A few weeks ago, while preparing for a conference call with a representative of a continuing education company interested in my writing services, I realized I had no idea what to ask for as a starting point in negotiating payment. I searched online, but despite the wealth of information available, I was unable to find anything informative on what one should ask for when negotiating payment for intellectual work such as this.
I finally reached out to a colleague who has been in the healthcare writing and editing business for some time and asked her advice. She provided logically structured information based on hours of anticipated work, going back and forth between the companies needs and my content, and on her personal and professional experience. Then she added the piece that’s most troubling for nurses-compensation for the value of more than 20 years of clinical experience and my level of expertise on the topic.
Why do nurses struggle with this? Attorneys bill for almost every minute on top of their retainer fee; physicians bill based on length of time spent in discussion with patients even when it’s the NP or PA who puts in the time; consultants bill for the most minute of interactions; and so on and so on. For these, and for many others, the question of the cost of their services is often bundled with the value of their work.
Nurses in clinical settings, research, and administration live by the mantra that they leave when the work is done and seldom ask for a penny more. Of course, this is because collectively, nurses care about and value their patients, the quality of their work, and their nursing colleagues, more than they do their wallets. I also suspect that if every nurse demanded payment for all of the “extra” time put toward work-on the premises or off-healthcare would be in much deeper financial trouble than it is right now-but that’s cost, not value.
It's the value of the work that nurses do that creates excess hours of work beyond the hours for which nurses are paid, for example
Time spent assessing the emotional state of a patient’s family member, helping the on-coming nurse who’s picking up a trauma patient with multiple injuries, sitting down with a fellow nurse researcher to explain why a protocol will never make it through the IRB, and precepting and mentoring younger or less experienced nurses to ensure patient safety and avoid potential pitfalls. We can’t assess the monetary value of these behaviors, but we can appreciate the human value of the work that nurses do: priceless.
PS: As the profession responsible for direct patient care and as a major component in the healthcare industry, collectively, nurses need exposure to business and finance education: too much of our work is bundled with hospital and physicians’ fees and we lose too much of the financial benefits of healthcare because we are often invisible in financial matters that effect our profession.