Lorie A Brown, R.N., M.N., J.D., Author at Empowered Nurses

Top 10 Nursing Practices That Are No Longer Approved

February 5, 2026 7:41 pm Leave a Comment

(A nostalgic, slightly alarming walk down memory lane)

I jokingly say I was practicing nursing when the dinosaurs roamed the earth but here are some things we did that we no longer do. I am sure you have some examples on your own.

1. Unclogging G-Tubes with Coca-Cola For years, Coca-Cola was treated like a medical device hiding in plain sight. If a G-tube clogged, nurses reached for a can, confident that carbonation and acidity would save the day. While this was historically common, evidence now shows that carbonated beverages and juices are inferior to warm water and can actually make clogs worse by curdling proteins in formula. The vending machine has officially been removed from enteral therapy.

2. Using Saline for Suctioning Instilling saline directly into a tracheostomy or endotracheal tube before suctioning was once thought to loosen secretions and make suctioning more effective. Research later revealed that this practice can cause hypoxia, increase infection risk, and add unnecessary discomfort. What felt helpful turned out to be harmful, and routine saline instillation is now firmly discouraged.

3. Shaving Pre-Operative Patients Routine shaving of surgical sites used to be standard pre-op care. The cleaner the skin looked, the safer the surgery—or so we thought. Evidence showed that shaving creates micro-abrasions that increase surgical site infections. Clipping, not shaving, is now the preferred method, and razors have been officially banished from pre-op prep.

4. Routine Gastric Residual Checks Checking gastric residuals on tube-fed patients was once considered essential for preventing aspiration. Nurses measured, documented, discarded, and worried. We now know that frequent residual checks do not reliably predict aspiration risk and can lead to clogged tubes and accidental dislodgement. Less poking, fewer problems.

5. Sliding Scale Insulin with Urine Dips Before glucometers became commonplace, urine dipsticks were used to estimate glucose levels, and insulin was adjusted accordingly. The problem? Urine glucose lags far behind blood glucose and is wildly inaccurate. Blood glucose monitoring has replaced this practice entirely, and urine dips have been retired to nursing history trivia.

6. “Milking” or Stripping Chest Tubes Stripping chest tube tubing was once taught as a way to prevent blockages and maintain drainage. Unfortunately, this practice can generate dangerously high negative

pressure, risking lung tissue damage. Current standards strongly discourage routine stripping, reserving it only for rare, provider-directed situations.

7. Routine Soaking of Feet for Diabetic Patients Warm foot soaks were once considered soothing and hygienic for patients with diabetes. We now know that soaking can macerate skin, increase infection risk, and cause injury in patients with neuropathy who may not feel heat or trauma. Modern diabetic foot care focuses on protection, inspection, and keeping skin dry and intact.

8. Reusing Needles, Catheters, and Other Instruments There was a time when supplies were reused after sterilization due to cost, availability, and necessity. Today, this practice is unthinkable. Reusing syringes, urinary catheters, or other single-use instruments carries an unacceptable infection risk and is strictly prohibited under modern infection-control standards.

9. Using Alcohol Rubs or Baths to Reduce Fever Alcohol rubs and baths were once used to bring down a patient’s temperature. While they appeared effective, alcohol causes vasoconstriction and shivering, which can actually raise core body temperature and increase discomfort. Evidence has fully retired alcohol from fever management.

10. Placing Antacids or Food Products on Pressure Ulcers At one time, antacids, sugar, honey, and other household substances were applied to pressure ulcers in hopes of promoting healing or controlling bacteria. These practices have been replaced by evidence-based wound care products designed specifically for tissue repair, moisture balance, and infection prevention.

None of these practices were done out of carelessness. They were done by nurses who were resourceful, committed, and working with the best knowledge available at the time. Nursing didn’t get safer because nurses were wrong—it got safer because nurses were willing to learn, adapt, and change. And that, arguably, is still the most important nursing skill of all.

For Nurse Business Owners: Focus on the Destination, Not the Plane Ride

January 30, 2026 7:58 pm Leave a Comment

Here’s something no one tells nurse business owners early enough:

There will be parts of this journey you do not want to do.

Not because they’re wrong. Not because they don’t work. But because they’re uncomfortable.

And nurses? We’re very good at confusing comfort with commitment.

The plane ride of business ownership looks like: Learning sales when you’d rather perfect your service. Marketing yourself when you were taught to be humble. Having hard conversations about money, boundaries, and value. Showing up before you feel “ready.”

And for me, it was dealing with the money and taxes when I can’t balance my checkbook.

None of that feels cozy. None of it feels natural at first. And none of it means you made a bad decision.

It just means… you’re in transit.

The destination—the reason you started—was never about loving every step. It was about freedom. Autonomy. Impact. A business that works for you, not one that drains you like an extra shift you never agreed to.

Here’s the shift that changes everything:

Commitment asks, “Where am I going?” Comfort asks, “How do I feel right now?”

If you only move when it feels comfortable, you’ll taxi forever and never take off. Also, feelings are the worst business owners because you will never feel like doing something that makes you feel uncomfortable.

Some days, commitment looks like: Sending the email you’ve been avoiding or making the call. Raising your rates before your nerves calm down. Hiring help before you feel “big enough.” Staying the course even when the turbulence makes you question everything.

You don’t judge a destination by the plane ride. You don’t cancel the trip because the seat is uncomfortable. And you don’t quit your business because growth feels awkward.

This is the part most people turn around.

But nurse business owners aren’t “most people.”

So if today feels bumpy, ask yourself: Am I choosing comfort—or am I honoring my commitment to where I said I was going?

Keep your eyes on the destination. That’s where the exhale lives.

When one nurse is lost, all of us feel it

January 29, 2026 8:39 pm Leave a Comment

That’s not just a line from a press release—it’s the quiet truth beating in the heart of every nurse, every patient, and every person who knew and even those that did not know Alex Pretti. On January 24, 2026, the world lost a bright light: a man who chose nursing not just as a job but as a calling through a needless and senseless murder.

Alex was just 37 years old—a registered ICU nurse at the Minneapolis Veterans Affairs Health Care System, where he cared for some of the sickest and most vulnerable among us. Colleagues remember him as kind, skilled, and ready with a joke even when the shift was long and heavy.

We enter nursing because we want to ease pain, hold hands, steady trembling hearts—not because we seek comfort for ourselves, but because someone must be there in another’s darkest hour. Alex embodied that truth. Patients and coworkers alike saw in him not only competence but profound compassion: the sort that wraps around families as much as it wraps around patients’ trembling hands.

In one deeply moving moment now shared online, Alex stands at the bedside of a veteran patient, honoring him with a “final salute”—a tribute spoken not with routine words, but with reverence for a life that served others. “Freedom is not free,” he said, reminding us all of the debt owed to those who sacrifice.

To know that someone with a heart like his was taken so suddenly and violently is devastating. In Minneapolis on that January morning, federal agents shot and killed Alex during a confrontation that has since sparked intense debate, mourning, and calls for accountability. The circumstances remain under investigation, and conflicting narratives swirl—but what remains clear to all who knew him is this: Alex was not a threat; he was a caregiver, a neighbor, a friend, and a healer.

His parents described him as a “kindhearted soul” who cared deeply for family, friends, and the veterans he served each day. “Alex wanted to make a difference in this world,” they said—words that now carry both aching grief and stubborn hope.

Because nurses see life up close, we understand how fragile it truly is. We’ve watched monitors flatline, held phones so families could say goodbye, and stood in silence when goodbyes were overdue. And we know that loss radiates far beyond a single moment—through shifts unfinished, through coffee mugs left warm, through the echo of laughter that once filled a break room.

But we also know legacy: a name spoken with love, a story shared to remember, a life that mattered fiercely to people who knew him and even to those touched by his example. Alex Pretti’s legacy lives in every act of kindness, every nurse who pauses to truly see a patient, and every person who today feels the weight of loss mixed with the warmth of having known him.

This is not just a sad story—it’s a call to remember why we serve, why we care, why human life matters. In the quiet moments between beeps and breaths, we keep his memory alive. When we

advocate for safety, accountability, and dignity for all caregivers, we honor him. When we choose compassion over convenience, courage over complacency, we honor him.

Because Alex didn’t just wear scrubs—he lived the promise of nursing: to show up, to shield, to comfort, to heal. And when someone like that is lost, the world feels a little colder, a little quieter, a little less sure of itself.

But his impact? That stays. That never leaves. That becomes part of all of us who continue to care.

Nursing strikes in New York, California, and Hawaii: where things stand and what it really means

January 22, 2026 7:20 pm Leave a Comment

Right now, nursing labor disputes across New York, California, and Hawaii feel less like isolated events and more like a system-wide stress test. When multiple regions are striking or preparing to strike at the same time, it’s not just a contract dispute anymore when nurses are already stretched thin.

In New York, the strike is no longer theoretical. As of mid-January 2026, thousands of nurses represented by the New York State Nurses Association walked out of multiple hospitals across New York City, including facilities within the Mount Sinai, Montefiore, and New York-Presbyterian systems. The strike began on January 12 and has continued into its second week, with negotiations restarting intermittently but without a comprehensive resolution. Nurses have been vocal about staffing ratios, workplace safety, and benefits, while hospitals maintain that they are continuing operations through the use of temporary replacement staff. From the outside, the lights are on and the doors are open—but anyone who has ever worked a unit held together with travelers and emergency staffing knows that “open” is not the same as “stable.”

Meanwhile, California and Hawaii are bracing for what could become one of the largest coordinated healthcare strikes in recent years. Tens of thousands of nurses and healthcare professionals at Kaiser Permanente facilities have issued notice of an open-ended strike scheduled to begin January 26, 2026. The planned walkout would affect hospitals and clinics across both states, with union leadership citing staffing levels, access to timely care, wages, and bargaining practices as core issues. Kaiser, on the other hand, has publicly framed the dispute as largely economic and has emphasized its contingency plans to maintain patient safety if the strike proceeds. At the time of writing, this situation remains a “strike pending” scenario—no resolution has been announced, and both sides are digging in.

As these disputes unfold, one of the most emotionally charged questions nurses face is whether to cross the picket line. This decision is rarely philosophical and almost never simple. Nurses who cross often do so because they need immediate income, or feel a deeply ingrained ethical pull to remain at the bedside. For some, strike pay does not come close to covering the cost of living, particularly in high-cost regions like New York City, California, and Hawaii. In those moments, the decision feels less like a labor stance and more like choosing between oxygen and principle.

At the same time, crossing a picket line can carry significant personal and professional consequences. Relationships with colleagues may fracture in ways that do not easily heal once the strike ends. Union members who cross may face internal disciplinary processes depending on the union’s bylaws. There is also the patient safety reality that replacement staffing, while legally permissible and operationally necessary for hospitals, often lacks unit-specific familiarity. Policies, workflows, and subtle patient cues can be missed. From a nursing standpoint, the patient may technically be monitored, but the margin for error grows thinner.

For nurses weighing this decision, it can help to think in familiar clinical terms. Assessment means taking an honest look at finances, family responsibilities, and professional risk. Diagnosis means naming what is truly driving the decision—fear, necessity, ethics, or exhaustion. Planning involves deciding how to act intentionally rather than reactively, and evaluation comes later, when the dust settles and lessons are learned. There is no universal right answer, only informed ones.

Behind all of this is a question hospitals rarely want discussed publicly: what do strikes actually cost medical centers? The answer is far more complex than “higher wages.” During active strikes, hospitals may pay replacement nurses rates reported as high as several thousand dollars per week per nurse, particularly in high-demand urban markets. I read $9,000/week. That figure does not include agency fees, travel and housing expenses, onboarding costs, or the overtime required for managers and supervisors to maintain coverage. Elective procedures, which are often the financial backbone of hospital operations, may be postponed or cancelled due to staffing instability, further eroding revenue.

Operational inefficiencies also multiply. Running a hospital with large numbers of temporary staff slows throughput, increases reliance on workarounds, and diverts leadership attention away from quality improvement and risk reduction. Even when adverse events do not make headlines, near-misses and system strain quietly accumulate. In past large-scale strikes, replacement staffing costs alone have reached tens of millions of dollars per week, offering a sobering reference point for how quickly financial losses can escalate. Why don’t they just pay nurses a fair wage rather than paying these exacerbated costs?

The hidden costs may be even greater. Prolonged labor disputes can damage a hospital’s reputation, make recruitment more difficult, increase long-term reliance on agency staff, and deepen turnover once the strike ends. In healthcare, winning a contract battle while losing the trust of your workforce is a short-term victory with long-term consequences.

As of now, New York nurses remain on strike, while California and Hawaii nurses are watching the calendar inch toward January 26. For nurses across the country, these events are being closely watched not just as labor actions, but as signals of how much strain the healthcare system can absorb before something gives. Like any patient under prolonged stress, the system may keep compensating—until it can’t.

Nurses: There Is a Path to Loan Relief — Here’s How Washington Is Helping

January 14, 2026 9:15 pm 1 Comment

For many nurses, student loan debt shapes career decisions long after graduation. It influences where you work, whether you pursue an advanced degree, and if teaching or serving in an underserved area is even financially possible.

Washington State has taken steps to address this reality through loan repayment initiatives designed specifically to support nurses while strengthening the healthcare workforce.

Here’s what’s happening and why it matters.

Why Washington Created These Programs

Washington is facing ongoing shortages in:

· Rural and underserved communities

· Primary care and behavioral health settings

· Nursing faculty and nurse educators

At the same time, the cost of nursing education continues to rise, especially for nurses pursuing graduate degrees. Many nurses want to serve in high-need areas or transition into teaching but simply cannot afford to do so while carrying large student loan balances.

These loan repayment programs are intended to reduce that barrier — not as a bonus, but as a workforce strategy.

Washington Health Corps Loan Repayment Program

The Washington Health Corps Loan Repayment Program offers student loan repayment for licensed healthcare professionals, including registered nurses and advanced practice nurses, who work in approved shortage areas.

Key points nurses should know:

· You must work at an approved site serving a high-need population

· Loan repayment is provided in exchange for a service commitment

· Awards can be substantial and are applied directly to qualifying student loans

· Applications are typically open once per year, usually January through early March

For nurses already working in these settings, this program can provide financial relief without requiring a job change. For others, it may make a previously unaffordable position realistic.

Nurse Educator Loan Repayment Program

Washington also offers loan repayment for nurses who teach in accredited nursing programs.

This program recognizes a critical issue: nursing schools cannot expand enrollment without qualified educators, yet teaching salaries often do not match the financial investment required to obtain advanced nursing degrees.

What this program supports:

· Registered nurses with advanced degrees

· Teaching roles in approved nursing education programs

· Loan repayment tied to a teaching commitment

Supporting nurse educators is essential to maintaining and growing the nursing workforce statewide.

Why This Matters Now

Recent federal policy discussions have raised concerns about reduced access to graduate-level student loans for nurses. If those changes move forward, nurses pursuing advanced practice or faculty roles could face even greater financial strain.

Washington’s loan repayment initiatives help offset that risk and demonstrate a commitment to keeping nurses in roles that are critical to patient care and education.

What Nurses Should Do Next

If you are interested in these programs:

· Review eligibility requirements early

· Confirm whether your employer or school is an approved site

· Gather loan and employment documentation ahead of the application period

· Speak with leadership or HR — many organizations are familiar with the process

These programs are competitive, and preparation matters.

Bottom Line

Loan repayment programs do not eliminate the challenges nurses face — but they can significantly reduce financial pressure and expand career options.

For nurses who want to serve where they are needed most or teach the next generation, Washington’s initiatives may provide the support that makes those paths sustainable.

If you are not in Washington State, share this initiative with your legislators in your states.

This isn’t about incentives. It’s about keeping experienced nurses in roles the healthcare system depends on.

Focus on the Destination, Not the Plane Ride

January 8, 2026 7:17 pm 1 Comment

Most nurses don’t quit because they don’t love nursing. They quit because the plane ride is exhausting.

Turbulence. Delays. Cramped seats. No legroom. Someone kicking the back of your chair while asking you to “do more with less.” Sound familiar?

Somewhere along the way, many nurses start believing that the plane ride is the trip. That if it’s uncomfortable, chaotic, or downright miserable, then maybe the destination isn’t worth it—or worse, doesn’t exist at all.

But that’s not true.

The plane ride is just the process. The destination is the life you actually want.

And nurses? We are very good at tolerating uncomfortable processes. Sometimes too good.

When the Plane Ride Becomes the Focus

When you’re in survival mode, it’s hard to see anything beyond the next shift, the next chart, the next crisis. Your world shrinks to tray tables and seatbelt signs.

You start thinking:

· “Once staffing gets better…”

· “Once leadership changes…”

· “Once I’m less tired…”

But that’s like staring at the flight map while ignoring why you booked the trip in the first place.

You didn’t become a nurse to sit in perpetual turbulence.

The Destination Matters

The destination might look different for each nurse:

· More autonomy

· Time with family

· A business, a pivot, a new role

· Peace without guilt

· Work that doesn’t require recovery days

Destinations don’t require perfection. They require direction.

And here’s the part nurses forget: You’re allowed to adjust the route.

You can change planes. You can upgrade seats. You can decide that nonstop is worth it—even if it costs more energy upfront.

A Gentle Reframe

When things feel unbearable, ask yourself:

“Am I judging my entire career based on the plane ride instead of the destination?”

Because no one posts vacation photos of the airport security line. They post sunsets, laughter, and the moment they finally exhale.

Your current discomfort does not mean you chose wrong. It means you’re in transit.

Final Thought

Nurses are trained to endure. But you were never meant to live in turbulence.

Keep your eyes on where you’re going. The destination is still there—even if the ride is bumpy.

And if it’s time to land somewhere new? That’s not failure. That’s navigation.

Your License Is Your Lifeline: What the NSO 2025 Claims Report Reveals About License Defense

December 31, 2025 2:13 pm 1 Comment

Most nurses think about malpractice insurance the way we think about crash carts — important, but something we hope we never have to use.

License protection? That’s more like oxygen.

You don’t notice it… until suddenly, you can’t breathe.

The 2025 NSO/CNA Nurse Professional Liability Claim Report (5th Edition) offers a sobering but empowering look at what actually happens when nurses face State Board of Nursing (SBON) investigations — and why license defense coverage is no longer optional, even for nurses who “do everything right.”

License Protection Is Not Malpractice — And That Distinction Matters

One of the most important clarifications in the report is this:

License protection matters are fundamentally different from malpractice claims.

· Malpractice is a civil lawsuit brought by a patient or family.

· License protection matters arise when the State Board of Nursing investigates you

And here’s the part many nurses don’t realize until it’s too late:

👉 A civil court cannot take your license. 👉 A nursing board absolutely can.

Boards exist to “protect the public,” not to protect nurses. Their outcomes range from dismissal… all the way to probation, suspension, or revocation. That’s not a slap on the wrist — that’s career-altering.

Think of it like this: A malpractice case is a complicated wound. A board complaint is a threat to your central line.

The Numbers Nurses Can’t Ignore

According to the 2025 report, license defense costs are rising sharply, even though the number of matters has slightly decreased.

Here’s what stood out:

· 1,125 license protection matters closed between 2020–2024

· Total defense costs exceeded $7 million during that period

· Average cost per license defense matter rose 18.3%, from $5,330 to $6,304

And remember — that’s just defense costs. Even cases that end with no discipline still require attorneys, responses, preparation, and time.

In nursing terms? That’s a long ICU stay… even when the patient survives.

What Triggers Board Complaints? (Hint: It’s Not Just Patient Care)

The most common reason nurses faced board action in the 2025 dataset?

Professional Conduct — 38% of all license protection matters

These included:

· Substance use or diversion

· Criminal charges (including DUI)

· Social media behavior

· Boundary violations

· Documentation and disclosure issues

· Even how information was reported on a license renewal

More than half of all board matters (52%) involved professional conduct or scope of practice — not bedside errors

This is where nurses often say:

“But I wasn’t even taking care of a patient…”

Exactly. And the board still has jurisdiction. They have a duty to ensure safety to the public. You are a nurse 24/7 and your actions off duty can cause discipline because of ethical issues. If

you chose to get behind the wheel of a car after drinking, what other judgments could affect patient care?

Scope of Practice: The Slippery Slope Nurses Don’t See Coming

Scope-of-practice allegations accounted for 14% of license protection matters

Many of these cases involved:

· Medspas

· Clinics

· Home care

· Situations with poor supervision or unclear policies

The report calls this “scope creep” — when nurses step slightly beyond authorized practice, often trying to help, move things along, or be a “team player”

In other words: Good intentions… poor outcomes.

Like pushing meds without a clear order because “that’s how we always do it.”

Why Your Employer’s Insurance Won’t Save You

This is the part I wish every nurse learned before they get the letter or email from the Board.

Employer insurance:

· Protects the facility

· Responds to patient claims

· Often does not provide independent license defense

Once the board comes knocking, nurses are frequently on their own — unless they have individual coverage that includes license protection.

The Real Takeaway: Preparation Is Protection

The NSO report isn’t meant to scare nurses. It’s meant to prepare them.

Here’s what it makes clear:

· Board complaints are common — and increasing in complexity

· Defense costs are rising

· Many matters involve non-clinical behavior

· Nurses with coverage and early legal support fare better

Your license is not just a credential. It’s your livelihood. Your identity. Your ability to keep doing the work you love.

Protecting it isn’t paranoia.

It’s professionalism.

Final Thought

Nurses are trained to assess risk early — before the patient crashes.

Your career deserves the same vigilance.

Because when it comes to your license, hope is not a strategy — preparation is.

Time Management for Nurse Entrepreneurs: Stop Treating Your Business Like a PRN

2:09 pm Leave a Comment

Nurses are masters of time.

You can pass meds, answer call lights, chart, calm a family member, and somehow still know it’s exactly 10:59 and the IV antibiotic must be hung by 11:00. That skill didn’t disappear when you became a nurse entrepreneur.

So why does your business feel like a patient circling the drain while your to-do list codes every afternoon?

Because most nurse entrepreneurs are running their businesses like an understaffed med-surg unit on a holiday weekend — reacting instead of leading.

Let’s fix that.

First, a Diagnosis 🩺

Most nurse entrepreneurs don’t have a time problem. They have a boundary problem.

You’re treating every email like a STAT order. Every request like it’s life-or-death. Every opportunity like you have to say yes “just in case.”

Sound familiar?

In healthcare, we triage. In business, many nurses forget that skill entirely.

Triage Your Time Like You Triage Patients

Not everything deserves immediate attention.

Ask yourself:

· Is this revenue-generating?

· Is this mission-critical?

· Or is this busywork dressed up in scrubs?

If it doesn’t move your business forward, protect your license, or put money in the bank — it goes to the waiting room. My favorite saying is do, delete or delegate!

You would never start an IV on someone with a paper cut while a stroke patient waited. Stop doing that with your calendar.

Stop Charting on Everything

Perfectionism is the silent time thief of nurse entrepreneurs.

You don’t need:

· The perfect website before you start

· The perfect logo before you pitch

· The perfect plan before you act

In nursing, we chart what matters. In business, document the essentials and move on.

Progress beats pristine every single time.

Block Time Like It’s a Medication Pass

Here’s a hard truth: If it’s not scheduled, it’s not going to get done.

Calendar everything and treat your time like it was money. How would you spend it? Would you network or not work!

Time blocking isn’t restrictive — it’s protective.

Create blocks for:

· Client work

· Marketing

· CEO thinking time (yes, that’s a thing)

· And off time (because burnout is not a badge of honor). I always block time for vacations first or I would not take one.

You wouldn’t randomly pass meds whenever you “felt like it.” Don’t run your business that way either. Your business is a baby. Don’t stick it in the closet!

Delegate Like a Charge Nurse

You don’t have to do everything.

And no — doing it yourself is not “saving money.” It’s costing you growth.

If someone else can do it 80% as well as you, hand it off.

· Bookkeeping

· Scheduling

· Tech

· Social media posting

In addition, hire out to make your life easier and give you more time to grow your business such as housecleaning, laundry, grocery shopping and even cooking.

Your highest and best use is strategy, vision, and leadership — not playing whack-a-mole with admin tasks.

Build White Space Into Your Shift

Here’s the part nurses struggle with the most: rest.

White space isn’t laziness. It’s clinical judgment.

That’s where creativity lives. That’s where clarity shows up. That’s where your next big idea breathes.

If you run your business at 100% capacity all the time, something will fail. In healthcare, we call that a sentinel event.

Final Discharge Instructions 📝

Time management for nurse entrepreneurs isn’t about doing more.

It’s about:

· Doing fewer things

· On purpose

· With intention

· And without guilt

You already know how to manage chaos. Now it’s time to manage your energy, your priorities, and your future.

Because you didn’t leave bedside to create another exhausting shift — you left to build freedom.

And that, my friend, deserves protected time.

Are We Shortchanging the Teachers of Nurses? The Stark Salary Gap Between Nurse Educators & Clinical Nurses

December 25, 2025 6:50 pm 1 Comment

Imagine you’re in a busy hospital unit at 0700: monitors beeping, report ending, meds due. That’s clinical nursing — high stakes, high stress, high compensation compared to many other nursing roles. Now imagine standing before a classroom of eager students, each hoping you’ll turn their anxiety into confidence — that’s the role of a nurse educator. But here’s the surprising twist: the clinicians at the bedside often make significantly more money than the educators preparing tomorrow’s nurses.

The Numbers Don’t Lie (But They Do Surprise) Recent research shows the average annual salary for nursing faculty — the people tasked with turning seasoned RNs into experienced educators — sits around $81,600, compared with about $90,400 for clinical RNs in direct care roles. That’s more than $8,000 less yearly on average, even before you adjust for experience, education, and hours worked.

Once those adjustments are added in, the gap widens dramatically:

· Nurse educators earn about $18,300 less than staff nurses

· $19,800 less than charge nurses

· And a whopping $27,500 less than front-line nurse managers who often still spend part of their time at the bedside.

Thus, educators are sending new grads off to earn more than you do for teaching it.

So Why Does This Matter?

This isn’t just about paychecks — it’s a workforce crisis. When educators make less than their clinical counterparts despite often having higher degrees and more experience, fewer seasoned nurses choose to step into faculty roles. That means fewer instructors for nursing programs, and fewer seats for students eager to enter the profession. That’s a pipeline issue with real-world repercussions — patients needing care and classrooms needing teachers.

To keep nursing education healthy, we can’t treat faculty like an afterthought. After all, they’re the ones teaching clinical judgment, triage skills, and the art of compassionate care — arguably more important than memorizing lab values.

What’s Driving the Gap?

Several factors contribute:

· Academic budgets often lag behind clinical revenue streams. Universities may not have the financial agility of hospital systems that bill — and get paid — for every procedure and nursing service.

· Clinical roles, especially in specialty areas, command premium wages, particularly in high-cost regions or when overtime and shift differentials are factored in.

· Some nurse educators work academic calendars, which can reduce the annualized pay compared to 12-month clinical contracts.

Why Nurse Educators Still Matter (and Deserve Better Pay)

You know that moment when a student finally masters an IV start they’ve been struggling with? That “aha!” moment lights up the room — and that’s the everyday reality of nurse educators. They are the heart specialists of knowledge transfer: diagnosing learning gaps, crafting teaching plans, mentoring through clinical uncertainty, and prepping nurses who will look after your family in their darkest moments.

Educators often do it with fewer resources — and less compensation. This isn’t just an economic disparity — it’s a mismatch between impact and reward.

What Can We Do?

Nursing organizations and policymakers are already sounding the alarm. Bills like the Nurse Faculty Shortage Reduction Act aim to bridge this gap by supporting faculty salaries and recruitment efforts so that educators aren’t pushed back into the bedside purely for financial reasons. Please call your congressmen to support this.

Conclusion

Clinical nurses save lives every day — that’s undeniable. But nurse educators save the profession itself. We wouldn’t tolerate an ICU with half the nurses we need, so why tolerate a faculty shortage that limits the nurses we can train?

We owe it to future patients, future clinicians, and future nurse educators to close the salary gap — to respect the educators who educate nurses with the same vigor we respect those at the patient’s side.

After all, a well-prepared nurse is the best medicine of all.

She Went to Heal — Not to Die: The Story of Nurse Joyce Grayson

December 18, 2025 7:41 pm Leave a Comment

It was just another October day in 2023, but for Licensed Practical Nurse Joyce Grayson, it was the beginning of a final chapter that would ripple across the nation of caregivers. Joyce walked into a home clinical setting — a halfway house in Willimantic, Connecticut — carrying her nursing bag, her years of experience (36 of them), and that nurse’s instinct to help. What she didn’t carry were the tools she needed to protect herself from what she already knew could be a dangerous situation.

A Hazard We Knew Was There — But Didn’t Fully Protect Against

Home health nursing is like being a solo paramedic clinician walking into a dynamic scene: the environment is uncontrolled, the patient’s history may be incomplete, and the safety net is thin. Joyce’s employer, one of the country’s largest home health care agencies, knew — or should have known — that the client visited that day was a convicted violent offender with a history of aggression. Yet Joyce went in without systems in place to protect her: no comprehensive background info, no panic alert device, no safety escort — nothing to buffer the unpredictable tension inherent in that setting.

OSHA’s investigation later concluded that the employer failed its legal duty to protect its workers from a recognized hazard: workplace violence in a home care environment. They cited the agency for not having adequate measures to reduce that risk — a general duty violation that cost a nurse her life.

The Cost of Caring

Nurses are trained to triage, to assess, to plan — but no amount of clinical skill can substitute for a broken system that doesn’t prioritize caregiver safety. When Joyce stepped into that home, she was simply doing her job. But the job, in this case, included hazards no nurse should face without protection.

Workplace violence in healthcare isn’t rare — OSHA reported hundreds of worker deaths from violence in 2022 alone — yet too often, the shield meant to protect clinicians is missing.

A Family, A Community, a Profession Changed

Joyce was more than a statistic. She was a 63-year-old nurse, a mother, a veteran of healthcare, and a heart full of care that outlived her body. Her death sparked outrage, grief, and a fierce conversation about how we protect those who protect life. Within legislatures and nursing organizations, the call for workplace violence prevention standards is growing louder — fueled by hearts broken but not silent. In Connecticut, lawmakers moved forward with new safety requirements for home care workers — tools clinics should have offered her long before she walked into harm’s way.

What Nurses Deserve — Always

Joyce’s story is tragic — this should have never happened. But it’s also a stark reminder:

· Every nurse deserves a workplace that recognizes and mitigates risks.

· Every home visit must come with intelligence, tools, protocols, and backup.

· Every agency must do more than train — they must protect.

Healthcare providers accept violence in the workplace too often as “part of the job.” We shouldn’t have to wear metaphorical armor just to administer care.

A Call to Action

We owe it to Joyce, and to every clinician who shows up wearing scrubs and compassion, to demand safety systems that work before tragedy strikes. The best protocol in the world can’t bring her back — but it can save the next nurse.

That’s how we honor her — not with statistics, but with real safety change.

Author Archives: Lorie A Brown, R.N., M.N., J.D.