Why Nurses Make More Than Social Workers

On social worker blogs and among my peers, I often hear about how unfair it is that nurses get paid more than social workers. A common catchphrase is, "Social workers have twice the education, but half the salary!" A while back, this same issue came up on a social worker salary post on SocialWorkersSpeak.org. I wrote a rather long comment in response and thought it would be good to repost it here. It's my take on this controversial and recurring issue in our field.

I can only theorize as to why nurses make more than social workers. While I don’t necessarily agree with everything on this list, here’s what I’ve brainstormed:

-Liability: Perhaps nurses are paid more because they directly impact the lives of patients. Injecting the wrong medication dosage, not using proper sanitation methods, and other such mistakes can severely hurt of kill a patient. Furthermore, nurses face many occupational hazards such as direct exposure to diseases, bodily fluids, needlesticks, etc. I did not go to nursing school because I did not want to handle wounds, clean bodily waste and commodes, and whatnot. I’m willing to pay the nurses to let them deal with that.

-Curriculum: My social worker friends me that they cannot handle nursing curriculum because it is too difficult and rigorous. I do not know if this is true, but I can attest that curriculum-wise, my MSW program was significantly easier than any science class I took as an undergrad (though my brain is probably just not wired for science). At work, I am frequently impressed by the breadth of knowledge the nurses have, even the ones with an AA degree. These nurses are individuals that make recommendations to doctors as to how to treat the patient. Even with an MSW, I find myself feeling like an idiot at work due to my utter lack of medical knowledge compared to nurses. Furthermore, I feel as if I apply very little of my grad school curriculum at work.
Where I work, RN case managers lead the discharge planning process. This seems to make sense to me because RNs are capable of obtaining psychosocial information while also being knowledgeable about the medical aspects of the patient. It’s much more efficient, as social workers like myself often have to defer to RN case managers when getting insurance authorizations, explaining why a patient needs a certain treatment, reading lab/PT/OT/x-ray results, and even determining if a patient is discharging. When coordinating care between the various allied health fields, I’d trust the nurse to do it over myself because I simply don’t have the medical knowledge a nurse does. I feel I work best when brought in as a consultant to handle the psychosocial aspect of care affecting discharge.

-Unions: Nurses have a very powerful union and are able to bargain for their wages. I know of hospitals with nurses that threaten to strike every year unless their demands are met. If social workers were to do the same, I’m sure the wages would go up.

-Economics: Nursing schools are severely impacted. At some schools in my area, there is a 5 year wait list to get in. By keeping nursing schools capped, this keeps the number of nurses entering the workforce low. With such a high demand for nurses, these hospitals with snatch up these new nursing grads and pay pretty generous salaries too.
Unfortunately the field is saturated with social science type majors who can get hired to perform “counseling” type work. Until social workers can ensure national title protection, we’ll have high school/college grads doing our work for cheap and driving down our wages. Nursing does not have this problem.
It seems like the high paying jobs these days are in health and hard sciences: engineering, computer programming, technology, medicine, etc. If you look at salary figures, those who studied the health/hard sciences tend to make more than humanities/social sciences. That’s because those in the former tend to work in profit-driven companies. Most social workers on the other hand end up in the non-profit sector.

I’m not trying to say that nursing is better than social work. However, I don’t think we should be talking about an AA in nursing like it’s cake. Many RNs I know with AA degrees are as knowledgeable than BSNs. Also, nurses should be our allies, not our rivals. At my job, the bedside nurse spends significantly more time with the patient than the social worker, and is hence an excellent resource when it comes to psychosocial issues.

Instead of comparing ourselves to other professions, we should look without our own field and see how we can improve. If we must compare ourselves to nursing, remember than decades ago, nurses were as overworked underpaid as social workers. By unionizing, advocating, and empowering themselves, they have grown to be a powerful profession in the medical field. Nurses have worked their way up since the days of Florence Nightingale. Social workers have the capacity to do the same.

Hope this explanation helps!

Thoughts?