It is a well know fact that nurses in all specialty areas are in great demand and that the nursing field offers job security and excellent employment prospects through the next ten years. Right alongside this demand is the relatively high salaries nurse earn but there are differences based on several factors.
Factors that determine nurse salary
The following are some of the most significant factors that determine nurse salary: a) years of experience; b) level of education; c) type of employer setting and public or private facility; d) specialty area; e) shift you work; f) facility location (rural or urban); g) whether the nurse is a member of a union; h) whether the facility is private or government funded; i) whether the nurse takes a benefit package or forgoes for a higher salary.
Years of experience
Most types of healthcare settings work on a seniority system so that the more experience you accrue, the grater will be your earnings. This will be especially true if you advance into supervisory or administrative roles.
Level of Education
In general, licensed practical nurses (LPN) earn less than registered nurses (RN) and advanced nurse practitioners with master’s degrees in nursing (MSN) degrees earn some of the highest salaries on all of the nursing profession with, many earning upwards of $100,000 per year or more depending on specialty. In most cases, salaries will also rise if an RN with a diploma in nursing pursues an associate’s degree or if an associate degree holder purses a bachelor of nursing (BSN) degree.
Type of Employer
Nurses employed in hospitals settings tend to earn more than those employed in private physician offices. Nursing facilities and home healthcare agencies tend to pay the lowest salaries of all healthcare settings.
Another determining factor with regard to nurse salary is whether your employer is private or government funded. In general, private hospitals and healthcare facilities tend to pay more than those who facilities that receive government funding.
The main contributing factor with regard to this nurse salary differential is how successful grant writers of public hospitals are in garnering government funds or private endowment contributions. However, even when the grant writer is successful in tapping into these resources, the issue then becomes dissemination of funds across departments, each with its own needs. Dissemination of funds is primarily the responsibility of the facility Board of Directors. Funds could be used to obtain new medical equipment, add care staff, or for the construction of a new wing.
Advanced practice nurses who specialize in one area of nursing, such as family nursing, pediatric nursing, family nursing, oncology nursing, nurse anesthetist, nurse midwifery, nurse psychiatric nursing, and clinical nurse specialist command some of the highest salaries in the nursing profession due to the advanced skills and knowledge they bring to their work. .
The specific department of the hospital in which the nurse works is also a contributing factor to salary differentials. For example, those nurses who work in emergency room nurses, operating rooms, recovery rooms, as well as those who work in intensive care units (ICUs) or cardiac care units (CCUs) often experience a high degree of stress and earn higher salaries to compensate for these working conditions. Another factor is the degree of risk associated with the specialty. For example, nurse anesthetists are well compensated for the degree of risk they assume.
Most employers alter the rate of pay depending on the desirability of the shift. Nurses who work what is called the “graveyard shift” (between the hours of 11:00 PM and 7:00AM) earn a higher salary than nurses who work regular shifts (between 7:00 AM and 3:00 PM or 3:00 PM to 11:00 PM). This difference in salary is called a “shift premium.”
In many states and hospital settings nurses need to be members of the local nurses union before they are eligible to begin work. In most cases, being part of a union will mean a higher salary, although you will need to pay monthly or annual dues in return for union representation. Working in a union setting means that you will also earn a higher rate differential for overtime, typically $2.00 to $4.00 more per hour. These rates can greatly increase your salary if you need to work double shifts (“doubles”) as is often required within the nursing sector. However, it is also the case that private hospitals can sometimes pay higher salaries than do unionized facilities.
Location of facility
This is perhaps the most significant factor in determining nurse salary. Cost-of-living expenses vary greatly from one region of the country to another and they are usually much higher in metropolitan areas than in suburban and rural communities. For example a registered staff nurse in New York City can expect to earn a salary in the range of $50,000 to $80,000 per year while the same nurse living in then Atlanta, Georgia area can expect to earn $50,000 to $75,000.
Health benefits such as medical, dental, and optical plans are often offered to nursing professionals. This is in addition to pension plans and possible stock options that may also be available. These benefits add significant value to the total compensation package.
Too many times job candidates fail to account for the indirect cost savings that these benefits provide and how they actually add to base salary. For example, if you choose a family health plan and need to contribute $250 per month but would need to pay $500 if you were not covered by your employer the difference of $250 can genuinely be considered money in your pocket every month!
However, some nurses choose to forgo a certain part of the benefit package in exchange for higher base salaries. In many cases, these nurses are covered by the health plan of a significant other so can safely turn down health coverage with the facility.
Representative sample of national median nurse salaries across different practice areas. Figures as per Salary.com July 2011.
Licensed Practical Nurse
Staff Nurse-RN (hospital)
Staff Nurse-RN (ICU of hospital)
General Nurse Practitioner (w/MSN degree)
Clinical Nurse Specialist (w/MSN degree)
Nurse Anesthetist (MSN degree)
Pediatric Nurse (MSN- Home Care)
Midnight shift premiums range anywhere from $2.50 per hour to $4.50 per hour. Since most shifts in hospitals are now twelve hour shifts, midnights start around 7:30 p.m. and end around 7:30 a.m. These are attractive hours for many nurses since they get four days off during a week and are still considered full time at thirty six hours per week.