A recently released study showed that in 2021 male nurses were earning a median salary that was $14,000.00 more than their female counterparts. The previous year, 2020, the median salary for male nurses was $7,297.00 higher that the ladies.
An interesting thing revealed by the study was that males consistently asked for higher salaries than females when accepting nursing positions.
So, I want to send this message to all nurses: nursing is the hardest profession on earth and many of the things that nurses do would not likely be worth any amount of money to the average person. There is something special in a nurse. It’s in our DNA as I always say.
However, though it is our calling to care for people, we do not need to be treated like a doormat. Nurses are needed now more than ever because of the loss of nurses during the COVID pandemic and due to the critical staffing shortage.
If you are offered a nursing job, advocate for yourself! It is not unreasonable to ask for better money to manage such crucial and vital duties. In fact, better your position by applying for several facilities and “play them against each other.” There is nothing wrong for you, so to speak, “to blow your own horn” to get paid what you deserve.
Getting back to my first paragraph in this article, there is NO reason for men being paid more than women in the nursing profession. Both sexes do the same work so there is no sound reason to pay one more than the other.
I always say for you to stand in your power, and, specifically in this case, for you to feel free to negotiate your salary because the healthcare field needs you.
I have come over the years to sort out businesses into three classes, each modeled after a current successful company: Walmart, Nordstrom, and Neiman Marcus.
A Walmart business gives discounts to pull in patrons to purchase your goods or services. It’s like Groupon where people look at the price and the product before deciding which they wish to purchase.
The business owner does not get repeat business from the Groupon purchasers unless the business owner offers another discount for continued services or products.
I’ll be straight with you, I used to be a Walmart for professional licensing defense. I made a $10,000 mistake but learned valuable lessons. I had so many nurses contacting me because of matters involving their licensure and a number would say they, “could not afford” me.
I’ll be straight with you, I used to be a Walmart for professional licensing defense. While I had so many nurses contacting me because of matters involving their licensure, some would hesitate when they learned the amount of the fees involved.
I felt bad for some nurses because they were going to face the board without legal representation because of financial limitations.
I decided to start a pre-paid legal fund where nurses could participate at a cost of $197.00 per year for which they would be provided with whatever defense they required if a legal situation arose.
In the meantime, under the plan, they could call me with questions and nursing employment issues.
I felt the $197.00 was fair and by pooling together everyone’s money, there would be sufficient funds to cover the cost and fees of providing a defense for the occasional nurse needing legal assistance.
After setting up the fund, I asked the Board through a public records request for the email addresses for all of Indiana’s licensed nurses. Now, mind you, this was before the CAN-SPAM Act which sets rules for commercial email use. My thought at the time was that I would email them about this amazing program to provide them with legal defense if they needed it. To me, it was a win-win for everyone.
Ultimately, the Board refused to allow me the email addresses but, in fact, sent out their own email to all the nurses informing them that I had asked for their contact information. At first, I was upset but I came to realize that name recognition is good, no matter what.
With that I hired my former boss as my attorney to take on the state to allow my public records request for the email addresses. After paying roughly $10,000.00, my efforts eventually were for naught as I lost the case.
The universe was clearly giving me a sign that my proposed plan was not meant to be.
Although it was costly, it was a great lesson to step into my work. Once I realized how much good I could do for nurses, felt my value to charge what I thought I was worth, everything changed.
I was able to attract the clients I wanted, clients able to afford my service and, in turn, clients whom I could reward with an excellent defense.
Those were my Walmart days.
Now, maybe you’re the Nordstrom style of business. Are your fees kind of in the middle-of-the-road? Not too cheap (not based on bargains and discounts) and not too expensive where you price yourself out of the market?
Nordstrom is a nice middle ground which is the level at which I like to keep myself. I needed to do a lot of work on my mindset to charge what I am worth and be able to receive it. Now, nurses have no trouble paying for my services because I know my value and am able to share it.
Lastly, you might be in the Neiman Marcus level with your nurse owned business. Neiman Marcus is high priced and consistently offers high value, high quality, and it overdelivers.
There is absolutely nothing wrong with being in the Neiman Marcus level with your business and, if you go this way, I think it’s great! You can be the icon at the top of the line for the service you provide.
Walmart … Nordstrom … or Neiman Marcus! No matter which level of business you go with is only a matter of choice. I suggest that you stay in your power and worth by selecting the style you think serves you the best.
The ship captain analogy was used quite a bit in our recent retreat as it is applicable in nursing.
In law, “the captain of the ship” is a doctrine meaning that the physician is responsible for everything that happens in surgery. However, I use the term to question whether you are charting the course and steering your ship where you want it to go? Or are you allowing others to take the helm while you sit back as a passenger, just there for the ride? Or do you have pirates aboard, sabotaging your mission and who you need to cast off your vessel?
There are 3 types of nurses.
The first type is holding on to the dock for dear life, staying in their safety and comfort zones. These would be nurses who hate their job but will not move on to other employment for fear of winding up sitting in the unknown.
You constantly hear me say, “You can get another job . . . but you can’t get another license.” If you’re holding on to the dock, staying with your job only because of loyalty but feeling that it is not safe to stay there, there is a whole big ocean out there waiting for you to discover.
So, jump in, get your feet wet and chart your own course.
The second type of nurse is the one who is out in the middle of the ocean, being tossed about by the winds, waves, and storms. This is a nurse who goes with the flow and let’s everyone else contribute to decide her future rather than taking the helm herself and charting the course for where she wants to go.
The “Captain of the Ship” is the third type of nurse who is firmly in control of the craft, charts the course she wants and takes the actions to get there.
This could be a nurse climbing the clinical ladder by continuing her education, but is happy with where they are, happy with their career and steering their ship to their own destination.
There are places like this in nursing where you can be the captain of your ship, feeling good about what you are doing. Now, it would be nice if all nurses were captains of their ships and not letting the hospital or other circumstances deflect them in other directions.
Food for thought: which type of nurse are YOU? Let me hear your comments below. If you are not Captain of your Ship, what are you doing to regain control and chart your course where you want to go?
I have heard that many hospitals have done away with Nurses’ week and now celebrate “Hospital week.” Interestingly, the largest workforce in healthcare is nurses, yet their one special week gets taken away from them when doctors have their own day and other health professions have their own day to celebrate.
According to an article in BECKER’S HOSPITAL REVIEW, and a survey in connectRN, 63% of nurses say, “The typical way their employers show appreciation feels patronizing.”
That is really sad. Although nurses want to be paid appropriately, they want to feel valued, respected, have adequate staffing, feel like they can do their job and feel supported at work both physically and emotionally.
Years ago, I created a “Nurses’ Bill of Rights” because we have a “Patient Bill of Rights” where patients have rights but nurses rights go unattended.
In another article by BECKERS, they discussed how 18 hospital executives wrote notes to nurses and praised them for the excellent job they were doing and how they are the backbone of the healthcare system.
Some lackluster gifts nurses received in the past for Nurses’ Week included business card holders. I don’t know how many nurses, if any, carry business cards, tote bags, cookies, cakes, and packs of Extra gum, “because we’re ‘Extra’ special.” Last year, rocks were given stating ‘gratitude rocks’ for the nurses’ services. Some now call these “Nurses’ Weak” gifts.
While these gifts seem to have been created by a corporate marketing person; they seem to fail in what is really in the best interests of the nurse.
I also have seen on Facebook, copies of emails to staff saying, “I know we’re extra short staffed now and if you do not take this assignment, we can take a walk to HR.” That is no way to treat nurses for all the hard work they do to care for patients and to support the cause for the hospital’s very existence.
I have always believed and claimed that nurses are the hardest working people on the planet. You cannot pay people enough to do the work that nurses do.
It is time that hospitals bring nurses to the table and ask them what they want … AND DELIVER!
Instead of fighting and letting nurses go on strike, let us sit at the table and have an adult conversation to find solutions. I believe nurses have the answers to the problems in the healthcare system. They just are not listened to.
It saddens me that the profession that I love is so broken and that nurses are treated poorly, especially on their special week, like factory workers that are replaceable.
I believe that nursing is in our DNA and not everyone can be a nurse. If you are a nurse for the money, you will not be in nursing for long.
I would love to see administration show the care and concern for their nurses the same as nurses do for their patients.
What does your health system do for you for Nurses’ Week? Let me read your comments below.
On April 30, 2022, halfway through his shift at the Kaiser Permanente Santa Clara Medical Center, a nurse entered a supply closet and, taking a gun he brought from home, took his own life in front of a coworker. This was the second suicide in that area since the first of the year.
This broke my heart to learn of these nurses, so stressed during their shifts, that the only release seemed to be for them to take their own lives.
Ambulances were diverted from the emergency room, but they still allowed walk-ins.
If a coworker killed themselves in the ED where you were working, are you going to feel like you can take care of patients?
Are you supposed to turn off your emotions and pretend as if nothing had happened? That is crazy!
When my son was on summer break before the fifth grade, he lost a classmate in an auto accident. When he returned to school, they still had the child’s vacant seat to honor the child who was killed. They brought in counselors to help the students. Mind you, school started a few weeks after the child’s death.
What about nurses? What are they doing for our mental health?
In this situation, it was the employer’s emergency room that was affected by this.
My heart breaks for this man who felt he had no alternative but to take his life. There must be another answer.
Suicide rates for nurses is much higher than the public. I don’t know how much more our profession can take before we all crash. I hope it does not come to this.
Did you know that almost every contract includes a provision called a “covenant not to compete” or a “covenant not to solicit”?
Basically, what these mean is that you cannot talk to any clients of a person or work in a particular area during the term of the contract and after.
Courts do not like covenants not to compete because they restrict the trade of an individual meaning where that person can work or with whom they can associate to get business.
However, if such provisions are reasonable as to distance and to time, courts usually allow these.
I see these provisions in a lot of nurse practitioner contracts. A number of NPs have reached out to me saying they would like to start their own practice. When I ask where they are now working, many will say, “For the hospital” to which I add, “Did you sign a contract.” When they say, “Yes,” I direct them to look for these non-compete provisions.
Contracts for many nurse practitioners have a provision that they cannot work within a certain area meaning not only where they work but the entire health system as well. Such provisions also set a restriction for a period, usually about 2 years.
For a legal nurse consultant, if they subcontract, they usually find this provision in their contract as well. I have seen one contract go as far as saying that the legal nurse consultant cannot contact any attorney in the restricted area regarding your legal nurse consulting services.
In my opinion, that is overly broad. However, because many nurses don’t understand these provisions, they sign the contract anyway.
If you are going to have a non-compete clause in your contract as a legal nurse consultant, I recommend that it should be specifically for that one client and service. So, if you are attending a DME for a legal nurse consultant for an attorney, the covenant not to compete should be for that one attorney and should be only for DMEs.
Therefore, if you want to contact the attorney for other consultant services, you have no problem. However, you do not want to bite the hand that feeds you. If this legal nurse consultant is subcontracting and giving you DMEs, you don’t want to go behind their back and take their clients.
It is important to be in integrity with these agreements and to know what they say before you sign. Be in integrity and respect and follow the agreement.
It is important to be knowledgeable about everything that you sign because you are required to abide by it. Ignorance is not a defense.
I did not realize that travel nurses make an average hourly rate of $120.00 per hour!
In an article regarding travel nursing by the numbers, the R.N. vacancy rate is a full percentage point higher this year than in 2020.
However, the number participating as travel nurses is declining because the cost of travel is so much more than it was last year thanks, in part, to rising fuel prices.
Travel nurses made an average of $1,673 per week last year, and now make more than $4,000 per week in some cases. In May 2020, the annual pay to travel nurses averaged $75,330 per year with the lowest pay for a registered nurse at a facility was $53,410 per annum.
While it is great that travel nurses are pitching in and seizing the opportunity to fill in where staffing help is needed, this is a huge area where nurses can get into trouble.
Nurses need to know the policies and procedures of the hospitals where they will be working. Just because you worked at one hospital where things were done a certain way does not mean you can do the same things the same way at another hospital.
Additionally, many nurses are not reading their contracts. DO IT!
I frequently receive telephone calls from nurses who say things like, “Well, they promised me this, but they didn’t deliver.” No matter what they may say, if it is not in the contract, it is not going to happen! You might be told that you will not treat CV-19 patients YET find yourself on a COVID floor. You do not have a choice unless it is specifically stated in the signed contract that you will be doing no such thing.
Many travel nurses just sign on the dotted line without knowing what they are committing themselves to. The contract may be canceled for any reason, even before they start. So, an unknowledgeable nurse may move across the country to take a position only to find upon arrival that the position is no longer available.
Another problem is that one may have to pay a fine should they decide to leave the position early. Failing to read and understand a contract can expose you to a myriad of problems.
It is my hope that all travel nurses seriously and deeply review their respective contracts when negotiating.
As of now, many contracts are standard with no negotiation, but if until travel nurses band and stand together saying, “We are not going to sign this, we are not going to agree to it unless we have certain conditions in the contract,” it will never happen.
Now is the time, as travel nurses are so needed, to band together and advocate for your protection with provisions in the contract that protect you.
California has become the 29th state to allow nurse practitioners to practice independently. New York, Massachusetts, and Delaware recently became full practice authority states as well. However, in California, they must go through 3 years of physician oversight before they can reach the point of independent practice.
This was a hard-fought battle that was settled with Governor Newsom finally signing the bill into law.
The reason for the legislation was that many patients in the Golden State do not have ready access to physician care. Despite its purpose to create an expanded envelope to provide greater care for state residents, the California Medical Association objected to the new law stating that physician-based care is the model that ensures the greatest patient safety.
The Association also claimed that other states which have allowed full practice authority for their nurse practitioners have not shown any meaningful improvement in the access to care in underserved communities.
That state’s Board of Registered Nursing will need to develop regulations to implement the particulars of this bill while the California Medical Association will remain involved.
This is a huge step for nurse practitioners in the state which also affects physicians who, because of the bill, will now lose the fees they had been charging for clinical practice oversight of the nurse practitioners.
Massachusetts and Delaware allowed NPs to practice due to the pandemic and recently passed permanent legislation.
Nurse practitioners provide care in a holistic manner and take more time assessing patient issues. I believe their care is outstanding, and they take the time to speak with patients and get to know them. I am glad that nurse practitioners are getting the recognition they deserve to be able to have full practice authority.
The State of Indiana just passed a law about transparency in healthcare because many healthcare providers who perform tasks like those done by physicians are not actually M.D.s.
For example, nurse anesthetists call themselves “anesthesiologists” which can confuse the average person. This new law requires that patients be informed of the specific qualifications of the healthcare professionals involved with their care.
In California, where I reside, there is an urgent care service called M.D. Today. People go there believing they will be seen by an M.D. but, most likely, the person will be seen by a Physician Assistant with no M.D. actually being in the facility.
Several medical groups have opposed the misappropriation of medical specialty title. In particular, the American Association of Nurses Anesthetists recently changed its name to the American Association of Nurse Anesthesiology (AANA).
Opposing that name change was the American Society of Anesthesiologists (ASA) and the American Medical Association (AMA) asking for transparency. According to the AANA, the name was changed due to rebranding. “The notion of being pushed by the American Society of Anesthesiologists that rebranding and changing the name of the AANA will somehow mislead or harm patients or create discord among providers is absurd at best and false and inflammatory fearmongering at worst.”
With so many different specialties in health care, a nurse practitioner who has a Doctor of Nursing practice, can call themself “doctor.” But just because one is titled as “doctor” does not mean that the person is a physician.
I believe the public has a right to know of the degrees their healthcare providers have earned but also, I question why that information would be hidden from the public.
It is interesting that Indiana feels compelled to pass a law on this.
How are health care professionals differentiated where you work? Let me know your thoughts in the comments below.
Lorie Brown, Nurse Attorney, talks about Nurses thinking about becoming an entrepreneur and gives her top 7 tips to starting a nurse business. Tips include choosing your business and marketing. To schedule a free 15 minute business assessment call with Lorie, go to: CallWithLorie.com
