Priced Out of Nur$ing
Conferences shape who gets seen, who gets funded, and which ideas travel. In nursing, they also determine whose realities define “best practice.” Yet the way many events are built, pricing, scheduling, abstract review, and compensation, quietly reproduces inequity. If we truly believe nursing is an equity-focused profession, then the spaces where we gather must reflect that value in their budgets, policies, and daily operations.
The inequity starts with hidden costs! Start with the math. Registration, airfare, hotel blocks, per diem, and time off can exceed a week, or more, of pay for many nurses. For students, adjuncts, and nurses in safety-net settings, that price tag is a hard stop. Add child or elder care, visa barriers for international nurses, and the door narrows further.
Then comes “pay-to-present.” Not a common practice, but, if organizations require to pay to submit and abstract, such as Sigma, or the AAN, or require membership to be able to present, the cost goes up even further. Many presenters, especially those sharing practice-generated evidence (QI, implementation, community impact), receive no honorarium and must still purchase a registration. The message is unmistakable: research backed by grants is prized; practice insights from resource-limited settings are optional.
So is this gatekeeping by design and are conferences just revenue generators for organizations? Most conferences still use a one-size abstract rubric built for randomized trials and externally funded projects. Non-blind reviews and reviewer pools drawn from the same institutions reproduce the “usual suspects.” Poster tracks are treated as second-class, even when the content is more transferable to real-world care than a lab-perfect academic or big name institution trial.
Language and format matter, too. English-only, jargon-heavy calls for abstracts shut out multilingual and international colleagues who deliver the bulk of global nursing care. Favoring those with high academic, well resourced institutions.
Accessibility is more than a ramp. It’s captioning and ASL for all sessions (not just plenaries). It’s slide design standards that work for low-vision participants. It’s lactation rooms, prayer/quiet spaces, gender-inclusive restrooms, and on-site childcare or stipends. And in 2025, “hybrid” can’t mean a livestream with no questions, no networking, and reduced CE options. Hybrid parity, equivalent learning and interaction for remote attendees, is the baseline, not a bonus.
And let’s also talk about those big donors! Companies that slap their name on everything and get special white glove treatment! Nursing needs vendors and sponsors, but not at the cost of integrity. When the exhibitors who underwrite the event also shape podium topics or speaker slots, we skew the program toward what sells, not what saves. A clear conflict-of-interest firewall is non-negotiable.
For many colleagues, nurses with disabilities, LGBTQ+ nurses, nurses of color, and immigrants, conferences can feel risky. A published code of conduct, multiple reporting channels (including anonymous), transparent response timelines, and publicly shared aggregate outcomes are essential signals that everyone’s safety is taken seriously. So let’s stop making Florida and Texas are conference hot spots! The NBNA, at a great cost to their wallet a couple of years ago, and moved their conference out of Florida!
So what can we do better?
If we want equitable participation and better knowledge transfer, we need design changes, backed by budget.
Pricing & Compensation
Sliding-scale fees and equity scholarships funded at 15–20% of gross revenue.
Pay all speakers; cover travel for invited speakers; end “pay-to-present.”
True hybrid parity pricing with full CE and networking for virtual attendees.
Program & Review
Dual-track rubrics: (1) research and (2) practice/QI/community impact—with equal prestige and CE.
Double-blind, diverse reviewer panels by practice setting, geography, and demographics.
Reserve at least 40% of podium slots for practice-generated evidence and community partnerships.
Accessibility by Default
Captioning + ASL for every session; accessible slide standards.
Childcare stipends or on-site options; lactation and prayer/quiet rooms; gender-inclusive restrooms.
International participation support (visa letters, asynchronous options, multilingual summaries of key sessions).
Governance & Integrity
Vendor COI firewall; clear labeling of sponsored content (non-CE by default).
Annual equity outcomes report with demographic transparency (opt-in), incident metrics, and improvement goals.
Labor-friendly venue policies (no crossing active picket lines).
Open Knowledge
Presenters retain IP; slides/posters deposited in an open repository with DOIs.
“Practice packs” (tools, checklists, protocols) so attendees can implement changes on Monday.
Who We Keep Losing When We Don’t Do This
Bedside and ambulatory nurses without CME/CNE budgets.
Public/tribal health, FQHCs, corrections, school, and long-term care clinicians.
Students and adjunct educators.
International and immigrant nurses; non-native English speakers.
Nurses with disabilities and those with caregiving responsibilities.
These are the professionals closest to the work—and the people most likely to bring pragmatic solutions back to patients and communities.
A Quick Equity Scorecard (Before You Submit or Buy a Ticket)
Ask “yes/no” to each. Fewer than 10 “yes” answers = high-inequity event.
Transparent speaker pay and travel policy
Sliding-scale fees + published scholarship budget
Double-blind, diverse abstract review
Equal prestige/CE for practice/QI/community tracks
Hybrid parity (recordings, Q&A, networking, CE)
Accessibility commitments spelled out (captioning/ASL/ADA)
Childcare, lactation, prayer/quiet, gender-inclusive restrooms
Code of conduct with reporting and public metrics
Limits on repeat headliners; reserved podiums for emerging voices
Vendor COI firewall
Open repository with presenter-retained IP
Annual equity outcomes report with goals
If You’re an Organizer: Minimum Viable Changes This Year
Publish the pay grid and scholarship pool.
Implement dual-track rubrics and double-blind review.
Budget for captioning/ASL and on-demand CE for all sessions.
Offer childcare stipends and list lactation/prayer spaces in the prospectus.
Set and report on a few concrete targets (e.g., ≥40% practice/QI podiums; ≥15% budget to scholarships).
If You’re an Attendee or Presenter: Use Your Voice
Ask organizers for their compensation, accessibility, and equity policies.
Prioritize conferences that meet the scorecard; tell others why you chose them.
When you present, share your slide deck openly and include a practice pack.
Offer to serve as a reviewer—and advocate for diverse, blind review panels.
Bottom line: Nursing is equity-focused. Our conferences must be, too. Equity isn’t a tagline or a special interest—it’s the infrastructure of who gets to learn, lead, and be heard. When we change the design of conferences, we change the direction of the profession.
