RN Pay Stagnant for 3rd Year; Annual LPN
Pay Up $2K

Marcia Frellick

October 11, 2019

Wages for registered nurses (RNs) have been stuck near an average of $80,000 for the last 3 years, the latest Medscape salary survey shows.

The Medscape RN/LPN Compensation Report, 2019 includes responses from 7145 nurses (5143 RNs and 2002 licensed practical nurses). Nurse members were asked about their 2018 earnings.

"We don't know the reason for the apparent wage stagnation in nursing," the authors of the report write. "We have speculated that this trend is related to the retirements of older, more highly paid nurses, which would tend to dampen average wages of the younger RN workforce, or it may reflect slower wage growth in general."

LPNs' gains were more substantial, up $2000 from 2017 to an average of $48,000. Their increase from 2015 was $5000.

Where They Work

Half of all RNs work in acute-care hospitals (37% in inpatient settings and 13% in hospital-based outpatient sites) despite predictions that more healthcare would be shifting out of hospitals. 

Inpatient acute-care hospitals traditionally have been the highest-paid, most desired settings for RNs, but this year nurses in occupational health and industry settings joined those nurses at the top with average pay at $83,000 and $84,000. The lowest paid RNs were the school/college health services nurses, who made $65,000 on average.

Similarly, the lowest-paid LPNs were in school/college health services ($36,000).

However, LPNs most often work in skilled nursing facilities/long-term care and those spots pay on average $51,000.

Geographically, pay saw a wide divide for RNs and LPNs. In Pacific states, including Alaska and Hawaii, average RN pay was $96,000, whereas those in the East South Central region — Alabama, Kentucky, Mississippi, and Tennessee — averaged $70,000. New England was the best-paying region for LPNs ($55,000) and the East South Central region paid LPNs the least ($43,000).

The survey also showed that most RNs and LPNs work full time (78% and 81%, respectively).

More RNs are paid by the hour (56%) than are salaried (44%). Only 15% of LPNs are salaried. The per-hour pay was the same whether the nurses worked full-time or part-time ($38 an hour for RNs and $23 for LPNs). Hourly pay in this survey does not include differentials.

Salaried nurses made more than hourly across the board. Salaried RNs made 5% more and salaried LPNs made 15% more.

The Gender Gap

Among RNs and LPNs, men consistently have been paid more.

"We don't fully understand why men earn more," the survey authors write. Only 9% percent of the respondents for this survey were male.

Male RNs earned about 4% more ($83,000 vs $80,000) and male LPNs earned about 10% more ($51,000 vs $47,000).

"This year we see a glimmer of hope for pay equity among nurses in salaried positions," the authors write.

Whereas salaried male RNs last year earned 7% (or $6000) more than their female counterparts, this year the gap was reduced to 2.5% more (or $2000). The numbers of salaried male LPNs were too small to compare salaried nurses in that category.

Some of the differences might be explained by work characteristics, the authors say.

The survey indicated that men were more likely to work in higher-paying inpatient and intensive care settings; were more likely to get hourly pay (which is easier to supplement); were more likely to work in urban areas (53% vs 44%); were more likely to work overtime (51% vs 41%); take paid evening/weekend call (26% vs 18%); and work shifts that paid a higher differential (40% vs 29%).

Education Pays Off

Almost half of RNs (49%) reported their highest level of education was a bachelor's degree; 26% had an associate degree; 17% had a master's degree; 5% had an RN diploma; and 2% had a doctoral degree.

The authors said those numbers have stayed fairly stable in recent years.

Generally, the higher the education level, the higher the pay. The pay increase from bachelor's to master's and from master's to doctorate was 9% for both steps.

Though diploma-trained nurses reportedly made more than associate degree-trained nurses ($78,000 vs $75,000 on average), the authors say that is likely related to age and experience and not related to education level.

Experience appears to be rewarded in nursing. Those RNs and LPNs working 21 years or more made $84,000 and $49,000, respectively, while those working less than 5 years were making $66,000 and $44,000, respectively).

Hourly rates for nurses in their first jobs were $25/hour (RNs) and $19/hour (LPNs).

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