Career Regret Stronger Among Nurses Than Physicians

November 18, 2015

Only 56% of registered nurses (RNs) would choose nursing as a career again, roughly the same percentage who are satisfied with their pay, according to the Medscape Nurse Salary Survey.

This measure of career satisfaction is higher (60%) for advanced practice nurses (APNs) and lower (48%) for practical nurses, who consist of licensed practical nurses and licensed vocational nurses. Again, these affirmative responses tracked salary contentment in the survey. At the same time, making good money is fourth down on the list of what nurses find rewarding, trailing relationships with patients, a sense of competence, and professional pride.

Career satisfaction for nurses as a whole is lower than that for physicians, 64% of whom said they would choose their field again if they could do it again in the Medscape 2015 Compensation Report.

Nurses expressed more widespread regret about other aspects of their career. Less than a third in each of the main categories of APNs, RNs, and practical nurses would choose their current practice setting again, and only 19% of RNs and 35% of APNs said they would pursue the same level of educational preparation.

Pamela Cipriano, RN, PhD, president of the American Nurses Association, called these findings "another wake-up call that we must do better to retain the all too critical nursing workforce."

"This survey shows that the working environment for RNs is still not uniformly providing the support and conditions that nurses find professionally rewarding and personally satisfying," said Dr Cipriano. "Not surprising, nurses point to the relationship with their patients as most rewarding. Nurses in all settings deserve to receive competitive and fair compensation, but more importantly, they want the time and resources to provide the care they deem necessary...for patients and families."

Medscape conducted its first-ever survey of nurses on compensation and job satisfaction from August 12 through October 2. Nurses who were Medscape members were randomly invited to participate. Almost 8300 nurses who met the screening criteria of working in the United States as a practical nurse, RN, or APN, a category that includes nurse anesthetists, nurse practitioners (NPs), nurse midwives, and clinical nurse specialists, completed the survey.

The findings on nurse career satisfaction differ from those in a study that appeared earlier this year in Academic Medicine. That study, based on a randomized survey conducted in 2012, showed that 73% of primary care NPs were very satisfied with their career, if not necessarily with their current job, and 88% would recommend that a young person pursue a career in primary care as an NP. In contrast, only 46% of primary care physicians were very satisfied with their career, and only 56% would recommend following in their footsteps.

The Medscape survey did not break down career satisfaction or recommendation levels by type of APN.

Nurse Anesthetists Are Top Earners

Predictably, the Medscape Nurse Salary Survey found that APNs are the top earners in nursing. Nurse anesthetists lead the way, at $170,000, followed by NPs at $102,000, nurse midwives at $99,000, and clinical nurse specialists at $95,000. RNs and practical nurses reported average salaries of $79,000 and $46,000, respectively.

A nurse's level of contentment with compensation tracked how much he or she received.

Table 1. Satisfaction With Compensation by Position/Licensure

Position/Licensure Satisfaction
Nurse anesthetists 73%
Nurse practitioners 61%
Nurse midwives 58%
Clinical nurse specialists 54%
Registered nurses 53%
Licensed practical nurses/licensed vocational nurses 43%

Source: Medscape Nurse Compensation and Satisfaction Survey

As in medicine, nursing has a sex gap when it comes to compensation: Male APNs and RNs earn 9% more than their female counterparts, whereas male practical nurses are ahead of female practical nurses by 6%. Men account for about 10% of the profession.

The survey uncovered regional differences in compensation as well: Both APNs ($120,000) and RNs ($105,000) in the Far West states of California and Hawaii made more than their peers elsewhere. Trailing everyone else were APNs and RNs in the North Central states, who earned $94,000 and $69,000, respectively.

Nationwide, 52% of nurses reported making more in 2014 than they did in 2013, and 7% said the increase topped 10%. Compensation stayed the same for another 39% of nurses, and decreased for 9%.

More results from the survey are available here.

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