Valuing the Art and Science of Nursing: 
A Comprehensive Approach to Compensation 

PART II 

Part II – Valuing and Compensating for “Care” Activities: Beyond the Procedure 

This section addresses the more complex, yet essential, task of valuing and compensating for the often-unseen work of “care”: 

1

Define and Operationalize “Care”: Making the Intangible Tangible 

• Practice: Move beyond vague notions of “caring.” Specifically define the activities that constitute high-quality nursing care beyond procedures. 

• Examples:

• Patient and Family Education 

• Care Coordination 

• Discharge Planning 

• Assessment and Monitoring 

• Emotional Support 

• Health Promotion and Prevention 

• Pain Management 

• Advocacy 

• List Item

• Fall Prevention and other preventative measures. 

• Implementation:

• Pilot different measurement methods. 

• Provide thorough training to nurses on how to use the tools. 

• Regularly audit the data. 

• Update market data at least annually, and more frequently in volatile markets. 

• Use the data to identify areas for improvement and demonstrate the value of nursing care. 

2

Develop Measurement Tools: Quantifying the Impact 

• Practice: Develop tools to track and quantify “care” activities.

• Methods:

• Time Studies 

• Self-Reporting 

• EHR Documentation (with careful attention to efficiency and avoiding increased administrative burden)

• Patient-Reported Outcomes (PROs) 

• Quality Metrics 

• Implementation:

• Pilot different measurement methods. 

• Provide thorough training to nurses on how to use the tools

• Regularly audit the data. 

• Use the data to identify areas for improvement and demonstrate the value of nursing care. 

3

Integrate “Care” into Compensation Models: Rewarding Value 

• Practice: Shift from a purely volume-based or hourly model to one that rewards the quality and impact of care.

• Options:

• Value-Based Bonuses 

• Care Density Adjustments 

• Shared Savings Programs 

• Skill-Based Pay 

• Professional Development as a component of the hourly rate. 

• Re-evaluate hourly rates based on the above factors. 

• Implementation:

• Start small and pilot new models. 

• Involve nurses in design and implementation. 

• Clearly communicate the goals and rationale. 

• Provide ongoing training and support. 

• Carefully evaluate the impact and adjust as needed. 

4

Advocacy and Policy Change: A Systemic Approach 

• Practice: Advocate for changes in reimbursement models to better recognize and reward the value of nursing care. 

• Actions:

• Support relevant legislation. 

• Work with professional nursing organizations. 

• Educate policymakers and the public. 

• Participate in discussions about healthcare reform. 

5

Leadership and Culture: Setting the Stage for Success 

• Practice: Cultivate a culture that values and supports the contributions of nurses. 

• Actions:

• Nursing and organizational leadership must champion these changes. 

• Nursing leaders need to be involved in financial decisions. 

• Create a shared-governance culture. 

Implementing these best practices requires significant commitment, but it is essential for attracting and retaining high-quality nurses, improving patient outcomes, and building a more equitable and sustainable healthcare system. The key is to recognize that “care” is not just a cost center, but a fundamental and invaluable component of high-quality healthcare. Investing in nurses is an investment in the future of healthcare.