Capitalism’s undervaluation of nursing care

Based on a talk given at the Feb. 5 webinar “Global Class War: Lessons from Sam Marcy for workers struggles today.” Go to to view the webinar.

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In “High Tech/Low Pay,” Sam Marcy spoke of the feminization of labor, as more women worked jobs that had been held by white males in factories — at significantly lower pay. My focus will be on the work where women already predominated — the so-called caring profession of nursing.

Historically, nursing was undervalued because it was believed that it required an innate feminine characteristic and lack of desire to be compensated monetarily, much like child care and housework today. Prior to the Industrial Revolution, care of the sick was undertaken by female family members. 

As industries mechanized and cities grew, hospitals were established by religious organizations and charitable groups. With the acceptance of germ theory and aseptic techniques, nursing schools were established to teach theory and technique, and nursing evolved as an acceptable profession for unmarried women. 

Medical and surgical technology advanced in the 20th century, and the role of the nurse expanded to include how to operate the high-tech gadgets and interpret the data they produced. Monetary compensation was slow to catch up, since nursing retained a predominantly female workforce.

High tech allowed for advancements in health care and disease prevention, which were made available to those with the means to pay. Capitalists saw profit-making opportunities and turned hospitals into money making corporations, passing their ever expanding costs onto the consumer while cutting expenditures deemed superfluous. 

Nurses fall into the latter category, undervalued by hospital corporate heads because nursing is  still considered a feminine profession with all the old baggage about innate caring. Additionally, they can’t be as easily commodified as say a surgical procedure or course of antibiotics.

Lillee Gelinas MSN RN FAAN, editor in chief of the journal “American Nurse,” described nursing work using the analogy of an iceberg. The physical task performed is only the tip of the iceberg. What is not seen are the countless skills a nurse uses to process and act upon information that will allow for the best medical outcomes and survival rates. All the hightech gadgets can never take the place of the complex nursing work performed below the surface.

In order to do that work, nurses must spend enough time with their patients. Appropriate nurse-to-patient ratio is critical. That is why the current labor uprising among nurses in the U.S. and abroad is primarily over staffing, not wages. 

In the last chapter of “High Tech/Low Pay,” Sam Marcy offers tactics to use in our labor struggles. One in particular is the withholding of labor until unfair and unsafe conditions are resolved.

Applying this strategy will require organizing and educating nurses to be united in their refusal to work if staffing is subpar. Strategies must be carefully developed. It won’t be easy, given the life-or-death stakes, but it’s essential if professional nursing is going to survive.

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