Personal Benefits and Risks for Nurses
Nurses are satisfied to successfully help other people with their problems. Nurses have the opportunity to change another's life for the better. Nurses work with people, as opposed to working with papers, machines or merchandise. The breadth of the field allows for job changes over time. Many positions are available with part time and flexible schedules to accommodate family responsibilities. Nursing knowledge is valuable for one's personal and family health.
Education below the bachelor's level is offered for nurses, yet a person with lower level education will have a limited career path and limited income. A separate license is needed for each state. The license application process can be very lengthy and take up to several months. Some states require fingerprints and a criminal background investigation.
Compensation for nurses varies tremendously. Beginning compensation is relatively good but there seems to be a "ceiling" in compensation for advanced careers. Nursing is a traditionally female occupation and vestiges of a male doctor-female nurse power structure remain, though this is changing.
Due to the variety of education and positions for nurses, each nurse may need to clearly describe his/her education and skills. And hospital nursing, in particular, is very demanding with a risk of physical and emotional overload.
According to one researcher, the nursing profession as a whole has made several costly mistakes. The first mistake nurses made was to sell their services to hospitals and other institutions, rather than directly to patients, as doctors do. Because of this, nurses lost control of their working conditions. In addition, they tend to work under doctors' orders, so their autonomy is sometimes compromised. They also allied themselves with orthodox medicine, which tends to promote symptom suppression through pharmaceuticals, as opposed to other kinds of interventions. Because of these decisions, nursing may have remained more static and less dynamic than other medical professions.
Professional nurses face challenges in many arenas related to their historical position in the healthcare team. The position of a professional is one of authority within a defined body of knowledge. In contrast to self-employed professionals such as physicians and others, over the years, nurses have commonly worked as employees of hospitals, physicians, health departments or other agencies. Furthermore, the body of knowledge unique to nursing has only recently begun to be defined through research. Handicapped by its history of being a woman's profession, nursing is just now coming into its own as an independent and respected profession.
A large challenge related to nursing's history is the low income ceiling for nurses. While many people are attracted to the profession by relatively high starting income, financial pressures within the healthcare industry, as well as the continued predominant position of nurses as employees, limits nurses' salary range. It is hoped that increasing the data on patient outcomes and high quality care that are related to nursing interventions will turn the tide on this issue. In addition, the rise of the Doctor of Nursing Practice may benefit nurses' incomes.
An additional challenge is the lack of public financial support for nursing education. Nursing educators commonly have lower incomes than their graduates! Consequently, there is a shortage of qualified nursing faculty. Many times the demands of teaching, academic service and research preclude nurse faculty practice and the additional income it brings to professional schools such as medicine and dentistry. In contrast to expensive medical education, about half of which is funded by tax dollars, public financing for much less expensive registered nurse and nurse practitioner education is quite limited. Yet, currently we have a surplus of physicians and a shortage of nurses in the U.S. A comprehensive evaluation of either nursing or medical education has not taken place since the Flexner report (for medical education) and the Goldmark report (for nursing education) in the early 1900s. Due to strong legislative lobby efforts by the American Medical Association (AMA), this imbalance in public funding is not likely to change in the near future without a strong public outcry.
Most RNs work in comfortable institutional settings. Some nurses travel to patients' homes, schools, community centers, and other sites. Many RN positions entail considerable walking, standing and other physical exertion. According to the Occupational Safety and Health Administration, the primary hazard in patient care is blood borne pathogens, such as hepatitis B and HIV. Nurses are also exposed to a variety of other infectious diseases. RNs must observe standards and guidelines to protect themselves against disease and related dangers in the health care environment, such as risks from radiation, accidental needle sticks, contaminated splashes, chemicals used for sterilization and medications. RNs are vulnerable to back injury from lifting and moving patients, electrical shocks from a variety of equipment, and fire and inhalation hazards from compressed gases such as oxygen and anesthesia.
RNs are subject to emotional strain from work with suffering patients and families as well as from strenuous job demands. For example, RNs may work with severely injured, mentally ill, and permanently debilitated patients and consequently, will see families come to grips with bad news. RNs may work with dying patients of all ages. In addition, even when they may be working overtime and caring for a number of other patients, RNs are responsible for accurate assessments and treatments and for timely communication of key information to physicians and other responsible providers.
National RN turnover is high; it is estimated at 15 percent. The physical demands of the work, including patient lifting, walking long corridors and standing, high patient care loads, and long, rotating shift work schedules, may cause older, experienced nurses to leave the workforce. In the past, the frequency of lack of recognition and advancement over a career and the often slow increase in fair compensation for valuable years of experience (as described above in challenges) has discouraged nurses from hospital work. However, this opens opportunities for new graduates and RNs who are willing to take on hospital shifts outside the usual Monday-Friday, 9-5 pattern. These positions may be particularly available in high turnover areas, such as critical care units, emergency departments, and operating rooms. Also, RNs have myriad work opportunities beyond the hospital. Jobs beyond the hospital include home care, public health, teaching, research and the like. A national survey of RNs done by the Bureau of Health Professions found that, of currently employed nurses, about 78 percent were satisfied (about 27 percent were estimated to be extremely satisfied with their principal nursing position and 50.5 percent moderately satisfied). Only13.8 percent of nurses employed in nursing were dissatisfied. Research has shown that nurses are more satisfied when they have a voice in hospital governance. About 14 percent of RNs were not working in nursing in 2004; 42.7 percent left for unspecified reasons connected with the workplace.
Salaries and benefits
The median annual earnings of registered nurses in the U.S. were $52,330 in May 2004, according to the US. Department of Labor. The middle 50 percent earned between $43,370 and $63,360. Most nursing positions offer standard benefits like health and life insurance, and many employers offer flexible work schedules, child care, educational benefits and bonuses. About one in four RNs work part time.
Nursing provides unique opportunities for all ages, genders, ethnicities, and languages. In 2004, about 27 percent of registered nurses in the U.S. were under the age of 40. The largest group is between ages 40 and 54. Nursing has traditionally been regarded as a women's profession; in 2004, 5.7 percent of registered nurses were male, but that is changing as salaries rise. There is still a gap between the growing ethnic diversity in the U.S. overall and that within nursing. It is likely that weaknesses in public education at the elementary and secondary levels have contributed to this gap (IOM). In 2004, 88.4 percent of RNs were White, non-Hispanic, according to the U.S. Department of Health and Human Services. Because of the especially rapid increase in the immigrant population, nurses who speak English plus a second language are in tremendous demand.