HOSPITALS: Why We Don‘t Have Enough Nurses (It’s Not Low Wages) By Maggie Mahar

THCB contributor Maggie Mahar returns today with another of her insightful pieces on the business  of healthcare. If you haven’t yet done so, you are hereby commanded – yes, as in that’s an order – you should go pick up your copy of Money Driven Medicine: The Real Reason Healthcare costs so much, Maggie’s recent study of the forces at work in the  healthcare marketplace.

this: In the San Francisco area, a nurse with a bachelor’s degree can
hope to start out with a salary of $104,000. The salary for a nursing
professor with a Ph.D. at University of California San Francisco starts
at about $60,000.

This goes a long way toward explaining why nursing schools turned
away 42,000 qualified applications in 2006-2007—even as U.S. hospitals
scramble to find nurses. We don’t have enough teachers in nursing
schools and the fact that the average nursing professor is nearly 59
while the average assistant professor is about 52 suggests that, as
they retire, the shortage could turn into a crisis. The most recent issue of JAMA (October
10, 1007) reports that in 2005 we had 218,800 fewer nurses than we
needed and by 2012, it’s estimated that we’ll be short some 1 million

Hospitals have had to raise nursing salaries (as well they should),
not just because nurses are scarce but because, in our chaotic hospital
system, the work can be extraordinarily stressful.   

Nurses know better than anyone just how many “adverse events” occur each day –even in the most prestigious U.S. hospitals.

“I’m terrified of killing someone,” one young nurse confided to me
about a year ago. After working in a hospital in Bermuda for a number
of years, she was bored, and had come back to work in New York, where
she had friends and family. She had worked in New York before, but she
wasn’t at all sure that she would stay. “In our hospitals, it’s just
too crazy,” she said.

Her story also sheds light on why nursing professors are willing to
work for $60,000 a year when they could, no doubt, more than double
their salaries if they were willing to wade into the fray at local

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franksrossLPN ClassesLizEricbrook Recent comment authors
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There is indeed a shortage of skilled nurses, and hospitals pay higher to recruit them. However, higher pay will be immaterial if you do not have job satisfaction.

LPN Classes

The patient is a more educated consumer, which is a good thing, but they also dictate to the physician and the nurse the testing and treatment that they would like to get.


We have plenty of unskilled nurses or carers and nursing aids doing short courses to give medications, but a huge shortage of skilled nurses as they cost too much. Perhaps it’s the same in California.


It seems to me there is no shortage of nurses here in California…there is a huge shortage of GOOD nurses…but we plenty of nurses in general.


In my opinion the shortage of nursing has been caused by bureaucratic greed both within the health system and politically. For years nurses have been over worked and under paid whilst administrative staff and doctors reaped the rewards. Nurses were forced to increase their level of education from the early 1990s, but they didn’t receive financial rewards for this; instead they were expected to take on more responsibility and more stress without complaining. Consequently work related injuries and accidents increased. Nurses who were injured doing their job were treated by their employers and work cover as criminals out to make… Read more »

Philip Offill
Philip Offill

Hospitals are nurses. The reason that there is a nursing shortage is that the nurses are so overworked by the current system that they burn out within five years. if you take into account the number of nurses that have graduated nursing school in the past twenty years you will find that a great percentage of them no longer work in the profession. This has not always been the case. They don’t leave because they don’t like nursing but rather because nurses now care for as many as 18 patients per day in some hospitals…You have to be a top… Read more »

CNA Training

I agree with the above commenter. It would seem most logical to provide an easy pathway for LPN/LVN’s, given that they are aware of what the role truly entails and have experience in the working environment.


This thread was started a while ago. I think a solution to some of the “nursing shortages” is to make it easier for LPN/LVN with a few years experience to enter into RN programs. I am a LPN with three years experience on a tele med/surge floor. I am having to wait with all the other students that have no experience for RN school, the lottery system wait list program they use typically runs three years. Even if I tried to get into the bridge programs, those spots are even more limited. The job is not for everyone, there aer… Read more »

new grad northern CA

I know these posts were a few months back… but if anyone is still reading them, i am a new grad in northern CA and I am making $41/hr to start. I do work nights so that is with an included &4/hr shift differential. However im working in a small hospital, not Kaiser or Sutter, and i will easily clear $80,000 my first year. Also i only work 3 nights a week doing 12 hour shifts, so like many of my friends have done, i have just applied for a per diem shift at Kaiser one 8 hour day a… Read more »

ashley rn
ashley rn

Ummm, the reason CA and Manhatten nurses appear to make so much more money is not some powerful nurses’ association but cost of living. An apartment the size of a closet in the city can cost 2000 dollars a month to rent! In SC, where I live and work as a nurse, a 3000 square feet house costs less per month to own. So it may look like the nurses in those states are cashing in at 40 dollars an hour, but it’s equivalant to a nursing salary in SC that averages 25 dollars an hour. Nurses aren’t making the… Read more »


This is my first time writing on a blog. I am a foreign trained nurse, working in a emergency room in NY. My qualifications are similar to my co-workers. All foreign nurses must pass the State Boards before working in a hospital. I have been a nurse for many years now and it is definitely more stressful. Patients are sicker and are discharged home earlier than in previous years. The volume of patients seen in an ED on any given day has increased, yet the staffing remains the same. Nurses are required to know all the latest technology, medications, interpret… Read more »


don’t worry y’all in the year 2010 i will be going to nursing school to get my RN license


Thanks John for the link to CNA. I came across another site http://www.nursecentral.org/index.php?/Nursing_Programs/Registered_Nurse_RN.htm which seemed to claim that the highest 10 percent of RNs earned more than $69,670 which would make it around $33.49/hr, so I suspect that their data is outdated.


Just a followup. If you are curious about California nurse compensation, look at the California Nurses Association web site for the Kaiser contract:
Look at the top of page 6 of the contract summary, for hourly rates for Staff Nurse II.
CNA has lots of other stuff on line; they obviously portray themselves in the best possible light, but they don’t fib.


BettyJazz: ———- Whereas your point is well taken your salary range is a bit inflated and definately not entry as you claim. A more realistic range can be found on this website. http://www.allnursingschools.com/faqs/salaries.php I have been a nurse in NY for 30 years and never made that salary even in a management position. ———- In California, San Francisco Bay Area, $40/hr is starting base pay for new grad RNs at Kaiser; I got that number from a Kaiser recruiter September 27. (I’ll send you her email if you’d like, but I don’t have her permission to post it.) She also… Read more »