Registered nurses (RNs) in the United States are paid differently depending on a range of factors that can include an economic state of the region, the population density, and the level of nurses’ education among other aspects (McGregory, 2013; Moore & Continelli, 2016). According to Spetz (2016), “cost‐of‐living differentials are apparent across regions and even within relatively small geographic areas such as cities” (p. 505). This factor also influences the trend. The significant difference in average salaries paid to RNs is also observed in Florida. Thus, an average wage per hour paid to RNs in Florida is $29.70 (Crawford, 2017). In the Miami-Miami Beach-Kendall Metropolitan Division of Florida, to which Hialeah belongs, a mean wage per hour is comparably high, and it is $32.72, but an average hourly salary in Hialeah is only about $23-$25 (U.S. Bureau of Labor Statistics, 2017). The purpose of this paper is to discuss the research problem related to the identified topic, present the research question, describe an appropriate sample, propose the most effective design, and present the plan for the data analysis.
The problem to be resolved by this study is that RNs in Hialeah, Florida, are paid significantly lower hourly wages in comparison to RNs from other cities of Miami-Dade County, Florida (the Miami-Miami Beach-Kendall Metropolitan Division), and factors that influence this trend are non-determined and addressed effectively. Statistics indicate that, even though the average hourly wage of RNs in Florida is about $30, it is significantly lower in Hialeah ($23-$25) (Crawford, 2017; U.S. Bureau of Labor Statistics, 2017). Besides, a remarkable difference in salaries can be observed while comparing wages in different cities from the Miami-Miami Beach-Kendall Metropolitan Division of Florida (U.S. Bureau of Labor Statistics, 2017). Thus, the significant difference in RNs’ salaries can be noticed while comparing wages reported in Hialeah and other cities of Miami-Dade County, including Miami, Miami Gardens, Aventura, Coral Gables, and others (Crawford, 2017; U.S. Bureau of Labor Statistics, 2017). From this point, it is important to determine specific factors that can explain the observed differences in RNs’ wages in Hialeah and other cities located in Miami-Dade County.
A range of factors can influence the situation in Hialeah, and it is important to conduct a study to identify these factors to conclude about ways of addressing them and improving the situation for RNs in Hialeah. Thus, it should be noted that the importance of this quality improvement project is in proposing strategies to address the situation to improve RNs’ performance in Hialeah that can be influenced by low wages or by those factors that contribute to determining this low level of salaries in the city in comparison to other regions of the state. According to Spetz (2016), one of the factors that can influence the salaries of nurses is an economic situation in a region or a city. As a result, average wages in both public and private hospitals are rather low (Spetz, 2016). Therefore, this issue needs to be studied in detail.
The problem can be associated with the fact that most nurses who work in Hialeah are Hispanics, migrants, or representatives of minorities, whose educational level and the knowledge of the language can be lower in comparison to white RNs (U.S. Bureau of Labor Statistics, 2017; U.S. Census Bureau, n.d.). According to Li, Nie, and Li (2014), education and language are important factors, and internationally educated or migrant nurses usually receive lower pages. Other researchers also paid attention to the role of ethnicity and discrimination in the process of determining wages for nurses in healthcare organizations while accentuating such factors as age, gender, race, cultural heritage, and education (Crawford, 2017; De Jesus-Rivas, Conlon, & Burns, 2016; McGregory, 2013; McHugh & Ma, 2014). Moore and Continelli (2016) also found that RNs from ethnic and cultural minority groups usually receive lower wages in comparison to white nurses. Thus, more research is required to determine other factors and identify strategies to address these aspects and improve the situation.
While focusing on the scope and details of the quality improvement project, it is important to note that, in Hialeah, the percentage of Hispanic and culturally diverse nurses is high (U.S. Bureau of Labor Statistics, 2017; U.S. Census Bureau, n.d.). Also, among culturally diverse nurses working in Hialeah, it is possible to observe the high number of nurses who belong to the non-English speaking minority. Furthermore, Florida is among the leaders in the United States in terms of attracting internationally educated nurses (U.S. Census Bureau, n.d.). Therefore, it is possible to expect that such factors as the lack of education, the migrant status, language barriers, economic barriers, and discrimination can have an impact on determining salaries for RNs who work in healthcare organizations in Hialeah. From this perspective, it is important to focus on determining factors that can be viewed by nurses in Hialeah as influential for their wages in comparison to the situation observed in other cities of Miami-Dade County.
The purpose of this study is to determine why there is a difference in salary rates for RNs who work in Hialeah and those nurses who work in other cities of Miami-Dade County (McGregory, 2013; McHugh & Ma, 2014; U.S. Bureau of Labor Statistics, 2017). This purpose is consistent with the formulated research problem, and it is appropriate to guide this study. To complete the selected quality improvement project, it is important to refer to RNs’ perceptions of factors that influence wage rates and identify strategies to solve the problem.
The research question that addresses the identified research problem and that is consistent with the research purpose can be formulated the following way
Why is there a difference in salary rates for RNs who work in Hialeah and RNs who work in other cities in Miami-Dade County?
This research question is appropriate to guide the study to find solutions to the set research problem. The focus should be on identifying reasons for the observed differences in salary rates for RNs in Florida. Also, the focus should be on emphasizing specific factors that can influence the development of this trend concerning RNs’ visions of the problem.
The sample selected for this study includes 10 RNs who work in different healthcare facilities located in Hialeah, Florida. The focus is on female RNs who belong to the age group of 25-55 years and have experience in this profession. Those nurses who worked in other cities of Miami-Dade County are also invited to participate in the study. From this point, the inclusion criteria determined for this sample are the location, age, gender, position, and experience. Those nurses who are internationally educated are also included in the sample, along with nurses who belong to different ethnicities because these factors are determined in the literature as important to affect RNs’ wages in Florida and other regions of the United States (De Jesus-Rivas et al., 2016; McGregory, 2013; McHugh & Ma, 2014; Moore & Continelli, 2016). It is important to note that this specific population should be studied in this research because, according to the statistical data presented in governmental and local sources, RNs in Hialeah receive minimal wages in comparison to salaries typical of other cities in Miami-Dade County.
It is assumed that a range of factors can influence this phenomenon, therefore, the focus is on attracting diverse participants who have different experiences in this sphere. Those participants who represent the sample for this study should be recruited with the help of professional networks (Li et al., 2014; McGregory, 2013; Moore & Continelli, 2016). In this case, it will be possible to invite those nurses who have certain ideas and thoughts regarding the causes of a difference in salary rates for RNs that are observed in Miami-Dade County. A specific sampling technique should be used to refer to the selected sample from the determined population of those RNs who work in Florida.
The focus should be on using a non-probability purposive sampling technique. The rationale to explain the choice of the technique is based on the necessity to examine the lived experiences of a particular group of nurses (Snelgrove, 2014). Thus, a non-probability purposive sampling approach allows for selecting and inviting only those nurses who can provide important information regarding their background and experience for the researcher to be able to answer the set research questions about the causes of differences observed about salary rates in Miami-Dade County. It is also important to provide RNs, who are invited to participate in the project, with informed consent forms to guarantee that all participants understand the nature and purpose of the study.
To address the set research problem and answer the proposed question, it is important to conduct a qualitative phenomenological study. The qualitative research methodology is selected to address the purpose of this project because it is appropriate to respond to the question about possible causes of differences in RN salary rates observed in Miami-Dade County concerning Hialeah and other cities (Snelgrove, 2014). To answer this question and address the research problem, it is necessary to collect data regarding RNs’ backgrounds, life stories, experiences, and observations. These detailed data are important to be analyzed to create a picture of a phenomenon studied in the project.
The in-depth investigation of RNs’ experiences is significant to understand why certain differences in salary rates are observed with the focus on nurses’ perceptions of the problem (Snelgrove, 2014). The quantitative methodology is not appropriate in this case because quantitative studies allow for determining relationships between certain factors, for instance, certain characteristics of RNs in Hialeah and salary rates. However, the focus of this study is only on determining these particular factors and characteristics concerning nurses’ experiences. In this case, the study concentrates on analyzing RNs’ perceptions of the observed difference and their ideas regarding possible causes of this phenomenon.
It is also important to pay attention to the fact that a phenomenological study is selected for this research. The reason is that a certain trend or phenomenon is observed, and it needs to be studied concerning analyzing people’s lived experiences (U.S. Bureau of Labor Statistics, 2017; U.S. Census Bureau, n.d.). A phenomenological study allows for concentrating on participants’ experiences, feelings, and perceptions to determine specific factors that can influence differences in nurses’ salaries (Snelgrove, 2014). It is significant to note that these factors are currently unknown, therefore, a qualitative phenomenological study will provide insights regarding this problem for further research and discussion. Other approaches typical of the qualitative methodology, including ethnography, grounded theory, and case study, can be discussed as inappropriate to address the purpose and research questions formulated for this project.
One should state that ethnography is used to examine large groups or populations to focus on their culture and specifics. The grounded theory allows for formulating a new theory concerning the findings of a study. These approaches are not effective to answer the research question in this study (Snelgrove, 2014). Furthermore, a case study is also inappropriate for this project because the opinions of a larger sample are required to answer the set research question. As a result, it is possible to state that the selected phenomenology is most appropriate for this study to address the research purpose and answer the question about the causes of differences in RN salary rates that are observed in Miami-Dade County.
To collect data regarding possible factors that can influence differences in RN wage rates in Hialeah in contrast to other cities in Miami-Dade County, it is necessary to conduct interviews with RNs who have diverse backgrounds and can share certain ideas regarding possible causes of this phenomenon. It is important to note that, to address the triangulation requirement, both primary and secondary qualitative data will be collected (Snelgrove, 2014). Thus, primary data will be gathered with the help of semi-structured phenomenological interviews, and secondary data on the problem will be collected with the help of reviewing sources published on the topic. As a result, it will be possible to make conclusions about factors that can influence the trend not only concerning RNs’ opinions but also with the focus on data presented in governmental and local reports, documents, and scholarly literature.
Unit managers in several hospitals located in Hialeah will be contacted with the help of e-mail and professional networks to select and invite RNs who can participate in the study with the permission of the hospital administration. Primary data will be gathered with the help of protocols for semi-structured interviews that include prepared questions and that can guide conversations with participants of a phenomenological study. The focus should be on questions that help RNs express their opinions regarding rates of salaries and possible factors associated with these rates. The use of semi-structured interviews allows the researcher to be flexible in asking questions while focusing on the major topic of the research (Snelgrove, 2014). The RNs selected for the sample will be contacted with the help of e-mail to choose dates and places for conducting face-to-face and telephone interviews depending on nurses’ preferences. It is planned that each interview session will take about 30 minutes to develop the conversation and answer the set questions.
Interviews conducted as face-to-face meetings or by phone will be recorded with the help of an Olympus digital voice recorder. This approach allows for storing data for further analysis. The nurses’ answers to interview questions recorded for the study will be transcribed and presented in the digital form (Snelgrove, 2014). The data will be analyzed with the help of a coding procedure to determine key themes identified during conversations that are important to define specific factors that can explain differences in RN salary rates. The data will be coded with the help of the Coding Analysis Toolkit (CAT).
Secondary qualitative data will be collected after reviewing governmental and local reports, documents, and scholarly literature on RN salary rates in Hialeah, Miami-Dade County, and Florida. The information in these sources will be analyzed to determine whether there is any support for findings associated with primary data (Crawford, 2017; Snelgrove, 2014; U.S. Bureau of Labor Statistics, 2017; U.S. Census Bureau, n.d.). The analysis of themes will be done manually. The conclusions and recommendations for this project will be based on the synthesized information and the detailed analysis of the research problem. The presented plan for analyzing the collected data can be discussed as effective as it allows for gathering all the required information, and the focus on triangulation is important to make bias-free conclusions.
It is important to pay attention to the fact that the analysis of these data will potentially demonstrate what factors influence the trend that RNs in Hialeah receive lower wages than RNs in other cities of Miami-Dade County. As a result, it will be possible to formulate recommendations to address the problem. It is stated in recent studies that wages of RNs directly influence the quality of their work (Li et al., 2014; McGregory, 2013; McHugh & Ma, 2014). As a result, it is necessary to propose certain changes in determining average hourly wages in Hialeah for all nurses, regardless of their migrant status, culture, education, and the used language (McGregory, 2013; Moore & Continelli, 2016). The analysis of secondary sources will be important to find potential solutions to the problem.
The paper has presented the proposal for the quality improvement project that is oriented to studying the problem of low wages for RNs in Hialeah. This issue can be viewed as important because it indicates the inequality in the region regarding paying for RNs’ services. To address this problem, it is important to conclude about factors that provoke the observed situation. For this purpose, it is necessary to refer to the opinions of RNs who suffer from low wages and who can explain this phenomenon concerning such factors as migration, education, and discrimination among others, as it is stated in the literature. To investigate this problem, it is appropriate to conduct a qualitative phenomenological study that is based on collecting both primary and secondary data to provide conclusions and formulate recommendations to solve the identified issue. As a result, the proposed sample, design, and analysis plan are developed with the focus on the qualitative methodology that is effective to address the formulated research question.
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