Politics, Economics, and Nursing Shortages: A Critical Look at United States Government Policies

Rob Elgie, BSN, RN, BC


Nurs Econ. 2007;25(5):285-292. 

In This Article

Nonmonetary Compensation

It is important to realize that nonmonetary compensation also draws nurses out of the nursing workforce to other occupations. "...Monetary compensation is not the only factor and sometimes not the most important factor influencing individuals' job choices" (Browning & Zupan, 1999, p. 450). The American Nurses Association (ANA) documented that this is true for nurses who actually left their nursing careers for other occupations and responded to a survey (DHSS, 2006). In that survey, "25 percent found their current position more rewarding professionally, 20 percent cited better salaries in their current position, 20 percent reported more convenient work hours in their current position, and 18 percent cited personal safety concerns with working in a healthcare environment" (DHSS, 2006).

The question has been raised whether nonmonetary compensation affects the distribution of nurses to other nurse employers. The 2004 NSSRN Preliminary Findings report (DHSS, 2004), identifies five major employment settings for RNs: hospitals, nursing homes and extended care facilities, community and public health settings, nursing education, and ambulatory care settings. Clearly, the nursing workforce fluctuates between these settings, with increasing numbers of nurses employed in ambulatory care settings in particular. But the fluctuations do not correlate clearly with any response to nonmonetary incentives such as working conditions.

While it is documented that large numbers of nurses leave nursing for other occupations in response to improved wages, convenience, and safety (DHSS, 2006), there is no research on whether nurses change settings within the profession in response to the same or similar contingencies. For example, one might ask if the number of nurses employed in ambulatory care settings have increased in response to nonmonetary compensation in those settings (such as better hours or better safety) compared to inpatient hospital care settings, but the answer is not known.


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