Hospitals Change Pay, Duties to Keep Nurses

Article excerpt

By Mary J. Pitzer Los Angeles Daily News LOS ANGELES - Pay at the City of Hope National Medical Center in nearby Duarte was getting behind the times. In the last couple of years nurse Debbie Vasquez had watched some of her colleagues leave for other hospitals where they could make more money.

As much as Vasquez liked her job, she says she might have left, too.

But that was before the oncology hospital came through with a blockbuster contract earlier this month.

A registered nurse fresh out of school with a two-year degree starts this year at $33,300, not including overtime and extra pay for evening and night shifts. The top base annual salary is $52,800 this year and $60,900 next year. A 20-year nurse who works the night shift can earn more than $75,000.

``The City of Hope already has my heart,'' Vasquez said. ``But with this contract I will definitely stay.''

Traditionally underpaid and overworked nurses are beginning to see better pay and working conditions. They are demanding - and getting - flexible schedules, more professional duties and more say in how they do their jobs.

While working on the front lines of medicine remains a grueling job, nurses are beginning to call the shots.

``Anytime you are in this kind of economic situation, you get control,'' said Kathy Barry, director of the Health Careers Information Center for the Hospital Council of Southern California.

Since 1986, hospitals, nursing homes and clinics have needed more than the 1.6 million registered nurses who are working. Part of the reason is that women, who still account for 97 percent of all nurses, are choosing to become doctors and lawyers and entering a host of other professions once reserved for men.

The high stress, low prestige and pay of nursing also have discouraged many women and men from entering the profession in recent years.

Nurses must juggle a maddening array of chores - such as fetching glasses of water and giving baths with administering medications, monitoring patients and performing other professional duties.

And working nights and weekends is just part of the job.

Even more critical to the shortage is that demand for nurses continues to grow.

Hospitals need more nurses than ever because Medicare and insurance companies are pressuring doctors to treat patients in offices and clinics. That means patients admitted to hospitals are more critically ill than they were a decade ago.

And with the aging of the population, more nurses are needed to tend to patients with long-term chronic diseases, such as Alzheimer's.

The supply of nurses is increasing, but not fast enough. After several years of enrollment declines the shortage finally is causing more students to sign up for nursing school.

Peaking at 251,000 nationally in 1983, enrollment dropped to 183,000 in 1987. Last year, enrollment climbed to 201,000, according to the American Nurses Association.

Despite the increase, health care industry analysts predict the nursing shortage will persist through the next decade.

Estimates vary, but, by the year 2000, hospitals, nursing homes and clinics will need 600,000 to 1 million more nurses than will be working, according to the California Nurses Association. As many as half of all nursing positions may go begging.

As a result, the shortage is giving nurses more clout.

In Southern California, for example, striking nurses at Kaiser Foundation Hospital in Hollywood and a skilled nursing facility in Inglewood have been on the picket lines for seven weeks.

They rejected Kaiser's offer for increases of 7 percent to 12.5 percent the first year. Under the three-year contract, the average base annual salary would be $44,000, Kaiser officials say.

The nurses might be able to hold out indefinitely because many of them are working part time for other hospitals through registries that pay more than a staff nurse would make. …