EMPOWERING. UNITING. ADVANCING.
Summer 2018
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Equal Pay?
Exploring the gender pay gap in nursing
Myth or Truth The Story Behind the Nursing Shortage
Fair Compensation? Are school nurses truly paid what they are worth?
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EMPOWERING. UNITING. ADVANCING.
Dave Smits Mary Watts
Content & Community Director mary@allnurses.com
Gregg Knorn
Sales Director gregg@allnurses.com
Brian Sorenson
Marketing Director bsorenson@allnurses.com
C.E.O.
Julie Bollinger
Business Operations Director admin@allnurses.com
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Recruitment Marketing Director claudio@allnurses.com
Joe Velez
allnurses is published quarterly by allnurses.com, Inc., 7900 International Dr., Suite 300, Bloomington, MN 55425 All rights reserved. Reproduction in whole or part without written permission of the publisher is prohibited. The opinions of contributing writers to this publication do not necessarily reflect the views of allnurses.com, Inc. Copyright © 2018 by allnurses.com. All rights reserved. Products featured within these pages do not constitute an endorsement by allnurses.com.
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EDITORS / CONTRIBUTING WRITERS Mary Watts, BSN, RN Judi Dansizen, MSN, APRN Beth Hawkes, MSN, RN-BC Melissa Mills, MSN/MBA, RN, BSN Sarah Matacale Keith Carlson, RN, BSN, NC-BC Brian Sorenson
7900 International Drive, Suite 300 Bloomington, MN 55425 Phone: 763-260-1232 email: magazine@allnurses.com Website: allnurses.com
Keith Carlson, BSN, RN, NC-BC is a holistic career coach for nurses, award-winning nurse blogger, writer, podcaster, social media influencer, keynote speaker, author, and popular career columnist. With more than two decades of nursing experience, Keith deeply understands the issues faced by 21st-century nurses. Keith’s career coaching services include resumes and cover letters, LinkedIn optimization, networking and interview skills, career management, and shaping the individualized nursing career that’s just right for you.
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Contents Myth or Truth
Myth or Truth – The Story Behind the Nursing Shortage 24
Is it real or is it a myth? With hiring bonuses seen for numerous nursing positions, the needle seems to be tipping towards the nursing shortage being real. With all of the facts looked at, there is clarity after cutting through the clutter.
By Melissa Mills
School Nurses – Does The Story Behind Their Compensation he Nursing Shortage Match Their True Worth
14
Diverse and unique, school nurses have everchanging job responsibilities, but are they compensated fairly?
By Sarah Matacale
Exploring the Gender Pay Gap in Nursing
Equal pay is still a distant goal for many. We dig deep to 20 uncover why the gender gap still exists.
By Melissa Mills
Purchasing Power of Nurses Across America
While a six figure salary sounds nice, what can it actually buy?
36 By Mary Watts
Class of 1998
We know that nursing has changed drastically in the past 20 years but this whimsical look back will certainly have you feeling nostalgic.
46 By Melissa Mills
Departments 6 As seen on the Web 7 Nursing News Briefs 10 The Best of... 11 Calendar 12 Career Tips 32 Trending Products 34 Get Social 35 LOL 50 Expert’s Corner
Connect
From the editor
Summer is officially upon us. If you’ve been paying attention to allnurses.com, you’ve seen the release of much of our 2018 Nursing Salary Survey results but there’s always more to the story. In this issue of allnurses Magazine we have some amazing in-depth analysis of our salary survey data. With nearly 18,000 responses, this is easily the most comprehensive survey of nurses in America. We know that you’ll find the features on the much talked about nursing shortage, the gender pay gap in nursing, and an analysis of the purchasing power of nurses by writers Melissa Mills and Mary Watts to be valuable resources as you move forward in your nursing career. There are also the features you love from the first issue of allnurses Magazine including career tips from Nurse Beth, nursing news from around the country and the all new Expert’s Corner which features Keith Carlson. If you followed our #NursesTakeDC coverage earlier this year, you may recognize Keith from the Facebook Live video series he worked on with Nurse Beth. As always, we hope that you’ll enjoy this issue and look forward to the next one!
Contact us
We welcome your story ideas. Reach us at magazine@allnurses. com
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as seen On The Web Trending topics and top stories from allnurses.com
Am I Still a Nurse? “Am I still a Nurse? The question I am asked too often.” I will start by saying, “Yes I am a nurse and I have been one for 21 years”.......after that, things get more convoluted. I don’t remember ever deciding to be a nurse, it seems that I just always was on that yellow brick road. You see, I am a nurturer. A caregiver. A quick thinker. I read people’s feeling and emotions. I try to fix what seems wrong. I am an educator. Most of all, I give with all I have …
Click here to read more and comment
The Wrong Dose - A True Story of Medication Error
Safety Nurse sat down with Margo, a fantastic oncology nurse, who talked about the night she gave a patient too much insulin, and he coded. He lived, and Margo is still at the same job. The hospital where she worked supported her and included her in a Root Cause Analysis of the event. Margo is now a well-respected nurse leader at her place of work. In the interview, she opened up about how the error went down …
Click here to read more and comment
Keeping the Peace: 6 Tips for Conflict Resolution in Nursing
Conflict arises from stress. Every workplace has conflict. It should be expected. Understanding how to take conflict and turn into a positive situation, takes intention and practice. Learn these 6 tips for dealing with conflict resolution on your nursing unit.
Click here to read more and comment
Nursing News Briefs
Thousands of Miles Apart Two Nurses Save a Newborn
colorado By Mary Watts, BSN, RN When two nurses started their day, they never dreamed they would be working together to save the life of a newborn baby. Kara Muma and Madeline Anderson are both nurses from Sky Ridge Medical Center in Colorado, but on this day they were at their jobs thousands of miles apart. While Kara, a nurse practitioner, was headed into the OR, she received a phone call from Madeline who was on a medical mission trip in Africa. Madeline was calling for help with a newborn that she just helped deliver. The baby boy was in trouble and needed to be resuscitated. She tried, without success, for an hour to get the baby to breathe and knew she had to do something else. “Finally, I had the idea, I have the phone number memorized for my unit back at Sky Ridge and then we couldn’t figure out how to make a long distance call,“ she said. Trying to get through to the right person with a foreign phone number was a bit tricky. “They’re like… they got this foreign phone number we can’t just transfer
you,” Anderson said. “I’m like, ‘Trust me, I work there, I know her, you just have to transfer me,” she said. It took about an hour on the phone for Kara to walk Madeline through a series of checks, but she was finally successful in intubating the baby and placing him on an adult ventilator, which was the only thing available.
saved his life) left the hospital with his mother. Anderson was so moved by what she saw on her trip she started a nonprofit to help get basic supplies to mothers in Kenya. If you are interested in helping, you can visit their website using this link: Mamapacksforkenya.org
A few days later the baby boy (named Madeline after the nurse who
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Nursing News Briefs
90-Day Implantable Continuous Glucose Monitor Approved by FDA united states By Mary Watts, BSN, RN A new device approved by the FDA will be much welcomed by the diabetic population. The Eversense implantable continuous glucose monitor (CGM) made by Senseonics, can remain in place for up to 3 months, far exceeding the 3-10 day wear time for most other CGMs. The small device with a fluorescent-based glucose sensor which is about the size of a
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headphone connector, is implanted in the patient’s upper arm. The sensor can detect glucose levels by LED light and a membrane that absorbs glucose. Glucose levels are measured by how much of the LED light passes through the membrane. The sensor will vibrate to give an alarm for low levels.
app on your phone. The information can then be sent to your health care provider.
The sensor receives power wirelessly from a small transmitter taped to the patent’s skin. The sensor collects and sends glucose readings to your transmitter which transfers them via Bluetooth to an iOS or Android
This device is intended for use by adults with type 1 or 2 diabetes in conjunction with traditional self blood glucose monitoring.
The app shows your current glucose reading and whether you are trending up or down. It also allows you to track when you eat, take insulin, or exercise.
Read more...
news wrap-up Gummy Candies With Sensors! What’s Next?? Researchers Just Printed Sensors Onto Gummy Candies By Mary Watts, BSN, RN
What do you think about swallowing a sensor that can monitor electrical signals in the brain or heart? What if the sensor was surrounded by something sweet and chewy? A team of researchers at the Technical University of Munich developed a method to inkjet print sensors on Gummy Bears. These printed microelectrode arrays can detect voltage changes that result from neuron and muscle cell activity. “In the future, similar soft structures could, for example, monitor nerve or heart function in the body or even serve as pacemakers,” says
“It’s very taxing, and sometimes they just need to go home and just recover”
Prof. Wolfrum, one of the research team members. Talk about thinking outside the box! Now there is even more reason for adults and children alike to love their Gummy Bears. They can provide healthy benefits after all!
Preemie Webcams Allow Families to Keep an Eye on Their Wee Little Ones Remotely
New parents and family members run themselves ragged trying to be at the hospital as much as they can so they can be with their precious pre-
mature baby. This can be a long and challenging time. Hospitals across the country are upgrading their NICUs by using webcams for each wee little patient, allowing parents, grandparents, friends to still keep an eye on their precious baby from home or anywhere in the world with a password. The NICU at St. Thomas Midtown in Nashville, Tennessee is the latest hospital to utilize the webcams. Sherri Anderson, a veteran nurse at St. Thomas said, “The parents go through a lot - emotionally, spiritually, physically. It’s very taxing, and sometimes they just need to go home and just recover.” This new webcam wave has provided peace of mind for the parents and reduction of germs that might be passed on to the baby by visitors.
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The Best of allnurses.com Highlights of some of the best comments made by allnurses.com members.
In response to a poster who questioned why he/she wasn’t teary when witnessing his/her first death vintage_RN
There is nothing wrong with you. As long as you can provide compassionate care and don’t feel indifferent toward the situation, this is actually a good quality to have … Life is not life without death and suffering.
The question is, “Can nurses live a luxurious life?”
You can project an image of living luxuriously if you want to work 80 hour weeks and max out your credit cards. Freedom is luxury, to me. I have to work very little to maintain my modest lifestyle. Sour Lemon
This is an answer to a first-year night nurse who says, “I’m so tired all the time, all I want to do on my few and far between days off is sleep. I feel so alone.” not.done.yet
As an aside, it has been my personal experience that the more you yearn for and chase “love”, the more elusive it is. Use this time to really get to know yourself and enjoy being single. Romance yourself. You will be happier - Happy women are confident and confidence is sexy.
Advice to a new nurse with school loans to pay
Wuzzie
Stay at home for 1-2 years. Work OT if possible. Pay your nice parents some sort of rent even it it’s just a token. Throw as much money as possible into paying off the student loans. Remainder of money goes into savings. Do not go on spending sprees ...
Advice to the newly graduated nurse
hppygr8ful
10 Summer 2018
Own your mistakes. The News Flash here is that you will not be the first nurse (New or Old) who is going to make mistakes. As long as your mistake doesn’t kill someone take it as a learning experience. Own it and don’t make excuses. Learn what happened and why, make necessary corrections to your practice and move on.
allnurses
Calendar of Events A brief and informative overview of events, conferences and special promotions for the nursing community.
National Black Nurses Association Institute and Conference 2018 Association for Nursing Professional Development Conference Lake Buena Vista, FL
This convention is for nursing professionals who wish to advance their continuing education offerings at their facilities. With over 19.5 hours of CEUs, this promises to be both useful as well as enlightening to nursing educators and managers. Come and join with other nurses who wish to expand their ability to reach staff July 17-20 in Lake Buena Vista, FL JULY
17
National Association of Hispanic Nurses Conference Cleveland, OH
With many varied topics, including nursing diversity, health care equity and immigration, this conference offers much for the Hispanic nurse. In addition, there will be sessions about leadership, furthering NAHN membership, and disaster relief in predominantly Spanish-speaking cities. Join with other Hispanic nurses July 30 thru August 3 in Cleveland, OH. JULY
30
St. Louis, MO
Join NBNA for this year’s theme of the Art and Science of Nursing. Earn up to 35 hours of CEUs while learning about advancing your education, developing a mentorship and many other interesting topics. Deepen your knowledge of professional development and broaden your professional network July 31 thru August 5 in St. Louis, MO. JULY
31
5th World Congress on Nursing London, England
This conference will identify ways nurses are revolutionizing health and constructing a better care delivery system There will be exhibits highlighting the work nurses are undertaking to drive policy changes that meets the health needs of patients. Join other nurses August 1518 in London, England. AUG.
15
11th Annual Advanced Practice Provider (APRN & PA) Leadership Summit Atlanta, GA
Join your fellow advanced practice provider leaders in a multi-day conference where you can hone your leadership skills. This conference offers a total of 24.2 CME hours. Sponsored by the Advanced Practice Provider Executives, covered topics will include novel strategies to further advanced practice in your organization September 12-15 in Atlanta, GA. SEPT.
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Career Tips
You have three seconds to get an employer’s attention
by Beth Hawkes MSN, RN-BC, HACP
Beth Hawkes (Nurse Beth) is an accomplished nurse working in Acute Care as a Staff Development Professional Specialist. She is also an accomplished author, blogger and columnist. As Nurse Beth, she regularly answers career-related questions at allnurses.com.
Dear Nurse Beth, I have a resume question! I’ve been a stay at home Mom (SAHM) for the past 3 years and am updating my resume to head back to work. My previous experience was in Critical Care in Hospital settings. Most recent, PACU, then Interventional radiology, and before that a few years as a travel ICU nurse. I’d like to make a change and hopefully work in a doctor’s office. My question is this, how in-depth do I need to go into each travel assignment? I’d planned to consolidate my travel nurse experience into one entry and then list each hospital and length of contract under that. All my travel assignments were in the ICU, so there’s a lot of overlap in experience. Considering I’m not looking to continue in a hospital setting, would this approach be okay?
Click here to submit your career-related question to Nurse Beth today or visit https://allnurses.wufoo.com/ forms/z1j8p9o81puszdb/
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Dear Updating Resume, Your instincts are correct, the description of your travel assignments should be brief and not in depth. A winning resume should catch the reader’s attention in a few short seconds. It has plenty of white space and includes bullet points for readability. A well written resume is captivating, and avoids clichés and overused phrases such as “highly-motivated team player”. To construct a resume for a doctor’s office, try to think like the hiring office manager. What is important? What are they looking for? Read the job description for keywords and use them in your resume. For example, they may be looking for someone with delegation skills who can coordinate care. If so, highlight how you delegated tasks to non-licensed personnel and coordinated patient-centered care.
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Many skills used in critical care are not transferable to a doctor’s office. They are not looking for someone who can manage balloon pumps or calibrate art lines, so instead identify skills they are looking for. This will depend on the services offered as well as your role. You may be hired to triage patients, provide patient education, or manage other workers. All employers need employees with customer service skills, and you undoubtedly have those. Emphasize those skills and include examples, for instance, if you were ever Employee of the Month. Find out what EHR they use (Epic, Cerner) and speak to your ability to your computer skills. If you’ve ever had AIDET training or other Studer training, it should be included. It might be important that you are ACLS certified in case of a code (Depends on the office. Are they doing any procedures?). In a nutshell, put yourself in the reader’s shoes and compose your resume accordingly. Good luck to you! Best wishes, Nurse Beth Author, “Your Last Nursing Class: How to Land Your First Nursing Job”...and your next!
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written by
Nurse Beth
Summer 2018
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School Nurses Does Their Compensation Match Their True Worth? by Sarah Matacale RN, BSN,CCS I have been a nurse for over 20 years specializing in cardiac critical care and hospice. After I lost a large percent of my hearing a few years ago, I regrouped and refocused on new career goals. I went back to school to become a clinical documentation specialist and have been diving head first into charts ever since. I found that I was longing for a way to still reach people, so writing became an outlet. I love writing about things close to my heart. Nursing is part of who I am and I am blessed to still share some of that with others!
S
chool nurses have always been one of the most diverse and unique sub specialties in nursing throughout the decades. While the specific job responsibilities and pay may have changed some, the mission and purpose of the job remains constant. The National Association of School Nurses defines school nursing as “ a specialized practice of nursing, that protects and promotes student health, facilitates optimal development, and advances the academic success” of its population. First and foremost I want to stress the many areas in which school nurses serve the community, the vital roles they play with our youth today, and challenges that come with those roles. As we dive into the 2018 allnurses.com salary survey results we can see trends in the field of school nursing such as salary comparisons, full or part-time hours, years of experience etc. Are school nurses compensated for their responsibilities appropriately? I will let you decide. Let me start by saying that I am not a school nurse. I am a nurse that has worn many hats in my 20+ year career, but school nursing is not one of them. I will say however, that I have ALWAYS wanted to be a school nurse. As a child they were the nurses that I had the most exposure to on a daily basis. They seemed to always play a huge role in the schools day-to-day function. I was awed by what school nurses knew, the fact that they teach AND practice medicine to hundreds of students, staff and visitors. They were so
“I have ALWAYS wanted to be a school nurse. As a child they were the nurses that I had the most exposure to on a daily basis.”
x2
organized, knew who to call and when and what was a true emergency. At the end of the day, they knew that sometimes we just needed a hug, a listening ear, and some TLC. I decided to be a nurse because of my school nurses. After nursing school, it was apparent that I needed to get experience before applying to work as a school nurse. So I did. When the “right time” in my career came to jump in, I realized that school nurses love what they do! They don’t leave their jobs, until they retire and I can can’t say I blame them. So my career and calling as a nurse went in different directions. Then, my admiration for school nurses was taken to a new level when I became a mother to three little hooligans, who, despite my best efforts grew up and started school.
2+2=4
I was about as much of a wreck as any other mom on our first child’s first day of school. He is still to this day, at 12 years old, our clumsiest child, peanut allergy laden, and asthmatic. This added to my anxiety in sending him to school, epipen and all. No joke, on the FIRST day of school, I got a call from his teacher to tell me that my son had walked into a wall and had a large goose egg on his head. I was then asked by the teacher what did I want her to do with him. What? I said...well, if you think he needs attention, send him to the school nurse. That’s when I found out that, in our school district, a school nurse visits each school only one day a week and serves up to 4 or 5 schools! During that day, the nurse’s job consists of managing paperwork and teaching teachers how to give kids their medicine’s, perform CPR, manage seizures, anaphylaxis etc., until emergency personnel arrive. SAY WHAT??!!
abc
a+b a2 –
b2 =
(a –
b)(a
+ b)
Since that day, I have become school nurse advocate extraordinaire. I believe in my Summer 2018
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2+3=5
heart of hearts that school nurses serve as one of the most important members in our community. Their job is so broad, ever changing, and wide reaching, that it cannot be compared fairly to any other in the field of nursing. They work as health educators and medical and mental healthcare professionals. One would think that school nurses would be one of the most valued members of a school system and the community as a whole, which would then lead to appropriate compensation, respect and funding. Boy, was I wrong…..
Tan Cos
I was shocked with several statistics that I discovered in writing this article, but this is one of the most profound to me. According to the Centers for Disease Control 2017, 18% of schools have NO school nurse at all or serve in a part-time capacity, and over 55% of schools have nurses responsible for 2 or more schools at a time! As parents, we send our kids to school entrusting that they will be in a safe, cared for environment. If, in the worst case scenario, they need medical attention for a chronic illness or an emergency such as injury or life threatening condition that the school would be staffed to handle the situation. Obviously this is not true for many of us. How are teachers and school administrators expected to care for these needs? Teachers are educated in teaching. Administrators are educated in administration and education. Nurses are educated in healthcare, health education and medicine. Simply put, teachers and administrators are not nurses and should not be responsible or accountable for that role.
+y
=1 1x1 =2 1x2 3 = 1x3 4 = 1x4
s
Celciu
According to the U.S Health Resources and Services Administration (2016), over 20% of students that are enrolled in school, enter 90 with a chronic health condition. Such chronic diseases as diabetes (with complicated glucose management systems), seizures, asthma , and
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of course allergies, (the dreaded food allergies included) are just a few examples off hand. School nurses are able to trend patterns seen with these conditions and can play a major role in student’s disease management through collaboration with pediatricians, specialists, parents, pharmacies, and community health staff. They can safely administer prescribed medication and assess and intervene if necessary. When/ if an emergency arises, they can communicate effectively with other medical personnel and start care immediately which can be crucial in many situations.
18% of schools have NO school ll a t a e s r u n
Let’s talk mental health in children. Many mental health disorders are not “officially” diagnosed until children are school aged or older based on patterns in behavior, grades and social situational responses. Collaboration with teachers, school nurses, pediatricians and mental professionals is pivotal it providing quality outcomes for these kids. School nurses participate, initiate and intervene in the treatment and management of ADD, depression, bullying, suicidal behaviors and autism, just to name a few, common mental health issues seen in schools today. Roughly one-third of visits to the school nurses are mental health related. School nurses get to know the children and family situations they serve. From a community health perspective,
The majority of school nurses do keep their summers off to vacation or spend time with families
think of the impact they have on children who may be abused, neglected, malnourished or lack adequate healthcare. Early intervention can prevent further mental health crisis down the road. Nurses are trained in the management of factors that come with mainstreaming children with mental health disorders. This is one area of education that is ever changing and can be very challenging for teachers and staff. Education is a key job responsibility for school nurses. They educate staff regarding health care issues of students and other staff. They participate in producing policies and procedures for environmental safety emergencies both outside and inside the school building. They educate students about maintaining their own health and wellness, diseases, social pressures, mental health, and community health concerns. They educate parents and caregivers on issues affecting their children such as diseases, immunizations, and concerns noted by school staff. This of course, is just a broad overview of some of the vital roles school nurses play in
schools and the community at large. With x the amount of responsibility placed on these nurses and the number of “patients” they serve each day, lets venture into some of the statistics from 2018 allnurses.com survey such as salary versus hourly 2+2=4 pay rates per state/ regions, number of years as a nurse and years of experience in current job title (school nursing). 2
99% of school e nurses ar womenabc
OK...shocking statistic #2 to me….according to results from the 2018 allnurses Salary Survey, the average pay for a full-time school nurse is only $37,164 for hourly employees, and $51,043 for salaried employees. The hourly pay per year feels very low to me given the responsibilities of a school nurse at large.
a+b a2 –
Summer 2018
b2 =
allnurses
(a –
b)(a
+ b)
17
2+3=5 Keep in mind with the next set of values, that for some states only a handful (sometimes only 1), school nurse answered the survey representing their respective state. Some of the highest paid school nurses reside in the states along the west coast and north east coast. For example New Jersey hourly paid school nurses make an average salary of $50K per year and salaried nurses make an annual salary of $67K per year. The Texas nurses that responded to the survey were all annual salary based and average $50K per year. This is a sharp comparison to Montana (who only had 1 nurse take the salary survey) making $20K as an annual hourly salary and Georgia with a few more responders making an average hourly salary of $25K per year and annual salary of $15K per year! This made my brain spin and my stomach upset!
Tan Cos
+y
I began to think about how much experience school nurses have and whether this plays into the average pay rates. As I suspected most of the respondents have 5 to 35+ years of career long nursing experience. As far as number of years in their current job, those numbers were pretty evenly spread over the span of less than one year to more than 10 years. I wonder whether this number spoke more to years as a career school nurse or years in their present job as a school nurse. Of the school nurses that responded, 99% were women. I further polled the allnurses’ school nurses and asked about whether they work 90 year round or have the summers off. The majority of school nurses do keep their summers off to vacation or spend time with families etc.
ge The avera fulla r o f y a p ol time scho nly nurse is o $37,164
=1 1x1 =2 1x2 3 = 1x3 4 = 1x4
s
Celciu
“As our nation’s healthcare needs evolve and change over time, we have a responsibility to provide a voice for those without one” Some work part time at their schools and other work in the hospital or as camp nurses during the summer. In wrapping this up, I have come full circle to where I began with how much I love school nurses. I admire them now more than ever, knowing how much they balance and the grand scope of their practice. I am grateful beyond words for the people who watch over our children as though they are their own. Those who put bandages on our children’s wounds both internal and external. Those who watch, listen and truly hear our children and their needs. Those who advocate for our kids individually, school wide, statewide, and nationally. School nurses are vital to our children and community’s health and welfare. So do we compensate them fairly based on those roles and responsibilities? For those states and counties where schools either don’t have nurses or have them part-time or less, we need to look for creative ways to fund full time nurses in our schools. We need to advocate and speak up for our children. As our nation’s healthcare needs evolve and change over time, we have a responsibility to provide a voice for those without one ... just as school nurses have done for our children for decades! As a side note, there are so many more aspects to the discussion of school nursing as a career in terms of roles, challenges, more pertain thought provoking questions regarding number of hours worked per day, degrees most commonly held, whether CNAs or LPNs can fill some of the gaps, continuing education requirements etc.
Have something to say? Click here to comment! 18 Summer 2018
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Exploring the Gender Pay Gap in Nursing by Beth Hawkes MSN, RN-BC, HACP
Beth Hawkes (Nurse Beth) is accomplished nurse working in Acute Care as a Staff Development Professional Specialist. She is also an accomplished author, blogger at nursecode. com and columnist. As Nurse Beth, she regularly answers career-related questions at allnurses.com.
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By Melissa Mills
T
he United States government passed the Equal Pay Act in 1963, yet American women in all industries continue to make less than men (Sheth, Gal, & Gould, 2018). According to the Institute for Women’s Policy Research, if the change in pay continues at the same rate of growth between 1959 to 2015, the overall wage gap won’t close until 2059 (2017). Does this hold true in nursing?
While $3000 may not be that impressive of a number, when you consider this difference over the lifetime of a career, it adds up. If a female nurse works a total of thirty years, they will lose approximately $90,000. This does not include any cost of living raises that may occur.
While the number of men in nursing remains low, we have seen growth in recent years. Our 2018 All Nurses Salary Survey was comprised of 5.78% male respondents. The U.S Census Bureau released a study in 2013 reporting that there was a total of 3.5 million nurses in 2011. Females made up 3.2 million of these employed nurses, leaving only 330,000 men in the profession (U.S. Census Bureau, 2013).
Education
Here are a few things you should know about the numbers and factors that contribute to the current salary gender gap seen in nursing.
The Numbers
Our survey revealed similar differences between male and female nurses with every license and degree type. What’s behind these disparities? Let’s explore: Men have been going to college in larger numbers compared to women for years. According to Statista, in 1940 only 3.8% of women went to college, compared to 6.2% of men. Today, these numbers have grown considerably. As of 2017, there were more women with a college education compared to men in general, with 34.6% of women completing a four-year college degree compared to 33.7% of men (Statista, 2018). If more women are enrolling in college than men, what could account for the difference?
According to our 2018 Salary Survey, the average pay for male nurses with a BSN is $36.70 per hour, while female nurses with the same degree make an average of $35.20 per hour. This is a difference of $1.50 per hour, which equates to an annual difference of $3,120 for a full-time nurse working 40 hours per week.
Education Level
53.64%
of Male Nurses have a BSN degree
Hourly Wage Male Nurses with a BSN
$36.70 per hour
45.18% of Female Nurses have a BSN degree
Female Nurses with a BSN
$35.20 per hour
Our survey showed that 53.64% of male nurses hold a bachelor’s degree compared to 45.18% of females. When you move up to advanced degrees, the difference remains. A total of 8.1% of men reported having completed an MSN, while 7.9% of females completed the same degree.
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While there is a small disparity among education, it does not appear that there is a significant difference between the levels of education of male and female nurses.
Specialty
Our survey results showed that men and women work
Men are more likely to initiate salary negotiation conversations than women
in different areas of nursing. The top three specialties for male nurses include emergency departments, med-surg, and cardiac units. Women’s top three units were med-surg, geriatrics/long-term care, and emergency departments.
The Glass Escalator A phenomenon coined the glass
escalator, or glass elevator, which refers to the precipitous promotion of men over women into management positions in female-dominated fields such as nursing, education, social work, and even ballet. One of the most prominent reasons for this phenomenon’s existence in nursing is due to career interruptions which women may experience when caring for family.
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Could this be powering the salary gap? A recent study by Advance Healthcare Network (2018) indicates that being certified in a nursing specialty could increase your annual salary by as much as 23%. Many specialty areas offer higher base salaries as well, providing a more substantial earning potential. If men work in these more highly-specialized fields of nursing and have a certification, this could account for some of the pay disparities seen in our annual survey.
Social Factors
Social factors affecting career decisions have been different for men and women for many years. Non-work-related traits like gender, race, or ethnicity affect access to workplace opportunities that creates advantages for some, while denying these advantages to others (Bishu, Alkadry. 2017). A 2016 article by Stephanie Stephens on healthcarecareers. com revealed that while men make more than women, their satisfaction with salaries was equal at 44%. What social factors influence the gender pay gap and salary satisfaction?
Negotiation
One social factor found in many studies is simple - men are more likely to engage in salary negotiations than women (Leibbrandt & List, 2014). One study found men were more likely to initiate negotiation conversations than women when no explicit statement was listed on the job description that the salary was negotiable. (Leibbrandt, List, 2014). However, if the job description stated that the wages were negotiable, the likelihood of negotiations was equal (21.2% of women and 21.4% of men). What does this mean? The main finding of this study is that explicitly stating that salaries are negotiable closes the gender gap in job applications (Leibrandt, List, 2014).
Career interruptions
A 2015 study published by Pew Research Center shows that 42% of women have reduced their hours to care for a child or family member, compared to 28% of men. Another staggering statistic revealed that 27% of women have quit a job to care for children or other family members, while only 10% of men reported doing the same. Women have long been the head of the household when it comes to children and care of the elderly or sick. Could this be decreasing the earning potential of female nurses? If a female nurse experiences a career interruption it will impact her overall wage potential as she works towards retirement. While society’s idea of men who stay home with children has changed, it is still a role primarily held by women.
Glass Escalator
even started flooding the male-dominated corporate world (Goudreau, 2012). However, there have been reports that women have hit the “glass ceiling” or an invisible barrier that keeps them from entering into senior-level management positions (Goudreau, 2012). Today, in female-dominated industries like teaching and nursing, women are met with a glass escalator. While women climb the ladder, it appears that men are riding an invisible escalator, straight to the top, taking senior level nursing positions (Goudreau, 2012). Goudreau explains that men tend to be promoted at a faster rate than women in female-dominated professions. Why would there be glass escalator in nursing? One answer is related to career interruptions that women may experience when caring for family. But, if men can rise to higher level position in nursing quickly and make more money, why have we not seen a rapid increase in the number of men in the field? Consider pop culture references of men in nursing. TV shows and movies like Meet the Parents provide poor representation of the importance of male nurses. When will the social stigma end?
Final Thoughts
Do male nurses indeed make more than female nurses? It appears that the simple answer is yes. However, there are many workplace and social factors to keep in mind when comparing the bottom line of nursing salaries.
Have something to say? Click here to comment!
A 2012 Forbes article describes the difficult history of women’s success in the workforce. Once a closed door for all careers, women now work in most industries and have Resources: Sheth, S., Gal, S., Gould, S. (2018). Business Insider. Retrieved from: http://www.businessinsider.com/gender-wage-pay-gap-charts-2017-3 U.S. Department of Employment Opportunity Commission. The Equal Pay Act Of 1963. Retrieved from: https://www.eeoc.gov/laws/statutes/epa.cfm Anderson, J., Milli, J., Kruvelis, M. (2017). Projected Year the Wage Gap will Close by State. Institute for Women’s Policy Research. Retrieved from: https://iwpr.org/publications/projected-year-wage-gap-will-close-state/ United States Census Bureau. (2013). Male Nurses Becoming More Commonplace, Census Bureau Reports. Retrieved from: https://www.eeoc.gov/laws/statutes/epa.cfm Statistia. (2108). Percentage of the U.S. Population who have completed four years of college or more from 1940 to 2017, by gender. Retrieved from: https://www.statista.com/statistics/184272/educational-attainment-of-college-diploma-or-higher-by-gender/ Stephens, S. (2016) Healthcare Gender Pay Gap Still Significant. HealtheCareers. Retrieved from: https://www.healthecareers.com/article/salary/gender-pay-gap-healthcare Bishu, S., Alkadry, M. (2017). A Systematic Review of the Gender Pay Gap and Factors that Predict It. Sage Journals. Retrieved from: http://journals.sagepub.com/doi/pdf/10.1177/0095399716636928 Goudreau, J. (2012). A New Obstacle for Professional Women: The Glass Escalator. Retrieved from: https://www.forbes.com/sites/jennagoudreau/2012/05/21/a-new-obstacle-for-professional-women-the-glass-escalator/#82e296b159d6 Senior, R. (2018). Nurses Salary by Specialty Certification. Advanced Healthcare Network. Retrieved from: http://nursing.advanceweb.com/nurse-salaries-by-specialty-certification/ Pew Research Center. (2015). Mothers, More than Fathers, Experience Career Interruptions. Retrieved from: http://www.pewresearch.org/fact-tank/2015/03/10/women-still-bear-heavier-load-than-men-balancing-workfamily/interruptions/ Leibbrandt, A. (2014). Do Women Avoid Salary Negotiations? Evidence from a Large Scale Natural Field Experiment. Retrieved from: http://gap.hks.harvard.edu/do-women-avoid-salary-negotiations-evidence-large-scale-natural-field-experiment
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Myth or Truth
The Story Behind the Nursing Shortage 24 Summer 2018
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By Melissa Mills
If you’ve been a nurse for any length of time, you’re likely aware of the nursing shortage predictions that span decades. On the surface, this seems like a reasonably natural occurrence to understand, right? A shortage means there is not enough and we all know how to identify a nurse. Unfortunately, It’s not that simple. Let’s explore the significant issues you must take into consideration when evaluating the nursing shortage to decide if it is a myth or the truth.
History of the shortage
In March 2000, the National Sample Survey of Registered Nurses conducted by the Division of Nursing of the U.S. Department of Health and Human Services Bureau of Health Professionals revealed several interesting facts about the future of nursing: The average age of a registered nurse increased from 42.3 to 43.3 years between 1996 and 2000 (Spratley, Johnson, Sochalski, Fritz, & Spencer, 2000). The number of licensed nurses in 2000 was nearly 2.7 million, which was a 5.4 percent increase since the last study. However, this was the lowest reported annual increase by the department since 1977 (Spratley et al., 2000) The RN population under the age of 30 dropped from 25.1 percent in 1980 to only 9.1 percent in 2000 (Spratley et al., 2000). By 2014, The U.S. Health Resources and Services Administration released “The Future of the Nursing Workforce: National and State-Level Projections, 2012-2025.” In this report, 34 states were projected to have a shortage of nurses by 2025 (U.S. Department of Health and Human Services, 2014). This would create a total deficit of 808,000 nurses across the United States for the same period (U.S. Department of Health and Human Services, 2014). While portions of the data were correct from these original studies, there have been significant changes that could not have been predicted. Let’s discuss the factors at play with the current state and future outlook of the nursing profession.
Average age of Registered Nurses increased from 42.3 to 43.3 years of age between 1996 and 2000
RN population under 30
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Factors for Consideration It’s not enough to merely accept we that are in a nursing shortage. We must strive to understand the positive and negative factors that have affected us as a profession.
Age
According to our 2018 Salary Survey results, with more than 16,800 participants, nurses between the ages of 50-59 made up the largest group of working nurses (25.12%), up form the 2017 results (21%). The next two largest groups included nurses between the ages of 30-39 years (23.7%) and ages 40-49 years (22.6%). The 2017 results for both of the last two age groups are down from the 2017 results (27%).
had baby boomers and millennials pegged incorrectly. Nurses under the age of 30 accounted for 12.72% of the nurses polled in our 2018 survey, down from 16% in the 2017 survey. The over 60 group accounted for 16% of the nurses polled. This is an increase of 7% in this age group compared to our 2017 survey results. Could the millennials fill the void the baby-boomers will leave?
Our results indicate that the majority of our nursing population is in the middle-age of life and getting older. As we look to the future, we must consider how our aging nursing workforce will keep up with the demands of the healthcare industry.
Average Age of Nurses 30% 25% 20% 15% 10% 5% 0%
50-59
30-39
40-49 Source: allnurses.com 2018 Salary Survey
While the baby boomers have continued to work longer than expected, we saw a new group take an interest in nursing as a career that no one saw coming - the millennials. As we look to the future, Generation Z is starting to choose careers and enter college. How does this impact our future?
Boomers, Millennials and Gen Z
Some of the predicted nursing shortage data
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According to an article published by Health Affairs, millennials are becoming nurses at nearly double the rate of baby boomers (Auerbach, Buerhaus, & Staiger, 2017). However, the pending retirement of the baby-boomers is upon us, with a projected decrease of 1.3 percent loss per year between 2015-2030 (Auerbach et al., 2017). While the millennials have helped fill the positions of the baby boomers, don’t hold your breath just yet. The rate of RN’s taking the licensure exam plateaued between the years of 20132016 (Gooch, 2017). So, what’s next? Should we look to the next generation - Generation Z? Yes, the nursing workforce is still in need. According to the New York Times, Gen Z outnumbers the millennials by one million (Williams, 2015). This generation is currently finishing up their high school careers and choosing college majors. This generation may be what the future of nursing needs.
Male Nurses
future of healthcare is still uncertain.
Men still hold a significantly small portion of the nursing jobs in the United States. According to the U.S. Census Bureau in 2013 the number of male registered nurses more than tripled between 1970 (2.7%) and 2011 (9.6%). The number of male licensed practical and licensed vocational nurses more than doubled from 3.9 percent to 8.1 percent for the same period.
Medicare enrollment is projected to increase by 50% over the next 15 years due to our aging population (Bradley University, 2016). More people than ever before will continue to be insured in the U.S. Forty-seven percent of healthcare workers have reported that emergency room use has increased due to more people having coverage for these services under the ACA (Bradley University, 2016).
While they hold a small portion of the total number of nurses, the trend of men entering the field of nursing has helped with the nursing shortage. They also create diversity within our profession that past generations have not seen.
The increase in patients with insurance was not factored into the original prediction for nursing shortages. The ACA continues to impact the future of nursing by creating the following:
The Affordable Care Act
The nursing shortage was in effect long before the Affordable Care Act (ACA) was passed in March 2010. Before the ACA, 48.6 million or 15.7% of Americans were uninsured (Bradley University, 2016). After the ACA, this number fell to 9.2%, which is the lowest uninsured rate in 50 years in the United States (Bradley University, 2016).
Declining Number of Uninsured Americans 15.7% 2010
9.2% 2016
This is good, right? More people are insured, which should equate to a healthier American population. Unfortunately, the
More jobs: As more people are insured, more nurses will be needed to care for patients. Previously uninsured people with long-term health conditions need education on disease processes, medications, self-management, and proper diet (Thompson, 2017). Nurse-Patient Ratio Changes: The increase of insured people in the United States could mean a higher number of admissions, creating a higher nurse-patient ratio (Thompson, 2017). An increase of patients could add strain on hospitals, clinics, and other healthcare facilities (Thompson, 2017). Higher Demand and Pay: Average pay projections for registered nurses have increased steadily since the passage of the ACA (Thompson, 2017). This is the law of supply and demand in action. As the need for nurses increases, we will have the ability to demand higher pay. Nurse Practitioners: Nursing is not the only healthcare profession experiencing a shortage. There is a projected shortage of physicians as well. One way to combat the lack of physicians is the use of Nurse Practitioners (Bradley University, 2016). Many practices employ at least one Nurse Practitioner and will likely hire more in the future.
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Nurses Leaving the Profession
As if the issues of nursing supply and demand were not enough, nursing has another problem - many nurses have plans to leave the workforce soon. According to the results of our salary survey, 35.39% of the nurses polled have plans to leave the nursing workforce within the next 15 years. But, why?
35% of Nurses Plan to Leave the Workforce in the Next 15 Years Job Dissatisfaction... Nurse-Patient Ratios... Career Change... The top two reasons, which accounted for nearly 70% of respondents, included age and retirement. This correlates well with the aging nursing workforce. However, the next three results in our survey are concerning. Job dissatisfaction was given as the reason for plans to leave the nursing profession by 7.66% of respondents. Another 4.65% reported that nurse-patient ratios were a factor influencing their decision to leave nurse. Finally, another 3.76% cited plans for career change as the reason for leaving. These three results account for 16% of those leaving the profession. What does this mean? A 2015 article on nurse. org explained that lack of ability to move to areas of need, disillusionment with the profession, a fast work pace and workplace bullying are factors that many new nurses don’t think about until they are working and find themselves dissatisfied with the profession (Dent, 2015). One study evaluated nurses intention to leave the nursing
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workforce related to “horizontal violence,”better known as workplace bullying (Armmer, 2017). This study found that newer nurses were more likely to leave the profession while more tenured nurses felt they could just find a new job in light of workplace bullying (Armmer, 2017). Nurse-patient ratio conversations have been an important topic in legislation lately. Many nurses understand the harmful effects of high nurse-patient ratios on burnout, increased risk of nursing errors and lower quality of care. One study evaluated the impact of wage, work environment, and staffing on nurse outcomes (McHugh, M. & Ma, C., 2014). McHugh and Ma (2014) found that while wage was important, interventions that improve the work environment and maintain staffing levels are more critical to attracting and retaining nurses in the workforce. For a more in-depth look at the importance of nurse-patient ratios, take a look at the spring issue of allnurses magazine. As more nurses leave the workforce due to dissatisfaction, we must each do a personal inventory of our feelings, actions, and biases against other nurses.
Nursing Faculty Shortage and Enrollment
According to the American Association of Colleges of Nursing (AACN), nursing schools across the country are struggling to expand nursing student capacity to meet the rising demand of healthcare following reform (American Association of Colleges of Nursing, 2017). The AACN (2017) projected a 3.6 percent increase in enrollment in entry-level baccalaureate programs in 2016. However, this increase will not keep up with the anticipated demand for nursing services. This touches on the need for nurses, but what about those people who educate nurses? You guessed it, another shortage. An article in Becker’s Hospital Review (2018)
reports that nursing schools rejected over 56,000 qualified applicants from undergraduate nursing programs in 2017. Many of these applicants were top of their high school graduating classes (Knowles, 2018). The article goes on to report that nursing schools are struggling to provide the clinical space and class size accommodations needed to keep up with the number of applicants and the nursing workforce needs (Knowles, 2018).
$80,164. While higher clinical nursing salaries are good, it may be keeping some nurses from considering a career as a nursing instructor. The current annual national faculty vacancy rate in nursing programs is over 7 percent today (Knowles, 2018). This equates to about two teachers per nursing school, or a shortage of 1,565 teachers across the United States (Knowles, 2018). Nursing school and faculty issues pose more concerns for the future. Even if future generations chose nursing as a profession, will nursing schools be able to keep up with the demand? How can we educate new nurses without qualified instructors? The future of our profession feels shaky.
Shortage by State
When you consider the nursing shortage, you may only look at the big picture or total number of nurses needed. Another interesting factor that must be considered is the location of the shortages. Not all states are projected to have a nurse shortage. According to Nursing@Georgetown, sixteen states will experience a nursing shortage by 2025. The most substantial nursing shortage will be seen in Arizona, followed by North Carolina and California (Nursing@Gtown). Meanwhile, states like Ohio, Pennsylvania, and New York will experience a surplus of nurses (Nursing@Gtown). While it seems like there is a logical solution to the problem, many nurses are not able to relocate to fill vacancies in other cities or states. We are left with a surplus in some areas of the country and massive shortages in others. Do hospitals and healthcare systems have a solution? Concerns over an inadequate number of nursing faculty further complicate this issue. According to the 2018 AllNurses Salary Survey, the average salary for educator is
Healthcare systems across the country are attempting to find ways to attract more nurses to their vacancies. According to a recent article on CNN Money (2018) hospital systems like
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UCHealth that operates nine acute-care hospitals in Colorado, Wyoming, and Nebraska has over 330 openings for Registered Nurses. To entice nurses to move to their locations, they have offered sign-on bonuses up to $10,000. And, that’s not all, they add on stipends for continuing education too. Other hospitals have provided sign-on bonuses, relocations bonuses, and hefty tuition reimbursement packages for employees and their children (Kavilanz, 2018). The University of West Virginia even offers free housing to nurses as part of their commuter program (Kavilanz, 2018). Bonuses and education stipends only last so long. Would higher nursing salaries make the profession more appealing? Can our current economy support wage increases across all
states? Maybe a more important question- can the healthcare industry and patients afford to not have nurses at the bedside?
The Verdict: Myth versus Truth
It seems there is enough evidence to conclude that we are still in the midst of a nursing shortage. But, you must come to your own conclusion. Many factors have both positively and negatively affected the flux of the shortage. But, the fact remains this is a complicated topic with many moving pieces. As nurses, we must continue to stay abreast of the latest data on the nursing shortage and decide how we can impact the future of nursing.
Have something to say? Click here to comment!
Is the Nursing Shortage Real?
FALSE
References:
Spratley, E., Johnson, A., Sochalski, J., Fritz, M., Spencer, W. (2000). The Registered Nurse Population. U.S. Department of Health and Human Services. Retrieved from: https://datawarehouse.hrsa.gov/DataDownload/NSSRN/GeneralPUF00/rnsurvey2000.pdf U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. The Future of the Nursing Workforce: National- and State-Level Projections, 2012-2025. Rockville, Maryland, 2014. Retrieved from https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/projections/ nursingprojections.pdf Auerbach, D., Buerhaus, P., Staiger, D., (2017). Millennials Almost Twice as Likely to be Registered Nurses ss Baby Boomers Were [Abstract]. Health Affairs, 36. Retrieved from https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0386?journalCode=hlthaff Gooch, K. (2017). Millennials Represent Boon to Nurse Workforce, Join Ranks at Twice the Rate of Baby Boomers. Becker’s Hospital Review. Retrieved from https://www. beckershospitalreview.com/human-capital-and-risk/millennials-represent-boon-tonurse-workforce-join-ranks-at-twice-the-rate-of-baby-boomers.html Thompson, M. (2017). How the ACA Affects Nurses. National Health Care Provider Solutions. Retrieved from https://nhcps.com/aca-affects-nurses/ Dent, S. (2017). 4 Reasons Nurses Quit (And What You Can Do Instead). Nurse.org. Retrieved from https://nurse.org/articles/reasons-nurses-leave-profession/ Nurse.org (2017). Nursing Demand by State: 2018 Projections. Retrieved from https:// nurse.org/articles/nursing-demand-by-state/
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Nursing@Georgetown. (2017). How Will the Nurse Shortage Affect your State? Georgetown University. Retrieved from https://online.nursing.georgetown.edu/blog/nurseshortage-map/ Williams, Alex. (2015). Move Over, Millennials, Here Comes Generation Z. The New York Times. Retrieved from https://www.nytimes.com/2015/09/20/fashion/move-over-millennials-here-comes-generation-z.html American Association of Colleges of Nursing (2017). Fact Sheet: Nursing Shortage. Retrieved from: http://www.aacnnursing.org/Portals/42/News/Factsheets/Nursing-Shortage-Factsheet-2017.pdf Armmer. F. (2017). An Inductive Discussion of the Interrelationships between Nursing Shortage, Horizontal Violence, Generational Diversity, and Healthy Work Environments. Administrative Sciences 2017, 7 (4), 34; doi: http://dx.doi.org/10.3390/admsci7040034 Bradley University. (2016). How the Affordable Care Act Affected Nursing. Retrieved from https://onlinedegrees.bradley.edu/resources/infographics/how-the-affordable-careact-affected-nursing/ Knowles, M. (2018). Nursing School Reject Thousands of Applicants Amid Shortage. Becker’s Hospital Review. Retrieved from https://www.beckershospitalreview.com/ workforce/nursing-schools-reject-thousands-of-applicants-amid-shortage.html McHugh, M, Ma, C., (2014). Wage, Work Environment, and Staffing: Effects of Nurse Outcomes. Policy, Politics, and Nursing Practice, 15 (0): 72-80. Doi: https://dx.doi. org/10.1177%2F1527154414546868 Kavilanz, P. (2018). Hospitals Offer Big Bonuses, Free Housing, and Tuition to Recruit Nurses. CNN Money. Retrieved from http://money.cnn.com/2018/03/08/news/economy/nurse-hiring-bonuses/index.html
How can you make the most of the nursing shortage?
Some states will feel the pinch of the coming nursing shortage more than others. The three states with the greatest need for nurses are California, Arizona and North Carolina. With those states identified, we have located a number of jobs from our web site and featured them below to help you in your job search.
California View all California nursing jobs at https://allnurses. com/jobs/browseby-state/California/
Arizona View all Arizona nursing jobs at https://allnurses. com/jobs/browse-by-state/ Arizona/
698
Jobs Available
at time of publication
North Carolina View all North Carolina nursing jobs at https://allnurses.com/jobs/browse-bystate/North%20Carolina/
1,954
Jobs Available
at time of publication
RN Clinical Nurse II Acute Care
Learn more at http://nurs.es/job14
3,249 Jobs Available
at time of publication
RN Full Time Day ICU Central
Learn more at http://nurs.es/job7
RN Manager Surgical Services
Learn more at http://nurs.es/job8
Biometric Health Screener
Learn more at http://nurs.es/job1
Coordinator of Student Health Services
Learn more at http://nurs.es/job2
RN ER Full Time Nights Learn more at http://nurs.es/job3
Inpatient Care Coordinator
Learn more at http://nurs.es/job4
Clinical Nurse - RN, Women’s Surgery
Learn more at http://nurs.es/job5
Nurse Practitioner: Psychiatric Mental Health
Learn more at http://nurs.es/job9
Neonatal Intensive Care Unit Nurse
Learn more at http://nurs.es/job10
Director Nursing ICU/PCU Learn more at http://nurs.es/job11
RN Full Time Day 10K Sign on Telemetry Central
Learn more at http://nurs.es/job12
RN ORTHO NEURO FT DAYS
TEAM LEADER/STAFF NURSE/SNF - RRNCC
Learn more at http://nurs.es/job15
RN CLINICAL NURSE II OPERATING ROOM
Learn more at http://nurs.es/job16
RN CLINICAL NURSE HH HOSPICE
Learn more at http://nurs.es/job17
Registered Nurse (RN)Behavioral Health
Learn more at http://nurs.es/job18
CLINICAL NURSE IV/TEAM LEADER - NEURO ICU
Learn more at http://nurs.es/job19
CLINICAL NURSE II EMERGENCY SERVICES
Learn more at http://nurs.es/job20
RN/CRITICAL RESPONSE CARDIOVASCULAR
Learn more at http://nurs.es/job21
Learn more at http://nurs.es/job13
Registered Nurse - Renal Telemetry
Learn more at http://nurs.es/job6
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Hot Products
Hot weather,
With thermometers doing their best to break new reco Here are some of the latest and the greatest nur
Eko Core Stethoscope
SutureOut Suture Removal SutureOut Suture Removal is the first disposable guarded blade for removing sutures and the ultimate suture cutting tool. It is easier for the Nurse, more comfortable for the patient, and less wasteful than other suture removal tools. SutureOut allows the Nurse to safely cut sutures from the outside, making it easier to access tightly-tied knots and embedded stitches. Click to learn more... https://allnurses.com/ products/128-sutureout-suture-removal
Tool Only: $3.00 Single Kit: $4.00
Dri-Fit Undershirt for Scrubs As Nurses, we work in hot and stressful environments. This is why the decision was made to create the Dri-Fit Undershirt for Scrubs. This undershirt is built specifically to provide medical professionals with a garment that is bacteria resistant, keeps them cool, and keeps them comfortable. In addition to the quality fabric, the undershirt is customizable to show off your specialty! Click to learn more... https://allnurses.com/ products/106-dri-fit-undershirt
32.00
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The Eko Core Stethoscope was developed in 2015, and operates as both an electronic as well as an analog stethoscope. It reduces ambient noise and in the electronic mode, has 7 levels of volume control, making it easy to further amplify sound. Click to learn more... https:// allnurses.com/products/ 35-eko-core-stethoscope
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Adapt to your own stethoscope for $ 199.00
hot products
ords, the weather and the products are both heating up. rsing-related products we’ve found just for you!
Hopkins Home Health Shoulder Bag
The Hopkins Home Health Shoulder Bag is a waterproof bag with large compartments. With a large “clean” compartment, you can carry all of your nursing supplies easily while staying organized. The secondary “soiled” compartment has no pockets, so once your soiled equipment is put inside, you can rest assured there will not be cross-contamination. This bag also has a file folder pocket to keep papers neat and organized. Click to learn more...https://allnurses.com/ products/107-hopkins-homehealth-bag
43.95
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“Do No Harm” Applies to Nurses Too!
Nurses enter into the nursing profession to deliver compassionate, skilled, and effective patient care. When they begin their first nursing job, they may discover the ugly truth: nurses can be horrific to each other. Finally, here is a book to guide nurses along a new path, “Do No Harm” Applies to Nurses Too! Renee Thompson, DNP, RN. CMSRN tackles the dirty secret that has plagued nursing for years. Click to learn more...https://allnurses.com/products/ 66-do-no-harm
19.97 Paperback
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8.97 Kindle
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Get Social A glimpse at some of the most popular comments from our various Facebook channels... Be sure to click the headlines to add your comment!
Protecting Your License – Notes from a Nurse-Attorney You have the right to view any file kept on you by your employer, and obtain a copy. If you leave, and they then proceed to fill your file with inaccuracies, you have grounds for legal action.
What Is Cannabinoid Hyperemesis Syndrome?
dying “
I have only seen one case in an adult male age 38. He finally told me what he smoked and how many years. An experienced Hospitalist gave a correct diagnosis in three minutes! The patient was extremely happy for a diagnosis “ I thought I was
What’s Not in the Supervisory Job Description Supervisory job in LTC means you will staff replacement when that can fill a spot or call-in. Plus make sure you have your assignments and everyone else’s are complete. 50- 60 hours work weeks and weekends. Not complaining just stating facts....this is how LTC addresses staff shortages
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LOL
Whether you believe that the nursing shortage is myth or fact, navigating the job market and its sometimes complicated language can often times be painful. Even with those difficulties and frustrations, finding humor within those struggles is sometimes the best plan.
Have something to say? Click here to comment!
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Purchasing Power
of Nurses Across America
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hether you are looking for your first job, considering switching positions, or even wanting to see how your current salary stacks up against others in your area or even a different location, what are the main things you take into consideration? Most people would say that salary is the most significant factor that influences their thoughts and decisions about job comparison, but a published or reported salary does not tell the whole story.
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By Mary Watts
The Fluctuating Value of the Dollar
The value of money does not stay the same. You can look back and see what you paid for your current home or first car and are shocked to look at today’s sticker prices. We don’t even have to consider time as a factor for value changes. You can travel across the country and see that your current dollar does not go as far in another state as it does at home. Or maybe just the opposite is true, and you find that the best bargains are not at home. This is all about your purchasing power and how the cost of living and location can affect it. How can you factor in variations in the cost of living in different locations to see what your
purchasing power really is? As someone looking at various job offers across the country or even in different sections of the state, how can you get a more realistic and accurate comparison of how far your salary will go?
Raw Salary vs. Adjusted Salaries
Below is a list of the states with the ten highest and lowest average reported (raw) RN salaries (Diploma, ADN/ASN, BSN) based on the results from almost 17,000 respondents to the 2018 allnurses Nursing Salary Survey that was conducted over 4 weeks in February 2018. This is just the beginning of where to start when making job comparisons. But be careful… Don’t stop here thinking you know the rest of the story.
NURSING SALARIES (RNs) - TOP & BOTTOM 10 STATES ADJUSTED SALARIES REPORTED SALARIES Top 10 (highest to lowest) Hawaii $105,750 California $98,938 Massachusetts $88,440 Oregon $84,375 Alaska $82,037 Washington $79,181 New Jersey $78,938 Nevada $78,707 New York $78,178 Rhode Island $75,119
Top 10 (highest to lowest) Nevada $67,073 Alaska $58,659 Hawaii $57,980 California $54,905 Massachusetts $54,345 Washington $54,253 Oregon $54,012 Louisiana $52,235 Wyoming $51,558 New Mexico $51,266
Bottom 10 (lowest to highest) South Dakota $57,400 Iowa $57,446 Alabama $57,586 Mississippi $58,281 Tennessee $58,627 North Dakota $59,342 Arkansas $60,736 Kansas $$61,408 Utah 461,455 Idaho $61,482
Bottom 10 (lowest to highest) Iowa $41,356 District of Columbia $41,650 Vermont $41,791 Illinois $42,152 Maryland $42,367 New Hampshire $42,884 Connecticut $43,078 Utah $43,265 New Jersey $43,374 Maine $43,490 Summer 2018
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You need to look at more than just the raw or reported salaries. The purchasing power of a raw salary will vary in different parts of the country depending on the cost of living. For example, $75,000 can probably buy a lot more in Minnesota than it can in New York or Hawaii. As you look at results from salary surveys or articles about salaries, you tend to look at the states with the top salaries and dream of working there. Most likely, what you are seeing is a list of raw salaries. As you think about where to apply for jobs, your decision will be based partly on salary comparison. However, instead of using raw salaries as your yardstick, you should look closely
at the salaries that have been adjusted factoring in the cost of living and location.
What are Regional Price Parities (RPP) and Why are They Important?
Regional Price Parities (RPPs) are used to give a more accurate comparison of salaries and purchasing power across states. RPPs measure the differences on price levels of goods and services across states for a given year and are shown as a percentage of the national overall price. Regional Price Parities are calculated using price quotes for a wide variety of items (rent, food,
The Southeast states KENTUCKY Reported Income = $63,250 Estimated Tax Burden = $22,414 Income After Taxes = $40,836 RPP = 87.8 Adjusted Income = $46,510 Number of Active RNs = 71,600 Location Quotient = 1.16
WEST VIRGINIA Reported Income = $63,393 Estimated Tax Burden = $19,684 Income After Taxes = $43,709 RPP = 87.6 Adjusted Income = $50,414 Number of Active RNs = 33,838 Location Quotient = 1.45
VIRGINIA Reported Income = $69,533 Estimated Tax Burden = $22,997 Income After Taxes = $46,536 RPP = 102.3 Adjusted Income = $45,490 Number of Active RNs = 105,034 Location Quotient = 0.83
TENNESSEE Reported Income = $58,627 Estimated Tax Burden = $16,422 Income After Taxes = $42,205 RPP = 90.2 Adjusted Income = $46,790 Number of Active RNs = 101,797 Location Quotient = 1
NORTH CAROLINA Reported Income = $64,125 Estimated Tax Burden = $20,703 Income After Taxes = $43,422 RPP = 90.9 Adjusted Income = $47,770 Number of Active RNs = 135,157 Location Quotient = 1.13
ALABAMA Reported income = $57,586 Estimated Tax Burden = $17,045 Income After Taxes = $40,541 RPP = 86.6 Adjusted Income = $46,814 Number of Active RNs 82,513 Location Quotient 1.26
SOUTH CAROLINA Reported Income = $65,547 Estimated Tax Burden = $21,405 Income After Taxes = $44,142 RPP = 90.3 Adjusted Income = $48,884 Number of Active RNs = 70,656 Location Quotient = 1.05
FLORIDA Reported Income = $64,498 Estimated Tax Burden = $18,291 Income After Taxes = $46,207 RPP = 99.7 Adjusted Income = $46,346 Number of Active RNs = 319,262 Location Quotient = 1.04
GEORGIA Reported Income = $70,177 Estimated Tax Burden = $24,040 Income After Taxes = $46,137 RPP = 92.1 Adjusted Income = $50,095 Number of Active RNs = 128,169 Location Quotient = 0.85
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Reported income varies rather widely in the southeast states with Georgia at the top and Alabama at the bottom but with adjusted income coming into play, West Virginia is at the top and neighboring Virginia is at the bottom.
transportation, housing, recreation, education, apparel, and medical) from the Consumer Price Index (CPI). When analyzing the salary data from the 2018 allnurses salary survey, we used information from the Bureau of Economic Analysis which provides Regional Price Parities
The East Coast states VERMONT Reported Income = $65,556 Estimated Tax Burden = $23,096 Income After Taxes = $42,460 RPP = 101.6 Adjusted Income = $41,791 Number of Active RNs = 15,092 Location Quotient = 1.01
(RPPs) for each of the 50 states plus the District of Columbia. The RPP Index uses 100 as the national average cost of living. These numbers can be used to see how the cost of living of one states compares to the National Average. RPPs exceeding 100
NEW HAMPSHIRE Reported Income = $66,212 Estimated Tax Burden = $20,798 Income After Taxes = $45,414 RPP = 105.9 Adjusted Income = $42,884 Number of Active RNs = 22,792 Location Quotient = 1
MASSACHUSETTS Reported Income = $88,440 Estimated Tax Burden = $29,856 Income After Taxes = $58,584 RPP = 107.8 Adjusted Income = $54,345 Number of Active RNs = 130,875 Location Quotient = 1.15
NEW YORK Reported Income = $78,178 Estimated Tax Burden = $27,224 Income After Taxes = $50,954 RPP = 115.6 Adjusted Income = $44,943 Number of Active RNs = 328,761 Location Quotient = 0.96
RHODE ISLAND Reported Income = $75,119 Estimated Tax Burden = $26,074 Income After Taxes = $49,045 RPP = 99.6 Adjusted Income = $49,143 Number of Active RNs = 20,572 Location Quotient = 1.22
PENNSYLVANIA Reported Income = $67,875 Estimated Tax Burden = $24,103 Income After Taxes = $43,772 RPP = 98.4 Adjusted Income = $44,484 Number of Active RNs = 220,174 Location Quotient = 1.21
CONNECTICUT Reported Income = $74,811 Estimated Tax Burden = $27,985 Income After Taxes = $46,826 RPP = 108.7 Adjusted Income = $43,078 Number of Active RNs = 63,938 Location Quotient = 1.02
MARYLAND Reported Income = $70,796 Estimated Tax Burden = $24,404 Income After Taxes = $46,392 RPP = 109.5 Adjusted Income = $42,367 Number of Active RNs = 81,217 Location Quotient = 0.99 DISTRICT OF COLUMBIA Reported Income = $70,893 Estimated Tax Burden = $22,620 Income After Taxes = $48,273 RPP = 115.9 Adjusted Income = $41,650 Number of Active RNs = 28,033 Location Quotient = 0.72
MAINE Reported Income = $64,357 Estimated Tax Burden = $21,563 Income After Taxes = $42,794 RPP = 98.4 Adjusted Income = $43,490 Number of Active RNs = 25,199 Location Quotient = 1.16
NEW JERSEY Reported Income = $78,938 Estimated Tax Burden = $29,839 Income After Taxes = $49,099 RPP = 113.2 Adjusted Income = $43,374 Number of Active RNs = 127,564 Location Quotient = 0.99 DELAWARE Reported Income = $72,674 Estimated Tax Burden = $21,828 Income After Taxes = $50,846 RPP = 100.2 Adjusted Income = $50,745 Number of Active RNs = 18,484 Location Quotient = 1.29
The reported income within the east coast states varies over $24,000 but the difference in adjusted income narrows to only $12,554 with Massachusetts taking the lead in both categories. Summer 2018
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represent prices higher than the national average while RPPs less than 100 indicate prices lower than the national average. Hawaii, with the highest RPP of 118.4, has a cost of living 18.4% higher than the National average cost of living, while Mississippi, with an
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RPP of 86.4, is 13.6% lower than the national average and has a cost of living 32% lower than Hawaii. Keep that in mind when comparing just the raw salaries. Hawaii not only has the highest RPP but also has the highest reported raw RN salary ($105,750) from the 2018 allnurses salary
The West Coast states WASHINGTON Reported Income = $79,181 Estimated Tax Burden = $23,873 Income After Taxes = 55,308 RPP = 105.5 Adjusted Income = $54,253 Number of Active RNs = 97,859 Location Quotient = 0.88 OREGON Reported Income = $84,375 Estimated Tax Burden = $30,471 Income After Taxes = $53,904 RPP = 99.8 Adjusted Income = $54,012 Number of Active RNs = 60,846 Location Quotient = 0.94 CALIFORNIA Reported Income = $98,938 Estimated Tax Burden = $36,127 Income After Taxes = $62,811 RPP = 114.4 Adjusted Income = $54,905 Number of Active RNs = 429,981 Location Quotient = 0.83
TEXAS Reported Income = $101,797 Estimated Tax Burden = $22,753 Income After Taxes = $48,283 RPP = 96.9 Adjusted Income = $49,828 Number of Active RNs = 318,505 Location Quotient = 0.88
OKLAHOMA Reported Income = $64,400 Estimated Tax Burden = $21,034 Income After Taxes = $43,366 RPP = 89 Adjusted Income = $48,726 Number of Active RNs = 53,184 Location Quotient = 0.87
Many assumptions are probably made regarding nursing salaries in California and if you were guessing that the salaries were near the top of those reported, you were correct. The real eye opener is the fact that when taking adjusted income into account, California is still at the top of the three west coast states in the graphic show to the left.
The South Central states The reported income in Texas is one of the highest across the country but when it comes to adjusted income, Louisiana jumps to the top of the south central states shown in the map below. ARKANSAS Reported Income = $60,736 Estimated Tax Burden = $19,364 Income After Taxes = $41,372 RPP = $41,372 Adjusted Income = $41,372 Number of Active RNs = 41,372 Location Quotient = 1 MISSISSIPPI Reported Income = $58,281 Estimated Tax Burden = $18,487 Income After Taxes = $39,794 RPP = 86.4 Adjusted Income = $46,058 Number of Active RNs = 49,979 Location Quotient = 1.26 LOUISIANA Reported Income = $67,582 Estimated Tax Burden = $20,271 Income After Taxes = $47,311 RPP = 90.4 Adjusted Income = $52,335 Number of Active RNs = 67,866 Location Quotient = 1.19
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survey. Mississippi, with the lowest RPP has the 4th lowest reported raw salary ($58,281). As you look at the list of Regional Price Parities, you will see that in general, RPPs are lower in the middle sections of the country and are higher on the east and west coast.
What about Taxes?
No one likes taxes. State and local taxes combine with federal income taxes to take a huge chunk out of your income. Sales tax, state income tax, property tax‌ All of these vary from state to state, so they must be included in the purchasing power comparison. We will refer to this as the Tax Burden. Many free online federal income tax calculators can be used to calculate the estimated tax burden based on location and reported income. The smartasset Federal Income Tax Calculator was used to arrive at the figures in the adjusted
salaries below. Taxes were based on the capital city of each state.
Location Quotient
Location Quotients (LQs) are ratios that allow an area’s distribution of employment by industry (nursing) to be compared to a reference, in this case, the U.S. If an LQ is equal to 1, then that location has the same share of employment than the average U.S. If the LQ is greater than 1, it indicates there is a greater share of (nursing) employment that the reference area (U.S. average). When seeking a nursing job, a state with a higher Location Quotient is more desirable since there are more employment opportunities in that area as compared to the average concentration. According to the latest May 2017 Bureau of Labor Statistics, states with the highest concentration of nursing jobs and location quotients are South Dakota, West Virginia, Delaware, Missouri, and Mississippi.
The Great Lakes states WISCONSIN Reported Income = $66,156 Estimated Tax Burden = $24,471 Income After Taxes = $41,685 RPP = 92.8 Adjusted Income = $44,920 Number of Active RNs = 94,836 Location Quotient = 0.97 ILLINOIS Reported Income = $66,246 Estimated Tax Burden = $24,558 Income After Taxes = $41,688 RPP = 98.9 Adjusted Income = $42,152 Number of Active RNs = 198,104 Location Quotient = 1.02
As you can see with the states bordering the Great Lakes, reported income and adjusted income only marginally. Indiana, though, stands out with the highest adjusted income in this region. 42 Summer 2018
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MICHIGAN Reported Income = $66,797 Estimated Tax Burden = $25,222 Income After Taxes = $41,575 RPP = 93 Adjusted Income = $44,704 Number of Active RNs = NA Location Quotient = 1.08 OHIO Reported Income = $63,637 Estimated Tax Burden = $23,807 Income After Taxes = $39,830 RPP = 89.3 Adjusted Income = $44,602 Number of Active RNs = 208,895 Location Quotient = 1.14 INDIANA Reported Income = $64,383 Estimated Tax Burden = $21,308 Income After Taxes = $43,075 RPP = 90.3 Adjusted Income = $47,702 Number of Active RNs = 114,338 Location Quotient = 1.11
The Upper Midwest states
MINNESOTA Reported Income = $68,922 Estimated Tax Burden = $24,189 Income After Taxes = $44,733 RPP = 97.5 Adjusted Income = $45,880 Number of Active RNs = 110,093 Location Quotient = 1.12
NORTH DAKOTA Reported Income = $59,342 Estimated Tax Burden = $16,916 Income After Taxes = $42,426 RPP = 91.5 Adjusted Income = $46,367 Number of Active RNs = 14,821 Location Quotient = 1.06
IOWA Reported Income = $57,446 Estimated Tax Burden = $20,125 Income After Taxes = $37,321 RPP = 90.2 Adjusted Income = $41,356 Number of Active RNs = 54,620 Location Quotient = 1.06
SOUTH DAKOTA Reported Income = $57,400 Estimated Tax Burden = $16,250 Income After Taxes = $41,150 RPP = 88.3 Adjusted Income = $46,602 Number of Active RNs = 18,353 Location Quotient = 1.47 NEBRASKA Reported Income = $63,667 Estimated Tax Burden = $20,542 Income After Taxes = $43,125 RPP = 90.5 Adjusted Income = $47,652 Number of Active RNs = 30,606 Location Quotient = 1.16
In the Upper Midwest, Minnesota takes the crown with the highest reported income but Missouri’s adjusted income is in first place with Nebraska a close second in both categories.
KANSAS Reported Income = $61,408 Estimated Tax Burden = $21,208 Income After Taxes = $40,200 RPP = 90.5 Adjusted Income = $44,420 Number of Active RNs = 58,405 Location Quotient = 1.04
MISSOURI Reported Income = $62,866 Estimated Tax Burden = $20,044 Income After Taxes = $42,822 RPP = 89.5 Adjusted Income = $47,846 Number of Active RNs = 110,642 Location Quotient = 1.27
What Is YOUR Purchasing Power?
Are you ready to see an estimate of what you really make after all the adjustments are made? Below is a list of the highest and lowest average RN adjusted salaries which incorporate the cost of goods, services, and taxes in an area. These figures, although surprising, more accurately represent the real value of your earnings for cross-area comparisons. When you see what the adjusted salaries are, it might change your ideas of where you might want to look for jobs. The salary that you thought was so low before might now look more attractive. Salary alone does not tell the entire story, and decisions to relocate for a job should not be based solely on salary numbers. Even if the salary for a potential job is higher, the purchasing power will decrease if the cost of living is also higher. When
ALASKA Reported Income = $82,037 Estimated Tax Burden = $23,377 Income After Taxes = $58,660 RPP = 105.4 Adjusted Income = $58,659 Number of Active RNs = 14,817 Location Quotient = 9.86
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actual salaries are adjusted for regional prices, this will give the job-seeker a more accurate representation of purchasing power for realistic comparisons between locations. For more information about the purchasing power of your salary, go to……. nurs.es/power.
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The Rocky Mountain states IDAHO Reported Income = $61,482 Estimated Tax Burden = $19,852 Income After Taxes = $41,630 RPP = 93 Adjusted Income = $44,763 Number of Active RNs = 22,288 Location Quotient = 0.95
NEVADA Reported Income = $78,707 Estimated Tax Burden = $22,378 Income After Taxes = $56,329 RPP = 97.4 Adjusted Income = $67,073 Number of Active RNs = 39,464 Location Quotient = 0.79
UTAH Reported Income = $61,455 Estimated Tax Burden = $19,258 Income After Taxes = $42,197 RPP = 97.3 Adjusted Income = $43,265 Number of Active RNs = 34,479 Location Quotient = 0.74
ARIZONA Reported Income = $69,290 Estimated Tax Burden = $21,150 Income After Taxes = $48,140 RPP = 95.9 Adjusted Income = $50,198 Number of Active RNs = 90,048 Location Quotient = 0.99 = 0.99
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HAWAII Reported Income = $105,750 Estimated Tax Burden = $37,103 Income After Taxes = $68,647 RPP = 118.4 Adjusted Income = $57,980 Number of Active RNs = NA Location Quotient = 0.84
MONTANA Reported Income = $63,776 Estimated Tax Burden = $19,662 Income After Taxes = $44,114 RPP = 94.1 Adjusted Income = $46,880 Number of Active RNs = 16,912 Location Quotient = 1.08
WYOMING Reported Income = $68,226 Estimated Tax Burden = $18,369 Income After Taxes = $49,857 RPP = 96.7 Adjusted Income = $51,558 Number of Active RNs = 14,534 Location Quotient = 0.9
COLORADO Reported Income = $68,613 Estimated Tax Burden = $21,882 Income After Taxes = $46,731 RPP = 103 Adjusted Income = $45,380 Number of Active RNs = 77,302 Location Quotient = 0.95
NEW MEXICO Reported Income = $69,348 Estimated Tax Burden = $21,363 Income After Taxes = $47,985 RPP = 93.6 Adjusted Income = $51,266 Number of Active RNs = 28,865 Location Quotient = 1
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! Y A D O T E E R F R O F LOAD
DOWN
arged! h C e B ’t n ard Wo C t i d e r C r You
Humorous Tales from the Bedside and Beyond
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Class of 1998
A Journey Through Two Decades of Nursing
by Melissa Mills RN, BSN, CCM, MHA
Melissa is a Quality Assurance Nurse, professor, writer, and business owner. She enjoys empowering other nurses to find their passions and create a unique nursing career that fits their passions, desires, and gifts. She is owner of www. makingspace.company, a website dedicated to helping women find their creative passions through writing and co-owner of enursingresources.com, a start-up Nursing CE company that will offer online courses soon.
This August marks the twentieth year I’ve been a nurse. This milestone has induced much reflection on my career and the advancements I have seen over the last two decades. If you graduated in 1998 or the few years before or after, you have likely started to notice that you are no longer among the “young” nurses. You now stand with tenure among nurses who have written the letters R.N. or L.P.N. after their names even longer. It’s funny to tell stories to younger nurses. Tales of paper charting and lower nurse-patient ratios bring glassy stares to their eyes. This place of tenure is a new adventure. During the trip down memory-lane, I have started to review some of the significant
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changes that have happened over the last twenty years and even considered what the future might bring. Here are a few of my memories and ponderings for the future.
Nursing School
I started my nursing journey by attending an Associate’s Degree program at a Community College. It was hard, as are all nursing programs. I had no intention of ever returning to school. However, advancements in technology changed my mind. I received my BSN in 2012 and a Masters Degree in Healthcare Administration in 2016 without ever leaving the comfort of my home.
Today, there are many options for nurses that were unheard of even 20 years ago. We can choose from traditional educational programs to online courses and certifications. Many nurses are enrolling in Nurse Practitioner programs as the need for advanced degree nurses continues to rise. I can only imagine what kind of advancements lie ahead. New laws like the BSN in 10 that was just passed by New York will likely further change the look of nursing education (University of Buffalo, 2018). Will Associate Degree programs still be around? I’ll let you know in 2038.
NCLEX
Today, because of the progressive nature of nursing, computerized testing is the standard across many healthcare disciplines (National Council on State Boards of Nursing, 2014).
Electronic Medical Records
In my first few jobs, we used all written documentation. A lot of time was spent keeping notes and paying particular attention to what was written. Mistakes created a risk management nightmare that led to uncomfortable conversations with the nurse manager.
The NCLEX has undergone many changes over the years. Initially a paper-and-pencil test, the NCLEX was given only a few times each year in large venues (National Council on State Boards of Nursing, 2014). It would take several weeks or even months before nurses received their results, leaving candidates nervously awaiting the mail (National Council on State Boards of Nursing, 2014). In 1994, the National Council on State Boards of Nursing (2014) pioneered computerized testing for licensure exams (National Council on State Boards of Nursing, 2014). They were the first healthcare organization to use this progressive method for entry-level knowledge licensing (National Council on State Boards of Nursing, 2014). When I took the exam, I answered approximately 110 questions when the test shut off. Of course, I had no idea if it turned off because I had passed or failed. I remember crying like a baby from pure stress and exhaustion. A few short weeks later, I hugged and kissed the mailman when he knocked on the door and handed me the most anticipated envelope I have ever received. It was addressed to me and had the letters R.N. on the outside of the envelope revealing my results.
While some healthcare sectors began using technology in the 1990’s, many did not fully integrate until several years later (net health, 2016). In 1991, the Institute of Medicine recommended that every physician should be using computers by the year 2000 to improve patient care (net health, 2104). Today, electronic medical records allow most healthcare facilities to be paperless. As we look towards the future, advancements in portability and interoperability will likely pave the way through the next few decades.
Telemedicine
Having spent a good bit of my career in home care, I have seen significant advancements in telemedicine. From home monitoring for at-risk pregnancies to chronic man-
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The average salary for registered nurses in 1998 was $43,070 In 2018 the average hourly nurse makes $65,350 annually. agement of CHF, heart failure, and diabetes, telemedicine has made aging in place easier for many patients.
Today, nurses make much more. According to the 2018 All Nurses Salary Survey results the average hourly nurse makes $65,350. This salary seems more in alignment with the work of nurses, however with the continued advancements, increased nurse-patient ratios, and extreme stress levels, further pay adjustments may be needed.
Telemedicine also offers nurses new career opportunities. Many nurses can work into advanced age due to options like telephonic case management, telephone triage, and quality assurance. These positions use nursing knowledge without the stress and physical demands of hospital nursing. As we look to the future, mobile health and telehealth will offer programs that allow nurses to improve the care management process and increase patient engagement (mHealth Intelligence). Future advancements in mobile health technologies will catapult nurses forward as dispensers of healthcare information (mHealth Intelligence).
Pay
I started working in July 1998. My first job was on a medical-oncology unit in a moderately sized community hospital in Springfield, Ohio. If memory serves me correct, my starting pay was around $16 an hour. The Bureau of Labor Statistics (1999) reports that the average salary for registered nurses in 1998 was $43,070. Resources: Bureau of Labor Statistics (1999) Annual wages of nurses, doctors, and other health care workers. Bureau of Labor Statistics. Retrieved from: https://www.bls. gov/opub/ted/1999/dec/wk3/art04.htm University at Buffalo, School of Nursing. (2018). New York’s new BSN in 10 law: What you need to know. University at Buffalo. Retrieved from: http://nursing.buffalo. edu/news-events/nurses-report.host.html/content/shared/nursing/articles/nurses-report/posts/bsn-in-10.detail.html National Council of State Boards of Nursing. (2104). Pencils Down, Booklets Closed. National Council of State Boards of Nursing. Retrieved from: https://www.ncsbn. org/InFocus_Spring2014.pdf
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The Next Twenty
What advancements will happen over the next twenty years? It is exciting to reminisce about the improvements of the past and dream of the ones in the future. Nursing continues to grow at a faster speed than other industries. The need for nurses will never end. I am excited about the future of nursing. There will be bumps in the road along the way, but the possibilities are endless.
Have something to say? Click here to comment! Net Health (2016). What is the History of Electronic Medical Records? Net Health. Retrieved from: https://www.nethealth.com/a-history-of-electronic-medical-records-infographic/ mHealth Intelligence. Telehealth, mHealth Make Nurses Pivotal Presence in Healthcare. MHealth Intelligence. Retrieved from: https://mhealthintelligence.com/features/telehealth-mhealth-make-nurses-pivotal-presence-in-healthcare
The Merck Manual Is Introduced in its 20th Edition Venerable Medical Reference Book Stands the Test of Time
Kenilworth, N.J., May 2018 – Trusted by doctors and other healthcare professionals for more than a century, The Merck Manual, now published in its 20th Edition, offers readers the tactile satisfaction of paging through an array of medical topics. Within weeks of its launch, the much-anticipated 20th Edition ranked as a “hot new release” on Amazon. com. Completely updated and extensively expanded content has added significant girth to the tome since the last edition was published in 2011, and it now weighs in at more than six pounds. “The Merck Manual has always served as the initial stop on the road to understanding for physicians and other healthcare professionals encountering a topic for the first time or for the first time in a long time,” said Editor-in-Chief Robert S. Porter, M.D. “Even in this digital age, the book still plays the same crucial role, providing the authoritative information necessary to make the healthcare professional ‘at once, master of the situation.’” Bibliophiles will appreciate the detailed index, page-specific cross references, large trim, and thumb tabs. Lists of bulleted “Key Points” summarize the facts in each chapter at a glance. A 16-page, full-color insert aids visual recognition of skin, eye, and oral disorders. All new “Pearls and Pitfalls” shaded boxes highlight noteworthy medical observations and areas of caution. The 20th Edition features more than 300 tables and figures. The 3,584-page volume is the work of a team of more than 350 expert contributors; all content is reviewed by an independent editorial board. The comprehensive resource covers a full range of medical specialties, including gastroenterology, cardiology, ophthalmology, dermatology, endocrinology, oncology, immunology, neurology, and psychiatry. There are dedicated sections for pediatrics and geriatrics.
The timely text addresses pressing social issues, many of which have significant public health implications, such as school bullying, domestic violence, and elder abuse. Current events have precipitated an in-depth discussion of injuries caused by mass casualty weapons, including biological and chemical agents.
Digital Platforms
Although it has long since grown too big to be carried in a lab coat, the book has returned to the pocket as an app that can be downloaded to mobile devices at no charge. All of the information in the print version is enhanced by many multimedia features also accessible on the free website at www.merckmanuals.com. The user experience is never compromised by advertising or commercial messaging.
Gold Standard for Generations
The pharmaceutical manufacturer, known as Merck & Co. at the time, first published The Merck Manual for doctors and pharmacists in 1899. The then slim manual quickly became a favorite among those in need of a compact medical reference. Dr. Albert Schweitzer carried the book to remote parts of Africa in 1913, and a copy accompanied Admiral Richard E. Byrd on his flight to the South Pole in 1929. The Merck Manual Home Health Handbook translates the complex medical terminology contained in The Merck Manual into everyday language for a lay audience. The first edition of the consumer version was introduced in 1997. The 20th Edition of The Merck Manual (ISBN-13: 978-0911910421) lists at $79.95 and may be purchased at leading book retailers or by visiting www. merckbooks.com. Merck and Co., Inc. publishes all of the books in The Merck Manual series as a not-for-profit service. Summer 2018
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5
Expert’s Corner
to Nursing Career STEPS Satisfaction
A
1.
by Keith Carlson RN, BSN, NC-BC
Keith Carlson, BSN, RN, NC-BC is a holistic career coach for nurses, award-winning nurse blogger, writer, podcaster, social media influencer, keynote speaker, author, and popular career columnist.
Checking off your required CEUs to maintain your nursing license and certifications is great, but learning can be so much more. Being a curious and inquisitive nurse who asks meaningful questions and digs deep for answers will serve you well. Use your innate curiosity about human behavior, science, and medicine to keep your mind flexible and ready to embrace new information and experiences.
With more than two decades of nursing experience, Keith deeply understands the issues faced by 21st-century nurses. Keith’s career coaching services include resumes and cover letters, LinkedIn optimization, networking and interview skills, career management, and shaping the individualized nursing career that’s just right for you.
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2.
chieving satisfaction in your nursing Get career isn’t rocket science, but in a personal complex 21-century world, life and Workaholism is rampant in many industriwork demand more of us on every level. Satisalized cultures, and we can easily allow ourfaction is an individual experience, yet there selves to be led down the road of identifying are many universal means to getting there. solely by the work we do. Nothing Be a curious lifelong ourselves will reduce your career to a monotonous learner grind more quickly than not paying attention As a nurse, learning doesn’t stop when you to your life outside of work. pass the NCLEX and get hired for your first “I’m a nurse”, “I’m a plumber”, or “I’m an job -- in fact, learning should never really insurance salesman” is a fine thing to say stop at all. Your nurse’s brain should be a when meeting someone for the first time, but sponge that continues to soak up experience, we mustn’t lose sight of the fact that we may skills, and knowledge. The engine that can also be a mother, a watercolor painter, or a drive this particular bus is curiosity. long-distance runner. Only identifying as a nurse puts an inordinate amount of pressure on that identity to deliver the lion’s share of your fulfillment. Widen the net by maintaining active awareness of the other things that light your fire. Acknowledging and feeding your personal life and interests will inform your career trajectory and your work as a nurse.
3.
Connect with your inner “multitudes”
Building on the idea of the importance
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of your personal life, it’s also crucial to be a well-rounded human being with diverse interests. As mentioned above, there may be things you do outside of work that put a fire in your belly and a smile on your face. Whether your interests are intellectual (e.g.: studying art history); physical (e.g.: running marathons); or otherwise (e.g.: reading poetry), these pursuits remind you that you’re more than “just” a nurse – as Walt Whitman wrote in Leaves of Grass, “I am large; I contain multitudes”.
4.
Reach out and say hello
Networking is key to career fulfillment.
When we stay inside our little nursing boxes and maintain a narrowly focused web of acquaintances and colleagues, we limit our exposure to novel ways of thinking, working, and living. A robust professional network keeps fresh ideas and people circulating in your heart and mind, pushing you outside of your comfort zone. Having connections with people in other disciplines, geographic areas, and walks of life keeps you flexible, curious, and ready for anything. Whether you use LinkedIn, allnurses. com, or in-person networking to build your tribe, it’s essential to do so. When you cast a wide net in terms of people in your personal orbit, this is where the magic happens. From Summer 2018
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finding a mentor and making great friends to meeting thought leaders or finding job leads, networking is a powerful way to enrich your life on every level.
5.
Nurse, know thyself
You can deepen your self-knowledge by reading and studying about personal growth, attending workshops and seminars, or even
Being aware of your own desires, needs, and goals is ultimately very important for
35%
Self-knowledge is powerful in relation to your career direction and professional goals, and also in relation to your place in the world, your gender identity, your political stance, or even the financial decisions you make in the interest of your future.
Job Satisfaction Rate for Nurses
30% 25% 20% 15% 10% 5% 0%
Very Satisfied
Somewhat Satisfied
Neither Satisfied nor Dissatisfied
having a satisfying personal and professional life. Self-knowledge stretches your sense of self, your worldview, and your professional/ personal identity.
Somewhat Dissatisfied
Very Dissatisfied
Source: Nursing2018 / Lippincott NursingCenter
in counseling or psychotherapy. The more you understand yourself and your own motivations and perceptions, the more you can approach your nursing career from a centered and mindful place.
It’s Up to You
In the end, your nursing career satisfaction comes down to you. Who are you? What do you want? Where have you been? Where are you going? These are questions to continually ask, and you can dig as deep as you want for the answers. Have something to say? Click here to comment!
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