Negotiating a Job Offer

Many job seekers miss out on an opportunity to increase their salary and benefits, due to their lack of understanding of, and preparation for, the negotiation process. Unlike some career fields where salary negotiation has been impacted negatively by the poor job market, the salary negotiation prospects for those entering high-demand positions within the allied health field are still good. But as with all aspects of the job search, preparation is key. Successful salary negotiation requires self-assessment, research, planning and strong communication skills. Careful preparation will increase your ability to create a mutually satisfying agreement between you and your potential employer.

The following steps will help you prepare for the salary negotiation process. Just remember that the topic of salary should never be addressed until the employer brings it up. And the actual process of negotiation shouldn’t begin until you have received an offer of employment.

Self-Assessment: Prioritize Your Needs

The first step in preparing to negotiate your salary and benefits is to clarify and prioritize what is important to you. This is necessary because your needs will influence all aspects of the negotiation process. When considering a job offer you’ll need to know what your priorities are in order to decide the value of the offer and what aspects you may want to negotiate.

There are many potential benefits to consider in addition to base salary when accepting a job offer. These benefits increase the monetary value of your base salary, in addition to adding quality to your work life. Depending on your priorities, you’ll want to consider various benefit areas when preparing to negotiate.

For example, if you value learning about new developments and opportunities for advancement in your field, continuing education should be an essential part of your compensation package. You may be able to negotiate reimbursement for renewal of certifications, subscriptions to professional journals, and/or tuition reimbursement for an advanced degree or continuing education courses.

Perhaps you are concerned about having ample opportunity for professional development. In this case, you could negotiate for payment of membership fees for professional associations, conference registration fees, or subscriptions to professional publications.

If you have children or are considering starting a family in the near future, the ability to balance your work and personal life will be important. You’ll want the opportunity to increase your vacation time, arrange for flexible work assignments, obtain reimbursement for child-care costs, and extend benefits coverage to family members.

Another subject you might be able to negotiate is your performance review. Some employers will grant a shorter time period before your first review, thereby giving you the opportunity to discuss a salary increase and advancement opportunities earlier than usual. Finally, if you’re really fortunate, you might even be able to get the employer’s assistance in repaying your student loans.

Take time to review and consider your priorities. Knowing your main concerns ahead of time will help you present yourself to your employer with composure and conviction. In addition, you will be prepared to compromise benefits of a lesser value in exchange for benefits that are more beneficial to you.

Self-Assessment: Know What You Have to Offer

Another step in preparing to negotiate is understanding your intrinsic value. What do you have to offer an employer in terms of your knowledge, education, skills and experience? You need to assess these areas to identify your strengths.

During the negotiation process you will present these strengths to explain your value to a potential employer. The strengths you choose to emphasize during the negotiation will depend on the needs of the employer. Understanding the employer’s needs can be difficult when you are thinking about your own priorities, nonetheless, it’s important to put yourself in the employer’s shoes. When you understand the priorities of the employer and the organization, you’ll be able to relate to the employer’s priorities and tailor your needs to the employer’s frame of reference. Your goal is to utilize this knowledge to create a mutually satisfying outcome to the negotiation.

Research: Understanding Your Market Value

When it comes to attaining the best possible base salary, you will need to do your homework ahead of time in order to discover your market value. This means identifying the current salary range offered for the position you are seeking.

There are various resources to access this information, many of which are available on the Internet. See the sidebar “Bookmark These Sites!” for further information on useful Web sites.

Utilizing the services of allied health professional associations or societies is a vital component of your career development process and many of these organizations provide salary data. Trade journals can also be good sources of salary information.

Planning: Negotiation Strategies

The best time to enter salary negotiations is when you have been offered the position and before you have fully accepted it. This is the time when you will have the most negotiating power. By that point you will have assessed your priorities, market value and needs of your potential employer. But before you enter into any negotiation, you will need to create a plan for a dialogue that addresses your concerns and creates an amiable negotiation. A useful strategy to focus the discussion on areas that you’re interested in is to use exploratory questions.

For example, an interviewee with a few years of laboratory tech experience may be interested in a promotion to a supervisory position. During the course of the discussion the interviewee could ask, “What is the opportunity for advancement into a management or supervisory position?” This question opens up the discussion on the requirements for this position and opportunities for receiving additional training. It also sends a clear message to the employer that this candidate is serious about a career and not just looking for just another job.

An interviewee just out of college may be interested in continuing his or her education. In this case the interviewee could ask, “Can we explore the possibility of reimbursement for an advanced degree?”

Always maintain proper etiquette during the negotiation process. One of the best ways to do this is by putting your requests in the form of questions, rather than stating your demands. This is especially important for entry-level interviewees; aggressive, inexperienced candidates turn off most interviewers. On the other hand, a candidate who is perceived as polite but inquisitive will often be viewed in a positive light. For examples of how to properly start off such questions, see the sidebar, “Exploratory Questions”.
As you discuss and explore the possibilities during negotiation, it is important to remain flexible in your questions and responses. When you are asked a question, never respond with a flat “no,” instead pause, consider the question and then respond. Remember you can’t get what you do not ask for.

When answering questions regarding salary, it is best to give a range because it allows flexibility during the negotiation. You want to find a salary that will satisfy both you and your potential employer. If you have done your homework, you’ll be able to provide a range based on your research to identify the market value for the position and an estimate of your intrinsic value based on your unique skills and experience. You need to decide what is the highest you are worth within that range and what is the lowest you will accept. To support your request, you can bring salary information from your research to the negotiation.

According to David Soprych, regional recruiter for HCR Manorcare, in Aurora, Ill., “Salaries are typically set for staffing levels at large organizations. Smaller organizations have more flexibility in salary. Also, for management positions there is greater flexibility for base salary.” In any case, you will have to sell your skills and accomplishments when negotiating your salary.

Another area that has received media attention is sign-on bonuses. Soprych cautions job seekers to be wary of large sign-on bonuses. “This could be a red flag that the organization is having difficulty keeping and finding employees,” he says. “Also, a company may provide a top salary but poor benefits or a moderate salary with excellent benefits. It is in your best interest to investigate these organizations carefully.”

Communication Skills: The Art of Diplomacy

Successful negotiations are built on developing rapport and trust. By applying active listening, strong communication and keen observation skills, you will be able to present yourself well and respond to various situations in an appropriate manner. Listen carefully and pay attention to the employer’s attitude, words and body language. You are looking for positive reactions to your statements; your goal is to create a positive and friendly atmosphere. This is very important when you are trying to reach a mutually satisfying outcome.

Because your emotions will be running high during the negotiation, it is helpful to rehearse your presentation with another person prior to your interview. This will prepare you for answering questions and allow you to receive feedback on your style of communication and the logic of your presentation. Through preparation and practice, you’ll increase your confidence and ability to handle the negotiation process.

Don’t miss out on an opportunity to negotiate a great offer. Take time to prepare and you’ll be able to negotiate an offer that is mutually satisfying for you and your potential employer.

Exploratory Questions

During the negotiation, you will want to steer the conversation towards points of negotiation that interest you most. Here is a list of appropriate introductions to such questions.

1. What is the opportunity for…?

2. Are you willing to…?

3. What would you consider…?

4. Can we talk about…?

5. What are the alternatives to…?

6. Have you considered…?

7. Can we explore the possibility of…?

8. Is there anything you might be able to do about…?

9. What if…?

10. Would you think about…?

Bookmark These Sites!

The following Internet sites are helpful for researching your appropriate base salary ranges.
Provides information on salaries searchable by profession and geographic location. Keep in mind that salaries for identical positions vary depending on geographic location and years of experience.
Lists salary surveys with links to other occupational salary sites.
The Occupational Outlook Handbook offers consolidated salary figures for specific occupations.
Provides salary information for various health professions based on degree level and years of experience but does not list by geographic area.

Earn What You’re Worth

You do a great job. You make an effort to stay educated in your field. You come into work early and you leave late. But you realized that you’re behind the curve when it comes to pay. So why not ask for a raise?

Today, you have more leverage than ever when it comes to asking for a boost in your paycheck. “It’s a good time to ask-there are shortages out there,” says David Westhart, director of career development at Thomas Jefferson University’s Jefferson College of Health Professions. “This year we had more recruiters at our career fair than ever before. Placement rates at Jefferson are 97% within a year after graduation.”

Alex Ogburn, vice president of recruiting at Allied Consulting, a firm specializing in the permanent placement of allied professionals, agrees. “It’s so hot [within allied health professions] that we’re seeing a double digit increases in income per year in some cases.”

Before you ask your boss for that big raise, however, it’s important to prepare your case. Read on to find out how much you’re worth, how to put together an irresistible package for your supervisor, and how to negotiate a salary raise (and other perks) that will have you smiling all the way to the bank on payday.

Beating the Pay Scale

Let’s get the bad news out of the way first: Some health care companies work under a rigid pay scale for their staff (though supervisors and managers have more leeway). Therefore, if you have five years of experience you get X-amount of dollars. Seven years of experience? You get Y. Sometimes it’s even stricter at larger employers. “The larger the facility, the more employees they’re managing, so to raise one person’s salary they’d have to raise everyone’s,” says Ogburn. “And if the employer tries to give a raise to just one person, they may have a mutiny on their hands.”

However, it never hurts to ask. “If you say, ‘Look, I know that’s the way it is here, but I can go [somewhere else] and make $8,000 more per year,’ all of a sudden the rules aren’t so hard and fast anymore,” says Westhart. Some of the tips given below will also help you get around this salary roadblock. And if you’re locked into a salary that puts you at a disadvantage, Westhart suggests taking your skills elsewhere.

How Much Are You Really Worth?

Knowing how much cash your job is worth helps you decide whether it’s time to ask for a raise and gives you more ammo when you approach your supervisor. “Not only is this information helpful to you, but administrators are very interested in data,” says Donna Cardillo, RN, MA, author of The ULTIMATE Career Guide for Nurses.

“If you’re asking for something more, they want to know why they should give it to you-the fact that you’re a nice person or a good worker isn’t enough.”

Here are some resources to help you find out the going rate for employees in your position:

Professional associations
Ask your professional association whether they have salary survey data. Some associations offer the info to members gratis, while others charge a fee.

The National Association of Colleges and Employers has an extensive salary survey that most schools participate in. Most university career officers rely on NACE or its regional counterparts.
This site offers the salary 411 on many professions, but “it trends a bit high, so I average it with a few other places,” says Westhart.

Career fairs
“Get out to some health care career fairs or even a health care convention where you’ll be in a room with people who work for many different employers,” suggests Cardillo. “They’re generally forthcoming with salaries, benefits, working conditions–you’ll have a great basis for comparison.” And you may even find that you’ve got it pretty good with your current employer.

Career development centers
Your university’s career center will be able to help you find salary information for your field.

It’s helpful to know not only the national and local rates, but also the rates within your company. If your employer doesn’t post salaries, you may be able to glean information through word of mouth. “People aren’t encouraged to share salary information but many do,” says Cardillo. Just be sure not to incriminate your fellow employees when asking for a raise by saying, “Sue says she gets X per hour and I get only Y!” Instead, suggests Cardillo, say, “The information I’m getting from my co-workers is that people are getting X. Can you verify if that’s true? If so, I’m concerned that I’m not getting paid on a comparable level.”

What Have You Done for Me Lately?

Put yourself in your employer’s shoes: What if an employee marched up to you and said, “I think I deserve a raise,” without giving any justification? Chances are, you’d send him back to do his homework. “When asking for a raise, justification is important,” says Deleise Lindsay of DBM, a global human resources consulting firm. “You will not be given a raise without proving your value to the organization.”

But how do you convince your boss that your place of employment would be lost without you? First you have to determine your value and then you have to present the highlights to your employer. Here are some ways to determine your worth:

Pull out your resume
Did you graduate from a well-regarded program? How have your skills developed since you wrote your resume? Have you gotten more education since then? These are the points your boss wants to know when you’re requesting a raise. Also, answering these questions can be a real ego boost, which you’ll need when your boss asks you to prove you’re worth extra money!

Go over your evaluations
Do you always get positive reviews from your supervisor? That’s another point in your scorebook.

Pretend you work for yourself and think about why you’re a superb staff member. This is especially helpful if you’re usually afraid to toot your own horn. “When people step back and look at what they bring to the table, they give themselves at least as much credit as they’re due, if not a little more,” says Ogburn.

Keep a file

“I recommend every professional keep an ‘atta boy/girl’ file,” says Lindsay. “This is an ongoing file that you keep as you receive recognition or documentation. The information is then at your fingertips, so you won’t forget an important piece of information or be scrambling six months later to come up with numbers.

Fish for compliments
“Ask people who know you well what your strong points are,” says Cardillo. “Many of us aren’t aware of our strong points.”

Go for PAR
Ask yourself, “What have I done to increase revenue? improve quality? increase productivity? cut costs? improve the efficiency of a process? comply with regulations? improve safety? improve customer service? implement a new program? improve performance?” Once these are identified, says Lindsay, develop a worksheet for each using the PAR method: What was the Problem I was trying to solve? What was the Action that I took to solve the problem? What was the Result? A sample statement would look like this: “Reduced workplace accidents by 20% by devising a safety program for my department.”

Getting to Yes

Once you’ve developed an arsenal of information proving that you deserve a raise, it’s time to talk to your boss. Follow these tips to make the meeting successful.

Make a date
Don’t grab your boss in the hallway on her way to lunch and blurt out, “Can I have a raise?” “Choose an appropriate time and place to ask for a raise,” Cardillo advises. “Make an appointment for a mutually convenient time with minimal distractions.”

Write it out
“It’s a good idea to put your requirements in writing,” says Cardillo. “There’s less of a chance for forgetfulness or miscommunication. The major points are clearer and it makes a greater impact. State what you’re asking for and why.”

Don’t give an ultimatum
No one likes to be threatened, and telling your boss that you’ll walk out if you don’t get a raise is just that-a threat. “[If you give an ultimatum], you automatically polarize the situation-me versus you,” says Ogburn. “You’re part of a team, and you want to approach this as a team member.”

Be prepared to wait
Sometimes your employer has to work with HR to determine if an increase in salary is possible, says Westhart, “so be prepared for it to take awhile.”

Don’t go fishing
“Sometimes people go interviewing to get other offers and come back to their employers and fish for a counteroffer,” says Ogburn. “However, oftentimes they’re not serious about taking another job. It’s a bluff and it’s not professional.” If you’re serious about another position, it is fair to ask for a counteroffer from your current employer. But if you don’t plan to follow through, your plan can backfire. Ogburn tells of an employee who tried such a bluff. The administrators gave him a raise, but were so offended that they documented everything he did for a few months and then served him with a pink slip.

Be flexible
Don’t go in with an all-or-nothing attitude; that just sets you up for disappointment. Instead, be flexible about what you’re willing to accept. “If your supervisor says there is not another nickel in the budget, maybe you can work something else out,” Cardillo says. For example, you can say, “I’ve been covering for other staff in my department and would appreciate it if I didn’t have to do that anymore.”

You can also ask for better working conditions, more time off, free parking or other perks. You can even ask your employer to pay for a percentage of an advanced education degree.

Aim high
When determining how much of a raise you’d like, shoot a bit higher than your actual goal so that there’s room to negotiate. For example, if you’d like an additional $5,000 per year and ask for exactly that amount, chances are your employer will haggle you down to $4,000 or even less. If you ask for $7,000, you can haggle and still get the $5,000 you wanted (or maybe you’ll even get the $7,000!).

Don’t go over your boss’s head
Always talk to your immediate supervisor; going straight to the head honcho will create bad feelings all around. If your supervisor thinks you have a case, she’ll present your request to the decision-makers.

Toot your own horn
Even if you’re a stellar employee with a ton of responsibilities, chances are your supervisor doesn’t know half of what you really do. After all, he doesn’t follow you around all day, putting little gold stars by your name when you do something well. “It’s always a great idea to enumerate the value you bring and your scope of responsibility,” says Cardillo. “That’s not bragging-it’s just giving people a report of what you do.” So if you’re always willing to help out when needed, if you get along with your fellow employees, if you always come in early and leave late, and if you often cover for other people-let your boss know!

The Next Step

Okay, so you met with your boss, followed all of our tips, and made a great impression. What happens now?

Most likely, your supervisor will consult with HR, but the final decision will almost always go to the top administration-especially if giving you a raise would mean increasing the department’s budget. Some employers act very swiftly, taking just a week or two to make a decision, while others may take months to cut through all the red tape. In any case, expect your immediate supervisor to keep you up-to-date on what the administration is saying and when you can expect to have an answer.

When the Answer Is No

Sometimes it happens-even though you’re the greatest staff member your employer has ever laid eyes on, they just can’t afford a raise. In this case, you have a few options.

If you still feel you should be getting paid more, Cardillo suggests creating a written proposal. “Enumerate all the things you do and be specific about what you want,” she says. “Ask your boss to go back to the powers that be with the proposal in hand.”

Or try getting around the salary cap by asking for a promotion instead. “Is there an improved title that comes with a higher salary, such as moving into a ‘senior’ position?” asks Westhart. “If you can demonstrate that you’re doing more than your job description states, then you should feel comfortable asking for [a promotion].”

Finally, if there’s no chance of receiving a raise and you feel you’re not getting paid what you’re worth, it may be time to move on.

Boost Your Bottom Line

Here’s some good news to mull over while you dream of a hefty raise: Unlike employees in other industries, health care workers are currently in hot demand. Your chances of receiving ample compensation for all your hard work are very high. Just follow these tips and watch your salary soar!

Benefits and Bonuses

If you’re like most students, job benefits are a completely foreign concept. Yes, your job as chief burger-flipper may have offered free “food,” and your stint at Mall-Mart may have offered a generous employee discount in exchange for making you work on every major holiday, but those mall job benefits barely scratch the surface of what real employers offer their workers.

Now that you’re preparing for a better future—one that hopefully won’t involve super-sizing anything—you need to understand what benefits employers will dangle under your nose, which employers offer the best deals and how to bargain your way to a more inviting work environment.

Benefit Basics

When interviewing prospective employees at job fairs or during campus recruitment drives, human resource personnel often refer to a “standard benefits package” while painting their place of employment as a worker’s utopia. Unfortunately, no benefits package is ever standard, as you’ll quickly discover once you start comparing one company’s offerings against another’s.

Here’s an explanation of benefits that employers might use to entice you, starting with those most likely to be offered and ending with ones you might have to bring up on your own:


As you might expect, health insurance coverage is offered by almost all employers. Not all health care coverage is created equal, however. And note that we didn’t say “free health insurance coverage.” In many cases, the employee will have to pay for at least of portion of the premium through payroll deduction, at least during the first year or so of employment. Premiums have been jumping by double-digit percentages each year, which makes it imperative for employees to become increasingly savvy about what’s covered.

“Most people have become pretty intelligent in terms of retirement packages, but the big difference now will be what your co-pay is, what your deductible is, what your out-of-pocket maximum is and so forth,” says Alex Ogburn, vice president of recruiting for Allied Consulting, Inc. in Irving, Texas. “[Health insurance] can be a tremendous part of any benefits package.”

If you have a spouse and/or dependents that need health insurance from your employer, be sure to find out how much you’ll have to pay out of your own pocket. Medical coverage for a family of four might cost you $600 a month through one employer and less than half that through another. It could be the deciding factor in choosing between job offers.

Liability insurance, which covers legal costs in case you are sued for mistakes on the job, also ranks high among benefits offered. Dental, vision, disability and life insurance are less common.

Vacation, holiday and sick leave

Every company offers some number of vacation days and paid sick leave, but specific figures vary widely, as does a company’s willingness to offer unpaid leave to employees who want to take long summer vacations.

Relocation funds

If you’re moving more than 100 miles for your new job, your employer may pick up the tab, sometimes on moving day itself. “In the past, you had to out-of-pocket that expense and wait to get repaid,” says Trevor Williams, vice president of recruiting for Martin, Fletcher, a retained recruiting firm in Irving, Texas. “Now, 30-40% of the hospitals use direct billing to pay moving expenses for you. You’re taxed on that relocation bonus, but you don’t have to wait to get reimbursed.”

Tuition or loan reimbursement

To get students right out of school, more and more employers are willing to cough up a few thousand dollars per year, generally for two to three years, towards repayment of student loans. “This benefit used to be only for pharmacists,” says Williams, “but now allied health candidates should ask for it every time.” Again, you’re taxed on this benefit, but it’s still better than laying out the funds yourself.


Having the freedom to choose your own hours is a given with many health care-related employers. Perhaps you want to work 6:00 a.m. to 3:00 p.m. daily so you can spend the evenings with your children, or you’d rather work 10 hours daily for four days so that you can enjoy three-day weekends. Ogburn says that some students placed by Allied Consulting have such diverse skills that they work three 12-hour shifts at one full-time job, then pick up two eight-hour shifts as a part-time position. “They still work five days a week, but for 50+ hours,” he says. “For someone right out of school with no attachments, they often think, ‘Why not work more?’”

Savings plans

The standard 401(k) option can be found with many employers, however, the dollar value or percentage of your contribution that the company will match can make a huge difference decades down the road.

Free housing

Some employers are so short-staffed that they want you to start as soon as possible—and they’ll prove it by paying rent on an apartment or placing you in staff housing for 60 to 90 days until you find a place of your own.

Commuting pay

If you live outside a certain radius from the employer, or you’re a CT tech, for example, who’s paged in the middle of the night, your employer might reimburse you for the commute, either directly or by adding hours to your paycheck. Says Ogburn, “That’s not really mainstream yet, but it’s something to look out for.”

Employee support and mentoring

Some facilities offer new employees the chance to work one-on-one with more experienced employees.

Certification bonuses

With each exam you pass, you’re a more valuable asset, both to your current employer and to the market at large. Some companies will reward you with a higher hourly rate (up to $1/hr) to keep you on their team.

Child care/dependent care coverage

Most parents will have to cover child-care expenses on their own because hospitals prefer to avoid the high liability costs associated with on-site child care. A flexible schedule can make it possible for you and your significant other to avoid day-care costs—just get used to communicating with your partner through notes.

Immediate benefits

Not a separate benefit so much as an acceleration of existing ones, Williams says that a number of facilities are forgoing the 90-day wait period before benefits kick in and offering them from the first day of employment.

Not-So-Basic Benefit Plans

Other benefits plans that you might encounter include the “cafeteria” benefit plan and the flexible benefit plan.

The cafeteria plan works as if you were choosing benefit options from a menu: Each employee has a certain amount of money to spend on the benefits that he or she deems most desirable, so one person can choose a pediatric dental plan to cover her four kids while a childless employee might opt for more vacation days and no dental plan at all.

A flexible plan grants an employee even more leeway about how his or her benefit dollars are spent. As in a cafeteria plan, the employer determines an upper limit for each employee, but the employee also has the option of receiving part of the funds in cash. However, cash benefits are taxable, whereas life and health insurance are not, so the “take home” value of these options isn’t always equal.

How Employers Stack Up

Nearly every position in the health care industries is in huge demand, in part because the economic boom of the 1990s drew students away from medical schools and into MBA programs. In a tight labor market, conditions have never been better for medical students entering the work force.


“Hospitals are a very good environment,” says Donna Broderick, director of the medical laboratory technician program at Harcum College in Bryn Mawr, Pa. “My husband works for Quest Labs, and his benefits aren’t any better or worse [than those available at hospitals].”

As might be expected, for-profit hospitals tend to be the most aggressive with their salary and benefit offers. In addition to including many of the largest health care systems nationwide, for-profit hospitals often have more leeway than non-profit facilities with their budget. As Ogburn points out, to fill vacancies on a temporary basis, a hospital typically must pay twice the normal hourly rate for that worker; an ultrasound temp, for example, might earn $50 per hour, whereas a staff member would earn $25. For-profits can count on the increased funds a permanent worker would bring in to offset the salary expense, but non-profits typically operate on a set annual budget and don’t have such freedom.

Trevor Williams says that a more important consideration than whether a hospital is for-profit or non-profit is where it’s located. “There’s a massive shortage of allied and nursing personnel in the Midwest,” he says. Richard Doolittle, head of the department of medical sciences at Rochester Institute of Technology, says that many students stay with the clinics and hospitals at which they intern during college, which means that those willing to travel cross-country to a more needy environment might receive juicier offers.

Clinics fall next in terms of aggressive benefits packages, says Williams, “largely because of the quality of life they offer a candidate versus call schedules and different types of shifts available elsewhere.”

Government hospitals fall at the bottom of the scale, offering little more than a strong retirement package and, as Tyler Wilkerson, director of research of Allied Consulting, puts it, “every holiday you can think of.” The government retirement package is strong enough, though, that Williams says many people come out of the service and head straight for VA hospitals.

Sounds Good, But…

Just like buying a new car, don’t feel compelled to sign on the dotted line after the first offer. “It’s very rare when an employer makes an offer that it’s a ‘take it or leave it’ offer,” says Steven Rothberg, founder and president of Minneapolis-based “There’s little to no harm, and often great gain, in asking for an increase in salary or better benefits.”

Despite how it might feel when you’re sweating in the interviewee’s chair, you have almost as much power as the HR manager doing the grilling. Once he makes an offer, you’ve been given the green light to start negotiating. He wants you to work there as badly as you do, and now it’s up to the two of you to decide how valuable you really are.

Ideally, you’ve done research ahead of time—either by asking other students about their paychecks, calling other companies in the field, or reviewing sites such as—so that you know what kind of salary to expect for this position. Before you blurt out a number, however, make sure you understand exactly what this position entails. You don’t want to accept an offer, and then discover you’re also responsible for driving tissue samples back and forth from lab to hospital. Oh, and picking up the lab coats at the dry cleaners. And….

Even if a salary offer falls in the range you expect, you lose nothing by asking for a bit more. Says Rothberg, “Many employers have more respect for employees who aren’t afraid to ask for what they feel they’re worth.”

If more salary is out of the question—and “hard” benefits such as health care insurance and pension plans are non-negotiable, as they often are—it’s time to switch gears and start pushing for “soft” benefits, which include flex-time, shorter review periods, a better workspace, paid or unpaid leave, sign-on bonuses and even fancy titles. “In many organizations, the managers have discretion over soft benefits,” says Rothberg.

Again, whether your proposals are accepted or brushed aside, you gain from having been bold enough to ask. “They understand that you’re not a pushover, that you have value and won’t blindly accept whatever they offer you,” says Rothberg. “Six to 12 months down the line, when it’s time for a formal review, you’ll enter negotiations with the manager knowing you’re not afraid to ask for more.”

Whatever salary and benefits package you finally agree on, don’t seal the deal with a handshake. Get the offer in writing to avoid arguments months later over whether you can take a week’s leave without pay or race lab carts down the hallway.

Finally, don’t be afraid to turn down an offer and go elsewhere. “Anyone in imaging—X-ray, CT, MRI, ultrasound—needs to understand the value they bring to a facility,” says Williams. “Facilities don’t really see the direct benefits of a nurse, but imaging brings revenue into the hospital.” Even if you’re not in imaging, your work will contribute to the value of any organization. Make sure to keep that in mind when you negotiate an offer, and your employer-to-be will have no choice but to do the same.

Negotiation Skills for Minority Nurses

Ampy de la Paz, MSN, RN, a 40-year nursing veteran who works as a quality management analyst at Bayshore Medical Center in Pasadena, Texas, uses an incident from her own career to demonstrate to newly arrived nurses from the Philippines how to negotiate in the American workplace.


The incident occurred when she was offered a promotion a number of years ago [by a previous employer] and met with her superior to discuss her new salary. The first lesson de la Paz imparts to her colleagues is that she didn’t walk into the meeting blindly. She prepared for it by deciding how much of a raise she deserved on a percentage basis and how much various percentages meant in actual dollars.

Then, when the initial offer came, she knew the dollar amount was a smaller percentage increase than she deserved, and she told her superior the amount he was offering wasn’t enough. A few weeks passed before the superior returned to say he had spoken with someone in human resources who claimed that a survey of people at other hospitals employed in the same position had found that the amount de la Paz had been offered was average for the position.

Her response was: “I’m not average.”

She had lots of management experience, she told him, as well as a master’s degree, so she couldn’t accept the salary the organization was offering. Several more weeks passed before the superior met with her again. This time, he made what de la Paz considered an acceptable offer and she took the job.

Although negotiating is more often associated with legal, business or union issues, advancing your nursing career requires negotiation skills, too. Many people find negotiating difficult and some experts believe minority nurses are at a particular disadvantage when it comes to lobbying for promotions, raises or support for their projects and ideas. For example, they may come from cultures where disagreeing with superiors is considered disrespectful, or where being humble and part of a group is valued over self-promotion.

“The majority of [Filipino women] are very shy, so they [are] not as assertive as [they need] to be,” says de la Paz, the former executive director of the Philippine Nurses Association of America (PNAA). “They’re taught to avoid arguments and not rock the boat.”

Filipino nurses often get passed over for promotions because of this, she continues. “Sometimes you have to encourage them and tell them, ‘Why don’t you apply for it? You’re qualified to do that.’ They want to be asked [rather than ask for it themselves]. They would not go out of their way to ask for [a promotion], but if it’s offered to them they would take it.”

Know Your Value

In negotiating for a promotion or a pay increase, de la Paz says it’s important to know your worth, become comfortable with the person you’re negotiating with and demonstrate your value to the organization by promoting yourself whenever you get the chance.

For Ruth W. Brinkley, RN, CHE, president and CEO of Memorial Health Care System in Chattanooga, Tenn., negotiating in the workplace means “having the confidence to position yourself in a way that helps you best put forth your unique qualifications, skills and abilities, so that those skills and abilities become apparent to the organization.”

That may mean obtaining skills and knowledge you currently lack. “However,” Brinkley maintains, “I believe that in many cases people [already] have the abilities and skills they need, but don’t know how to position themselves and package themselves correctly. Once you know what skills you have and you’re confident in what you have, then you’re better able to negotiate from a position of strength and sell yourself to your organization.”

When a position that you want becomes available, she continues, “the first thing you’ve got to do is be able to package your unique set of skills that [are a good fit for that job]. It’s not always apparent. Many times we don’t recognize the skills we have.”

Years ago, Brinkley left a job as a chief nurse at an academic medical center to become a consultant for a professional services firm. “It took me a while to understand how to repackage my skills from an operational framework to a consultative framework,” she says. “I began to recognize that I did have the skills to be an effective consultant. What I needed to do was use the skills I had in a different way.”

Know Your Organization

Gwendylon Johnson, RNC, MA, a staff nurse at Howard University Hospital in Washington, D.C., and past president of the District of Columbia Nurses Association, says one of the most important things a nurse can do is to understand his or her organization as much as possible. This means not only knowing the direct care aspects of your working environment but the business aspects as well. Selling your idea, or yourself, will be easier if it fits in with the organization’s mission, she says.

“You have to make sure to bring to the table something that will expand the mission of the organization in a positive sense,” Johnson explains, “because [that way] you’re more likely to be able to get them to accept what you’re trying to do.”

Johnson, a past member of the American Nurses Association board of directors, says knowing the organization you work for means knowing its culture and how that culture defines value. This will help when it comes time to promote an idea, seek a higher-level position or negotiate for a pay raise. Determine what qualities the organization values and then seek to obtain those qualities.

Keep in mind, she says, that successful nurses don’t limit themselves to activities at the bedside. They bring other skills to the table, such as leadership abilities, organizational skills or knowledge of the community.

“[Hospitals] are now asking direct care nurses for ideas about how to market the organization,” Johnson points out. “If you are the nurse who comes up with the best idea, then you are probably the one who is going to be asked to advance or promote that idea. Also, [it’s important to have] a business sense of what the organization’s needs are and [how those] needs are in line with the mission statement of the organization.”

Gloria Ceballos, MS, RN, CNAA, BC, former chief nursing officer at Kettering Medical Center in Ohio, recommends volunteering to serve on a hospital committee that advances the organization’s mission.

“Volunteer for maybe some ad hoc work that the committee has to do,” she says. “This will expose you to other people, their ways of thinking and other professions outside of nursing. Not only that, the leaders [of your organization will] focus on people who want to advance. Those are the first people that leaders think of.”

Participating in committees and other volunteer activities helps increase your visibility within the organization and sets you apart as someone who is interested in more than just collecting a paycheck. “No leader is going to give advancement to somebody who’s just doing their work, coming in and going home,” explains Ceballos, who now works as a fill-in nurse while pursuing her doctorate. “You have to demonstrate that you bring value to the organization and that’s when the salary increases come.”

For example, Hispanic nurses should remember that their knowledge of the Spanish language and Hispanic culture can often be an asset, she says. “If [they work for a facility that serves] a lot of Hispanic patients, they add great value in communicating culture and differences in care that Hispanic patients would need.”

Ceballos recommends serving on diversity committees or volunteering to translate brochures into Spanish.

Prioritize and Practice

Johnson, who has worked as a union activist for the District of Columbia Nurses Association, advises nurses not to rush into things when preparing to negotiate with their employers.

“Take your time and fully develop what you see as a priority interest for you and the organization, because you have to set priorities,” she says. Build a strategic plan if necessary for how you can achieve your goals and how you can best sell yourself.

“Do not feel embarrassed about taking ownership of a new idea and doing something with it,” Johnson continues. “There are times when you have to step up and say, ‘Yes, this is my idea.’ But you also have to take ownership of the challenges and problems as well as the successes. Use every opportunity as a learning experience you can build on for future use, both from an individual growth perspective and an organizational growth perspective.”

Like other important nursing skills, negotiation skills can be learned. Johnson points out that many hospitals offer professional development programs that focus on cultural diversity and how different cultures address issues such as conflict resolution and assertiveness. She also advises minority nurses who have difficulty in asserting themselves to role-play.

“If you have difficulty doing it in a mixed-culture group,” she says, “one of the things I suggest is practicing in some type of group where you can feel comfortable–where you can say ‘this is what we have to learn how to do’ and practice it.”

Johnson says she has seen it work in minority nursing associations, such as the National Black Nurses Association (NBNA) and the PNAA. “I have experienced it firsthand with the NBNA and with Chi Eta Phi Sorority. Organizations like these have programs that focus on teaching nurses, regardless of their cultural background, to speak up and stand out as a positive influence in the workplace.”

Strength in Numbers

Having an advocate in the workplace who can lend support to your cause is also beneficial. “One of the things that helps is if you have a mentor,” Johnson says. “That person can also serve as a conduit for floating some of your ideas.” If you don’t have someone who can serve as an advocate, she adds, then finding a partner who has the ability to enhance your proposal is the next best thing. “That means knowing your colleagues and knowing the organization to be able to make that determination.”

Brinkley agrees that it’s helpful to have an advocate in the workplace who can tout your abilities. It’s also important, she says, to be willing to take on extra duties and responsibilities, especially unpleasant or difficult ones, in order to get noticed and increase your value. Plus, you should be willing to take risks and work outside your comfort zone.

If you don’t have certain skills, learn them and work with a mentor or a career coach, Brinkley advises. Talk with that person about ways to position yourself to improve your value at work. “I would encourage any minority nurse who’s having trouble with that, or who can’t find a mentor within their organization, to invest in a coach,” she emphasizes.

It’s important to remember, Brinkley adds, that because of the nursing shortage, nurses are in a good negotiating position at the moment. “Organizations don’t want to lose valued employees, they just don’t. So to the degree that you are able to constantly repackage and refine and continue to develop your skills, you make yourself that much more valuable to the organization.”

Improving your negotiating skills also means being willing to change employers if necessary. “If it isn’t going to happen for you in the organization that you’re in,” says Brinkley, “then you have to decide whether you’re willing to move on and [find] an organization that values you.”