Op-ed: Why should community-based nurses be paid less?

PeaceHealth’s flagship hospital, Southwest Medical Center, let its contract with its nurses expire nearly three months ago. One of the major issues keeping us from a deal has to do with management’s respect for our bargaining unit – specifically, home care and hospice nurses like me.

Since January, PeaceHealth has refused to offer community-based nurses the same wages they’ve offered to our inpatient coworkers at the hospital for our next contract term. This includes home care and home hospice nurses, as well as inpatient hospice, palliative care, and hospice discharge planners.

Community-based nurses see patients in private homes, apartments, adult family homes, large and small facilities like nursing homes and assisted living. Wherever our patients live, home care and hospice nurses will follow. Sometimes that is in RVs, hotels, and occasionally homeless shelters.

We have been called angels because we show up day or night during a crisis, giving families support and reassurance as they take care of their dying loved. Yet, we don’t feel valued by our own hospital, PeaceHealth Southwest.

We are highly skilled nurses with specialized expertise. We don’t work within hospital walls, but that doesn’t mean our job is easier. We work independently and must have strong assessment skills. We are experts in symptom management and educating patients about their disease and what to expect during their final days. We also educate families and caregivers how to recognize symptoms and how they can best care for their loved one that is dying. We are the eyes and ears for our doctors and nurse practitioners, who rely on us as clinicians in the field.

PeaceHealth won’t even hire new graduate nurses into home care and hospice because they don’t have these skills.

I love being a home hospice nurse for many reasons. I enjoy the personal connections I make with my patients, families, and community partners. We improve quality of life drastically for our dying patients.

The job is also tough.

We can be called at all hours.  We can be exposed to homes in disarray and family members with mental illness and weapons. If a dangerous situation comes up, we don’t have security teams ready to help us. That can quickly turn tragic: one of our peers, a home health nurse and WSNA member in Spokane, was killed by a patient’s family member during a visit less than eighteen months ago.

So how did PeaceHealth come to this decision?

When we asked that question in a meeting with our department’s director, he did not have a clear answer. When we asked again at the bargaining table, PeaceHealth cited a “market analysis.” And when we asked whether their proposal was based on budgetary constraints, they said it wasn’t, explaining that their proposal is based on market research. In other words, PeaceHealth can pay us the same wages they pay our coworkers in the hospital – they just don’t want to.

Paying community nurses less will have huge consequences. It will have impact morale among nurses who are still recovering from the pandemic. It could cause more home care and hospice nurses to take hospital-based jobs, depriving our community members of services they desperately need. And it will communicate to our neighbors that the hospital cares more about the bottom line than their care.

PeaceHealth needs to do the right thing – pay home care nurses and hospice/palliative care nurses the same wages as hospital nurses.

Churchman has been a nurse for 25 years, 14 as a hospice nurse at PeaceHealth Southwest.