Nurses deserve to be paid like the essential workers they are
The future of healthcare in the United States depends upon the nursing profession. But there is a concerning narrative that many nurses left the profession because they were “burned out” due to COVID. I would like to correct this view. To say nurses are “burned out” implies a lack of resilience. Nurses epitomize resilience.
Rather, nurses left a toxic environment that neither valued them nor compensated them for the expertise and service they provided. And that crisis continues, even though COVID may seem to have faded into the background.
An essential profession
In 2000, the Institute of Medicine (now the National Academy of Medicine) reported that patients who are cared for by nurses with a Bachelor of Science ( BSN) degree have better health outcomes. Since then, more studies have demonstrated that BSNprepared nurses at the bedside, and policies such as higher staff-to-patient ratios, result in fewer medical errors, produce better clinical outcomes for patients, and lead to higher rates of nurse and patient satisfaction.
Long before COVID, there were calls to recognize the clinical expertise nurses provide at the bedside and to compensate nurses accordingly. Then, nurses understood that part of the job was being resilient and caring for the patient, despite being underpaid and sometimes without appropriate resources. During COVID, it simply became obvious to everyone else, and could no longer be ignored.
Nursing is a noble profession but should not be a self-sacrificing one. There is still a great need for high-quality nursing care to address an ongoing healthcare crisis. Nurses are educated in physical assessment, physiology, nutrition, pathophysiology, and pharmacology. Your nurse will notice a change in your demeanor and begin life-saving interventions before an overhead page gets to the physician’s ears. Yet it’s common to believe that nurses who call for more pay or better staffing ratios are denying the altruistic mission of the profession and should be ashamed.
All things to all people
During COVID, many hospitals prohibited visitors. It was a labor and delivery nurse who cared for a woman laboring to give birth to her baby with no heartbeat. It was a critical care nurse who administered pain medications in one room and then held an iPad for a 45-year-old woman with advanced COVID in another room so she could say goodbye to her husband and children before she died. It was an emergency room nurse who met, assessed, and advocated for your loved one when they were dropped off – alone — with signs of a heart attack.
It is certainly easier to bemoan nurses leaving due to burnout. But, if we concede that narrative, it does little more than shift blame onto those who worked hard hours, placed themselves and their families at risk, and, as a result, faced trauma and moral injury daily.
During COVID, many nurses were able to move to other hospitals and, while they still worked hard, were appropriately compensated. How can we expect them to go back? Was the new wage only due to a moment of perceived value and need?
Caring for caregivers
Today’s healthcare crisis is not the same as a few generations ago. People are admitted to the hospital with acute conditions complicated by underlying health problems and are sent home sooner. Our healthcare system would benefit most from investing in high quality nursing care with savings realized due to people being able to manage their conditions better and to achieve their health goals.
There are five million nurses in the United States, and over 180,000 graduate every year. But new nurses are leaving the bedside after two years. We need to honestly question the narrative that there is a nursing shortage and that the nursing problem is due to burnout.
Every hospitalized person should have a registered nurse at their bedside. Every hospital should be reimbursed at a level that maintains evidence-based nurse-to-patient staffing ratios. Every nurse should be able to practice to the full extent of their education.
This is not the time to pity nurses for being burned out or shame them for standing up for positive change. Nurses need our collective outrage at the status quo and unrivaled support for meaningful healthcare reform now.