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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
For the past 6 years, Medscape has surveyed nurses annually about their earnings and their satisfaction with nursing. This year we faced a novel quandary: How do we talk about earnings in the midst of a pandemic that has probably changed the lives, personally and professionally, of most US nurses? Does it even make sense to analyze earnings from 2019, before the pandemic prompted layoffs and furloughs for some nurses and vast hours of overtime for others? And can we even begin to gauge the impact of nurses changing roles, responsibilities, and even employers as part of the healthcare response to COVID-19, and the effect that this has had on how they feel about being nurses during these mercurial times?
We acknowledge that the full effects of the pandemic on annual income won't be known for at least another year. We can't predict how long this pandemic will last or what our "new normal" will look like. So we decided to forge ahead with our survey but to ask new, timely questions about the impact of the pandemic on US nurses. The following slides describe findings related to earnings, and a subsequent report will explore how the pandemic affected nurses.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | 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 July 1 to August 25, 2020, a total of 10,424 nurses met the screening criteria and completed the survey.
The following slides report survey findings from two subgroups of respondents: RNs (n = 5130) and LPNs (n = 2000). Where possible, we compare these findings with those of last year's compensation report. A future report will focus on findings about the compensation of APRNs.
Notes:
1. Although the survey was conducted in 2020, respondents were asked to report earnings from the calendar year 2019.
2. 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.
3. The annual salaries and hourly rates reported here are averages and are based on full-time earnings Some nurses make less and some make more.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Some may have seen this coming. It appears that the COVID-19 pandemic has prompted somewhat of an exodus, voluntary and involuntary, from the nursing profession.
The first survey question asked respondents whether they are currently working in nursing. If a nurse said "no," we asked a second question: "Are you not currently working due to COVID-19?" In answer to this, 23% of RNs in the not-working group said they were not currently working due to COVID-19. Among LPNs, 26% of those no longer working cited COVID-19 as a cause.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
The primary employment setting for RNs is the acute-care hospital. Compared with our 2019 report, the proportion of hospital-based full-time RNs has increased (43% vs 37% in the 2019 report).
Only 6% of LPNs report that they work in acute-care hospitals. Instead, LPNs are concentrated in ambulatory care settings; more than 1 in 4 LPNs work in a skilled nursing facility/long-term care.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Including this year, average annual earnings for full-time RNs have been statistically unchanged for 5 years: $78,000 (2015), $80,000 (2016), $81,000 (2017), $80,000 (2018), and $81,000 (2019). The news is better for LPNs, whose wages have consistently risen since 2017: $46,000 (2017), $48,000 (2018), and $50,000 (2019). Median earnings in 2019 were $79,000 for RNs and $48,000 for LPNs.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Most RNs (77%) and LPNs (81%) work full-time. We compared data from previous surveys and did not see a significant trend toward more part-time workers in nursing.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Most RNs (61%) report being paid by the hour, while 39% are salaried. Among LPNs, only 17% have salaried positions; the remaining 83% are paid on an hourly basis (data not shown). Hourly wages do not include differentials.
For full-time RNs paid by the hour, the average hourly wage was $38, similar to last year's finding. Full-time LPNs' hourly rate of pay rose from $23 to $24. Part-time RNs report making more ($40 per hour) than those working full-time, while LPNs reported the same hourly rates as those working full-time.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Most full-time RNs (61%) and LPNs (83%) in our survey are paid hourly rather than with a salary. Even though average annual earnings did not increase over the previous year, RNs and LPNs who are paid by the hour saw a $1 increase in average hourly wage. Salaried nurses, as in previous years, reported higher annual earnings than hourly nurses. For nurses paid by the hour, hourly wages for RNs and LPNs overall increased this year except for full-time RNs.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Full-time RNs employed by hospitals and healthcare industry companies (eg, insurance/health plans) report the highest earnings, and those employed in schools and public health settings report the lowest. The average annual income of RNs who work in hospice or industry settings increased over the past 2 years.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
For full-time LPNs, skilled nursing facilities paid the most and school health services paid the least. However, the average income for LPNs in skilled nursing facilities, home health settings, hospital-based outpatient clinics, and non–hospital-based medical offices all increased over the past 2 years.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Male nurses continue to represent about 10% of RNs and 9% of LPNs, figures that have changed little in recent years. The annual gross income of full-time male RNs and LPNs continues to exceed that of their female colleagues by about 5% for RNs and 10% for LPNs. This pattern has been relatively unchanged for the past 4 years of our survey.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
The gender earnings gap persists in terms of annual gross income whether nurses are paid a salary or an hourly wage. Among RNs, salaried men earned 11% more annually than salaried women, and hourly men earned 6% more annually than hourly women. Among LPNs, men earned 15% more annually than women.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
The average hourly wage reported by male and female RNs was identical, at $38. This finding suggests that if men who are paid hourly earn 6% more annually than women, factors other than the hourly rate of pay must be responsible for the pay gap.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Differences in work characteristics of RNs might help to explain the finding that men earn more than women in nursing. We've seen this pattern before, in which men are more likely than women to be paid hourly, work on inpatient hospital units, work more high-differential shifts, and take on the role of charge nurse.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Among RNs, 53% reported having a bachelor's degree, an increase from the 2019 report (49%). At the same time, the proportion of RNs with an associate degree was lower (24% vs 26%). Again this year, 17% of RNs report holding master's degrees, and 2% hold doctoral degrees. The percentage of RNs with a diploma in nursing dropped slightly, from 5% to 4%.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Nurses often wonder whether it's worth it financially to seek a higher nursing degree. Typically in our annual survey, we've found that nurses' earnings jump predictably with each higher step in education. This year, although we saw an increase of 14% between the BSN and MSN level, nurses with a doctoral degree earned only 2% more.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
More than half of RNs report having earned a specialty certification, and 2 in 5 of these nurses were financially rewarded for being certified. One in 4 certified nurses reported receiving higher annual pay (average, $10,000), 6% received an annual bonus, and 7% received a one-time bonus. Certified RNs reported an increase in annual earnings over the previous year, and men who were certified earned more than certified women ($89,000 vs $85,000).
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
We know from previous surveys that RNs' and LPNs' annual income rises with increasing years in practice, a trend that was again evident this year. Nurses with the most experience reported the highest incomes. And even though average nurse earnings were flat overall, among early-career nurses and those with less than 10 years of experience, income has been trending upward for the past few years.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
A minority of nurses (17% of RNs and 10% of LPNs) are members of a union or collective bargaining unit. A significant earnings benefit of belonging to a union was evident, although we don't know how much of the higher wages attributable to union membership are offset by union dues.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
As shown in this map, RN membership in a union or collective bargaining unit varies by region of the United States and is highest among the Pacific, New England, and Mid-Atlantic regions.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Average annual nurse wages vary by region of the United States. Consistently, the highest-paid region is the Pacific (California, Oregon, Washington, Alaska, and Hawaii), and the lowest-paid were the East South Central (Alabama, Kentucky, Mississippi, and Tennessee) and West North Central (North Dakota, South Dakota, Minnesota, Nebraska, Iowa, Kansas, Missouri) regions. (Note: Regional incomes are not adjusted for cost of living.)
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
The pattern of highest- and lowest-paying regions of the United States is identical for LPNs.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Readers often tell us that the average incomes reported for the region they work in do not reflect what they are earning. This is probably related to the type of community where the nurses live and work. Average annual pay for full-time RNs and LPNs declines as the type of community shifts from urban (most populated areas/highest wages) to rural (least populated areas/lowest wages), explaining why two nurses working in the same state might earn vastly different amounts. For example, RNs and LPNs working in urban areas earn an average of 13% more than those in rural areas.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Over the past few years, a lack of wage growth for RNs and LPNs has been evident. That doesn't mean that all nurses weren't paid more in 2019 than in 2018, however. This graph shows that more than half of nurses reported that their earnings had increased over the previous year. This is balanced by the finding that substantial numbers of nurses either saw no change or earned less than the year before. Cost-of-living increases, which aren't considered wage growth, could explain the higher reported incomes as well.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Although few nurses take on second jobs, many are able to augment their earnings by working overtime, taking call, or functioning as preceptors or charge nurses. Like last year, supplementing one's base nursing income was more common among men than women.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
An important question in our annual survey is whether nurses feel that their compensation is fair. After several years of declining satisfaction with pay, this year, 57% of RNs and 45% of LPNs believe that their 2019 compensation was fair, a significant increase among RNs over the previous year. Factors associated with higher pay satisfaction include nurses with the highest earnings, union members, and men. Higher satisfaction was also expressed by RNs who have worked 11 years or more.
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
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Medscape RN/LPN Compensation Report, 2020
Laura A. Stokowski, RN, MS; Daniela Bastida; Mary McBride; Emily Berry | October 28, 2020 | Contributor Information
Tell us what you think. Do the incomes reported by this year's survey respondents match your own experience? Did the COVID-19 pandemic affect your employment status? And what should we ask nurses in next year's survey?
What's happening to nurse wages across the United States? Are nurses finally seeing significant wage growth, or are wages stagnating? Find out in our 2019 report.Medscape Features Slideshow, October 2019
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Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
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Contributor Information
Laura A. Stokowski, RN, MS
Editorial Director, Medscape
Daniela Bastida
Market Research Analyst, Medscape
Mary McBride
Associate Director, Market Research, Medscape
Emily Berry
Editor, Medscape
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