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* Rebutting the argument by Heyes that lower wages attract better, "vocationally called" nurses, the authors invalidate this position on several grounds including existing research regarding the relationship between wages, retention, and patient outcomes as well as forces evident in the current nursing labor market.
* Simply put, the strength of "vocation does guarantee skill" and good nursing care hinges heavily upon clinical and technical knowledge.
* In addition, Heyes projects the possible decisions of an individual onto the entire labor market, ignoring the possibility that some caring nurses also need a well-paying job to support their families.
* Taking Heyes' assertion to an extreme, the best way to secure a fully "vocational" workforce would be to rely solely on volunteers to deliver patient care.
* While Heyes asserts that higher wages "crowd out" good nurses, he overlooks the evidence that wages, when used as a form of recognition, can "crowd in" good nurses.
* In reality, the lack of wage incentives in the U.S. is one factor leading to the labor shortage and the need for recruitment of foreign-trained nurses.
IN A RECENT ARTICLE TITLED "The Economics of Vocation or 'Why Is a Badly Paid Nurse a Good Nurse?'" economist Anthony Heyes (2005) argues that a willingness to accept a lower wage, all else equal, distinguishes a "good" nurse from the "wrong sort." Therefore, he argues, raising nurses' pay would reduce the proportion of nurses who have a vocation for it and result in a decrease in the quality of care. Lest such work be taken seriously - or tarnish the reputation of all economists in the eyes of serious scholars of health care - this article, written by two economists who have studied the economics of occupations with a "care" component (Folbre & Nelson, 2000), rebuts Heyes' argument.
Heyes' result is based on fallacious reasoning and a disregard for considerable literature on quality of care, worker motivation, and morale as will be discussed in this article. It also ignores actual nursing shortages emerging in the United Kingdom and many other advanced industrial countries. There are many reasons to believe that higher salaries for nursing would increase both the quantity and quality of nursing care.
The "Bad Pay = Good Nursing"...