Pay vs. specialty - page 2

by Ted D 4,175 Views | 17 Comments

Seems like ED and especially ICU start off with lower wages than fields like school/rehab/mental health. Why is this? Not to belittle rehab or mental health nursing, but isn't there a lot more critical thinking and stress... Read More


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    Where I work, ICU, CCU and ER nurses get a higher starting salary than everyone else, also a nurse with a BSN gets a higher starting salary than a nurse with a diploma, and a nurse with an MSN gets a higher starting salary than the previous 2, regardless of experience. A lot of people dont like this and the argument is always that, nurses working on the same floor do the same thing so why the pay difference if not based on experience? We also have a direct entry masters program here, for people interested in going into nursing with a bachelors degree in another field. When they graduate, they have a higher starting salary even though they have no experience
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    I'm not sure why the individual states in the U.S don't have unions to regulate wages. I work in Saskatchewan, Canada. I have been a diploma RN for 22 years and am at the top of my wage scale. The facility I work at is not unionized but we follow the pay grades of the union which include increases when new contracts are negotiated with the government. I am not sure what new grads start out with but I am sure it must be around $ 30.00 an hour. It always amazes me that we are going to the Philipines and other countries to recruit for nurses when I read that jobs in the U.S are scarce. Why are USA nurses not applying for jobs over here?? I work in LTC and make $45.35 an hour. Our dollar for the past few years has been at par or better. It is like we don't exist for US nurses. I realize why the unions haven't been able to organize like ours is because your healthcare is privatized and ours is government run. There are good and bad things to be said about both, but that is another topic.
    Altra, KelRN215, and BrandonLPN like this.
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    In our hospital we don't pay extra for specialties (ER, ICU, etc). We pay extra for degrees (BSN) and national certifications (CCRN). Makes more sense since I think we all work hard and paying extra for the specialties drives a wedge between groups. I wish they'd pay extra for my master's degree but at least I get the extra pay when I teach clinical for the college.
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    Quote from Ted D
    Seems like ED and especially ICU start off with lower wages than fields like school/rehab/mental health. Why is this? Not to belittle rehab or mental health nursing, but isn't there a lot more critical thinking and stress involved for a nurse in the critical care setting?
    No. No. and: No.

    (And I did critical care for twenty years)
    Meriwhen likes this.
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    Quote from BrandonLPN
    I'm surprised so many people keep saying school nurses need a batchelors/masters degree. Where I live at least 50% of school nurses are LPNs, with one or two RNs to supervise entire school districts. I also know school nurses here (both RN and LPN) make much, much lower wages than nurses in hospitals or LTC.
    Depends on your state regulations. In NH, you are required to be an RN. If you are an LPN, you work directly under the supervison of an RN.

    SO it is not just people floating an opinion. School districts pay teachers based on an educational level.

    Bachelors, Bachelors +36, Masters, Masters + 36

    If you are lucky enough to be in one that puts school nurses on a teacher contract ( I am) they value the education you have worked for and attained (and bring to your practice) and thus you are paid on teacher scale.

    I hope that clears up any confusion about what school nurses have to offer and does not mean they should be paid on a lower scale because they are not in a hospital or acute setting?
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    Quote from KelRN215
    I don't think it has anything to do with specialty and more to do with employers. A school nurse is employed by a different institution than an ER or ICU nurse. In my city/state school nurses are paid per the teachers' wages and usually represented by the teachers' union. A step 1 school nurse with a Bachelor's degree (and, yes, a BSN is required for a school nurse in MA) in my city makes an annual salary of just under 47,000. A full time new grad nurse in the hospital I worked at as a new grad makes about $58-$59,000 annually, regardless of specialty. A new grad RN working inpatient psych earns the same salary as a new grad RN working ER, ICU or on the floor. Now, for someone with my experience (nearly 6 years), I'd actually be making more working as a school nurse in my city than I was making when I left the hospital. If you break down the hourly wage, it's undoubtedly more for the school nurse here because they work 6-7 hrs/day 180 days/year. That, and since they're represented by the union they have guaranteed raises. It appears (as I'm looking at the salary steps published on the school system's website), that school nurses/teachers in my state get about a 6% raise every year. My raises while working in the hospital were 0-2% and were at the discretion of department supervisors.
    A point to remember is that as any salaried employee (as in the school system), there is no OT. EVER.

    We stay as needed, on a teacher salary, I stay for faculty meetings, open house conference, meeting with parents on their schedule etc. And if there is a crisis when I am leaving, I stay till it is over. If there is a crisis after schol (student, teacher death, community crisis etc) I come back to school. It is the way it is.

    I am NOT complaining, just pointing out a fact. It is a choice you make when you enter the public sector/school system.

    BTW We do NOT get 6% annual raises...and many of us are NOT represented by unions
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    I think it's the opposite of OPs theory, as a lot of hospitals pay a critical care differential (some HCA facilities pay up to $10/hr diff). Clinics and schools are known to sometimes pay far less.
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    Quote from nhnursie
    A point to remember is that as any salaried employee (as in the school system), there is no OT. EVER.

    We stay as needed, on a teacher salary, I stay for faculty meetings, open house conference, meeting with parents on their schedule etc. And if there is a crisis when I am leaving, I stay till it is over. If there is a crisis after schol (student, teacher death, community crisis etc) I come back to school. It is the way it is.

    I am NOT complaining, just pointing out a fact. It is a choice you make when you enter the public sector/school system.

    BTW We do NOT get 6% annual raises...and many of us are NOT represented by unions
    I never said all school nurses get those raises or are represented by the union. I said in my state, most school nurses are paid via the teachers' salary scale and are represented by the teachers' union. Raises are dependent on individual collective bargaining units... I said in my city, based on the salary scales I was looking it, the raises appear to be about 6% every year. That's much more than the raises my mother receives in a small suburban public school system although I believe her raises were still more than mine when I worked in the hospital.

    I never made a dime in OT when I was working in the hospital... my hospital treated all nurses as "salaried" employees but we didn't get the perks true salaried employees get. It's a trade off when you enter school nursing... you sometimes have to come in early or stay late for meetings but you still get paid during school vacation weeks and/or on holidays and in the summer. School systems in my area get Jewish Holidays as well as Good Friday and all federal/state holidays off and three and a half weeks of school vacation/year. I work per diem in a private school now but am hoping to break into the public school system in a few years and continue home health per diem... to me, the trade off seems like it would be worth it.

    My original post was in response to the OP's question and my point was school nurses work in a different environment than hospital nurses and are paid according to how teachers are paid so comparing the salary of a school nurse to that of a hospital nurse by numbers alone doesn't necessarily work.


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