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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | 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 May to August 2021, a total of 7469 nurses met the screening criteria and completed the survey.
The following slides report findings from two subgroups of respondents: RNs (n = 5038) and LPNs (n = 2431). Where possible, we compare these findings with those from last year's compensation survey. A future report will focus on the compensation of APRNs.
Notes:
Although the survey was conducted in 2021, respondents were asked to report earnings from the calendar year 2020.
The annual salaries and hourly rates reported here are averages. Some nurses make less and some make more.
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.
Reported findings are based on full-time nurses unless otherwise noted.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
The COVID-19 pandemic began more than a year before this survey took place. With no end in sight, the pandemic has taken an enormous physical and emotional toll on nurses, and unfortunately for some nurses it has been career-ending. In this year's survey, among respondents who were no longer employed, 27% of RNs and 30% of LPNs blamed COVID for their unanticipated exodus from nursing. More than 1 in 5 of these nurses retired earlier than originally planned.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Nurses are needed most where the sickest patients require care, and that is reflected in work settings, as the proportion of RNs employed in acute-care hospitals continues to climb. Hospital-based RNs increased from 43% in our 2019 report to 45% in this report. LPNs, on the other hand, tend to work more often in ambulatory care, skilled nursing facilities, and long-term care.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
For the first time in 5 years, full-time RNs reported an increase in earnings, by an average of $2000 annually. But we found something unusual. The median pay reported by full-time RNs ($74,000) was significantly lower, by almost $9000, than the average (mean) pay. Why would this occur? It may be that the pay of some nurses increased rather significantly during 2020, inflating the mean. RNs may find that their annual earnings are closer to the median reported by our respondents.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Although most RNs (74%) and LPNs (81%) still work full-time, we are starting to see more RNs switching to part-time or per diem work. Five years ago, 81% of RNs reported working full-time, 15% worked part-time, and 5% worked per diem. Our data may reflect a recent trend for nurses to choose part-time or per-diem positions over full-time work in a stressful job setting, particularly since the start of the COVID pandemic.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
For several years of our survey, the hourly rate of pay for RNs has remained flat or inched up very slowly from year to year. Although it appears that the average hourly pay increased by $2 in 2020, in reality this increase was not statistically significant. The same is true of the apparent $1 increase in the hourly rate of pay for LPNs.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Although fewer nurses (36% of RNs and 19% of LPNs) receive a fixed salary, those nurses continue to have higher average incomes than colleagues who are paid by the hour. Nurses who receive a salary earned more than hourly-paid nurses: 17% higher for RNs and 19% more for LPNs. Of note, the annual income increased for salaried RNs but not for salaried LPNs.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Traditionally, RNs employed by acute-care hospitals were the highest earners. However, although they are a much smaller group overall, RNs employed by health insurance companies have reported annual earnings that rival those of hospital-based RNs.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
LPNs working in skilled nursing facilities were among the highest earners in this year's survey, and those working in school or college health services were among the lowest.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
The proportion of male nurses in our annual surveys has changed little over the past 5 years, varying between 8% and 10% of respondents. This year, however, the proportion of men jumped to 13% (RNs) and 9% (LPNs). And men continue to reap the benefits from a well-documented and persistent gender pay gap in nursing. Overall, male RNs earned 6% more than women, and male LPNs earned 14% more, continuing a pattern we have observed in surveys of the past 5 years.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Among all nurses, women are more likely than men to hold salaried positions. However, men outearn women in annual income whether they are paid by the hour or receive a fixed salary.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
The hourly rate of pay for male RNs was not significantly higher than that of female RNs in our survey. Thus, the higher annual earnings of hourly-paid men must be a consequence of factors other than base hourly rate of pay. The next slide takes a look at some of these work-related factors.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
This graph suggests that the observed pay gap is not solely a function of gender but can at least partly be explained by different work habits between men and women. For example, among RNs, men were more likely to work on inpatient units in acute-care hospitals in urban settings and to work high-differential shifts — all factors associated with increased pay.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
The bachelor's degree was the highest degree held by 52% of RN respondents. The proportion of RNs with an associate degree is down to 21% from 24% last year. Although the number of RNs with a bachelor's degree is essentially unchanged from 2020, we saw an increase in the number of RNs with a master's degree, which was 20% in this report, up from 17% the previous year.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Does pursuing a higher degree have monetary rewards? In terms of annual income, the answer seems to be yes. According to our survey, the average annual earnings of RNs do increase with their level of education. Going from BSN to MSN was associated with 16% more pay, and from MSN to a doctorate in nursing garnered 6% higher annual pay.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
More than half of RNs hold a certification in their specialty, and one fourth of these RNs receive higher pay for maintaining their certification status — an average of $11,000 more annually vs noncertified RNs. Another 5% of certified RNs are rewarded with an annual bonus. The annual pay of certified RNs increased by $2000 (from $86,000 to $88,000) over the previous year.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
For most RNs and LPNs, annual income rises steadily with increasing years in practice. However, we don't know whether this pattern continues beyond 21 years of experience. Many nurses will hit a salary cap at some point, beyond which merit raises are no longer given.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Union membership among nurses has not changed significantly from the previous year. In this survey, 18% of RNs and 9% of LPNs reported belonging to unions. From an income perspective, union membership has a significant benefit. RNs and LPNs who are union members earned 12%-15% more annually than nonmembers, a pattern that has been consistent for the past 4 years. Another possible explanation for this finding is seen on the next slide.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Unions tend to be concentrated in the Northeast, Mid-Atlantic, and West Coast regions of the United States, where pay for RNs and LPNs is highest. 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, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
It's typical for nurses' wages to vary regionally within the United States. As in previous compensation surveys, we found that the Pacific (West Coast) region pays the most and the East South Central portion of the United States the least. The map displays the mean annual earnings of nurses in these regions, but these median figures might better reflect regional incomes:
Pacific: $102,000
Mid-Atlantic: $87,000
New England: $85,000
Mountain: $77,000
West South Central: $75,000
South Atlantic: $75,000
East North Central: $74,000
West North Central: $66,000
East South Central: $65,000
(Note: Regional incomes are not adjusted for cost of living.)
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
The pattern of highest- and lowest-paying regions of the United States is similar to that of RNs. The map portrays the mean annual earnings in each region, but nurses may find that their pay is closer to these median pay figures:
New England: $61,000
Pacific: $60,000
Mountain: $53,000
Mid-Atlantic: $51,000
West South Central: $48,000
East North Central: $47,000
West North Central: $45,000
East South Central: $41,000
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Disparities in annual earnings can occur between nurses from the same region. The type of community (urban, suburban, rural, etc.) also plays a role in setting local wage expectations for nurses. In this report, urban-based nurses outearned rural-based nurses by 13% among RNs and 18% among LPNs.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
We asked nurses whether their annual pay had increased compared with the previous year. An increase in earnings was reported by 56% of RNs and 50% of LPNs. We don't know for certain whether the pandemic played a role in these changes, but it seems likely given the dramatic increase in demand for nurses in acute-care hospitals seen throughout the pandemic.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Many nurses supplement their base income by working overtime, functioning as a preceptor or charge nurse, or taking off-hours call. Overall, as seen here, 44% of RNs and 51% of LPNs did not earn supplemental income in 2020. Of note, male nurses were more likely to earn supplemental income by various means.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Each year, we ask nurses whether they feel that their compensation is fair. In this year's survey, we saw a drop in the proportion of nurses who feel that they are paid fairly for the work they do. This did not come as a surprise, given how much more difficult the work has become during the pandemic. As in previous surveys, RNs who are content with their pay are the higher earners, making $92,000 annually vs $76,000 among nurses who are not happy with their pay. The same is true of LPNs: Those who are satisfied with their pay earned more than those who were not satisfied ($54,000 vs $47,000). Younger RNs and those with less than 5 years of experience were most likely to express dissatisfaction with their annual pay.
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Medscape RN/LPN Compensation Report, 2021
Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | October 29, 2021 | Contributor Information
Nursing earnings are more important than ever. Are yours keeping pace with those of your colleagues around the country?Medscape Features Slideshow, Oct 2020
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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
Sarah Lesser
Manager, Market Research, Medscape
Mary McBride
Associate Director, Market Research, Medscape
Emily Berry
Editor, Medscape
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