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Susan Estrich: The Value of Nurses? Women in the Field Still Shortchanged

I never quite understood what “nursing” really meant until the past six months, when the supposed superstar doctor who operated on me in Phoenix (One of the smartest male doctors I know told me she was the best, a woman, how wonderful; beware gender bias.) made a mess of my intestines, leaving me rather critically ill with peritonitis and unbearable pain while she went to Maui.

Some very fine physicians, in California and in Arizona, tried to clean up the mess she left, but it was the nurses who took care of me.

Nursing, I came to understand, means far more than doling out shots and pills, although keeping track of all the different medicines I was on was a challenge, and a mistake on a transfusion can kill you. Nursing was about taking the grab bag of medicines (many of them over-the-counter, not strong enough, the product of extremist attitudes toward pain killers, with some doctors prescribing more than I could possibly need (BAD) and some nothing at all (ALSO BAD), and leaving it to the nurses to improvise) and working to keep me safe and as pain free as they could.

Nursing meant sitting with me when I was scared and sick and reassuring both my children and me that the pain would pass, that I would be OK. It meant finding food I could hold down, brushing my matted hair and insisting on clean pajamas and clean sheets.

The first two times I came home from the hospital, I thought I could take care of myself, or that untrained “caretakers” could nurse me. The third time I came home with registered nurses, and they nursed me back toward health.

All of my nurses, as it happened, were women.

So why don’t they make as much as men?

Dr. Ulrike Muench, a nurse practitioner with a Ph.D. from Yale, and her colleagues at UC San Francisco examined two decades of data from some 80,000 RNs and concluded that, in this female-dominated profession, the minority of male nurses earn almost $11,000 per year more than their female counterparts.

Controlling for all the obvious factors — advanced degrees, clinical specialties and experience — explained away only half of the difference.

The rest? A pay gap of $5,148 per year that costs women and their families, over the course of a career, more than $150,000.

Why?

The researchers were able to point to fields in which the gap was greatest — e.g., nurse anesthetists were paid $17,290 more if they were men than if they were women; male cardiac nurses earn just over $6,000 more; and orthopedics, where women came closest to parity). Still, over the course of the multiyear study, which included responses from more than 80,000 RNs, women never achieved parity.

According to the study’s authors, more than 2 million women and their families are being “shortchanged,” and while the authors “hope that our results will bring awareness to this important topic,” more than awareness is needed.

When I first started in politics, we used to wear buttons that said “69 percent,” which was the average pay gap between men and women at the time. You got all kinds of responses in those days: that it was just the market, or that women chose (or were chosen) to work in lower-paying female-dominated positions like nursing and teaching.

But none of the old bromides explains why within a profession like nursing, where, if anything, the stereotypes of women as more caring should actually produce higher pay, the pay gap has endured.

But I do know this. My doctor easily could have killed me. My nurses, among the smartest, most talented, most compassionate women I have met in my life, with meticulous care nursed me back to life. They are worth far more than they are paid.

Susan Estrich is a best-selling author, the Robert Kingsley Professor of Law and Political Science at the USC Law Center and was campaign manager for 1988 Democratic presidential nominee Michael Dukakis. Click here to contact her or click here to read previous columns. The opinions expressed are her own.

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