Three Things All Nurses Should Know

This blog began around the compelling evidence mounting around the shortage of RN’s.  The graph below is another view the result of a National Institute of Health publication of 2004, showing the demand for nurses (green line) against the supply based upon various assumptions on increasing supply of graduates.  Still this isn’t the story, but rather the result of a story.

As I’ve been looking into this issue, I find on the net, no shortage of articles, I’ll be it sparsely published, describing the size of the problem, but few focused, as we are here, on what to do about it. One choice might be to simply ignore it.  The assumption here might be that it is simply to big a problem of multiple causes so why bother.  Another might be that some form of technology will likely come to the rescue and eventually mitigate the problem all together.  Frankly, either choice is likely as reasonable as the other because the chooser can move on and no longer bothered by the issue.  But if curiosity won’t allow that, then additional thought is required, so for a moment, consider this.  Why is it so difficult to create an RN?

I started out as a Hospital Corpsman in the Navy, a course that took about 12 weeks of training, 8 hours a day, 5 days a week.  It was legitimately challenging, and highly rewarding.  As a result of that training and subsequent hospital work, I was able to “challenge” the Licensed Vocational Nurse exam.

As a civilian I returned back to college and now able to work part time as an LVN.  Later became an RN while finishing my undergraduate degree in Economics.

I recall being struck by how little the RN training provided me in incremental education relative to the work required.  Sure, the core sciences of physics, chemistry and biology were important, but for an experienced LVN, the nursing training was remedial.  For one term I was taking calculus at the university in the morning, and nursing math (a licensing requirement) at the nursing school in the afternoon.  There was no way to take advantage of predicate, outside the nursing program training, and because I really did want to become an RN, I just sucked it up and showed up.  Still I regret the waste of time and requirements to license that produced dubious marginal value.

Having become an RN, I finished the BA in Economics, I stayed around an additional year studying the labor economics of nursing.  Here are some things I think you should know.  You may not like it, but here it is.

1. Nursing is a technical job, not a “profession”.  This doesn’t mean that nursing doesn’t have professional ethics or objectives, or is any less important or “prestigious”, just that it doesn’t posses the necessary attributes of autonomy to be classified as a classical Profession; nurses do not practice independently.   Now it’s important to get comfortable with this in order to move on in assessing nursing as a career choice. The focus on nursing as a profession avoids the real issues of compensation and competing in the market place of skilled labor.
2. Nurses have a relatively flat wage-experience curve.  This, fits with #1 and explains part of why we have so few nurses in the field.  What this means is that a nurses wage does not grow dramatically with experience and compete effectively with other labor choices.  Typically nursing wages flatten out within two to three years after receiving a license, this means that in order to accelerate earning, one has to leave. There is a lot more behind this which I hope to address at a later time.  You’ll like the story thought it might anger you at first.  Perhaps another time, remind me.
3. Caring is not enough.  I’ve heard the adds from Johnson & Johnson in support of attracting people into nursing and I applaud them for their effort and investment, but its more than caring.  If you care about me as a patient, but have no idea what your doing and as a result my condition worsens, it matters to me little that you cared. What matters is that you are aware of my condition, know what to do and can intervene if things go poorly.

As the single largest providers of healthcare in the world, nurses are valuable because what they do is valuable, necessary and effective.