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Nursing’s state of pay

A quick look at the numbers on nursing pay makes it shockingly clear that our best professionals are underpaid and struggling. 

Leah Roberts has worked in the nursing profession for more than 20 years. During that time, she has worked in a few different hospitals in Victoria but the mainstay has been Frankston Hospital, which she has been duly employed for the past 13 years.

After her four-year degree and two decades of working, Roberts is a registered nurse division one, earning $34 an hour. When she first started it was $18 an hour.

“I love the profession but you certainly don’t do it for the money,” Roberts says. “It is a hard slog and the reality is that while most of the medical profession undertake the work to care for patients, the pay could be a lot better.”

Roberts says it is common in the nursing profession for nurses to work either double shifts (7am–10pm) or try to get weekend work (time and a half pay) or public holidays (double pay) in order to secure extra funds.

“I have seen so many nurses throughout the years needing extra pay for Christmas or school fees or even a holiday, requesting to do weekend work and public holiday shifts,” she says.

“The double shifts are a killer, and even though you get a paid meal break and time and a half in the afternoon/evening shift, it is a very long day and it is hard to focus for that amount of time.

“But the reality of the nursing profession is that if you need extra money they are your only options.

“I know that the universities are encouraging students to do post-graduate qualifications but for nurses who have been in the profession 10 years or more the thought of going back to study is not really appealing.”

Roberts, who is currently on workers compensation after having a shoulder reconstruction, says that the physical and mental toll has an impact too.

“My shoulder starting playing up a year ago, and even after surgery four months ago I am struggling to move it,” she says. “You spend a lot of time lifting and moving patients, helping them into wheelchairs, changing beds, and all it takes to try and help someone a lot physically bigger than you, and you fall or bend the wrong way and you can end up injured too.

“I have done a lot of lifting throughout the years and it got to the stage where I couldn’t even lift my arm above my shoulder, and I still can’t after surgery.”

She is also having second thoughts about staying in the profession.

“Look, I love caring for patients but given my time again, I wouldn’t be a nurse,” Roberts says frankly. “It is a very demanding profession that is not financially rewarded and even that well-recognised within the medical fraternity.

“When my shoulder eventually heals I will consider whether to continue as a nurse or look at something else in the medical profession. Twenty-one years is a long time.”

Joss Sullivan has also had a 20+ year career as a nurse and finished her career as a nurse practitioner. Having worked in hospitals across Australia, though mainly in Western Australia, she finished her career earning at the low end of six figures, but said that was the least she should have been paid.

“No one enters the profession for the pay but at the same time there needs to be an overhaul of the pay structure,” Sullivan says.

“It is great that the Australian Nurses Federation has secured a 14 per cent pay rise over three years here in Western Australia and that is badly needed. It shouldn’t have had to come to marches in the streets and industrial action, but sometimes you need to wake the government.”
Sullivan, who has two small children, said that the job had become too demanding to juggle with raising a small family.

“I do really love the profession, but enough was enough,” she says. “Good luck to the young nurses coming through and I hope they walk into better conditions than we inherited, but there is big discrepancy in whether you work in private or public practice, aged care facilities, city or country, in my experience.

“Every nurse in Australia wants to be able to work in safe conditions and devote their attention to ensuring that their patients receive the best possible care. I think, however, the time has come for the system to be overhauled to give nurses more responsibility when dealing with patients, as ultimately they are on the ones who spent most of the time with them.

“Of course, this would ultimately result in more pay but I think the issue here is that the hospital system in this country needs a complete overhaul whether we are admitting patients to emergency or following up injuries and treatments.”

Professor Jill White, dean of Sydney Nursing School, at the University of Sydney, said: “I think nurses don’t enter the profession for the pay but they certainly do want career opportunities.

“They also want the right conditions to work in and work with and that is essential for their functionality. Nurses enter the profession because they want to care for patients and the longer they prevail in the industry, they want to be able to make decisions. I think that is an area that will only increase in time. Nurses also want the respect and trust of their colleagues.”

While the majority of Australians agree that nurses should be paid more, it is financial burden that most state governments struggle to meet. Our ageing population is stretching the budget. Nurses also want better conditions, career options and general recognition for the work that they do.

The Australian government report, Review of Australian Government Health Workforce Programs, released in May 2013, revealed that spending in health workforce programs has risen from $286 million in 2004–05 to a projected $1.79 billion in 2016–17.

It predicts that by 2025 Australia will have a shortage of 109,490 nurses. The report states that even with substantial reform within the development of the health workforce, there will still be a shortage of nurses in 12 years’ time.

The report also states that university courses alone will not be able to meet the supply needed by 2025, and “that the Commonwealth should work with the profession and across jurisdictions to establish a National Nursing and Midwifery Education Advisory Network (NNMEAN) that would develop nursing education plans across the whole training pipeline from enrolled and undergraduate nurse training to advanced scopes of practice and nurse practitioners candidates”.

Further reading into the report reveals: “A major recommendation is that the Commonwealth should provide seed funding for a feasibility study of a national rollout of leadership courses to mid-level nurse and midwife managers.”

The University of Sydney has doubled its nursing numbers in the past five years. It offers three ways to enter nursing: a combined degree (BA, BSc or BHSc combined with a Master of Nursing); a graduate entry Masters (for holders of another degree); and two years ago it introduced a Bachelor of Nursing (Advanced Studies). It also offers eight post-registration Grad Cert/ Grad Dip/ Masters and a PhD program, all of which are proving very popular.

“We have seen a 55 per cent increase in undergraduate enrolments and a 129 per cent in post graduate enrolments since 2009,” White says. “People are very interested in nursing. I think the rise in post-graduate qualifications comes about because of nurses wanting not only to learn more, but also specialise and become more involved in making decisions about patient care.”

Linda Shields, professor of nursing, tropical health, James Cook University and Townsville Health Service District, believes that conditions are the key for nurses to stay in the profession.

“I’m not convinced extra pay would induce people to become nurses,” she says. “Conditions are probably more important, such as having adaptable, cheap child-care available at and through the workplace, creative shift options for night duty, and others.

“But the most important thing for nursing, I suggest, is raising its profile, credibility and status. How often do we see the media ask doctors to comment on research when nurses may be better placed to do so? Nursing needs to claim its rightful place in the health hierarchy; after all, many health services have nurses with PhDs on their staff, and many nurses ‘at the coalface’ hold at least Master’s degrees.

“And this is the responsibility of nursing itself. We, as a profession, must make sure our voices are heard, we must contact the media, politicians, community leaders to tell them how terrific nurses are, how well educated, and how much we contribute to the scholarship and intellectual capital of health care.”

Shields believes that the reason nurses are undertaking a post-graduate qualification is not about money, but acquiring extra knowledge.

“The main way to specialisation in Australia is through post-graduate study, and Australian nurses embrace this,” she says. “The extra study produces extra knowledge which translates directly into better patient and client care.

“Most important are those who continue to do post-graduate studies in research, which takes the knowledge level to nurses producing and generating their own knowledge, that then is used to guide practice; in other words, this makes a real difference to the way nurses in Australia deliver care, thereby enhancing patient and client outcomes.”

Nursing pay around the country

Nursing pay varies greatly throughout and across Australia depending upon whether you work in private or public practice, city or country, and the medical facility and which section within the medical facility.

Public pay varies considerably from state to state.

An enrolled nurse’s entry pay will vary from $41,698 in South Australia up to $46,729 in Queensland. A maximum basic pay for an enrolled nurse working in Tasmania will be $50,454.
A registered nurse/ midwife entry pay only varies by $1000 across the states with the highest entry

starting salary being $49,439 in New South Wales and the maximum reaching $70,091 in Queensland.

A clinical nurse/ midwife can start as low as $57,158 in South Australia but as high as $72,212 in New South Wales.

In fact, the maximum pay in South Australia is still $1,500 less than the entry pay in New South Wales. Western Australia pays the highest maximum salary at $85,642.

A nurse practitioner can start as low as $88,732 in South Australia but as high as $103,183 in Western Australia.

The pay for a nurse unit manager varies by as much as $24,000, depending on whether you work in a small or large facility, with New South Wales paying the highest amount of $108,135, while a director of nursing role can rise to $139,360 in South Australia.


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