Nursing Salaries Trend Higher: The News Is Good, but Minorities Still Struggle

Nursing Salaries Trend Higher: The News Is Good, but Minorities Still Struggle

If you’ve seen an increase in your paycheck in the past few years––and hopefully you have––you are part of an overall trend of increases in salaries for nurses. And, as you might expect, some of that has to do with the effects of the COVID pandemic.

“We’ve seen an increase in nursing salaries, particularly since the pandemic,” says Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC, director of nursing programs and co-lead for Project Firstline at the American Nurses Association (ANA).nursing-salaries-trend-higher-the-news-is-good-but-minorities-still-struggle

Registered Nurses (RNs) earned a median salary of $81,220 in May 2022, according to the Occupational Employment and Wage Statistics (OEWS) program from the Bureau of Labor Statistics (BLS). That’s up from a median salary of $77,600 in 2021. The mean (as opposed to median) annual wage for RNs as of May 2022 was $89,010.

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Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC, is the director of nursing programs and co-lead for Project Firstline at the American Nurses Association (ANA)

Nurses on the West Coast and Northeast generally enjoy higher salaries than nurses in other areas of the country, with an annual mean wage of $87,990 to $133,340. The top-paying states for RNs included California, Hawaii, Oregon, Massachusetts, and Alaska. The lowest salaries were clustered in the middle of the country, where the annual mean wage of $37,360 to $74,330 was indicated for nurses in states such as South Dakota, Missouri, Tennessee, and South Carolina.

Some 46% of surveyed nurses earned a salary between $80,000 and $139,999, according to the 2022 Nursing Trends and Salary Survey Results published in American Nurse, the official journal of the ANA. Those figures were up from 39% in 2021 and 41% in 2020. Nearly half (47%), notes the report, earn less than $80,000, but 62% reported that their salary was higher than the prior year.

Pandemic Effects

Before the pandemic, healthcare organizations were moving away from merit increases for nurses and shifting more toward bonuses and cost of living increases, according to Boston-Leary. But that has been problematic, she notes, because a great deal of data indicates that, to a certain degree, nurses live barely above livable wage in some markets. As a result, some nurses work overtime or take on second jobs.

The pandemic encouraged nurses to feel justified in asking for fair compensation. “It’s important to recognize also that, culturally, it has been taboo for nurses to raise the salary issue because the thinking around nursing has always been that it’s altruistic. It’s about serving others. It’s not about money. It’s true. Many of us didn’t get into nursing to get rich. But you hope you’ll get compensated appropriately, and it’s always been a struggle for nurses to advocate for what they deserve in terms of their salaries. So I think some of that broke through with the pandemic.”

Not only were nurses who were incumbents in organizations making less than the staff they were training, notes Boston-Leary, but also agency nurses were making a lot more than they were. “That created this untenable situation where many nurses rallied,” some striking or entering new bargaining agreements.

“Now we’re in this place where there’s a reckoning point, and there is some making up that’s happening,” says Boston-Leary.

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Minority Challenges

Nurses of color face challenges when it comes to salaries. “The difference is that many nurses of color don’t get the opportunities to climb the career ladders as quickly as their white counterparts,” says Boston-Leary. “That in itself presents a salary discrepancy. And there are many more minoritized nurses with multiple degrees and academic achievements that are not in leadership roles compared to their white counterparts with lesser credentials.”

Organizations have had the reluctance to track such data as turnover for nurses of color and nurse satisfaction by race, notes Boston-Leary. “There’s been an unwillingness over the years to look at that because when you look at it, you must deal with it. That is starting to change, but we’re still not fully there.”

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What Determines Nursing Salaries?

What Determines Nursing Salaries?

According to a recently released report, nursing salaries has remained fairly steady, but the wider averages in pay depend on where the nurse works.

The Medscape RN/LPN Compensation Report, 2019, collected information from the 7,145 nurses (5,143 RNs and 2,002 LPNs) who responded to the online survey over an 11-week period this summer. The nurses were asked questions about their earnings, workplaces, and general hours (about 75 percent worked full-time as opposed to part-time or per diem) for 2018.

The compensation report found that RN earnings averaged $80,000 (down from $81,000 in 2017) while LPN earnings rose from $46,000 to $48,000 over the same period. Employees who are paid with an annual nurse’s salary earn more than those who are paid an hourly rate. Salaried RNs report earnings that average $83,000 vs. hourly RNs who make $78,000. A salaried LPN reports an average annual pay of $53,000 compared to the hourly earnings of $47,000.

Without specific explanation, the report says it’s difficult to determine the root cause of the nearly flat earnings, especially for RNs over the past three years of surveys. Because the results are the average, meaning some nurses make more and some make less, the flat levels could reflect higher paid experienced nurses retiring or it could be a result of stagnant wages for nurses.

Despite all those fluctuations in nursing salaries, it is the type of workplace that drives the higher wages. Traditionally, the report states, RNs in hospital settings earn the largest salaries ($83,000) and nurses who work in non-profits or in school settings earn the lowest salaries ($65,000).

On the higher end of the earning spectrum are nurses in industry settings (insurance or health plans), an occupational health setting, a hospital-based outpatient clinic, a home health or visiting nurse position, or an academic faculty role all earn an average of at least $80,000.

RNs in hospice or palliative care, in non-hospital medical or urgent care, in a skilled nursing facility, or in a public health setting earn somewhere between $72-80,000. For LPNs, working in a skilled nursing facility brought in an average full-time nurse’s salary of $51,000 as compared to the lower earnings of an LPN in a school or college setting who earned an average of $36,000.

One finding that repeats yearly is the distinct gender pay gap that persists in nursing salaries. Male RNs report earning an average of $3,000 more than their female counterparts while a male LPN reports earning an average of $4,000 more than female LPNs. The report points to variations in how men and women work—with  more men reporting working overtime, working on inpatient units, working high differential shifts, and working paid weekend or evening hours—that could account for the higher earnings.

As expected, the greater the education level, the higher the earnings with nurses with a doctoral degree reporting average earnings of $94,000 vs. $75,000 for an associate’s degree level. And, as with many industries, workers with more years of experience, with professional certification, and in higher-paying regions will earn more.

The Medscape report, like Minority Nurse’s annual salary reports, offers points for nurses to think about when choosing a location to live, when considering getting additional education, or when thinking about what type of facility matches their interests and can support their cost of living.

Maximize Your Salary as a New Nurse

Maximize Your Salary as a New Nurse

You’ve just finished your nursing degree and you’re ready for your first nursing job. Or perhaps you have only been a nurse for a year or two and you’d like to increase your salary. What can a new nurse expect to make in today’s job market? What are some strategies for increasing your earning potential?

Carmen Kosicek, RN, MSN, author of Nurses, Jobs and Money — A Guide to Advancing Your Nursing Career and Salary says that the average salary for new nurses is between $20-$25 — depending on the region. And starting salaries don’t vary much in terms of specialty according to Kosicek. “If you are a new medical/surgical nurse versus an ICU nurse, the pay is not much different; there’s simply a flood in much of the major markets. Even the difference between AND (Associate Degree in Nursing) level nurses versus BSN (Bachelor of Science in Nursing) level nurses is merely $0.50/hour at best. It’s sad, but true,” she says.   

Today Kosicek shares some insights and tips on how to earn as much as you can when starting out.

Minimize the Cost of Benefits

“First of all, if you are under 26 and can stay on your parents’ health insurance, do so,” Kosicek says. “It’s odd, but most hospitals don’t have very good health benefits. Additionally, if you can, sign off that you don’t/won’t take the health care benefits. That is a savings for the employer and can potentially lead to more income for you — though not every employer offers this as an option.”

Seek Employment Outside of the Traditional Settings

If you’re only looking at jobs in hospitals and clinics, you could be missing out on higher earnings. Kosicek advises nurses to look for employment beyond the “traditional settings” and instead consider some alternatives. Examples include:

Industrial Health Nurse
Insurance Nurse
FDA Nurse
Employee Health Nurse
Dialysis Nurse
Nurse Navigator
Wellness Nurse
Nurse Consultant
Risk Manager Nurse
Utilization Review Nurse
Quality Management Nurse
Nursing Informatics
Nurse Liaison
Rural Nurse
Nurse Investigators
Nurse Accreditators

Ask

You don’t have to accept the first offer from an employer; nurses do have negotiating power. The first step, according to Kosicek is to simply ask. But be ready to ask specifically for what you want and be flexible.

Before you enter into negotiations, Kosicek recommends doing your research by exploring salary websites such as GlassDoor.com for salary data that you can use to make your case to an employer.

If they reject your request for a certain salary amount, don’t give up.

“Ask for a pay difference,” Kosicek says. “If they won’t say yes to the pay, hit them across different buckets of money. For example, get more money for CEUs (continuing education courses), travel reimbursements and the time off to attend. Also ask for a higher 401(k) match if that’s something to negotiate; ask for your association dues to be covered; ask for work-from-home days.”

Finally, remember to explore those non-traditional venues. “They are more flexible with negotiations because they don’t have as many RNs knocking at their door,” she says. They are more business savvy, they want to have a win-win relationship with their nurses and they simply need great nurses who understand business.”


 Denene Brox is a freelance writer based in Kansas City.

Denene Brox is a freelance writer based in Kansas City, Kansas. – See more at: http://www.mndivi.wpengine.com/blog/denene-brox/spotlight-annette-russell#…
Denene Brox is a freelance writer based in Kansas City, Kansas. – See more at: http://www.mndivi.wpengine.com/blog/denene-brox/spotlight-annette-russell#…
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