Nursing shortchanged

The revised bill to restrict the use of mandatory overtime to fill the nursing shortage is one of the better examples of thoughtful compromise likely to come out of the Legislature this session. Rather than merely object to the original proposal and threaten veto, Gov. King laid out his concerns in detail, nurses, hospital administrators and other interested parties met and addressed those concerns, the House and Senate incorporated the needed changes into the bill.

The result – restricted use of mandatory overtime with a specific limit and required rest period – is, as those on both sides of the issues agree, only a start, a much-needed acknowledgement of the larger problem. This was never, despite the assertions of some early opponents in the Legislature, a squabble between one hospital and one nurses’ union in which the state had no interest, but a small part of an enormous national, even international, crisis.

It is a crisis rooted in the same antiquated discrimination that keeps another traditionally women’s profession – teaching – underpaid and overworked. It is aggravated by welcome changes in attitude elsewhere in the business world that have opened many new and rewarding opportunities for women. It will be resolved only with competitive pay and respectful working conditions.

With the enormous and growing amounts of money spent on health care, it would seem obvious that the way to ease a nursing shortage would be to spend some of that money on paying nurses well, thus attracting more people to the profession. As a recent Washington Post story illustrates, however, the hospital industry apparently will spare no expense in avoiding paying nurses a decent wage.

The nursing shortage is so severe in the Washington area that hospitals there are recruiting overseas, bringing in hundreds of nurses from, principally, Britain and the Philippines. In one case, a private recruiter was guaranteed more than $1 million in fees to deliver 235 foreign nurses. In another, a recruiter lined up 90 foreign nurses at a London job fair and billed the Washington hospital on the receiving end $5,000 for each as a finder’s fee – a total of $450,000. Hospitals there defend this as preferable to the old practice of paying employment agencies up to $70 an hour to hire free-lance local temps.

Since temps usually work for low pay and no benefits, it may be. But then the Washington hospitals spoil whatever advantage patients get from having full-time, permanent staff nurses by getting stingy. Rather than the pay of their imported nurses on the prevailing standards, the hospitals are crediting the U.K. and Philippine-trained nurses for only half of their experience – paying a 10-year nurse like a five-year nurse, for example. This substantial difference, several thousand dollars per nurse, not only creates disgruntled new employees but also aggravates the existing staff of American nurses who correctly see this policy as one designed to drive down wages.

The nursing shortage was caused by an outdated attitude that created a historic pattern of shortchanging nurses in both the pay and working conditions that should accrue to highly educated professionals in any field. The overtime bill worked out by Maine lawmakers is a good start on improving working conditions, but, as the Washington story suggests, the outdated attitude still has a lot of catching up to do.