the cost of living. But to claim that wages alone matter seems myopic. This data obviously suggests that there is a correlation between U.S. wages and nurse employment. But it does not seem to show causation, and it does not mean that simply raising nursing wages at the rate of inflation will solve the nursing shortage. That is extremely unlikely. Many if not most U.S. nurses who have left the bedside have cited desperate short-staffing and abysmal working conditions, not a lack of pay. And it is very difficult to believe that the half a million U.S. nurses no longer working in nursing can be lured back with simply pay increases at or even above the rate of inflation. Even if some could, that does not mean that the profession will be able to attract the huge numbers of additional nurses it will likely need to cope with demographic shifts. And of course, simply raising wages at the rate of inflation will not necessarily help much if the wages started out too low relative to the local cost of living. Any suggestion that small pay increases will resolve the shortage would appear to have more to do with narrow, short-term economic agendas than a genuine understanding of the global nursing crisis. A far more promising measure is that suggested in a recent study by Peter Buerhaus and colleagues in Health Affairs, which found that improving nurse staffing could actually save money in the long run. Another key element will likely be directing far more resources to nursing educators, who are reportedly unable to handle the number of qualified nursing applicants.

We thank the Washington Post for covering this important issue.

See the article: "Study Links Nurse Shortage to Pay That Lags Behind Inflation" from the March 15, 2006 edition of the Washington Post.