ICU pay differential?

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So I'm moving to our surgical ICU next month and have found out that I'm getting no pay increase for intensive care. I'm not the only one, the last couple of people I know to have transferred down there haven't gotten anything extra.

Is this happening anywhere else or is my hospital just ripping us off? I guess the rationale is that floor nurses are just as valuable in patient care......in which case we should be making the same as doctors too. I'm happy about moving but this has put a real damper on my anticipation.

Specializes in CEN, CFRN, PHRN, RCIS, EMT-P.

We should all be paid more period.

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I keep seeing the same questions about why I think critical care nurses deserve to be paid more, please see my previous posts. Obviously I'm not the only one that sees why it makes sense because there are many hospitals that still do it.

Secondly, it has NOTHING to do with "working harder". I never said that and have never thought that. Again, see previous posts.

Lastly, I'm not bitter and I don't have a bad attitude about it. I was asked multiple times by many people in the ICU and their manager to come work there, so obviously I'm not pouting about the pay thing. I'm moving because I want to, my impression that it paid more was just a sort of cherry on top. I just wanted to see if it was normal in general to not have some kind of critical care differential because around here it's not unusual, and even expected.

I don't think anybody said you were bitter, it's just that those of us who are already in the ICU perhaps have a different viewpoint on it. ICU nursing doesn't necessarily require more knowledge than floor nursing; I think this is a fallacy you're buying into. Additionally, don't assume that being in an ICU is more specialized. Some ICUs take care of very specific patient populations at very high acuity, others are more general. Which should be paid more, those who know a lot about a little or those who know a good amount about "everything." It's all too complicated to just be reduced to "ICU nurses should be paid more."

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I keep seeing the same questions about why I think critical care nurses deserve to be paid more, please see my previous posts. Obviously I'm not the only one that sees why it makes sense because there are many hospitals that still do it.

Secondly, it has NOTHING to do with "working harder". I never said that and have never thought that. Again, see previous posts.

Lastly, I'm not bitter and I don't have a bad attitude about it. I was asked multiple times by many people in the ICU and their manager to come work there, so obviously I'm not pouting about the pay thing. I'm moving because I want to, my impression that it paid more was just a sort of cherry on top. I just wanted to see if it was normal in general to not have some kind of critical care differential because around here it's not unusual, and even expected.

I'm not sure why some seem to have an attacking tone when responding to your post, but as a new grad with 2 new jobs, I found this entire conversation to be very helpful! I also found your question to be valid, as some ICU's do, indeed, pay more than floor units in various places. I didn't think your post conveyed a message of devaluing any type of nursing.

In one of the hospitals I will be working at, ICU & ER nurses do get paid a little more & do require various certifications & training (I'm not sure about the other one)- both are major, union hospitals in the city. From what I've experienced thus far, I think all nurses deserve a little more pay :yes:. I'm a Med-Surg nurse myself, and the variety of patients I've cared for, thus far, has been astounding to me (or maybe that's just the newbie in me :dummy1:). In my humble opinion, I would be fine with pay being equal across the board, as far as ICU vs floor goes. All types of nursing are skill-driven, rewarding &, at times, exhausting. While the ICU may have critical patients, the MS nurse is usually caring for more patients at a time, so I think it balances out (as far as pay goes).

Best of luck to you in your new position!!

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I have seen this about 15 years ago but not in today's hospital environment. You could say that the L & D, the ER, OR and PACU are all specialty areas that deserve a differential for working in those areas as well, the hospital would go broke. Those were done away with a long time ago!! Back in the day you would get a differential for having your BSN, for working on certain units, for being charge, for working weekends, on call etc. I have recently seen a hire-on bonus for Critical Care Nurses, but that is extremely rare nowadays.

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Specializes in Critical Care/Vascular Access.
I have seen this about 15 years ago but not in today's hospital environment. You could say that the L & D, the ER, OR and PACU are all specialty areas that deserve a differential for working in those areas as well, the hospital would go broke. Those were done away with a long time ago!! Back in the day you would get a differential for having your BSN, for working on certain units, for being charge, for working weekends, on call etc. I have recently seen a hire-on bonus for Critical Care Nurses, but that is extremely rare nowadays.

haha, I guess we still live "back in the day" around here, because I still get a differential when I charge or work weekends and nights. We still have a hire on bonus too for our ICU's, which unfortunately doesn't apply to in house transfers like myself. And as I mentioned, we just recently did away with the critical care differentials, including PACU.

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Specializes in Critical Care/Vascular Access.

Anyway, again, thanks of the input everybody. Gave me a different perspective on the issue.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Well, I work L&D where ACLS, NRP AND fetal monitoring certification are all required. I want higher pay!

Just kidding, I don't think pay should be based on specialty, but on experience. My facility does also have a clinical ladder, and gives a $.75/hour differential if you have a unit-specific certification.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Yes. The union might have affected some type of differential. The union might have an effect on the type of differential.

Nope, you have it backwards. Sorry, not backwards, but the first sentence would be "effected" - "to effect change" is pretty much the only time "effect" can be used as a verb.

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Specializes in Emergency, Trauma, Critical Care.
Well, for one example, ACLS is required for our ICU's. We also are required to go through an intensive care training course, but maybe that's not common elsewhere. I haven't worked many places so I don't have many other points of reference aside from talking to people.

Tele nurses everywhere I have worked had to have ACLS also. ER nurses usually require far more certs than ICU. In ER I have to have ACLS, PALS, TNCC and eventually MICN. When I worked ICU all I had to have was ACLS, yes there was a critical care training program, but they are giving you that training for free and you're getting paid to do it.

I think because every specialty has additional specific requirements, it's hard usually to give a differential to one unit and not another. When I was in ICU I specifically trained for open hearts and CRRT because I wanted to, there was no incentive other than it made me more marketable in the job realm.

I'm sorry you didn't get the differential you believed you were getting, but it's a great opportunity to learn some new skills and I hope you enjoy it.

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Way too many people want to work in critical care for hospitals to provide financial incentives for working there. Physicians who specialize get more money because they're harder to find, but since any RN can get the job, we aren't exactly in short supply.

I've always wondered why hospitals are so fixated on nurses getting a BSN, when having a speciality certification would be a better indicator of a nurse's ability to practice. Obviously, you don't NEED a CCRN to be a great critical care nurse, but a CCRN is way more impressive to me than a BSN. If speciality certifications were required, nurses who could work in these jobs would be harder to replace...then maybe we'd get paid more.

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Specializes in Critical Care.

Where I work they used to have differentials for ER and ICU, but they have long since gotten rid of both for new hires/transfers. No extra pay for BSN or certifications either.

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Specializes in SICU, trauma, neuro.

I've never heard of an ICU differential anywhere I've worked. I've said this on another post a while back, but the hardest I've ever worked in was on the floor of an LTACH. I went from this LTACH to my current ICU position, and I took a small pay cut. The cut was well deserved, IMO, because I worked so much harder there for less appreciation and fewer resources. My hospital now is union, and wages are based solely on type of degree and hours of nursing experience. (Yes, hours--we have to fill out a worksheet at hire time with each previous position, dates worked there, and our FTE.) Besides, it's not like employers need to pay someone to come work in their ICUs. There are WAY more RNs/students who want to work in the ICU than there are positions available.

I'm sorry you're disappointed about the wages, but please don't let this "put a damper" on your anticipation. I'm sure there are hundreds of AN members who would love to be in your shoes. Congratulations on the new job! :up:

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