Nurses’ Position

Other changes have also worsened nurses’ position. First, because RNs can perform more tasks more efficiently than LPNs, hospitals now save money by assigning RNs many of the labor-intensive, menial tasks formerly performed by LPNs. Because RNs remain responsible for many administrative and skilled tech- nical tasks, this shift has both deprofessionalized their daily work and dramatically increased their workload. Second, hospitals increasingly save money by hiring nurses tem- porarily and without benefits or by moving full-time nurse employees from ward to ward as needed. As a result, nurses have considerably less control than in the past over their schedules and the nature of their work, and they are less able to choose the people they will work with. Third, hospitals have saved costs by shifting ser- vices from inpatient wards to less expensive outpatient clinics, where fewer RNs are needed, RN salaries are lower, and their work is less prestigious (Norrish and Rundall, 2001). Fourth, nurses are increasingly pressured to work back-to-back shifts and longer hours (often unpaid). Taken together, these factors have resulted in high dropout rates from nursing careers.

Advanced Practice Nursing and Professional Status Although most nurses continue to struggle for professional status, few would doubt that advanced practice nurses have achieved it. These nurses typically hold master’s degrees that license them to work as nurse–anesthesiologists, as nurse–practitioners, or in other specialized fields. Since 2015, however, all new advanced practice nurses must earn a doctorate in nursing practice. In addition, nurses who want to work as nursing professors or researchers must earn a different sort of doctorate that focuses on research training.