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Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Medscape US nurses were invited to participate in a 10- to 15-minute online survey about their annual earnings. Respondents were required to be practicing nurses identifying as registered nurses (RNs), licensed practical nurses (LPNs), or advanced practice registered nurses (APRNs). After a recruitment period lasting from June 13, 2017, through August 2, 2017, a total of 10,523 nurses met the screening criteria and completed the survey.

The following slides report survey findings from two subgroups of respondents: RNs (n = 5072) and LPNs (n = 2034). In a few instances, we compare findings from the current year with last year's compensation survey. A later slideshow will be devoted to findings about the compensation of APRNs.

(Note: Although the survey was conducted in 2017, respondents were asked to report earnings from 2016. LPNs are referred to as "licensed vocational nurses" [LVNs] in some states, but the positions are similar. We combine LPNs and LVNs in this survey).

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

The trend away from working exclusively in hospitals continues. Only 38% of RNs work in acute care hospital inpatient units (down from 41% in 2016). Another 15% work in hospital-based ambulatory care clinics. The remaining 47% of RNs are divided among a broad array of community settings, a few of which are new to this year's survey: industry setting—insurance/health plans; industry setting—other (health-related companies); and hospice/palliative care. However, the proportions of nurses working in these areas are small (≤ 3%), making it difficult to draw income comparisons with RNs in more common work settings. In contrast to RNs, LPNs are less likely to be employed in hospital inpatient units and more likely to work in medical offices, skilled nursing, or long-term care.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

The average earnings of full-time RNs and LPNs for 2016 were $80,000 and $46,000, respectively. Both of these figures are significantly higher than the annual wages reported in last year's survey (based on 2015). The US Bureau of Labor Statistics (BLS) reports that the average annual full-time salaries for 2016 were $72,180 for RNs[1] and $44,840 for LPNs[2]—both lower than the figures in our survey. It's likely that this disparity is because the BLS figures represent annual base pay, calculated by multiplying the average hourly pay rate by 2080 (full-time, based on a 40-hour work week). In contrast, our respondents reported their entire nursing-related gross income (including overtime and differential pay, among other factors).

Nurses who are considering advancing their education and embarking on new careers might like to know how much earning power they can expect as APRNs. Although not shown on this slide, our survey found that full-time APRN earnings averaged $182,000 for nurse anesthetists, $106,000 for nurse practitioners, $103,000 for nurse midwives, and $102,000 for clinical nurse specialists in 2016.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Among all RNs, 80% reported that they worked full-time in 2016, 15% worked part-time, and 5% worked per diem. These figures are essentially the same as those reported in last year's survey. Among all LPNs, 82% worked full-time, 13% worked part-time, and 5% worked per diem.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Slightly more than one half (54%) of RNs reported that they are paid by the hour, and 46% are salaried. Among LPNs, only 16% have salaried positions, and the remainder (84%) are paid on an hourly basis (data not shown). For those paid by the hour, average hourly wages were identical for full-time and part-time/per diem RNs ($37 per hour) and LPNs ($22 per hour). The hourly rates for RNs were the same as last year but LPNs saw a significant $1 per hour increase. The BLS reported lower average hourly wages for RNs in 2016 ($34.70)[1] and similar hourly wages for LPNs ($21.56)[2] compared with our survey.

Still, we wondered, how did the annual incomes of hourly-paid nurses in our survey increase without a corresponding increase in hourly rate of pay? Several factors might explain this apparent discrepancy. First, the rate of $37 per hour is an average of all RN respondents. When we looked at just the hospital-based nurses, their hourly rate had increased, by about $1 per hour, from the previous year. Second, nurses were asked to round their hourly rate of pay on the survey, so it's possible that this masked an hourly wage change. Flat hourly wages suggest that other factors are increasing average annual gross income, such as overtime, higher differential pay, bonuses, or increasing hours worked. Reaching a cap on hourly rate of pay is another potential reason for the lack of an increase in hourly wages over the previous year.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Among RNs and LPNs, salaried nurses had significantly higher gross incomes (5% higher for RNs and 16% higher for LPNs) than nurses paid by the hour. Receiving a monthly salary rather than an hourly rate of pay is becoming more common in nursing, and may reflect the broadening diversity of roles filled by nurses away from the hospital bedside, particularly for RNs.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

The average annual wages of hospital inpatient RNs increased significantly, from $82,000 in 2015 to $84,000 in 2016. Reported full-time earnings for RNs once again varied somewhat predictably by practice setting, with acute care hospital inpatient nurses receiving the highest wages and those in medical offices, public health, and school nursing at the bottom of the scale. Only one ambulatory specialty—occupational health—reported annual wages that rivaled those of hospital inpatient nurses. Although this figure ($84,000 annually) is higher than compensation data collected by the American Association of Occupational Health Nurses (AAOHN) in 2013, it is consistent with anecdotal reports that occupational health nurses in some settings are earning up to $150,000 annually, and with the fact that a large proportion of occupational health nurses have been working at the same company longer than 20 years, according to Kathleen Buckheit, AAOHN director of education.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

The annual wages reported by LPNs this year were significantly higher for those working in two settings: hospital-based outpatient clinics and school or college health services. In general, LPN earnings follow the same pattern as those of RNs, with hospital inpatient care paying the most and school or college health services the least. However, one category proved to be an outlier: LPNs who worked in the insurance/health plan industry reported earning $59,000 annually, which is 20% higher than the next highest-paid position for LPNs. This setting may offer an unusual opportunity for LPNs with the requisite background and business skills.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Among all respondents to this year's survey, only 9% of RNs and 8% of LPNs were men (unchanged from last year). These figures are slightly lower than those from BLS, which in 2016 reported that 10% of employed RNs and LPNs were men.[3]

As a profession, nursing continues to grapple with an apparent gender wage gap. Many studies and surveys report that male nurses earn more than female nurses.[4,5] But are men truly being paid more for the same work, or do some of the work habits of men result in higher earnings? It's a complex question, and we still don't have all the answers. First, our survey did show, once again, that male RNs earn an average of $4000 (5%) more annually than female RNs (last year's difference was 6%). Among LPNs, men were paid an average of $3000 (6.5%) more than women. However, gross salary differences between men and women don't tell the full story (see the next three slides).

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

In terms of annual gross income, men were paid more in 2016 regardless of method of pay (salary or hourly). Among salaried RNs, men reported earning $8000 (10%) more annually than women. Among hourly-paid RNs, the annual income of men was $4000 (5%) higher than that of women. Among hourly-paid LPNs, the annual income of men was $3000 (almost 7%) higher than that of women. Too few salaried male LPNs provided data to calculate the difference among this subgroup.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

To further investigate the wage gap between men and women, we analyzed differences in average hourly rate of pay for nurses who were paid by the hour, finding that it is essentially the same for male and female RNs. The hourly rate of pay is higher for male LPNs versus female LPNs as well, but the number of male LPN respondents was relatively low. These hourly pay findings suggest that the higher annual gross incomes of hourly-paid men may not be a consequence of a difference in base pay. An unanswered question, however, is why the hourly rate of pay for men and women is virtually identical when men, on average, have been practicing for fewer years (only 48% of men have worked > 20 years vs 68% of women). And this still doesn't explain why salaried male nurses earn more than their female counterparts.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Differences in work characteristics between male and female RNs offer potential explanations for the wage gap, some of which may apply to both hourly and salaried RNs. More men worked in healthcare settings that typically pay higher wages, such as hospital inpatient units, and men were more likely to work in urban (rather than rural) hospitals. Men were more likely than women to routinely work overtime, and when they did, they worked more hours of weekly overtime. Men were more likely to supplement their regular income by taking call, working shifts that paid more differential, or functioning as charge nurses. Any of these factors could contribute to a higher annual gross income for men in nursing.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Among RNs, 49% now report having a bachelor's degree (BSN), a small increase from last year (47%). This proportion is not growing as fast as the profession had hoped it would. A goal of the Future of Nursing initiative was that 80% of the nursing workforce would have at least a BSN by 2020, now only 3 years away.[6] As expected, the proportion of nurses with an RN diploma is declining (6%, down from 8% last year) as this group of nurses gradually retires from active practice. The proportions of RNs with an associate's degree (ADN), master's degree (MSN), or doctoral degree have remained relatively stable for the past 3 years, as have the educational degrees held by LPNs (data not shown for LPNs).

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

As we have seen in previous surveys, the annual earnings of RNs increase with their level of nursing education, beginning with their basic nursing degree. Both BSN- and ADN-prepared nurses earned significantly more in 2016 than 2015. Furthermore, BSNs earned an average of $6000 more than ADNs in 2016. In 2015, the difference was $8000, suggesting a narrowing income gap between these groups, explained primarily by rising wages for ADNs. The average income of RNs with diplomas falls between that of ADNs and BSNs, but this may reflect a longer tenure in nursing, with correspondingly more clinical or administrative responsibilities, rather than an effect of education. According to this year's survey, the economic advantage of each educational step, from ADN to BSN, BSN to MSN, and MSN to doctorate, is approximately an 8% increase in annual earnings.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Certified RNs earned significantly more than noncertified nurses (an average of $7000, or about 9% more). However, our data do not clarify whether RNs are paid more by virtue of being certified, or whether certified nurses tend to assume responsibilities that pay more. For example, our survey showed that certified RNs are significantly more likely to supplement their income by acting as a preceptor or teaching classes. They are more likely to hold MSNs, work in inpatient hospital settings, and increase their income by advancing on clinical ladders.

One of the profession's major certifying organizations, the American Association of Critical-Care Nurses, confirms that meaningful recognition of certified RNs is often monetary. Certified RNs can be rewarded with bonuses, salary differentials, or certification renewal fee reimbursement. In a recent survey of perioperative nurses, 41% of respondents said that their employers paid more for holding a nursing certification.[5]

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

As expected, the earnings of both RNs and LPNs rise with years of experience. This is true of both annual gross income and hourly rate of pay. This year, we also asked nurses who had been working 5 years or fewer to report the hourly rate they received for their first job in nursing. The average "first job pay" was $24 per hour for RNs and $18 per hour for LPNs.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

A new question on this year's survey addressed union membership. Union membership was fairly uncommon (12% of RNs and 7% of LPNs), but our figures are consistent with those of another recent nursing survey that reported that 12% of respondents belonged to a union or collective bargaining unit.[5] Among union nurses in our survey, annual wages were significantly higher for both RNs ($90,000 vs $79,000 annually) and LPNs ($50,000 vs $45,000 annually). A few other differences could help explain the higher wages for union nurses. Compared with nonunion RNs, union RNs were more often paid hourly versus being salaried (74% vs 51%) and were more likely to work in hospitals (48% vs 37%), although they were less likely to work in Magnet-designated organizations (21% vs 41%). Union RNs were less likely to experience a drop in income related to a job change, and both RNs and LPNs who belonged to unions were more likely to receive certain benefits (education allowance/reimbursement and paid parental leave).

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

The regional pattern for RN wages across the United States was again apparent in this year's survey. The difference in average full-time earnings of RNs between the highest-paid (West) and lowest-paid (North Central) regions is $32,000 annually. Nurses in the western states earned 45% more than those working in North Central states. RNs working in three regions (West, Mid-Atlantic, and Southeast) experienced significant increases in average annual income from the previous year. With respect to high-paying regions of the country, our data are consistent with those of BLS, which reports that 3 of the 5 top-paying states for RNs are those that make up our Western region (California, Hawaii, and Alaska).[1]

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

The average annual full-time earnings reported by LPNs were highest in the Northeast, followed by the West and Southwest. The difference in average full-time earnings of LPNs between the highest- (Northeast) and lowest- (North Central) paid regions was $14,000. LPNs working in three regions (South Central, Great Lakes, and Southeast) experienced significant increases in average annual income from the previous year.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

It's likely that the higher wages in certain regions of the country (West, Northeast) can be explained, in part, by the preponderance of large, urban population centers in those states. However, another factor could be a higher rate of union membership among RNs. This graph shows that union membership is indeed highest in the West, with a significant difference in annual income between union and non-union RNs. We didn't have sufficient numbers of respondents to analyze the salary differences for all regions, but in the regions that we were able to analyze, it's apparent that RNs who belonged to unions had higher annual incomes than other nurses from the same regions:

  • West: $109,000 union; $99,000 non-union
  • Mid-Atlantic: $89,000 union; $80,000 non-union
  • Great Lakes: $80,000 union; $76,000 non-union

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Wages vary by state and geographical region of the United States, but also by community type. Almost one half of RNs work in urban settings, and one third work in suburban settings. Average annual wages declined as community type shifted from urban (most populated/highest wages) to rural (least populated/lowest wages), explaining why nurses working in the same state can have vastly different annual incomes. The average difference in wages reported between urban and rural RNs was $12,000 annually. Fewer LPNs work in urban settings, and the difference between urban and rural wages was $6000 annually.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

In this year's survey, only 37% of RNs who were paid hourly reported working overtime (a decline from 47% the previous year). However, among RNs who worked overtime, most worked 5 or fewer hours of overtime weekly. Most overtime hours were voluntary; only 16% were mandatory, suggesting that overtime is viewed by most RNs as a way of supplementing income. LPNs were significantly more likely than RNs to work overtime, but did not necessarily work more overtime hours on a weekly basis. We can't tell from our survey whether the trend toward working less overtime is a consequence of an improved economy, better staffing, or a personal decision on the part of nurses to reduce their working hours when possible.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

One of the variables that might influence the apparent gender-related wage gap among nurses paid hourly is the amount of overtime worked. Men who are RNs more often reported routinely working overtime (50% vs 35%), and among RNs who routinely worked overtime, men were more likely to work more hours of overtime. A similar but less pronounced pattern was found among LPNs.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

We asked nurses whether their 2016 income increased, decreased, or remained the same compared with the previous year. More RNs than LPNs reported an increase in annual income from 2015 to 2016. Still, a majority of both groups saw their annual incomes increase, and about one third of both groups saw no change.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

For most people, an annual merit or cost-of-living raise is the primary method of increasing income from one year to the next. Among nurses who experienced an increase in annual income from the previous year, 77% of RNs and 67% of LPNs attributed this to a raise or salary adjustment. LPNs who earned more in 2016 more often reported working more hours (including going full-time, working more overtime, or taking more call).

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

This year, among nurses whose income didn't increase, the main reason was the lack of a raise. Statistically, RNs more often reported a salary cap, followed by frozen wages, as the reason for flat earnings from 2015 to 2016. Although we don't have data on salary caps from last year for comparison, we know that 67% of RNs in our survey have been in practice for 21 years or longer. It's reasonable that salary caps could have affected the incomes of a significant proportion of these nurses.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Among RNs who reported a drop in earnings between 2015 and 2016, the most prominent reason was working fewer hours (including going part-time, working less overtime, or taking less call). This is consistent with our finding that nurses in general are working fewer overtime hours. Among LPNs, the most common reason was a job change.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Nurses frequently have opportunities to supplement their regular full-time income by assuming additional responsibilities. This year, apart from working extra hours or shifts, RNs most often reported performing charge nurse or preceptor functions, or teaching classes, to increase their nursing income. Only 8% of RNs worked a second job or had another income-producing activity, although LPNs were significantly more likely to take this route to increase their annual income.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

The benefits offered by employers to full-time nurses showed little change from the previous year. Paid time off and health insurance are the major benefits offered to both RNs and LPNs. RNs more often than LPNs receive such benefits as contributions to retirement savings, education allowance/reimbursement, paid parental leave, professional liability coverage, or professional society membership dues.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

This year, we asked respondents whether they worked in a Magnet-designated organization. Although less than 10% of healthcare organizations have a current Magnet designation,[7,8] our survey showed that 38% of RNs and 29% of LPNs work in Magnet facilities.

Annual wages did not significantly differ between Magnet- and non–Magnet-employed RNs or LPNs. However, other differences were found between nurses who did and those who didn't work in facilities with Magnet status. For example, Magnet-employed nurses were more likely to have educational allowance/reimbursement as a benefit, and they reported better employer-assisted preparation for retirement.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Like last year, 26% of RNs and 33% of LPNs report that they are currently paying off college or nursing school loans. Of interest, men are more likely to report still paying off nursing school loans (35% vs 27% of women). A surprising proportion (23%) of the RNs who were still paying off their nursing school loans were approaching or had passed retirement age.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Climbing slightly this year, 58% of full-time RNs agree that they are fairly compensated for their work. Significantly fewer LPNs (48%) believe that their compensation is fair, although this figure is also higher than last year's (41%). No differences in how nurses reported the fairness of their compensation were found for gender, age, years of experience, work setting, Magnet status, or union membership. However, a belief that compensation was fair corresponded with annual earning power. Among those who earn more than the average annual income for RNs, 68% feel they are fairly compensated, whereas among those who earn less than the average annual income for RNs, only 49% admit to feeling fairly compensated. Similarly, among LPNs with above-average earnings, 57% feel fairly compensated, whereas only 41% of those with below-average earnings would agree.

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Medscape RN/LPN Compensation Report, 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | October 4, 2017 | Contributor Information

Tell us what you think: Do the incomes reported by this year's survey respondents match your own experience? Has your annual income gone up or down significantly, and if so, why? Are your benefits in line with what is reported here? Finally, is there anything else you would like us to ask nurses in next year's survey? Please add your comments at Voice Your Opinion: Medscape Nurses RN/LPN Compensation Report 2017.
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Medscape RN/LPN Compensation Report, 2018

How do your wages compare with those of other nurses? Where in the United States are nurses paid the most and least? Does being certified boost a nurse's pay? Find out in our 2018 report.Medscape Features Slideshows, October 2018
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