No one has called for the undertaker yet, but the patient-- the Skidmore College nursing school-- is sinking fast. The board of trustees has announced plans to close the institution, even though it has been regarded since its founding in 1922 as one of the nation's premier centers for nursing education. No new students are being accepted, and by next year Skidmore's seven-story building on 38th Street will be for sale.
Skidmore's departure from nursing is part of the national pattern. Admissions and graduations have been dropping for the past five years in every part of the country. No relief is in sight. Federal aid for nursing education has dropped from $100 million in 1981 to $49 million for '82 and $12.5 million for '83.
This assault on education is not a devastation unique to the nursing profession. Nurses stand alone for other reasons. At the American Nurses' Association, an official with a talent for terseness put the situation into pill form: among doctors, hospital administrators and a large part of the public, the prevailing attitude about nurses has been keep them down, keep them dumb and keep them dispersed.
They are down because of salary. A survey in Denver reveals that the starting wages for sign painters, tree trimmers and parking meter repairmen were higher than for graduate nurses. The American Journal of Nursing reports that in 1945 nurses earned about one-third of physicians' incomes. Now they make less than one-fifth.
They have been kept dumb because as a 97 percent female work force in the male-run health-care industry they are subject to dated doctor-knows-best rules. This authoritarianism goes well beyond hospital floors, where doctors can get away with treating nurses more as servants than as professional colleagues. Few hospital policy-making boards include nurses.
The germs of this discrimination are contagious. In California, the UCLA medical school budget is being cut 5 percent while its nursing school budget is being cut 40 percent. This at a time when an oversupply of doctors looms as medicine's next major problem and the shortage of nurses--88 percent of the nation's hospitals can't fill their nursing vacancies--has been a longstanding crisis.
They have been kept dispersed because as members of a caring profession they were conditioned by doctors and hospital administrators not to betray the idealism of Florence Nightingale with such grubbiness as joining unions. Nurses who thought too much about salaries and power-sharing, or kicked that the health-care industry's profits were disproportionately going to others, were isolated as rebels. For sedatives, they would be assigned night shifts or weekend duty.
Despite all these ailments and injuries, American nursing remains surprisingly strong. Out of 1.6 million licensed nurses, 1.2 million are currently working. This participation rate of 76 percent well exceeds the 50 percent rate for all work-eligible women. In addition, a Chronicle of Higher Education survey reports that among college freshmen nursing was in the top four choices of majors and careers.
Much of this is traceable to the mid- 1970s, when a few members of the profession decided, first, to stop dreaming that the health-care establishment would suddenly begin being fair to them and, second, to demand their rights.
Following amendments to federal labor laws in 1974, the unionization of nurses surged. Five years before, only 30,000 nurses were covered by collective bargaining contracts. Five years after, the number reached 125,000. This year it is 155,000. Strikes have become common.
The idealism of nurses hasn't been diminished by the profession's new toughness. It has been enhanced. Self- esteem has replaced self-pity. The public should be grateful when nurses care enough about their ideals to go on strike--rather than quit the profession for easier, better-paying work--or when nurses go before Congress to challenge the narrow-minded positions of the American Medical Association. If nurses are treated less like underlings and more like the highly skilled professionals that they are, this professionalism gets passed along more fully to the patients.
Those whose vocation it is to care compassionately for others are now extending that care to themselves. It's healthy for everyone.