'Can anyone blame nurses for turning the tables?'

Expensive reliance on traveling nursing is a symptom of a longer-running, self-inflicted disaster: hospitals' failure to hire and support enough nurses to weather crises, an op-ed contends in The Washington Post.

"The undervaluing of nursing has deep roots. From the dawn of modern American hospitals in the 19th century, hospitals have treated nursing care like something they should get for free," Sarah DiGregorio, author of "Early: An Intimate History of Premature Birth and What it Teaches Us About Being Human" and a forthcoming cultural history of nursing, wrote in her op-ed for the Post

She outlined numerous ways nurses are undervalued, from nurse educators being paid a fraction of what they could make working clinically — leading to a shortage of instructors that limits the nursing pipeline — to reimbursement models contributing to lean nurse-to-patient ratios. 

"Employing more nurses per patient is safer for patients, and it makes nurses less likely to burn-out and quit," Ms. DiGregorio wrote. "But hiring and supporting a large nursing staff is expensive, and many hospitals have been unwilling to do it. Travel nurses are expensive, too, but they are a short-term expense; they don't get benefits or job security." 

Travel nurses can command an average of about $3,500 per week — sometimes more. In late January, nearly 200 House members urged the White House to investigate costs charged by nurse staffing agencies. Shortly after, the American Hospital Association and American Health Care Association/National Center for Assisted Living followed suit, urging Jeffrey Zients, the White House COVID-19 response coordinator, to investigate staffing agencies. The groups carefully pointed out that staffing agency prices are not directly correlated with the income that individual travel nurses bring in. 

"Incredibly, given Congress' inability to come together to curb prescription drug costs or pass paid family leave, they have found common ground on one issue: cracking down on nurses' pay," Ms. DiGregorio wrote. "Meanwhile, rising hospital administrator pay has escaped political scrutiny — though there is no correlation between those salaries and hospital mortality or readmission rates. This is not only deeply unfair and shortsighted, it may make the problem worse." 

Ms. DiGregorio says the only way for hospitals and lawmakers to address the nurse staffing crisis is to address a "collective failure to value caring."

"Can anyone blame nurses for turning the tables, for working within the system's own flawed, profit-driven logic, for charging what the market will bear? Can we really look at the state of our healthcare system and conclude that travel nurse salaries are the problem? Isn't it telling that the industry has only asked the government to step in now, when nurses are the ones wielding their market power?"

Read Ms. DiGregorio's full op-ed in the Post here.

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