Nurses Week falls on May 6-12 — commemorating the work and dedication of millions of nurses across America, and culminating on the birthday of the founder of modern nursing, Florence Nightingale.
This week I thank my colleagues, my former students, and my caregivers for their inspiration and dedication to our profession. I personally thank the nurses who have cared for me at Utah Cancer Specialists, at LDS Hospital same day and recovery units, the University Murray Ophthalmology Clinic, and the Moran Eye Center. You have given me exemplary care, you have helped me recover, and you have kept me safe. Thank you.
My care over the past three years has exclusively happened in out-patient settings. Yet most people associate nurses with hospitals. Why? Most patients go to hospitals with major health challenges. They go to hospitals for nursing care (and the coordinated care of other specialists.) This is fact. Without nurses, hospitals cease to exist as we know them today.
Yet, within the financial analysis and the hospital boardroom, nursing is considered a cost, not a revenue-generating part of the hospital. Nursing is seen as an ongoing expense. The value of nursing care is charged for as a standard rate based on the type of unit a patient stays in, or the diagnostic group or disease process that the patient falls into. If some patients on a given unit require much care and others require less care, all nursing care will essentially be averaged into a cost per room. Look at your itemized bill — do you see any charge for nursing care?
Being seen only as a cost to the bottom line and not a revenue generator, the entire nursing staff becomes a liability, not an asset. This puts nurse leaders into a position of defending the very real need for safe staffing for a patient population that has only gotten sicker over the past decades. Always defending and never able to fully promote the value of nursing. As Nightingale noted, “How very little can be done under the spirit of fear.”
Why are other specialties such as medicine, physical therapy, speech therapy, occupational therapy, radiology, and pharmacy considered to earn money for the hospital while nursing only costs money? That is the question.
With another nursing shortage looming, nurses will soon be courted again with sign-on bonuses and promises. The value of nursing care will continue to be buried in the room charge. Are we professionals or are we furniture?
Why does this all happen? Are our methods of quantifying the value of nursing so inadequate that the true value is not known? Does the finance department just take the easy way out?
What happens to staffing a unit when costs need to be controlled? The workload for the direct care nurse is increased until there is no time to do essentials of nursing: time to plan, teach, care, counsel, and answer questions from patients and their families. The workload is simply increased to offset the “cost” of the nurse — rarely decreased to reward the “revenue-generating” work of the nurse.
Instead of averaging all care on a unit, why not actually have patients and insurers pay for care received? And do add a charge for the unit’s staff nurses who are certified and educated to give that emergency care that saves your life – emergency care we all hope you will not actually need. Preparation to care has a cost.
Yet your nurses persist — for as long as they can tolerate working conditions that preclude rest breaks, lunch breaks, and sometimes bathroom breaks. (Sitting charting at a computer is not a break.) Your nurses persist because they put your safety and care above all else.
Your nurse’s value rises far above the level of the bed, lights and temperature control of your room. Your nurse is the reason you get 24/7 coordinated care that hopefully leads to the best outcome for you. So ask your hospital administrator how nurses are valued in your hospital. And thank your nurses. Thank them every one!
Kathleen Kaufman, MS, RN, is a retired nurse, full-time patient, a past president of the Utah Nurses Association and retired nurse educator.