Does your hosp differentiate between nurses re pay?

  1. My VP of nursing believes "a nurse is a nurse is a nurse" and we are paid according to years of nursing. All nurses with 5 yrs experience are paid the same, all nurses with 6 yrs experience are paid the same, etc. I was just wondering if there are any hospitals that pay nurses who work in critical areas more than those nurses who work in med-surg?

    Believe me when I say that I am not trying to start a war here between nursing specialties, I am just curious. I have noticed in the ads in my area that ED/ICU/CCU sign-on bonuses are higher and was just wondering if the pay was, too.

    Thanks. Peace!
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  2. 8 Comments

  3. by   Q.
    At my facility, we are paid according to where we are in the clinical ladder. All new grads start out the same.

    We have ICU differentials - but NOTHING for Labor and Delivery - which is considered a critical care area by most standards. (Yes I work L&D)

    Also, we don't get any additional pay for being charge nurse, or for having a BSN, or any other added certifications for that matter.
  4. by   deathnurse
    Yeah, like 20 years in a nursing home should bring you the same pay as 20 years in ICU or ER with no adjustment for knowledge or experience. This "nurse is a nurse" thing is nothing new...it's a management technique for price fixing in the face of managed care profits. In most any other "professional" occupation, your income goes UP with experience and ability. Except nursing. A nurse can start and end his or her career making approximately the same as someone just entering it. Yes, there may be some minor adjustments for critical care or inconvenient shift work, but don't waste your time on credentials or higher degrees. We are CHEAP consistent labour.
  5. by   Navy Nurse
    Most hospitals have a "red line" as to how high a nurses salary can go. Then they use incentive pay (BSN, Certifications) to raise the salary.
  6. by   Stargazer
    My hospital used to pay a differential for certifications but not for degrees or for areas worked, although the degree earned you points in our clinical ladder program which was paid in the form of a cash bonus.

    The certification differential only applied if you were working in the area relevant to your certification (e.g., if you had your CNRN, you had to be working on the neuro unit to get the $$). Also, you could only get a differential for ONE certification--I had a friend who had her CCRN and CNRN but only received one differential.)
  7. by   ornurse2001
    At our hospital, we are paid by yrs of experience with added difs for BSN and added certifications-of course to a cap.Inevitably as in most places, the senior employees are usually not making much more than new grads because over the yrs pay for beginners goes up at a faster rate than do raises.I do feel deathnurse that the statement you made regarding LTC nurses could have been avoided.I know that a LTC nurse of 20 yrs could probably not function in ER or ICU without some increased education and mentoring, but how much would an ICU or ER nurse need to learn about LTC before able to function in that setting?I have experience in all 3 of those areas as well as others and I would choose any of those positions today as opposed to one in which I must pass meds to 30 or more people in an hr time frame,get spit on, kicked at, clean up lots of sh**, and do all that documentation.Every position is important.That is why I feel that incentive pay for certifications and added education is a good thing.
  8. by   -jt
    in NYC they do because they have to, not because they chose to. Its a standard we have set in our union contracts.

    Since all nurses work hard, and every area is its own specialty, and every area has a certification available for that specialty from the ANCC, who's to say that the ICU RN knows more or works harder than the Med-surg nurse?? ICU RNs and Med-surg RNs both work hard & both have difficult jobs. One is not better than the other, they are just different. Med-surg is a specialty in its own right too. Paying one RN more than the other just because she works in a different part of the hospital creates a 2-tier elitist system, divides the nurses & pits nurse against nurse. It also makes working in certain units more attractive than others & could lead to a shortage of nurses in one area of the hospital with a waiting list of nurses for another. So with all this in mind, we chose to focus the extra compensation on education, experience (without a cap on salary), responsibility (charge nurse, preceptor) and degrees instead. Those are what we get differentials for - recognizing the RN's skills, knowledge & longevity, not the floor she happens to work on. So we can have an ICU RN who does not go for specialty certification earning less than a med-surg RN who has the same amount of experience & degrees but also obtained her specialty certification. And theres nothing wrong with that. The RN is rewarded for her efforts & achievements - not the unit shes assigned to.
  9. by   -jt
    "the senior employees are usually not making much more than new grads because over the yrs pay for beginners goes up at a faster rate than do raises."


    Thanks for pointing that out. I forget that happens in someplaces. I am so used to having contracts with across-the-board raises every yr plus automatically having a raise on each anniversary date of employment to reflect another year of RN experience, while our new grad rate stays constant throughout the life of the contract. With each contract it is increased but then so are the raises & other compensations increased at the same time. There is a conscious effort on our part to avoid exactly what you mention & having been unionized with my state nurses association for 18 of my 19 yrs as an RN, I sometimes just expect that everybody has it the way we do.

    A major focus of negotiations is always on fairness, parity, & recognizing & retaining the experienced nurse, specifically to avoid the problem you describe. A NEW GRAD ADN starting salary is $55,188/yr. (Thats average in Brooklyn. Its higher in Manhattan). An experienced RN (ADN) who is a new hire has a base salary of $56,138/yr and she is paid a differential for each yr of outside experience as an RN elsewhere - up to 10 yrs experience credit ontop of the base salary.

    So an RN with 10 yrs prior experience comes in as a new hire but at the 10 yr level, earning the same as any other nurse who has been at that facility for 10 yrs & has the same degree & works the same shift. All RNs receive an additional $1,000/yr differential on top of their base on each anniversary date of employment, an additional $2,100/yr for specialty certification, an additional $1,400/yr for BA/BS (not just BSN), an additional $1,700/yr for MA/MS (not just MSN), an additional $1,800/yr for Ph.D plus 100% tuition reimbursement for school for any of these degrees. Shift diff for eves/nights is $5,300/yr (a recruitment incentive), and charge nurses receive an additional $3,000/yr.
  10. by   ornurse2001
    Things really do differ in different geographical areas-I will learn more and become more enlightened when I start travel nursing in July I am sure.It will be interesting to learn more about how nursing is handled and performed in other areas of the country.I work at a small(<100)beds hospital in a small Mo. Town.Our in-patient census is sometimes as low as 5 patients(no kidding!)We have one med surg hall, and an OB dept. that caters mostly to the medicaid population in our immediate area and our hospital struggles daily to keep the doors open and remain independant of a larger entity.Today, I am going into work along with 4 other OR nurses and we have no scheduled surgical cases because our only general surgeon(whom is soon retiring)is on vacation.We have some family practice docs who do endoscopic procedures(also part of our surgery dept.) and OB cases that may come up.We could help elsewhere in the hospital, except with only 7 patients on the med-surg unti yesterday, they probably won't need us either.I am as detached aas anybody when it comes to how it is other places after being here for 4 yrs, and trust me when I say that my knowledge is certainly limited to what I have seen here, and where I have been previously to here, and the largest hospital I have worked in was about 500 beds-so, take what I contribute knowing that on some of these issues, my sight is limited

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