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Nursing proved to be one of the most in demand labor in the United States. Numerous factors influence the supply and demand of nurse’s position. On the labor market, nursing pay and salaries are determined through many factors. Many states have taken steps to increase the supply of nurses. Nowadays, nurses are needed in almost every state throughout the country. Nursing profession is known to lead to high level of stress. To increase the supply of nurses, more nurses need to be trained. The best way to accomplish this is to have more teachers, but it is difficult to convince nurses to teach instead of work in a hospital due to the salary differences. Nursing teacher make approximately $41,000 annually compared to $42,000 of a nursing graduate just out of school. There is a shortage of nurses throughout the world. Nursing salaries are determined by the needs and of a community, and of course, training, expertise, and experience required. ( Bergmann, 2004).
First of all, economic factors influence nursing salaries. There are 10 principles of economics. The first one is tradeoffs. As we make decisions, we make tradeoffs, which mean we choose something over something else, or we have to give up something in order to have something else. Therefore the government has to choose how much money to use in certain aspects of the country. Nowadays economic issues are more visible in health sector decision-making than ever before. The search for measures that maximize available resources has never been greater than within the present decade. A staff payroll represents 60%-70% of budgeted health service funds. In order to make nurse rewards more effective it is suggested to : improve nurses salary, provide compensation for job- related expanses, introduce promotional opportunities within the clinical areas, make available range of financial rewards such as insurance benefits. Different clinics try to employ new stuff promising various benefits.
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The factors which influence the earning in the nursing field can be based on two concepts: people face trade –offs and government can affect the market in the positive way. The trade-offs in nursing are definite, because there is very little chance of wage increase. There is only a $3.87 per hour or 14% increase between median pay wages for nurses with one and twenty-one years in service (PayScale, 2009).
It should be mentioned, that nurses represent the largest category of health workers and provide 80% of direct patient care. Their contribution to the provision of services cannot be overestimated. That’s why nurses expect to be paid properly for the labor. Another factor that influences on nursing labor market is government. The positive affect can be seen in the government action to improve the nursing shortage by offering federal incentives to enter the field. The most important factors impacting a nurse's wage are the number of years the professional has been working in the field, tenure at the employer, and, as in many fields, location. Though the average salary remains around $30 an hour nationwide, the median between metropolitans can vary by as much as $10 an hour or $20,000 annually.
The area also influences on wages’ rates, because factors like population, demographics, and availability of health care affect the supply and demand of qualified nurses. There are several other factors which should be blamed for the nursing shortage. Nurses often do not practice because of job dissatisfaction. That is the reason why less people are entering the field. There are only few nurses who posses the necessary degree to teach college nurse programs. Students entering the profession would want to know that they are guaranteed fair pay for their commitment. Though the demand is huge and the supply is more than lacking, the value is not seemingly increasing. This can be explained by the monopoly that privatized healthcare has on nurses.
There was agreement that incentives must come from within the nurses' value systems. Financial incentives, as a category of economic incentives, were mentioned most frequently although investments in improving working conditions and rewards in kind were suggested as more meaningful for nurses. As a general principle, it was agreed that direct and indirect economic incentives should exist at comparable levels with other professions.( Antrobus, 1997). In general, performance-related pay was believed to be inappropriate for nurses and great concern was voiced as to the criteria used for determining success.
It is clear from the statistics that hospitals need more registered nurses. New nursing positions have to open to supply medical care with new forces as well as to replace nurses who retire. Hospital administrators are concerned about a nurse shortage, some are even declaring a crisis in nurse staffing. Nurses are worried about the impact of understaffing on the quality of patient care. In general, wage growth is so concentrated in the early years of a nurse’s career that earnings after twenty years in the profession are only one percent to three percent higher than those of nurses with only five years of experience. Nurses with starting salaries of $35,000 reach an earning up to $47,000 and have more room for earning growth. Extra education should also improve worker’s wages. Nurses trained in diploma programs earn more than those with a bachelor’s degree.
According to statistics, health care jobs are one of the riskiest. Hospitals have the highest rates of injury and illness of all industries. Nurses are vulnerable to all sorts of allergies like latex allergy, physical assault, blood-borne pathogens, and pollution from surgical waste. Workers such as nurses who are exposed to greater risks on the job, should be paid properly for the risk associated with their occupation.( Levine, 2001)
Many factors have a negative influence on supply and demand. Employers may offer too low wage, so they are not able to hire enough workers. Workers may have gotten the wrong kind of training, so they are not qualified enough to accept jobs that employers suggest. As far as nurses are primarily women, the mere fact that women are the main holders of the job leads to their pay being usually low. (Levine, 2001). Despite the fact, that nurse’s wages were not changing, in the last few years nurse wages begun to rise. Even though the wage issue was neglected, it is proved that wage plays a critical role in the labor supply. Analysis of recent wages and nurse employment shows that wage increases are accompanied by significant increases in employment as well as growth in enrollment in training programs. This is evidence that hospitals can effectively address problems they have in attracting qualified nurse personnel by offering better wages. Currently trained nurses and new training program enrollment appear to be responsive to wage signals. Higher pay would encourage new trainees to enter the nursing profession.
It is obvious, that low pay and poor working conditions push nurses out of hospitals. The proportion of all nurses who are employed by hospitals has been decreasing during recent years. This happens because of the nurse’s dissatisfaction with working conditions in hospitals. Many nurses are able to find both higher salaries and preferable work schedules in jobs outside nursing. Mostly, those who are not working in nursing are getting higher pay.
Unions strengthen nurses’ voice in negotiating wage and compensation issues with their employers. According to recent surveys, unionization increases hospital nurses’ wage. (Bergmann, 2004). Another way to stop nurses’ shortage is through the recruiting programs. Nurse recruiters may work for an agency, for a specific hospital or clinic. They may use creative options to attract nurses. Also it is obvious, that shortage should be attacked through budget changes.
Basically, wages are higher for all nurses in cities with greater levels of unionization. The average hospital nurse wage in the least unionized cities- Salt Lake City, San Antonio, Texas, Denver, Houston is $22.85. In unionized cities as Buffalo, San Jose, New York City, San Francisco the average wage is $29.20. The difference is $6.34 an hour. Union density varies from a high of 70 percent in Hawaii to a low of 3 percent in North Carolina. The relationship between unionization and pay can be measured statistically. It shows a strong correlation between the presence of unions and overall wages of nurses. (Levine, 2001).
Higher wages and benefit programs are the keys to solving the hospital nurse shortage. Other solutions include regulation of minimum nurse wage. Analysis of the impact of nurse staffing and wages on public health care costs and patient outcomes would also support new mobilization around the impact of nurses’ employment conditions on quality of care. Training programs are necessary to produce registered nurses, but many applicants are denied access to the school because the schools are not adequately funded. Students, who are eager to become nurses, are thus denied the opportunity to pursue a career in nursing. Therefore, lack of funding of nursing schools contributes to the nursing shortage. Until this issue is taken seriously, the nursing shortage will continue.
The positive point of the nursing shortage is that those who are in the sphere are provided with long hours, nurses who are graduate from a nursing school or program are guaranteed a position in a hospital, clinic, or other institution. There is also large employment growth from two new demographic groups: younger people, particularly women in their early thirties, and men. Hospitals should agree not to engage in collusive behavior that artificially reduces nurses’ wages and to strictly adhere to U.S Department of Justice and Federal Trade Commission guidelines on information sharing. Hospitals should not set nurse wages together with other hospitals.( Antrobus, 1997).
The nursing shortage has given to registered nurses an opportunity to practice outside of the hospital. Nowadays, nurses can find jobs in family clinics and schools. Many nurses even prefer to work in the home. More nurses choose to provide their services at home, going to the patient instead of the patient coming to them. It is beneficial to join a program at a college or university and to estimate your options in deciding which way to choose in the field of nursing. The nursing shortage has opened up opportunity for people seeking to enter the field of nursing: it is travel nursing. This is a way that many nurses may choose to bring the variety to the routine. Travel nursing is absolutely different from working in the same hospital. With travel nursing, qualified nurses are able to travel to different cities and states across the country to complete their assignments. Nursing organizations that send nurses on traveling assignments offer a decent salary as well as benefits. Therefore, nurses do not have to be employed at a hospital in order to enjoy their work. Many nurses choose to pursue home healthcare, in which they provide healthcare directly to the patients. This is an option for nurses who want to work independently, and home healthcare can often be an interesting and rewarding job. Other nurses find their place in healthcare working in schools, government facilities, or public health clinics.
As a conclusion, it is important to point out, that when nurse pay remains low, as was said above, nurses change their job to more satisfying or less stressful, such as doctors’ offices. The strategies to solve the shortage, such as subsidies for nurse education and media campaigns to make nursing popular, will remain unsuccessful unless accompanied with higher wages. Increasing the number of qualified workers will not solve the problem, new nurse graduates will look for more attractive jobs with other employers.
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