1. Steltzer, Theresa M.
  2. Woods, Anne RN, CRNP, APRN,BC, MSN
  3. Gasda, Kimberly A.


Nursing Management 's fifth annual salary survey offers nationwide data on nurse leaders' salaries and provides insights into compensation issues and retention incentives.


Article Content

Explore the latest salary statistics for nurse leaders across the nation.


You spoke out in record numbers this year, and we're excited to share your insights. More than 1,000 nurse leaders responded to Nursing Management 's fifth annual salary survey-a 20% increase over last year's returns. * In addition, the number of write-in comments doubled. Nurses at various stages of the career continuum, from supervisors to CEOs, participated in the survey, which was featured in our March and April issues, as well as on our Web site.


This year's high response rate provides a more complete representation of your salaries, as well as the challenges and scope of your positions. Retention initiatives, nursing shortage issues, and pay inequities top your list of concerns.


Salary semantics

Compared to last year, the salary scenario has begun to blossom: Your average income this year is $66,020, up $3,230 from $62,790 in 2002. And this monetary increase represents the largest in 2 years; from 2001 to 2002, salaries increased by $1,430. In addition, slightly more respondents joined the $70,000 to $85,000 average salary bracket (22.2% in '03; 21.3% in '02). More of you earn over $100,000 (6% in '03; 5.3% in '02). This is all good news for an industry that yearns for pay to compensate for work environment imbalances.


Regardless of title, many of you are relatively new to your positions - 70.6% of you have held your current positions for 5 years or less, a similar percentage to last year (69.4%). For the past two surveys, the majority of you reported working in nursing more than 20 years, (57.8% in '03; 51.3% in '02), which is representative of the mature nursing workforce.


This year, the greatest number of responses came from Nurse Managers and Directors of Nursing, both of whom reported over 20 years of experience. Fifty percent of those responding as Nurse Managers and 65.9% of those responding as Directors of Nursing have over 20 years of experience.


As anticipated, years of nursing equate to higher earnings: Those with a more than 20-year nursing career average an annual salary of $70,270, holding steady with last year's amount of $70,320. Those of you with between 16 and 20 years of experience (14% of total respondents in '03; 13.7% in '02) have a lower average salary, which is most likely a factor of having less experience ($63,960 in '03; $61,830 in '02). (See "Years in nursing by average salary.")



Table. Years in nurs... - Click to enlarge in new windowTable. Years in nursing by average salary

As in 2002, our largest group of respondents holds the title Nurse Manager (29.4% in '03; 30.1% in '02). Director is this year's second largest group (22.5%). Respondents of the Other category (18.9%) include Clinical Coordinators, Clinical Nurse Specialists, and Staff Development Coordinators. The fourth largest group of respondents fell under the category Educator, with 11.4%-up from 6.6% in 2002.


Last year, you reported a substantial salary gap between Director and Administrator, and Administrator and Vice-President. The gap between Vice-President and Administrator has notably increased this year, while it has significantly narrowed between Director and Administrator. (See "Average annual salary by title.")



Table. Average annua... - Click to enlarge in new windowTable. Average annual salary by title

Participant profile

The highest number of respondents reside in the East North Central region (18.4%), with South Atlantic close behind at 17.9%. Your responses indicate that there's a clear regional impact on income. In 2002, all salaries-except for those in the South-exceeded the previous year's amounts. This year, however, highs and lows were scattered. Those of you from the Pacific region once again checked in with the highest average salary, at $77,280 ($78,030 in '02). The New England, West South Central, and Pacific regions reported salary decreases. Consistent with data from years past, the East South Central region had the lowest U.S. salary average, $60,690. (See "Average salary by region.")



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The average age of respondents is 47, with most of you falling between the ages of 46 to 50 (25.8%), closely followed by 51 to 55 (22.2%). Generally, younger nurse leaders earn less money, with the largest salary jump between the 20 to 25 age range ($40,470) and the 26 to 30 age range ($55,080). As in 2002, salaries rise through your 30s and early 40s by about $3,000 to $6,000 in 5-year increments. This year, those of you in the 41 to 45 and 46 to 50 age brackets average virtually the same amount. Salaries peak at ages 56 to 60 ($72,340) and slightly decline at age 60 and above to $71,740.


You told us loud and clear that your work setting impacts your income. Hospital positions pay more than most other care environments, most likely because hospitals provide acute care, have higher acuity, and receive higher reimbursement from third-party payers than other locations of practice. (See "Salary based on work setting.")



Table. Salary based ... - Click to enlarge in new windowTable. Salary based on work setting

The number of you working in hospital positions, however, continues to decline (67.1% in '03; 75.6% in '02), while the number of nurse leaders working in long-term care is still growing (8.3% in '03; 7.1% in '02). Further, many of you wrote in that you're seeking alternative work settings (7.9% in '03; 6.0% in '02), including hospice, office practices, rehabilitation facilities, correctional facilities, and schools.


Hospital nurse manager respondents typically work in community/nonprofit (48.3% in '03; 45.0% in '02) or private/nonprofit settings (26.2% in '03; 28.3% in '02). Private/for profit hospitals capture 11% of nurses this year, compared to 9.6% last year. The percentage of you reporting from university settings remained virtually the same as last year (7.0% in '03; 7.5% in '02). (See "Salary based on hospital type.")



Table. Salary based ... - Click to enlarge in new windowTable. Salary based on hospital type

For the past 2 years, most of you report working in a facility with 101 to 300 beds (42.9% in '03; 46.1% in '02). However, the number of you who've migrated to smaller facilities is on the rise (25.1% in '03; 20.3% in '02). Nurse managers working in facilities with more beds are usually responsibile for more staff and higher salaries. Your average salary by number of beds in the facility is $61,620 for 100 or less ($57,610 in '02); $67,020 for 101 to 300 ($62,660 in '02); $72,790 for 301 to 500 ($65,980 in '02); and $70,276 for 501 or more beds ($75,617 in '02). Larger hospitals are usually university/academic facilities.


Nearly one fourth of you are managing more employees this year (24.4% of respondents), which is in line with other reports that nurse managers are taking on additional responsibility. One frazzled respondent says her workload has almost doubled since last year, with no financial increase. She's charged with initiating an overflow unit within her acute care facility and will be evaluated on recruitment/ retention issues and patient/staff satisfaction. She says, "I'm responsible for everyone's satisfaction but my own! I'm frustrated and fragmented!"


Another concerned respondent shared that within 2 months of being hired as a Supervisor, she assumed Executive Director responsibilities- including reducing her facility's deficit by $2 million within 18 months-but received no additional compensation.


Regarding personnel responsibilities, most of you manage between one and 50 staff members, similar to last year (54.7% in '03; 54.0% in '02). Only 9.7% of you manage fewer staff than last year. And just as last year, most of you manage only one department (54.9% in '03; 53.3% in '02). Likewise, a smaller percentage of you manage two or more departments (35.5% in '03; 35.1% in '02). Regarding units managed, 43.7% oversee one unit, closely followed by 42.8% who oversee two to five units.


With employees, departments, and units to lead, you're still clocking overtime; 34.6% of you work between 40 and 45 hours per week, and 28.3% work 46 to 50 hours per week. This year, your average workweek is 47.8 hours, up slightly from last year's 47.1. (See "Salary based on work hours.")



Table. Salary based ... - Click to enlarge in new windowTable. Salary based on work hours

Many of you aren't adequately compensated for your intensive work schedules. Says one respondent, "My salary increased 1.9% last year-the first change in 4 years. It's difficult to accept 24/7 responsibility when staff RNs make more than I do." Another respondent echoes: "At my facility, managers don't receive shift differential and are expected to remain available 24/7. During performance evaluations, we were told that no one would receive an 'exceeds expectations' rating unless he or she walked on water."


Gender gaps?

In 2003, the difference between men and women's salaries was $1,700, much narrower than the $5,340 deficit reported in 2002. The ratio of female respondents to male respondents remains fairly constant (women: 90.3% in '03; 89.2% in '02; men: 9.7% in '03; 10.8% in '02). Although the comparison of male-to-female salary averages isn't statistically valid due to the small male sample size, this year's data suggest that the glass ceiling may have a few fissures: Though men still earned more, the difference between average salaries shrunk (men: $67,340 in '03; $67,150 in '02; women: $65,640 in '03; $61,810 in '02). Most female respondents report earning between $60,000 and $64,999 (12.8%), while most males report earning $65,000 and $69,999 (17.9%). (See "Salary by gender.")



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The education edge

As in 2002, most of you hold a BSN (31.0% in '03; 30.9% in '02). Education is a priority, as those of you with a master's degree in nursing rose (20.2% in '03; 17.4% in '02). The percentage of you responding with PhDs slightly increased from 1% to almost 2% this year.


Higher education nets respondents a bigger paycheck: Those with PhDs earn $85,880, almost $10,000 more than those with a master's degree in nursing. (See "Education by average salary.")



Table. Education by ... - Click to enlarge in new windowTable. Education by average salary

Certification is another salary boost. Nurse leaders who are Critical Care Registered Nurses (25.8%) earn the highest average salary of all certifications, at $74,280; those who've completed Certified Nurse Operating Room certification (11.2%) earn $69,500; those without certification with RN licensure (28.8%) earn $65,230; those who've completed Advanced Cardiac Life Support (44.6%) earn $62,760; and those who've completed Pediatric Advanced Life Support (13.1%) earn $55,970.


Rising remuneration

This year provided many exceptions to the rule. A surprising 5.0% earned more than a 7.0% raise, while only 2.2% of you reported earning a 6.1% to 7.0% raise. For more than half of you, (56.3%), your salary increase stayed about the same as last year. While 23.2% reported earning a higher increase than last year; 20.5% received less. This year, as with last year, most of you received a raise. The majority (46.7%) earned between a 2.1% and 4.0% increase, followed by (26.1%) earning a 0% to 2.0% increase. A smaller number received weightier increases (15.3% received a 4.1% to 5.0% raise; 4.6% received a 5.1% to 6.0% raise). (See "Who's getting the big raises? ")



Table. Whos getting ... - Click to enlarge in new windowTable. Who's getting the big raises?

Perks, please

The majority of facilities offer you tuition reimbursement (79.9%), conference travel (64.1%), and flexible scheduling options (54.0%). A slightly less percentage offer additional perks such as paid certification exams (41.6%), more than 4 weeks of vacation (33.5%) and incentive bonuses (22.6%). Only 7.6% of you receive retention bonuses, up from last year's 6.6%. Says one respondent, "There have been definite strides in recruitment and retention efforts for staff nurses, but the minimum has been done to keep nurse managers."


Top perks for staff include tuition reimbursement (84.1%) and flexible scheduling (63.4%). While sign-on bonuses are higher for staff (47.9%) than for managers (21.5%), retention bonuses are almost 10% higher for staff than for managers, and conference travel is significantly lower for staff (47.0%) than for managers (64.1%).


Focused feedback

This year's feedback highlighted common themes. Continually, your responses indicated that there's a definite disproportion of responsibility to title and income: "I supervise and have more responsibility than many RNs, though they make a higher salary than I do and qualify for incentive programs I'm not eligible for." Another nurse manager offered the same sentiment, "After 27 years of nursing, I make only $3 an hour more than this year's new graduates. Pay inequities continue." (See "Average staff starting hourly rate by location.")



Table. Average staff... - Click to enlarge in new windowTable. Average staff starting hourly rate by location

Fortunately, our survey suggests that a number of your facilities are noticing these pay inequities and making an effort to rectify the situation. One participant shared, "We recently had four managers leave due to a lack of mentoring and follow-through by the Director. Now the hospital is considering hefty salary increases to make managers happier."


Thank you for your overwhelming response to this year's salary survey. We've set our goal to continue tracking your salaries over time and to evaluate the market effects on nursing overall. We strive to provide you with the information you need to be the best nurse leaders nationwide and to command the salary you deserve.



* About this survey


Nursing Management 's 2003 Salary Survey was published in the March and April issues of the journal and on-line at from March 3 to May 14. Franklin Communications, a research firm in Mt. Arlington, N.J., tabulated data from 1,023 respondents. [Context Link]