Nurses Tell All! Salaries, Benefits, and Whether They'd Do It Again

Carol Peckham

Disclosures

November 17, 2015

In This Article

What Factors Affect Nurse Income Levels?

Primary Work Setting

RN compensation by work setting. In the Medscape report, the highest salaries for full-time RNs were reported by those working as contract nurses ($95,000) and in government, which included the military ($93,000). This is consistent with the BLS, which also reported that the highest paid RNs were working for the government. It should be noted, however, that, according to BLS data, only 6% of all nurses do government work.[1] Hospitals, where the majority (61%) of RNs work, were third and fourth in compensation levels ($83,000 for inpatient care and $79,000 in outpatient settings).

APN compensation by work setting. Full-time APNs who work in long-term care (including nursing homes) and in the government make the most ($106,000) but are followed very closely by those doing inpatient work in hospitals ($105,000). According to the latest BLS report, nearly half of APNs work in medical offices and most of the others in hospitals.[5] No full-time APNs responding to this survey did agency or contract work.

Note: the number of LPN/LVN respondents were insufficient to reliably report their results on this question.

Sex Demographics

According to the US Census Bureau report, in 2011 there were 3.2 million female and 330,000 male nurses.[6] The overall proportion of male and female nurses in this year's Medscape survey mirrors that of the general nurse population (about 10% and 90%, respectively). Of interest, in the Census data, the proportion of men among nurse anesthetists—the highest paid nurses—is much higher (41%).

As in far too many professions, the sex disparity in compensation among nurses appears to favor men. According to a report based on the latest US Census Bureau data, full-time female nurses make 91 cents for every dollar that male nurses make.[6] In the Medscape survey, male nurses also reported making more money than their female peers, with almost no differences according to type of nurse: Male APNs and RNs make 9% more and male LPNs/LVNs 6% more than their female peers, respectively.

A 2015 JAMA study[7] found that the salary gap between male and female nurses was similar to that between male and female physicians. Furthermore, the differences in pay had not changed significantly since the passage of the Equal Pay Act 50 years ago. The authors stated, "A salary gap by gender is especially important in nursing because this profession is the largest in health care and is predominantly female."[7,8]

In a Medscape interview,[9] Pam Cipriano, PhD, the president of the ANA, commented on the JAMA study. "I can't point to anyone who has been able to say that yes, this is true—men do make more than women in nursing. I wondered when I looked at the data whether this was a factor of men just tending to work more hours. In my anecdotal experience, I've known a lot of men who tended to work more extra shifts, weekends, and off-shifts, so they would be paid more differentials, and that would boost their overall compensation. I don't believe that the [JAMA] study was sensitive enough to pick up on some of those differences." She continued, "I can only say from my experience of being a chief nursing officer and hospital executive for many years that I don't know of any facilities that would purposefully put into place a salary structure that would favor men."

Age

As reported from the survey, APNs not only make considerably more than RNs, but, when comparing the salaries reported by RNs who are younger and presumably at the beginning of their careers vs those reported by older, more experienced RNs, income increases at a lower rate for RNs compared with APNs. There was only an 11% difference between the average yearly salaries of the youngest and oldest RNs, whereas for APNs, this difference was 15%, suggesting that not only do RNs earn less than APNs, but over time, increases in income are slower for RNs than APNs.

RNs are also working longer than in previous decades. A 2014 study reported that between 1991 and 2012, 74% of nurses were still working at age 62 years and 24% at age 69 years. In the previous 20-year period, only 47% were working at 62 years and 9% at 69 years.[10]

Geographic Region

An analysis published in 2012 projected that the most severe RN shortages between 2009 and 2030 would occur in the West.[11,12] However, a 2014 ANA fact sheet reported that 14 states were predicting an annual growth rate in number of nurses of 20% or more, eight of them in the West.[13] So, it is of interest that in this year's survey, full-time RNs as well as APNs who live in the West make the most ($105,000 and $120,000, respectively) compared with those in other regions. RNs who live in the North Central region and the Southeast are at the bottom in compensation ($69,000 and $74,000, respectively). On average, APNs make the least in the Southeast ($95,000) and North Central ($94,000) regions.

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