1. Hader, Richard RN, PhD, CNA, CHE, CPHQ


Nursing Management 's sixth annual salary survey offers nationwide data on nurse leaders' earnings and provides insight into compensation issues and retention incentives.


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For the sixth consecutive year, Nursing Management eagerly shares with you the results of its annual salary survey. Nearly 700 nurse leaders responded, representing the nine regions of the United States as well as Canada. Participants ranged from first-line supervisors to chief executive officers (CEOs).


This year's results reveal bigger gains in salaries, while your verbatim responses continue to portray your challenges with budget cutbacks, recruitment and retention issues, an aging workforce, and a competitive marketplace.


Naturally, those of you who earn the most are CEOs and have been in nursing the longest number of years. You're also 56 to 60 years old, hold a non-nursing master's degree or have advanced certification, work in a university hospital or health system with more than 700 beds, live in the Pacific region, and work more than 70 hours per week. Sound daunting? Whether or not you fit into any of these categories, review the following results to see how your salary compares to others across the global community of nurse leaders.


Salary: STAT

Your average salary this year is $72,080, a substantial 8.4% increase from $66,020 in 2003. This finding is significant, as these salaries rose 4.9% from 2002 to 2003. Over half of you (53.9%) earn between $60,000 and $89,999, 29.5% earn less than $60,000, and 16.4% earn greater than $90,000. Impressively, 9.6% of you earn more than $100,000 per year, up from 6% in 2003 and 5.3% in 2002. Thankfully, salaries are beginning to climb since employers are competing to recruit and retain a shrinking pool of talented nurse managers to lead staff through the worsening shortage.


The greatest number of survey responses came from the Educator category, totaling 21.8%-up from 11.4% in 2003. Educators had the third highest salary percentage increase this year (8.9%), for an average salary of $64,170, compared to $56,950 in 2003. Note that the average educator has been in nursing for more than 17 years, and your high salary increases most likely reflect your increased value and importance to the nursing team. (See "Average annual salary by title.")


The majority of you (66%) have held your position for less than 5 years, down from 70.6% last year, which emphasizes your more frequent career mobility in recent times. Over three-quarters of you have more than 15 years experience as a nurse, with a mean of 17.5 years. Up 6% from last year, 40% of you are older than 50, compared to 34% in 2003. This causes great concern, as age demographics will eventually hit home when our experienced nurses retire from the workforce.

FIGURE. Average sala... - Click to enlarge in new windowFIGURE. Average salary by region

The greatest number of you works in the South Atlantic (22.5%), with East North Central (17.5%) and Middle Atlantic (13.9%) emerging as the next most represented areas. Each of the remaining geographic areas comprised 10% or less of the total respondents. Those of you who work in the Pacific region earn an average annual salary of $90,590, while those of you who live in the West South Central region earn the least at $69,140. All regional areas reported higher wages than last year, with the largest percentage increase in the Pacific (14.7%) and the lowest in New England (1.4%). (See "Average salary by region.")

TABLE. Years in nurs... - Click to enlarge in new windowTABLE. Years in nursing by average salary
TABLE. Average annua... - Click to enlarge in new windowTABLE. Average annual salary by title
TABLE. Salary based ... - Click to enlarge in new windowTABLE. Salary based on work setting

Education elevation

Most of you hold a baccalaureate degree (68.1%). Regarding master's degrees: About 20% of you hold an MSN and 11% of you hold a master's degree in another field, from sociology to business administration. In comparison to the 2003 survey, a larger number of you are educated at the diploma or associate degree level (27%), up from 23.5% last year. This increase most likely reflects the promotion of lesser educated nurses to fill the dire need for nurse managers. Those of you who hold a non-nursing master's degree earn the most, with an average of $87,130, followed by those of you with MSNs, at $84,810. Diploma graduates earn the lowest amount, at a yearly rate of $63,640. (See "Education by average salary.")


Respondents' most common national certification or continuing education course is advanced cardiac life support completion (46.3%), followed by peripherally inserted central catheter certification (32.0%), certified operating room nurse (21.7%), pediatric advanced life support completion (16.0%), and critical care (12.6%). Based on our findings, you and your employers favor clinical certifications rather than advanced nursing administration or management certifications, as neither of the latter ranked in the top five most common certifications.


Greater than 40% of you report that your employer pays the fee required for you to take national certification exams. Those of you who hold a national certification in operating room nursing earn the most at $80,610, with the average salary of a nationally certified respondent at $72,080.


Where you work

The majority of you work in an acute care hospital or health system setting (74.1%), a 7% increase from last year, while almost one-fourth of you work in the remaining categories: outpatient (4.7%), community home care (5.5%), long-term care (4.9%), rehabilitative care (.7%), subacute (.6%), and academic settings (1.2%). The 8.3% of you who work in other settings provide care in psychiatric, correctional, or hospice facilities. Over half of you work in community nonprofit organizations (52.5%), followed by private nonprofit facilities (25.8%), while those of you from the university, private-for-profit, community profit, and military settings comprise less than 8% of respondents. (See "Salary based on work setting" and "Salary based on hospital type.")


The location of your place of employment is similarly divided between urban (37.1%), suburban (31.6%), and rural (29.8%). Average capacity of your institutions was 286 beds, with the majority offering 101 to 300 beds (44.2%), followed by 301 to 500 beds (23%), 100 or less (19.5%), 501 to 700 (7.4%), 701 to 1,000 (4.7%), and more than 1,000 (1.2%).

TABLE. Salary based ... - Click to enlarge in new windowTABLE. Salary based on hospital type
TABLE. Salary based ... - Click to enlarge in new windowTABLE. Salary based on work hours

Gender and experience play a part

At $71,340, the overall average salary of female respondents was 9.6% higher than male respondents ($68,710). At the nurse manager level, men earn an average of $72,500, while women earn $71,090. At the director level, men earn $86,870 and women bring in $80,510. While female respondents earn more on average, higher management male colleagues receive greater financial compensation. Results also indicate a smaller salary gender gap for those earning over $100,000 per year-8.4% of females and 8% of males. (See "Salary by gender.")


New nurse leaders-those of you in your position 1 to 2 years- earn an average of $50,000 per year, while those of you with more than 20 years of experience have an average salary of $75,760. There's a 34% salary differential for the most seasoned leaders; specifically, those of you with 1 to 2 years of experience in your current role received a 3.35% increase, on average, while those of you with more than 30 years of experience reported a 2.51% increase. (See "Years in nursing by average salary.")


It's a long day

Forty percent of you work 45 hours or less per week, and 31.2% of you work more than 50 hours per week, up slightly from 30.5% in 2003. Nearly a quarter of you (24.5%) report that you manage more people than last year; almost half of you (47.5%) oversee staffs of 50 people or more.


As expected, longer hours are, for the most part, proportionate to higher salaries. Those of you who work 40 to 45 hours per week earn an average of $64,750, while your colleagues who work 61 to 70 hours per week earn $82,295. (See "Salary based on work hours.")


Spheres of influence

Interestingly, your influence on the purchase of more costly equipment and supplies is growing. Last year, only35.8% of you reported purchasing authority for items greater than $5,000. This year close to half of you (45.2%), are calling the shots. In fact, 8.7% of you are influencing or approving purchases greater than $500,000, up from 5.7% in 2003. Nurse administrators demonstrate strong influence over purchasing items that impact patient care delivery. It's evident that hospital executives want you at the decision-making table to ensure the availability of appropriate patient care items. You can also increase your influence by partnering with materials management to ensure that purchasing decisions consider both cost advantages and clinical effectiveness.


Employers continue to offer incentives to recruit and retain top talent. Most of your facilities give tuition reimbursement (85%); a majority (65.7%) provide paid conference travel, up significantly from 2003 (47.0%).

TABLE. Education by ... - Click to enlarge in new windowTABLE. Education by average salary
TABLE. Whos getting ... - Click to enlarge in new windowTABLE. Who's getting the big raises?

This year's survey revealed strong evidence that employers more frequently provide sign-on, retention, and incentive bonuses to staff nurses than to managers. The survey also found that employers provide more vacation, greater scheduling flexibility, and tuition reimbursement in greater frequency to staff nurses than to department leaders. Employers should carefully evaluate the benefits they offer all staff members. Managers who become disenfranchised will seek employment elsewhere, costing facilities greatly in terms of related recruitment and retention fees stemming from management replacement.


Despite these issues, responses conveyed nurse managers' resilience and optimism. One participant credited her "love of community" with keeping her in nursing. Another characterized her facility as "supportive and wonderful."


Thank you for your participation in this year's salary survey. We'll continue to track earnings over time and evaluate nursing market trends. We're proud to offer you this annual insight that you've come to expect, and we encourage you to take stock of the return on investment that you're garnering for your time and talents.