America has always undervalued nurses

As of April 23, more than 21,800 health care workers in the United States have tested positive for coronavirus. As these workers toil away at the frontlines, caring for a growing number of patients during an uncharted global emergency, little protection is offered to these susceptible employees — the majority of whom are women.

Nurses, nursing home employees, domestic workers, and caregivers have long been industries dominated by women, who have long been underpaid. On average, registered nurses — more than 85% of whom are women — make less than $72,000. Home health aides earn an average of $24,000, and only a quarter can expect to be insured. Yet, our nation needs more nurses. In fact, we need an additional 1.6 million registered nurses and nursing assistants, as well as an additional half million home aides.

Our country has long dealt with this shortage. There was an abundance of nurses during the early years of the Great Depression, even though they were pressed for resources and needed to be creative and resourceful in caring for patients. But by 1936, hospitals across the country were reporting that nurses were exiting their hospitals at a large and fast rate.

The U.S. Department of Labor conducted an investigation into why this was happening in 1947. Their report, “The Economic Status of the Registered Professional Nurse,” found that small salaries, long work hours, poor conditions, lack of retirement pensions, and unlikelihood of promotion made nursing an unattractive job. In fact, the job was so insufficient in capital reward that during the Great Depression, nurses snuck leftover soap home for personal use.

Yet hospitals made no changes to remedy work conditions after this report was published. Rather, they divested their resources to promote nursing school in order to seduce fresh droves of young women into the profession that would end up disappointing them.

Now, even amid this pandemic, only 30% of nurses say they have enough personal protective equipment (PPE) to cope with infected patients. Instead, some nurses are resorting to wearing trash bags and swim goggles to protect themselves from contracting infections, while others are crowdsourcing masks. The standard on how much protection these workers need seems to fluctuate with little consideration for safety. As intensive care nurse Mary Mills told NPR, “What [hospital administrators] decide I need, in terms of safety, is being changed based on availability of product, rather than the science.”

While many have praised nurses for putting themselves on the front lines — like U.N. Economic & Social Council President Mona Juul, who said she expresses her “sincere appreciation for the countless frontline health care workers, who are working to prevent further outbreak and develop treatments, with their own safety on the line” — most have few other choices since Congress excluded most health care workers from its paid leave aid package. “You’re super exposed, [but] you have much less choice about stepping back, so you have to work,” Ariana Hegewisch, program director of employment and earnings at the Institute for Women’s Policy Research, told The Atlantic of nurses in this position.

In addition to working in conditions that are unsafe for themselves, nurses’ lack of respect and authority in their workplace often puts their patients in danger, too. Some hospital managers have not treated nurse’s claims with seriousness, thus not moving quickly enough to perform tests on staff and patients when nurses voice their concerns.

Nurses rarely hold health leadership positions, and thus are not able to effectively look out for other nurses’ safety and comfort. But the World Health Organization finds that when nurses are propped up to leadership positions, conditions for nurses get better.

In addition to unsafe working conditions, nurses are finding danger in the public eye during the pandemic. A nurse in Oklahoma City was attacked on her way to work as she was accused of spreading the virus. She has not been the only victim; as anxieties spread about the virus, other civilians have targeted health care workers, too.

Nurses have been and continue to be “the most important single element in reshaping the day-to-day texture of hospital life,” as Charles Rosenberg writes in The Care of Strangers. It is time we give them a realistic valuation.