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Skills should be rewarded

Early in my first placement it struck me how multi-skilled nurses have to be, and how little this was reflected in their pay.

In the space of a month, in a restricted way, I realised I had been learning the role of clerk, counsellor, teacher, auxiliary, doctor, psychologist, housemaid and mortician. I had administered medicines, advised patients and carers, performed observations, written handover reports, changed beds, worked hoists, bathed patients, scrubbed dentures and washed dead bodies. Nursing must be one of the world’s most multi-sided occupations.

So why is this not reflected in nurses’ financial remuneration? One reason may be that, as the famous nursing theorist Virginia Henderson said, the nurse does for the patient (only) what they would do for themselves if they were healthy.

This being so, nursing skills may be unfairly dismissed as little more than common sense – a quality that does not count for much at annual pay reviews. Hence the huge disparity between nurses’ salaries and those of more narrowly specialised personnel like doctors and surgeons. Nurses may acquire ever more skills – but it does nothing to improve their status or their income.

There is a way round this, though I don’t suppose it will ever be adopted by pay boards. Twenty years ago, when I was working in commerce, I learnt that Japanese firms rewarded their workers, not for the work they did but for the skills they had at their command if needed.

Is it silly to imagine this principle being used in nursing pay calculations? At least it would provide a basis for quantifying and rewarding a nurse’s range and versatility. It might also motivate them to broaden their skill base constantly to meet changing healthcare demands.

Lesley McHarg is third-year nursing student in Scotland

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