ALMOST 1,400 NURSES responded to our sixth annual salary survey, and they bring good news: The overall average annual income for all respondents is $58,600, 7.3% higher than 2004 ($54,600) and 18% higher than 2003 ($49,600). Continuing a trend over the past few years, the starting hourly base salary for RNs also rose, averaging $20.15/hour-an increase of 4.2% over last year. And LPNs gained even more, reporting a 6.2% increase over the previous year ($13.58 to $14.43/hour). Salaries for unlicensed assistive personnel (UAPs) rose 5.5%, to $9.74/hour.
On the downside, salaries remain flat for experienced hospital staff nurses. In written comments, many nurses echoed these concerns.
"I work for an agency for the money. I'd gladly become staff if the hospital would pay the same amount. The hospital even paid out sign-up bonuses for 13-week contracts. Maybe they should take better care of the financial needs of their staff to improve retention."
Let's look at the survey highlights and trace some trends.
Age and experience: Are they undervalued?
The average survey respondent is in her 40s and has over 15 years of experience in nursing. (See Who responded to this survey?) These data correspond to the national profile of nurses in the United States today.
Survey findings suggest that older nurses don't get their just desserts on payday. As shown in Figure 1, nurses in their 40s make only $4,400 more per year than nurses in their 30s. Salary growth is even flatter for nurses over age 50, who on average make under $2,000 more than nurses in their 40s.
|Figure 1: Salary by age group|
What about years of experience? As you'd expect, nurses with the most experience make the most money, with salaries topping out at $63,500/year for nurses with more than 15 years of experience (see Figure 2). But salaries for less-experienced nurses make the biggest jump compared with increases earned by their more seasoned colleagues: Nurses with 6 to 10 years' experience earn about $11,500/year more than those with only 5 years' experience or less. But after the 10-year mark, pay increases flatten-nurses with 11 to 15 years' experience make only $2,300 more on average than those with 6 to 10 years' experience.
|Figure 2: Salary by years in nursing|
Employers who wonder why they have trouble retaining staff nurses should consider this nurse's observation.
|Figure 3: Salary by hospital type and location|
"I've worked at my hospital for over 25 years and I'm maxed out on vacation and salary. They're bringing in new grads off the street with almost the same pay that I had to work 30 years to get."
No bonus bonanza
Our figures show a trend away from giving nurses signing bonuses: Only 28% of current survey respondents reported that their facilities offer signing bonuses for new hires, compared with 32% in 2004 and 36% in 2003.
Many facilities offer pay differentials, although these figures are also dropping. Shift differentials, the most common type, were reported by 67% of respondents, but this is down from 72% in 2004. Ten percent said their facilities give retention bonuses. About 24% of respondents reported that their facilities offer no differentials.
Two respondents had this to say about differentials.
"At my facility, we've been told that no one is paid more based on educational level, experience, or department. All are hired with the same base salary and receive merit increases. This means that new graduates are hired at the same salary as a nurse with years of experience."
"At our hospital, we had a shortage of nurses on nights for our ICU and ER. Instead of implementing a hiring bonus, they started a $4.00/hour differential on top of the normal night shift differential. This helped with retention and recruitment."
About 70% of respondents report getting reimbursed for continuing-education activities, but only 28% report reimbursement for certification fees.
Nurses reported other types of benefits in the comment section; for example, profit and gain sharing, uniform reimbursement, five conference travel days per year, free online continuing-education opportunities, payment for nursing journals, career and clinical ladders bonuses, attendance bonuses, and free meals.
Sex and the salary
As in years past, an income gap persists between women and men. Although nurses of both sexes made salary gains in 2005, men were still paid more on average ($61,949 versus $58,249). However, the disparity-$3,700-was narrower than in 2004, when it was almost $6,000. One reason is that salaries for women rose by $4,300 in 2005, compared with an average increase of only $2,100 for men.
More education: What's it worth?
Although many respondents said they don't believe that more education translates into higher pay where they work, our data show that nurses with advanced degrees generally earn more (see Figure 6). The relatively high salaries for nurses with RN diplomas may reflect a higher proportion of older diploma nurses who are at the top of their pay scales.
|Figure 6: Salary based on highest level of education|
Nearly 39% of respondents reported that they're certified in a specialty. As Figure 4 shows, these nurses make considerably more than nurses who aren't certified. Even if a facility doesn't pay a differential for more education or certification, these factors open doors to higher-paying positions.
|Figure. No caption available.|
|Figure 5: Base starting hourly rate for RNs, LPNs, and UAPs by geographic region|
|Figure 4: Salary based on specialty certification|
Setting and position
Nurses working in hospitals earn more than those employed in other settings. Hospital nurses report an average annual salary of $61,400. Here's how some other settings compare:
* outpatient areas and clinics, $59,000
* community and home health nursing, $57,700*
* long-term care, $47,300
* nursing school faculty, $53,900*.
In Figure 7, which breaks down salaries by position, you can see that staff nurses and nursing faculty make the lowest salaries. The low figure for staff nurses ($47,600) may be due in part to a larger proportion of new graduates at the bottom of the pay scale. But the poor compensation for members of nursing faculty, who are typically both well educated and experienced, is disturbing. No wonder many nurses don't see teaching as a good career move. The failure to attract new faculty members as the current generation retires is already severely limiting the profession's ability to respond to the nursing shortage.
|Figure 7: Salary by position|
Note the high salary level for advanced practice nurses. This reinforces the value of furthering your education. At the same time, it underscores one reason more nurses with advanced degrees aren't joining academic faculties: Nursing schools don't offer competitive salaries.
Breaking down the numbers by type of unit, we found that nurses making under $55,000 annually were medical/surgical nurses ($54,425), pediatric nurses ($54,057*), and geriatric nurses ($47,122). Nurses with the highest incomes worked in:
|Figure 8: Regional comparison of salaries by selected groups|
* perianesthesia/operating room ($67,422*)
* emergency department ($62,986*)
* outpatient unit ($62,557*)
* psychiatric unit ($60,864*)
* obstetrics/gynecology/nursery ($60,297*)
* intensive care unit/critical care unit ($57,486).
Note, however, that many of these figures are based on a small sample size.
Some gains, but still underpaid?
Salary gains for nurses have gained momentum in recent years, fueled in large part by the nursing shortage and high vacancy rates. But many nurses consider themselves significantly underpaid compared with other professionals. Said one nurse bluntly, "Nursing pay is a disgrace for the responsibility involved."
But as many nurses pointed out, even a good salary is poor compensation for nurses who struggle daily with unsafe staffing levels, overtime issues, and other problems associated with the nursing shortage.
Let's give the last word to two nurses who summed up the opinions of many of their colleagues.
"Nursing is still a predominantly female occupation and continues to be lumped into the facility's per diem rather than billed separately. We haven't succeeded in articulating precisely what we do so as to award an appropriate dollar figure to our interventions. (I'm not convinced the nature of our work lends itself to such an endeavor, either.)"
"Our issues may appear on the surface to be pay-related, but the lack of respect for nursing by nursing administrators and their inability to see how dangerous staffing is even on a 'good' day are what is really wrong. Salary is only a problem when it's very low-otherwise, give us safe staffing and directors of nursing who care."
Who responded to this survey?
The typical respondent to this survey fits this profile:
* an RN (83%) with a BSN degree (31%)
* female (91%)
* between ages 41-50 (36%) or over age 50 (34%)
* works in a hospital (60%)
* works full time (92%)
* is paid with an hourly wage (55%) rather than an annual salary (45%)
* has over 15 years' experience (58%)
* works as a staff nurse (33%) or as a manager/supervisor/administrator (32%)
* has held her current position for 5 years or less (66%).
The 45% of respondents who reported being paid by salary (rather than hourly) is an increase over the 37% who reported salaries in 2004. Staff nurses made up a lower proportion of respondents in 2005 (33%) than in 2004 (47%), which may reflect severe shortages of staff nurses in many facilities.
How to negotiate a better salary
After reviewing these survey results, do you think you're being fairly compensated for your work? If not, consider negotiating for a better salary. Don't be shy. Negotiation is a professional skill all nurses should develop. To confidently present your case, try these tips.
* Arrange for a special meeting with your nurse-manager-don't just talk in the hallway. Ask him for some time to discuss your compensation and set up an appointment.
* Do your homework. Prepare for the meeting by gathering information on salaries offered in your geographic region for nurses with your skills and background. Call other facilities and ask about salaries for nurses. Investigate benefits that are important to you, such as paid time off or reimbursement for educational expenses. Take your data to the meeting with your manager.
* When making your case for a raise, point out your accomplishments. This isn't the time to be modest. What do you contribute beyond your day-to-day routine? Do you mentor new graduates? Work on committees? Also discuss your work with nursing organizations, your professional growth and development activities, and your educational credentials and certifications.
* Discuss patient interactions and consider taking some thank-you notes from patients.
* When you get down to hard figures, be ready with specifics. Be clear on your terms and limit it to two requests, such as a certain salary plus reimbursement for certification fees.
Start with a salary figure that's slightly higher than what you really want, to give yourself some room for compromise. But don't set an unrealistically high figure, or you'll undermine your chance for success.
* Close the deal. Give your manager some time to consider your request and set up another meeting if necessary. No matter what the outcome, he'll respect you for your clear goal setting and assertiveness. Even if he can't give you a raise right now, he'll have your case in mind for the next budget development period.
About this survey
The Nursing2005 Salary Survey was published in the January 2005 issue and posted online. Nurses could return results by mail, fax, or online. The sample was a convenience nonprobability sample. The distribution of nurses on key demographic and geographic variables in this sample is a close match with that in a probability sample used for larger U.S. nursing market studies. Not all respondents answered all questions and some figures have been rounded. The accompanying graph shows the incremental yearly increase in salary reported in Nursing journal salary surveys over recent years.
Cheryl L. Mee is editor-in-chief of Nursing2005 and adjunct faculty for Immaculata (Pa.) University.
|Figure. No caption available.|