According to Welton and Harper (2015), nursing labor is one of the largest expenditures of resources and dollars spent within the health care system, in reality however, nursing work is literally invisible in many healthcare reimbursement systems (Welton & Harper, 2015). The authors declare that over half of the three million registered nurses in the United States work in hospitals, yet inpatient nursing care is billed as a daily per diem charge and there is no direct relationship between the actual nursing care hours provided to individual patients and the associated nursing care costs (Welton and Harper, 2015). One key recommendation from the authors is to change how nursing care is viewed away from a staffing model to one where each nurse
