By Mathew Keller, RN JD
MNA Regulatory and Nursing Policy Specialist
It is a common misconception that nurses get great healthcare at a reduced price through their employer. It makes sense. If I work at the car dealership, I get an employee discount on cars, right? Not so for employees in the healthcare field. Despite working with the sickest of the sick, despite having higher rates of work-related injuries and illnesses than any other industry, and despite putting themselves in harm’s way for the sake of their patients every single day, healthcare employees often have sub-par health insurance and access to healthcare. As health systems seek to cut more and more costs, Minnesota nurses’ access to care may suffer. Because poor health benefits cost employers in the long run by inducing nurse turnover, and because nurses get sick or injured on the job more than any other profession, nurses’ healthcare benefits are the wrong place to look for cost savings.
Hospital Nurses Work in One of the Most Hazardous Environments in the US
According to the Bureau of Labor Statistics, hospitals are one of the most hazardous places to work, inducing 6.8 work-related injuries and illnesses per year for every 100 full-time employees.[1] That’s almost twice the rate for private industry as a whole. In fact, nurses are injured more than those working in professional services, manufacturing, and even construction fields. Granted, some of these injuries are best covered under Workers Compensation insurance. However, “workers comp” does not cover injuries which result in less than 3 day’s absence from work. Furthermore, studies have found that up to 24 percent of nurses take sick leave or switch shifts in order to recover from an unreported injury.[2] In the long run, a nurse’s health insurance ends up covering the cost of many injuries and illnesses sustained at work.
It makes sense, then, that the employers who are responsible for exposing nurses to such high rates of illness and injury have an obligation to provide reasonable health insurance to those nurses. It’s a reasonable cost of doing business in the healthcare sector. Ultimately, it’s also better for patients as well. Sick nurses equate to sick patients. Studies have shown that caregiver fatigue, injury, and stress are tied to a higher risk of medication errors and patient infections.[3] Conversely, safer caregivers means happier patients: studies have shown higher patient satisfaction levels in hospitals where fewer nurses are dissatisfied or burned out.[4]
Attempts to Diminish Nurses’ Access to Healthcare are Short-Sighted
Health insurance is neither free or cheap. However, most Minnesota hospitals and health systems are experiencing record profits. For example, Allina Corporation profited $130.5 million dollars after expenses in 2015 and $146 million dollars the year before but is attempting to cut costs by slashing nurses’ health benefits.[5] Even if hospitals were experiencing a financial crunch, however, healthcare facilities need to factor in the long term cost savings of offering reasonable health benefits to its employees when they perform cost/benefit analyses.
The reason is nurse turnover. It costs anywhere from $27,000 to $103,000 to replace a nurse, depending on the area and specialty.[6] Thus, a hospital experiencing the average RN turnover rate of 16.4% loses an average of $4.9 -$7.6 million dollars a year from nurse turnover—and the cost is much, much greater for large healthcare systems.[7]
What does this have to do with health insurance? Everything! One study of 95,499 nurses found that one of the highest sources of RN job-dissatisfaction, and thus turnover, stemmed from sub-par health benefits.[8] In fact, the study’s authors found that nurses working in non-healthcare sector jobs had much better health insurance and job satisfaction. As the authors put it, “It is particularly striking that there was so much dissatisfaction with health care benefits among bedside care nurses—the nation’s largest group of professionals who devote themselves to caring for others…This suggests that nurses in caregiving roles are experiencing a distinct disadvantage relative to their peers and others in the broader workforce—a disadvantage that is likely to affect the stability of the nurse workforce in the future. Given nurses’ multiple opportunities to work in jobs with better benefits outside the hospital or nursing home setting, turnover and retention challenges may be a costly consequence for these institutions” [emphasis added].
In other words, cutting nurses’ healthcare benefits is likely to cost hospitals more money than it saves them in the long run.
Nurses Need Reasonable Access to Healthcare
Hospitals have an ethical obligation to provide their healthcare workers, who are routinely exposed to the highest incidence of workplace illness and injury of any occupation, with reasonable health-insurance. Doing so is in the best interest of hospitals’ profits, their employees, and most of all, their patients. Offering sub-par health benefits to nurses is short-sighted and wrong.
[1] BLS. Incidence rates for nonfatal occupational injuries and illnesses involving days away from work per 10,000 full-time workers by industry and selected events or exposures leading to injury or illness, private industry, 2011
[2] Siddharthan, K., M. Hodgson, D. Rosenberg, D. Haiduven, and A. Nelson. 2006. Under-reporting of work-related musculoskeletal disorders in the Veterans Administration. International Journal Health Care Quality Assurance. 19(6): 463-476
[3] Rogers, A.E., W.T. Hwang, and L.D. Scott. 2004. The effects of work breaks on staff nurse performance. Journal of Nursing Administration. 34(11): 512-519.
[4] McHugh M.D., A. Kutney-Lee, J.P. Cimiotti, D.M. Sloane, and L.H. Aiken. 2011. Nurses’ widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health Affairs. 30(2): 202-210.
[5] http://www.startribune.com/minnesota-s-largest-hospital-systems-saw-big-jump-in-2014-income/321081861/
[6] Li , Y., and C.B. Jones. 2012. A literature review of nursing turnover costs. Journal of Nursing
Management. 21(3): 405-418. (Dollar amounts presented here are adjusted to 2013 prices.)
[7] Nursing Solutions, Inc. 2015 National Healthcare Retention & RN Staffing Report. Available at http://www.nsinursingsolutions.com/files/assets/library/retention-institute/NationalHealthcareRNRetentionReport2015.pdf.
[8] McHugh, M., Kurtney-Lee, A., Cimiotti, J., Sloane, D., and Aiken, L. 2011. Nurses’ widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health Affairs. 30(2): 202-210.