Alisa Zayas, Informatics Specialist Wednesday, Nov 13, 2024
Nearly a century ago, the women’s suffrage movement of 1913 marked a significant step in advocating for gender equality, and by the 1920s, nursing had become a primary pathway for women’s financial independence globally. Many nurses operated their own businesses or worked privately for families, granting them substantial autonomy and control over their own careers.
Hospitals soon recognized that the inclusion of nurses led to marked improvements in patient care and therefore, outcomes. Initially, nursing services were billed separately, allowing nurses to see the financial impact of their contributions to hospital revenue.
However, hospital leadership, uncomfortable with this transparency, adopted a model similar to that used by hotels during that time: bundling nursing services into room rates to obscure the value of nursing. In the 1930s, nurses protested this change, as it diminished their economic freedom. These efforts failed, and nursing remains the only licensed healthcare profession unable to bill directly for its services, a practice that continues to obscure the direct effect Nursing delivers to the bottom line.
Nurses, once highly respected for their skill and compassion, are now often treated as interchangeable labor.
In recent years, the commodification of nurse labor has worsened as healthcare systems have increasingly prioritized near-term profit. Nurses, once highly respected for their skill and compassion, are now often treated as interchangeable labor. This shift, driven by the short-sighted goal of driving down labor costs, not only devalues the nursing profession but also threatens the quality of healthcare itself. Nurses, who provide the majority of direct patient care, are being asked to do more with fewer resources, leading to burnout, high turnover, and a decline in care quality. The consequences of this model go beyond immediate financial gains for healthcare institutions—it undermines long-term health outcomes for society as a whole. This is the true bottom line, socially, but also financially, as there is a long tail of costs that follow poor quality care, costs we’re already reckoning with.
While the profit-driven model might appear lucrative in the short term, it is, in reality, deeply flawed. Poor healthcare today creates a cascade of health problems that affect individuals for decades, often extending into the next generation. The costs of neglecting quality care are not just financial, but human, leading to chronic illness, disability, and reduced quality of life. These long-term burdens, compounded over time, are far greater than the immediate financial gains that come from cutting resources and devaluing the contributions of nurses. By neglecting the vital role nurses play in healthcare, the system is not only harming patients but also diminishing its own future sustainability.
The costs of neglecting quality care are not just financial, but human, leading to chronic illness, disability, and reduced quality of life.
Thus, the fight to reclaim the dignity and autonomy of nursing is not only about restoring respect and fair compensation—it’s about challenging the myopic system that ultimately harms both healthcare providers and the patients they serve. Investing in nurses, recognizing their expertise, and allowing them to directly impact the care system is key to improving healthcare outcomes and ensuring long-term societal well-being. Reclaiming the nursing profession from commodification is essential, not just for the profession but for the future health of entire populations.
Fortunately, there is one area of healthcare that still fully recognizes the unique value of nursing: Specialty Pharmacy. In this field, payers structure reimbursement by distinctly valuing each part of the care process—allocating specific payments for pharmacy services, drug costs, and nursing services. This structure within Specialty Pharmacy makes it possible to prioritize nursing quality, offering both an opportunity and a responsibility for the nursing profession. With clear value associated directly with nursing care, there is a chance to enhance and refine this quality over time.
Float Health has built a platform to support this phenomenon, deploying the best part of the hospital - the nurse - to the home. We at Float are building the foundation for adopting analogous models throughout healthcare. When nursing care has a defined value, the outcome is better patient results, improved care quality, and reduced costs.