Pennsylvania is heading toward the worst nursing shortfall in the entire nation and will soon have over 20,000 empty positions. Here in Pittsburgh, our enormous health systems have the financial resources to lead the way in solving this crisis. Instead, the health care industry has done the exact opposite and failed to invest in building a sustainable nursing workforce, especially when it comes to retaining experienced nurses. That’s why my fellow nurses and I throughout the city are advocating to modernize the nursing profession and ensure we can provide the safe, quality care our community deserves.

From the time I was a kid, I always wanted to be a nurse. Currently I work in neonatal intensive care transport at West Penn Hospital. We go by helicopter or ambulance to retrieve the sickest, most vulnerable babies from facilities across our region and bring them back to our hospital to provide cutting-edge critical care. There are few experiences more meaningful than working to save the life of a newborn.

Even though nursing is my life’s purpose, for years I have seriously considered leaving this profession that I love. As a registered nurse for more than two decades, I’ve been a firsthand witness to the spiraling problems facing nurses.

In our city’s hospitals today, our patient population is older and sicker than ever before and needs more care. Yet as nurses are being expected to take on more patients and duties, we have less staffing and resources. There’s a vicious cycle that has taken hold. Veteran nurses are leaving the bedside due to severe understaffing and burnout. Newly graduated nurses are brought on without access to the mentorship and institutional knowledge of longtime nurses. As those young nurses are ground into dust and quit, hospitals try unsuccessfully to fill in the gaps with expensive travel nurses, which wastes resources that could go toward hiring permanent staff.

One of the main reasons our hospitals are understaffed is that nurses are underpaid. According to research our union has conducted based on data from the Bureau of Labor Statistics, the average starting wage for nurses nationally is more than 12% higher than in Pittsburgh. What’s worse, that disparity increases with time, so that the average wage for experienced nurses nationally is over 23% higher than in our city. In other words, there’s actually a penalty for being a veteran nurse in Pittsburgh, and the longer you practice, the further you fall behind.

When our hospitals are plagued with constant turnover and short staffing, it’s extremely exhausting and almost impossible for nurses to deliver the high level of care we believe in. That can be very despiriting and demoralizing. In the nursing profession, there’s an ethos of self-sacrifice, sucking it up and just pushing through. But the health care field has become so toxic that even this stoicism is not enough.

Nurses are no longer willing to kill ourselves in order to do our jobs.

These kinds of conditions led me and my 600 nurse co-workers to form a union at West Penn four years ago. In our first union contract negotiations, we were able to gain important standards aimed at stabilizing our nursing workforce. We established staffing guidelines and committees to make sure our hospital follows those policies. Additionally, we created a transparent payscale that rewards all years of experience, lifted unfair wage caps on veteran nurses, won guaranteed annual raises and made other improvements. At another union hospital, Allegheny General, 1,300 nurses also won substantial raises, a commitment by management to hire more staff, and improvements in staffing levels last year.

But even with these advances at individual union hospitals, we are still not doing enough to retain long-time nurses because the issues are systemic throughout the overall market in our city. If we fix the problems with the market, there are more than enough non-practicing registered nurses out there who could be brought back to the profession. There are over 240,000 people with registered nurse licenses in the commonwealth, but only about 144,000 are practicing, meaning there’s a pool of around 96,000 nurses who are not. There’s not a shortage of nurses, just a shortage of people willing to work under the intolerable conditions in our hospitals. Solving our compensation disparities would be a major step toward returning nurses to the bedside and keeping them there.

The health care industry in Pittsburgh certainly has the financial capacity to stop the revolving door in nursing. The top two health systems had combined revenue of $54 billion and more than $19 billion in cash and investments last year. Nurses at West Penn and hospitals throughout our city are leading the way in our current union contract negotiations to transform our profession and make the health care industry invest in retaining and recruiting nurses.

Pittsburgh has world-class health care resources. Now it’s time to ensure world-class standards for nursing.

Kari Xander, a registered nurse for 21 years, is a leader of her union, SEIU Healthcare Pennsylvania.

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