Nurses earn more money than doctors?

I recently saw an article on Yahoo with the headline of nurses being paid more than doctors. The title is misleading, the actual article goes on to explain that Certified Registered Nurse Anesthetists (CRNA) make more money than family medicine doctors. It's a poor comparison, CRNAs have an extensive (and expensive) education and do not represent the earning potential of regular nurses. Family medicine physicians are the lowest paid doctors and do a year less residency than other MDs. Let's see a better comparison:

Salary data for Surgeon, Family Medicine, and RN come from the US Bureau of Labor Statistics (BLS), the CRNA Yahoo article quoted above. I note that the BLS reported a lower figure for family medicine than the article. I also note that physicians are paid during their residency while the CRNA is free labour during their MSN.

I am, in no way, denigrating the family medicine physicians. They are in short supply, not because of the lack of demand but the lack of interest by many medical students to enter the field. Prestige and additional money await specialists and bright students are encouraged to actively avoid the role of primary care medicine. High office overhead with an ever-increasing bureaucratic maze created by private insurance companies makes primary care less attractive as well.

I also suspect gender has a lot to do with this issue. Women now outnumber men in medical schools while men are entering nursing in larger numbers. Any field that is dominated by women has traditionally been poorly compensated. Doctors in Soviet Russia had little prestige and were very poorly paid. In all specialities except surgery. It is no surprise that the ranks of physicians were mostly filled with women except for surgery - almost entirely male. I see more and more of a slide in the salaries of Western doctors in the future. I also see continued improvement in the remuneration of nurses as more and more men enter the field.

Violence towards nurses

While national nursing organizations, nursing unions, and most employers tell you that violence against nurses is not tolerated in the workplace - the truth is that we get attacked. A lot. According to the federal Bureau of Labor Statistics, nurses have 12 times the rate of days off because of assaults in the workplace. That's double the rate for police officers.

I work in mental health, specifically psycho-geriatrics. Many people, especially fellow nurses, roll their eyes and say, "Well, of course you're going to get hit." It's part of the nursing culture to accept abuse. A booklet published by the Occupational Safety and Health Administration (OSHA) in 2004 noted that violence in health facilities was, “...likely to be underreported, perhaps due in part to the persistent perception within the health care industry that assaults are part of the job.”

Today I received a good scratching and a blow to the ribs from a patient. It reminded me that we spend very little time discussing this subject in nursing school and often it is not at all addressed in specialties outside psychiatry. We are not alone though. In a 2006 survey by the national Emergency Nurses Association, almost 90% of respondents said they had experienced violence in the previous three years, and 20% said they encountered it frequently.

Fewer and fewer students are entering the nursing profession. The U.S. Department of Health and Human Services report that the average age of RNs climbed to 46.8 years, the highest average age since the first comparable report was published in 1980. They go on to say that just over 41 percent of RNs were 50 years of age or older (33 percent in 2000 and 25 percent in 1980). As for the young blood in nursing, only 8 percent of RNs were under the age of 30, compared with 25 percent in 1980.

There are many reasons young people are not choosing to go into nursing. The public understands the unpleasant shift hours, the stress of an ever increasing technological environment coupled with more and more limits to resources, and the difficult science requirements to get into nursing. What the public doesn't know is that we also work in a culture where violence against us is both ignored and accepted.