Health Care's Forgotten Majority: Nurses and Their Frayed White Collars

By Jacqueline Goodman-Draper | Go to book overview

Chapter 1 Introduction

We're a profession? That's what they tell us, What other profession do you know that does heavy labor? We lift, we carry, we make beds. . . . It's hard physical labor, continually running. . . . Yet they call it a profession.

Besides taking care of patients, I'm working to put shoes on my son's feet. . . . I work to support my life outside this hospital.

Health care is undergoing a major transformation. The United States still spends a greater portion of its gross national product (GNP) on health care than any other country in the world (14 percent of the gross domestic product), with 20 percent going to administrative costs alone ( Gilbert, 1990: 33). The Clinton administration has proposed its own remedy, a system of managed competition,1 in an effort to drive that spending back down to 9 or 10 percent of the economy while providing universal coverage as well ( Eckholm, 1993: 270). No one knows what the future holds.

While physicians, hospitals, and insurance companies continue to feast at the health care banquet, there are layers of health care workers beneath this level that have gone hungry. Nursing aides, for example, are still paid close to the minimum wage of $4.25 an hour, and registered nurses' average annual salaries of $24,127 compared to the average annual physician salary of $170,600 ( Eckholm, 1993: 75; U.S. Bureau of Labor Statistics, 1993).

Will this medical profession's "forgotten majority"--the educated, wage- earning "professional" white collar worker, such as registered nurse Mary Anne Silver quoted at the start of this chapter--still remain forgotten in this health care hoopla? Mary Anne Silver is but one of that cadre of white collar workers, promised, yet generally denied, professional status and its concomitant social and economic status.

The white collar workforce in the United States has grown considerably since the turn of the century, with the majority of workers finding employment in large,

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Health Care's Forgotten Majority: Nurses and Their Frayed White Collars
Table of contents

Table of contents

  • Title Page iii
  • Copyright Acknowledgments iv
  • Contents v
  • Illustrations vii
  • Preface ix
  • Chapter 1 Introduction 1
  • Notes 25
  • Chapter 2 Rise of the White Collar Worker, Ideology of Professionalism, and White Collar Strategies: The Case of Nursing 29
  • Notes 48
  • Chapter 3 Nurses' Class Position 51
  • Notes 86
  • Chapter 4 Visions of Professionalism: A Window on Class Identity 87
  • Notes 129
  • Chapter 5 Conclusion (or Where Does the Frayed Collar Go From Here?) 133
  • Note 139
  • Appendix A Professional Nurse Survey 141
  • Appendix B Survey Coding 147
  • Appendix C New York State Nurses Association: Questions and Answers About Entry into Practice 155
  • References 159
  • Index 169
  • About the Author 174
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