By James X Stobinski, Ph.D., RN, CNOR, CSSM(E), CNAMB(E)
I would like to comment on a recent social media post which generated considerable discussion among nurses. The post featured a list of the range of salaries for tradesmen such as plumbers and electricians and made a comparison to nursing compensation. The consensus from many of the nurses that responded was that nurses were undervalued in comparison to these workers. Full disclosure here – my father and many of my relatives were/are skilled tradesmen so my view is a little different than some nurses. I would like to offer another perspective on comparisons between nurses and other workers.
First, let’s narrow the field and speak to just one trade – plumbing. Much like nurses, plumbers have a long period of education and training. The Salary.com website informs us that the median salary of a journeyman plumber with roughly 5 years of experience is $67,020.¹ On the Salary Solver website, we are told that Mid-Level RNs (5-10 years of experience) earn $70,000 to $85,000 per year.² This gives us a rough comparison of salary levels of registered nurses who are not APRNs and journeyman plumbers who are not licensed as master plumbers.
We can argue about the relative value of nursing work versus plumbers. We can also speak to nurses making lifesaving decisions and that the work of nurses is more consequential than that of a skilled tradesman. From my perspective as someone well familiar with the work of skilled tradesman I maintain we should not begrudge these workers their hard-earned wages. We should instead consider a larger question – Why do the nurses who responded to that Facebook post feels undervalued? For that we should look a little deeper.
In many healthcare facilities nursing is seen as a necessary but substantial labor expense. Keeping nursing staffing lean is a priority for leadership and nursing-related education and training is often an early casualty when budgets are tight. The visceral responses of nurses to that Facebook post on the compensation of skilled tradesmen then logically follows.
What could benefit nursing over the long term is a change in how American healthcare views the labor costs of nursing care. The work of Dr. Olga Yakusheva from the University of Michigan with the Nursing Human Capital Value Model can inform a change in perspective. The authors state that, “ … we propose a new conceptual model and definition of nursing’s economic value.”(3) They maintain that the economic value of nursing should be redefined as an outlay which can yield a real, concrete return on investment (ROI) in terms of, “ … the improvement of consumer, nurse, and organizational outcomes.”³ In this view, improving staffing ratios and nursing professional development is as an investment in human capital versus just an expense.
These authors contend that nursing-related expenditures are, “ … investments in growing, developing and sustaining an organization’s nursing human capital.” which initiates a cycle of value creation.³ In this cycle the delivery of nursing care is a “ … a foundational ingredient to the production of healthcare services and consumer outcomes. Improved outcomes, subsequently, drive organizational revenue growth.”³ To justify this cycle, we must find ways to substantiate the value driven by nurses. But first, we must start talking the language of ROI and think in human capital terms.
This article, although a challenging read, is well worth your time. Consider it a worthwhile investment and an alternative to social media posts. We know the value we can bring but we need to better articulate that and the Nursing Human Capital Value Model provides a framework for discussion and future research. The ROI for our profession could be substantial.
James X. Stobinski, Ph.D., RN, CNOR, CSSM(E), CNAMB(E), Ph.D., RN, CNOR, CSSM(E), CNAMB(E), is on the faculty at Central Michigan University and director of hospital and ASC surgical education relationships with National Institute of First Assisting (NIFA).
References
1. Salary.com (2025). Plumber, Journeyman Salary in the United States. https://www.salary.com/research/salary/alternate/plumber-journeyman-salary
2. Salary Solver (2025). NP vs RN Salary in 2025. https://salarysolver.com/np-vs-rn-salary/
3. Yakusheva, O., Lee, K.A., & Weiss, M. (2024). The Nursing Human Capital Value Model, International Journal of Nursing Studies, 160:104890. doi: 10.1016/j.ijnurstu.2024.104890. Epub 2024 Aug 31. PMID: 39316994.
