# If there is a shortage of nursing aides, why do they make so little? **URL:** \ **Category:** Factual Questions\ **Created:** [April 12, 2018, 12:52pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284 "2018-04-12T12:52:40Z")\ **Posts on this page:** 12\ **Page:** 3
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [April 13, 2018, 3:25pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/41 "2018-04-13T15:25:44Z")
> [@Jasmine](#): > > It does to some extent because our moral values often determine what we find economically valuable. Again, I cite the example of the parents who are outraged about the new $100 a year property tax assessment for their children’s schools while, at the same time, spend many times more on things that they obviously deem more valuable to them. That’s certainly correct, but it is not exactly my point. Our values certainly affect our choices. The market, however, operates after choices are made. I decide to buy crack instead of feed my children. That is certainly an immoral choice, but the market will thus reflect the increased demand for crack and the reduced demand for baby food just as it would if I decided to spend the money on Gerber’s instead. Because what I really want, in both cases, is what I do, and that is what the market reflects. Maybe we don’t want it to do that in the first case and do want it in the second, because the first choice is immoral and the second isn’t. The market still operates. Or we decide that people shouldn’t buy crack, so we make it illegal. The market then reflects that decision, because it increases the opportunity costs of using crack and/or reduces the supply. It also reduces demand, because people don’t want to break the law. The market price of crack is going to reflect those factors. Or I vote for a bond referendum for increased pay for teachers, and against one for a new stadium. That raises pay for teachers, increases the supply of people who want to be teachers, and reduces the demand for construction workers on stadiums. You can change the people whose decisions make up the market forces, but you can’t stop the market from operating. That’s why we have things like the drug trade, and black markets, and empty buildings in cities with rent control, and rationing in WWII, as well as housing bubbles and a rising standard of living. The market isn’t good or bad, any more than a thermometer is good or bad depending on whether global warming should or shouldn’t happen. It just is. Regards, Shodan ---
**Author:** ![Tom\_Tildrum](https://avatars.discourse-cdn.com/v4/letter/t/e95f7d/32.png) [@Tom\_Tildrum](https://boards.straightdope.com/u/Tom_Tildrum)\ **Post date:** [April 13, 2018, 3:48pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/42 "2018-04-13T15:48:16Z")
> [@UDS](#): > > What it _doesn’t_ say is that this will result in hospitals offering higher wages, any more than it says the result will be workers deciding to accept the lower wages. There are constraints on hospitals raising the wages (the size of the budget, the other things they need to buy with it, the sensitivity of demand for their own services, should they raise prices) and there are constraints on what wages the worker will accept (the need to eat, the need to pay rent, the level of wages the worker can earn doing some other job). The law of supply and demand does not magically remove these constraints. Supply is also constrained by the [training](https://cna.plus/cna-certification-requirements/) and licensure requirements. Training programs to become a CNA cost around $1000 and take 4-12 weeks. States require 75-180 hours of clinical experience before sitting for the licensure exam (which costs around $100). Continuing education and recertification requirements periodically take additional money and time. ---
**Author:** ![CookingWithGas](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cookingwithgas/32/485_2.png) [@CookingWithGas](https://boards.straightdope.com/u/CookingWithGas)\ **Post date:** [April 13, 2018, 4:06pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/43 "2018-04-13T16:06:12Z")
There is also a [“shortage” of low-wage farm workers](http://fortune.com/2017/08/08/immigration-worker-shortage-rotting-crops/) and food-processing jobs, especially with the reduction of undocumented workers in that work force. This is very similar to the OP’s question but with different causes. The commonality is that due to the structure of the business, the employers have to pay low wages to make a profit. The end customer is only willing or able to pay so much for those services. My MIL requires full-time live-in companion care, and even though the worker probably doesn’t get paid a huge amount (she is not a nurse’s aid or other trained health-care professional; she is more of a caregiver who knows how to call 911 or drive to the doctor’s office) it is very expensive to contract for this service. > [@UDS](#): > > No, it is pretty ironclad. The law says that, the lower the wages you offer for nursing assistants, the fewer people will be motivated to work as nursing assistants. That might be a true statement but that is not what the law of supply and demand actually says. If you look at a supply and demand chart in an economics text you will see that Quantity is the \*independent \*variable and price is the \*dependent \*variable. IANAE and this may work a little differently in job markets than it does for goods and services, but I’ll put this in reverse: the more people who want to work in a field, the lower the wage. That’s why most artists and musicians make so little, and people say teachers are underpaid for their training and responsibilities. They really love what they do and find it rewarding beyond the income, so the quantity of them falls to the right on the demand curve, hence a lower price. > [@DesertDog](#): > > [list of cites to starting salaries in various sports] > > Yeah, the superstars are a _lot_ more than that, but I’d bet even teachers would be pleased as punch to make even 10% of the big four minimums, never mind the aide working in your mum’s nursing home. Those are for major league sports. There are a lot of professional athletes who play for peanuts in minor leagues, and many of them are considered semi-pro because they have to take a second job to make ends meet. [Even at the upper levels of minor league baseball most players earn $2,150 a month](http://money.cnn.com/2016/07/01/news/companies/minor-league-baseball-pay/index.html) ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [April 13, 2018, 5:22pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/44 "2018-04-13T17:22:59Z")
The laws of economics also involve “elasticity” in supply and demand. I.e. the higher the price, the more goods (or workers) you get - but the relationship is not linear. In reality, (almost) nobody will pay $100,000 for a gallon of water, just as the market for chocolate bars would disappear at $100 each; but if gas were half the price it is now, would you sell twice as much? If gas is twice the price it is today, people would still have to drive a certain minimum to live their lives -work, shopping, etc. Doubling the amount you pay to top caliber pro athletes does not get you twice as many top caliber pro athletes or star quarterbacks. Hospitals and nursing homes basically are providing adequate services, so the shortage has not reached the point where they feel impelled to offer more money to attract more employees - i.e. the price is not as elastic as we would hope or want, the need for staff is more elastic than we think - they can get by with fewer, until the Health Inspectors notice that patients have been lying in their own waste for more than a day… ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [April 13, 2018, 6:49pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/45 "2018-04-13T18:49:16Z")
> [@CookingWithGas](#): > > That might be a true statement but that is not what the law of supply and demand actually says. If you look at a supply and demand chart in an economics text you will see that Quantity is the \*independent \*variable and price is the \*dependent \*variable. IANAE and this may work a little differently in job markets than it does for goods and services, but I’ll put this in reverse: the more people who want to work in a field, the lower the wage. It works the same in the job market. Lots and lots of high school kids want to play in the NBA, but there are very few players in the NBA, and those players make a lot of money. Wanting to work in a given field isn’t enough - you have to meet the qualifications such that you can be in demand to get hired. Probably very few people dream of cleaning bedpans when they grow up, but meeting the qualifications is not nearly as hard as being a basketball star in college. If we produced 100,000 Michael Jordans every year, but only two or three people who could be nurse’s aides, the salaries in the NBA would go down and the salaries of nurse’s aides would go up. Regards, Shodan ---
**Author:** ![Corry\_El](https://avatars.discourse-cdn.com/v4/letter/c/ecae2f/32.png) [@Corry\_El](https://boards.straightdope.com/u/Corry_El)\ **Post date:** [April 13, 2018, 7:10pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/46 "2018-04-13T19:10:29Z")
> [@naita](#): > > So the law of supply and demand is ironclad, but what you expect to happen isn’t happening? That suggests to me that “supply and demand” is merely a part of a more complex system of human actors and culture and that there is nothing “ironclad” about it. Nah, properly understood it is pretty ironclad. I think the answer here and in similar cases is actually pretty simple. There isn’t actually a ‘shortage’ (to the degree of causing an intolerable problem) and it actually means employers lobbying to change the regulatory constraint under which the law operates. For example, more visa’s for low skilled workers, shifting the supply curve favorably from the POV of employers as to how much the wage must be to a attract a given number of employees (in the US labor market). It’s only not ironclad when you start appending to it then knocking off various straw men that ‘worshipers of the free market’ supposedly attach to it, but which no serious and informed person actually does. As for example the idea that the law itself implies perfect information for all participants and zero friction in markets. Which of course it doesn’t. ---
**Author:** ![Dinsdale](https://avatars.discourse-cdn.com/v4/letter/d/97f17d/32.png) [@Dinsdale](https://boards.straightdope.com/u/Dinsdale)\ **Post date:** [April 13, 2018, 7:20pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/47 "2018-04-13T19:20:47Z")
Just offering my experience - nurse’s assistant/caregiver/home attendant/companion is probably the category of occupation I most commonly encounter among applicants for SS disability benefits. I can’t recall ever seeing anyone who had received a “certification.” (Which I just realized this moment is odd, since the majority of them refer to themselves as CNAs.) I’m sure there are CNAs/NAs who work for fine organizations, and find their work rewarding. Unfortunately, I do not often encounter them. My impression is that there are a great many folk in such positions who are very poorly paid, experience stress dealing with clients who have various profound physical/mental/emotional impairments, and experience stress from the perception that their employer does not value their services highly. The NA position is generally characterized as unskilled, and is very low paid. From what I hear, it can be a very challenging job - both physically and emotionally. I’ve never seen anything like a study, but it sure seems as though the vast majority of folk alleging fibromyalgia are women with past work as a CNA. The reason we have a shortage of such caregivers (if we do) is that medical technology keeps people alive way past the time they can care for themselves, and that any number of entities profit handsomely from doing so. While providing such care for profit, their incentive is to economize wherever they can. Paying unskilled labor as little as possible is a good way to increase profits. ---
**Author:** ![Snnipe\_70E](https://avatars.discourse-cdn.com/v4/letter/s/b5a626/32.png) [@Snnipe\_70E](https://boards.straightdope.com/u/Snnipe_70E)\ **Post date:** [April 13, 2018, 7:37pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/48 "2018-04-13T19:37:36Z")
> [@xnylder](#): > > Because most are women. Because many are minorities. > > Need stats? From an American 2004-2005 study here: [https://academic.oup.com/gerontologist/article/49/2/185/553634](https://academic.oup.com/gerontologist/article/49/2/185/553634) > > The study identified 56,340 male nursing assistants to 646,142 women. > The study identified 375,416 white nursing assistants, 271,582 black, and 55,484 other. > That’s a far larger proportion of black nursing assistants than one would extrapolate from the overall population. > > People are looking for market reasons for this lack of pay, but I believe discrimination is the key factor. Not really a planed discrimination. When there is a shortage the employer does not want to raise the pay rate because when the shortage is over the employer does not want to be paying the higher rate. In some industries employers have held out for years without increasing the pay level because they were waiting for the market to drop. ---
**Author:** ![nightshadea](https://avatars.discourse-cdn.com/v4/letter/n/7ba0ec/32.png) [@nightshadea](https://boards.straightdope.com/u/nightshadea)\ **Post date:** [April 13, 2018, 8:15pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/49 "2018-04-13T20:15:29Z")
in the 3 years I dealt with CNA’s as part of my deceased nephew through an home care employment agency … it was weird as some made money and some didn’t since it depended on how many clients you wanted But 90 percent of the ones I dealt with were African and Filipino females with the occasional white or Hispanic girl and one very nice African man who was a minister ( I leaned that people fron Africa love gossip as a hobby even they there all friends ) But one reason the pay is so low is the attitude of" anyone can do it " The only special training a cna needs is a 2 week course on patient safety … how to operate/fix machinery if it beeps the wrong way and how to measure and inject medicine in a tube" and someone watching you perform Because his mom found out she could get paid for it she took the course and was certified through the agency The cnas loved us because we were more hands on with my nephew than a 99 percent of people … all they did was give him the medicine he needed help with the breathing machine and help change him when he needed it … other than that they sat and watched me and others play video games for him … as they did crossword puzzles and such But they did have one gripe … when a new hospital opened up the hospital staff decided it wasn’t going to hire any CNA’s at all and they were like " all those nurses aren’t going ot have the time or inclination to change diapers give medicines and all the “scrub work” they did … ---
**Author:** ![Corry\_El](https://avatars.discourse-cdn.com/v4/letter/c/ecae2f/32.png) [@Corry\_El](https://boards.straightdope.com/u/Corry_El)\ **Post date:** [April 13, 2018, 8:17pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/50 "2018-04-13T20:17:30Z")
> [@Dinsdale](#): > > Paying unskilled labor as little as possible is a good way to increase profits. Paying anybody as little as possible is a good way to increase profits, if it doesn’t mean you have to turn away business that would be profitable even if you had to pay them more. If the basic idea were just to offer people very low wages and that actually worked, why wouldn’t everyone’s wages be very low? The answer is not ‘sense of social responsibility by the good employers’ or govt regulation or unions (in an economy where that comprises something like 5% of the private sector labor force). It’s because the employers wouldn’t be able to get the workers they needed consistently offering below market wages for particular types of labor. It’s a market. Acknowledging that reality doesn’t mean you can’t regulate labor markets, override their answers with mandates (like minimum wages) or (less inefficiently than minimum wages) allow them to clear naturally but then tax people whose labor is worth more in the market to subsidize people whose labor is worth less. As was pointed out above though, labor markets have varying elasticities of supply and demand. If offering a lot more is only going to attract a relatively few more workers (under all the other prevailing ‘natural’\* and govt\*\* constraints), and given the likelihood pay raises for new workers have to be passed on to all the existing ones to avoid damaging loss of morale, that is a characteristic of the supply/demand relationship which affects the outcome of the market mechanism. \*the prestige of caring for the hygiene needs of others is particularly low in some cultural groups, particularly American born, compared to non-American born people, in general. Such work for example has very low prestige among American born African Americans, perhaps in view of the history of ‘domestic work’ being once overtly viewed as ‘a black person’s work’. So the history of race factors in there, though not necessarily in the sense of employers now paying people less because they aren’t white. People in home care jobs are disproportionately foreign born; foreign born people in the US are disproportionately non-white. \*\*the public via the govt sets the de jure and de facto policies how many low skilled people can immigrate. ---
**Author:** ![nightshadea](https://avatars.discourse-cdn.com/v4/letter/n/7ba0ec/32.png) [@nightshadea](https://boards.straightdope.com/u/nightshadea)\ **Post date:** [April 13, 2018, 8:35pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/51 "2018-04-13T20:35:08Z")
missed the edit timer it was supposed to read : in the 3 years I dealt with CNA’s as part of my (now deceased) nephew home care after he left the facility he was stuck in through a home health care agency ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [April 13, 2018, 10:24pm UTC](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284/52 "2018-04-13T22:24:15Z")
> [@adaher](#): > > This is also true of exotic dancers and escorts. these jobs require little in the way of skills, but their prices are bid up because there is a shortage since most women don’t want to work in those careers. The same should be true of people who handle feces for a living. And it is true! Except employers have just made a conscious decision to just do without rather than pay more. I just wish they’d stop complaining about it and asking for government to find a way to get them more cheap labor. Either pay the price or do without, but whining is so childish. Though I’ve never been in a strip club, I’d guess that if the audience had to wait an hour to see a dancer or get a lap dance they’d pick up and leave, and the club owner would lose money. If you are hooked up to IVs and have to wait an hour to get your bedpan emptied, you don’t have much choice but to wait. But I agree that employers who don’t want to pay competitive wages should stop complaining. [Previous page](https://boards.straightdope.com/t/if-there-is-a-shortage-of-nursing-aides-why-do-they-make-so-little/812284.md?page=2)