Tit for Tat

The Department of Health and Human Services is releasing a whopping $13.4 million for nurse loan repayment. $8.1 million will be competitively awarded to nurses who agree to work in one of these facilities with a critical shortage and will be used to pay 60% of their student loans, while the other $5.3 million will go to  schools of nursing to support the training of 500 masters or doctoral students who agree to work as full-time faculty at a school of nursing for four years. The masters and doctoral students will have up to 85% of their loans cancelled. Recipient universities can be found here. My own university is receiving less than $10,000. That’s enough to cover not quite one year of tuition and books for one masters student.

Note that the $8.1 million is intended to help “100 nurses”…. is this a typo? Are there exactly 100  nurses out there with $135,000 in loans? I don’t get this. Still, I’m not sure 100 nurses can really tackle the problem.

Details aside, $13.4 million is a piddly sum to support nurse recruitment and education on a national level. But fine, that’s okay, money is money. We’ll take what we can get. Thanks government. Except these repayment programs lock a nurse into  potentially dangerous situations at facilities in which her or his license is routinely jeopardized. Perhaps this is a fair exchange for a nurse struggling beneath a mountain of debt, but most nurses I know who have signed onto loan repayment programs like this end up regretting it because they find themselves trapped in miserable, unsafe working conditions. If anybody has information or insight to share on this subject, I’d love to hear your opinion, especially if you work at one of the hospitals on the list. I’ve heard good things about Bannar Good Samaritan in Phoenix and Dell Children’s in Austin, but other than that I don’t know about the working conditions at the other hospitals.

I don’t like spitting at money, and perhaps I’d feel better about this whole exchange if the repayment program covered closer to 100% of a nurse’s student loans or if the money affected nursing on a greater scale (which would, of course, require more money.)

Anyhow, the money that will be used for masters or doctoral students seems to be a better deal, at least for students. Nursing faculty earn next to nothing, and perhaps assistance with loans will help some people who want to teach but can’t justify the cost make the decision to pursue careers in education.

C’mon nurse friends. Comments plz.

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4 Responses to Tit for Tat

  1. OK, since you said plz so nicely, I will be a nurse friend and leave a comment. I have worked at two of the hospitals on the list and they are great. If I was a nursing student I would jump at the chance to have my education paid for. I use to work in an inner city University Hospital that would pay your undergrad tuition, if you worked at the hospital for two years. Most nurses were too afraid to sign the contract, but they ended up working at the hospital for more than two years anyway. Wasted money.
    I also have a Master’s in nursing, but I would be taking a greater than 50% pay cut to teach. I will stay at the bedside until they match my hospital salary.
    BTW, it is not that easy to “lose your license” I hear that thrown around all the time by nurses who don’t like their patient assignments, feel overworked, or sometimes who are just plain lazy. Drives me crazy.
    Keep up the good nurse blogging ! 🙂

    • Whitny says:

      I found myself in a very scary situation in Dallas in which I really was afraid I was going to lose my license, not because I was overworked (I was) or lazy (I’m not), but because I would sometimes be responsible for 11 or 12 newborns, some of which were very ill. C’mon. They are newborns. You can’t screw up with somebody’s brand new baby. I wanted to provide them with quality care, but I simply couldn’t. I left after 3 months, and I can’t imagine being locked into that place for 2 or 3 years. Anyhow, I know my story is not at all unique, so it seems are right about it not being very easy to lose your license… It is an annoying phrase that people throw around too much, and so I should have articulated my argument differently, perhaps in terms of patient safety (because though very few of us lose our licenses, all of us jeopardize patient safety when we are unable to fully attend to our patients.) I tried to find some information on how many nurses are named in lawsuits or have their licenses revoked each year, but couldn’t find nuthin’ (on PubMed or CINAHL or the first 20 pages of a Google search or so). I am sensitive to the loan repayment contingencies becasue I don’t want nurses to be stuck in a situation in which they have no power just because they are financially vulnerable (though this happens all the time, with or without loan repayment programs.) But, on the flip side, I can see how loan repayment would be a wonderful option for so many people, especially if they are looking to be settled in one of those cities for the next two or three years anyways. Hopefully those 100 nurses will be chosen carefully and placed where they will be very much needed and appreciated and supported. Do you think the money will go to new grads? Should new grads be placed somewhere with a critical nursing shortage? Do you think the money will pull people away from their current jobs and relocate them to a place with a critical shortage, thus creating a shortage at their previous place of employment? Or do you think the money will be nice for the 100 nurses who receive it but will have very little impact overall?

      About teaching: maybe public money should be used to increase nurse faculty salaries instead of repaying student loans. I wonder if we’ll ever see that day.

      Anyhow, thanks for your input, nurse friend! I hope we make lots of other nurse friends who will talk with us about stuff like this.

  2. “but because I would sometimes be responsible for 11 or 12 newborns, some of which were very ill. C’mon. They are newborns.”
    Because I am a NICU nurse, you have me very intrigued. Were these 11-12 newborns, normal newborns who should not have been in a nursery to begin with, but with their mothers? If it was a NICU, and you had a patient assignment of 11-12 babies, I would be calling CNN, Fox news (cue vomit sounds), ABC whatever. Trust me, I have been in some sh*t hospitals and situations, which I have posted on frequently.
    I do not think new grads should be thrown in a war zone, without a lot of assistance. I am going to guess I am older than you, and I started out my career in a war zone, nursing shortage situation. Thank God I had very experienced nurses to back me up. Now, because of that experience, I feel like I can handle anything.
    As far as nursing instructors, there are plenty of us nurses with Master’s degrees who would be willing to teach if the price was right. Who would you rather have as an instructor? A nurse with 16 years of NICU experience with a Master degree, or a nurse with a Masters degree,with zero bedside experience and no student loans? HMMMM.

  3. Whitny says:

    Yeah, this was a “regular” newborn nursery at a private hospital in Texas. I don’t want to slander the hospital’s name because I’ve heard that things have improved since I left. Anyhow, even though it was a regular nursery, we accepted babies with IVs, severely jaundiced kiddos, babies with unstable sugars, babies on oxygen…basically stuff you’d see in a level 2 nursery. Which would have been fine (actually very refreshing) had we not had so many patients. Also, the hospital had abandoned couplet care and had separated the postpartum nurses from the newborn nurses. So moms had the option of leaving their (breast-fed) babies in the nursery all night with the newborn nurse. We’d either take the babies out to mom every 2 hours for feeding or finger-feed them ourselves in the nursery. The majority of moms kept their babies in the nursery at night, because they were… how to put this delicately… privileged women who needed their sleep, so we did all the care. It was such a stupid policy, and it wrecked havoc on women trying to breastfeed. I’d try to explain that they should keep baby with them and avoid formula, but they were…um…not receptive. They wanted their sleep. So babies stayed in the nursery. Plus we usually had no techs, one at the most. So imagine 10 babies, all needing PKUs, HepBs, q 2 hour feedings and changing, q 4 hour vitals, bili checks, 10 moms needing breastfeeding help or help with pumps (because NBN did all the BF stuff), plus admissions throughout the night. And one or two sick kids with IVs to boot.

    About 10% of the time, we’d get an extra nurse or have a low census, and then we’d have 6 patients. Those were nice nights. But that unit was losing nurses right and left and I have to admit that I was one of them. I couldn’t tough it out. Every night I was afraid to go to work, becuause I was afraid I’d forget about the four and a half pounder in the corner with the IV or something. I also couldn’t stand the depressed morale of the place (which speaks to how bad the place was, since it’s pretty hard to depress the morale in a newborn nursery), the dissatisfaction from the moms and families who didn’t understand why we didn’t have time to teach them to breastfeed properly or why we forgot to change dirty diapers or whatever it was that we were doing wrong, because in that situation there’s always something you’ll be doing wrong. The numbers just don’t add up in your favor. You can sometimes kinda fudge that care with adults if you have to, but everybody watches a newborn like a hawk so the terrible quality of care was really visible. Except to management, of course.

    Anyhow, none of us go to nursing school to shuffle babies back and forth all night and change diapers (I changed 133 diapers one night that I had 11 babies. I counted.) The job was a terrible combination of really hard but also really boring. I switched to med-surg afterwards and, although I miss the babies like crazy, I haven’t looked back since. I’d love to try NICU and ER and wound care and radiology and OR and all kinds of places, but I’m back in school now so it’s not the time to start branching out. Which brings me to your point about what type of instructor I’d prefer… 16 years of experience, hands down. I don’t really feel like I have enough experience to be in grad school myself and there’s so much more I’d like to try as an RN, so I’d recommend that any new nurse clock some time in the ICU and get vomited on in the ER and catch a baby in L&D before committing to grad school. Your future patients will probably thank you for it.

    But I’m in grad school now, grateful to be here, stupidly excited to be be on my way towards my FNP.

    And since I just went ahead and used this comment as a platform to tell my life story and bitch about work, I invite any other unfortunates who happen to be reading this to dish some stool on the worst job you’ve ever had.

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