I'm wondering if all of the salary wars, bonuses, incentives, etc. that are offered to the bedside nurses these days is removing one of the long standing advantages (higher pay) of nurses moving into leadership positions. I am finding it much more difficult to hire nursing leaders. Is it because it is too stressful to be in management these days, are nurses scared of the shortage and don't want to be responsible, or are they making enough money at the bedside so they figure - why have the headaches of management?
When your facility gives RNs across the board raises or offers incentives- are the managers included or eligible?
Don't get me wrong, bedside nurses deserve to be very well paid for what they do, but there is a certain advantage to being able to go home at the end of the shift and have no further responsibility for the operation.
I'd love to hear the thoughts of other nursing managers. Thanks.
Jan 10, '03
No- my salary is not moving up when the staff's is. As an inpatient nursing manager I'm getting increasingly frustrated, as are my peers. I am one of the lucky ones on the higher level of pay for departmental managers (22 yr RN, MSN 14 yrs and 12 yrs management experience) I'm a little further ahead in wage than many of my peers, but the staff is really creeping close, and when they go home at the end of the day they aren't on call 24/ 7. I know that several of my peers are making less than some of their more senior staff-and most of us do when you calculate the hours we put in.
It has been at least a year since we have been talking with senior management to adjust our wages. The staff nurses have had wage adjustments 3 times in this period. I received a merit increase with my performance eval in July, but no general adjustment for all. I'm getting pretty tired of waiting, as I assist many of the new managers in their role transition. They don't say much because they are looking at this position as a stepping stone. Having done education, staff, and administration-both unit and divisional and recognizing that I prefer to be closer to the patients I choose to stay in middle management. I am however again reevaluating my decision based on the lack of monetary recognition for my efforts.
If money doesn't get a bit better soon I believe that I will work agency on a prn basis, but I hate to do that because I like what I do - I just am sick of the situation.
Last edit by Gardengal on Jan 10, '03
Jan 11, '03
my salary is not going up..my hospital is not a magnet facility, with no clinical ladder offered to nurses..
so my bs in psych, and my ancc certification is not rewarded..
and there is no cost of living raise this year either.
Jan 11, '03
Gardengal, thanks for your reply.
Your answer is what I think is happening more and more. I work for a growing LTACH company and we are opening up smaller specialty acute care hospitals in many different locations and I have never seen such a lack of motivation among my colleagues to be groomed for promotions into leadership positions. I am the chief nurse (MSN, 17 years experience, CRRN) at one of our hospitals and I have always found it to be rewarding to identify leadership potential in others, mentor them, and prepare them for promotion opportunities. We are going to need several more nurse managers and directors soon and I don't know where they are going to come from.
My staff would never believe it, but there are some who probably make close to what I do or more when you add up the base rate plus generous shift differentials, overtime, incentive payments for working certain hard to fill shifts, and our perfect attendance incentive - especially considering that I work 50-60 hours per week and get paid for 40. And of course, like you said, I have the on-call pager for the entire month of January and get called when staffing problems arise even when I'm not on call.
We need to do something, or I'm afraid that we are going to have a serious nursing leadership shortage. And you know that other healthcare leaders would be more than happy to decide what is best for nurses.
Jan 11, '03
How does one groom themselves for a leadership position? I think it is exactly what I want to do because it seems to offer easier advancement that I can achieve with the least amount of effort. I am seriously think about enrolling in a Health Care Admin
graduate school but have serious reservations about outcome and salary, so what does NM make, or a chief nurse, or DON?
My mother was a DON for several years and states that that can be the job from hell, is your experience the same?
Another thing, just where would one ascertain the salaries of nurrsing management from a formal publication. Do you have knowledge of any publication like this that you could share?
Lastly, what is the tier structure of nurse mangement? And the approximate salary ranges of those positions?
Jan 11, '03
Clinical Coordinator for an agency doing PDN on high tech Peds.
Annual merit raise in this fall brought me to $21.50.
I just hired a nurse whos entire experience is limited to well kids. Someone got the director involved and she was hired in at $21.00.
The thing that bothers me the most is that we are hurting so bad for staff that when somebody walks in our door they can almost write their own paychecks...we have very dedicated longterm nurses making $2+ less than some of the new hires...and "they" won't let me give raises that would bring them up the level of the new hires.
Jan 12, '03
Glad To Be Here,
I don't know enough about your background to give a thorough response, but as far as formal education a BSN plus a MSN, MHA, or MBA is a good start. If you have only had bedside positions, I would volunteer to be on some committee or task force - maybe a performance improvement team, clinical practice council, product evaluation committee or something like that. This will broaden your network, expose you to a different aspect of the operation, and show some initiative to those already in leadership positions. I would recommend joining some professional organizations. Since I work in a specialty hospital that focuses on critical care and rehab patient populations, I belong to AACN (American Association of Critical Care Nurses) and ARN (Association of Rehabilitation Nurses). Since I hold a nursing administrative position, I also belong to AONE (American Organization of Nurse Executives). After you join these organizations, you need to be willing to invest in your career and go to their national conferences. When I was first starting out and still today, I read numerous professional journals to advance my skills and expertise too.
As far as salary surveys, many nursing journals periodically publish average salaries by position and by region. "Nursing Management" and "Nursing" are two journals that come to mind. Salaries vary widely based on the cost of living and local market data.
As far as your Mother's experience, nursing management is more difficult than clinical nursing. It requires one to develop two distinctly different skill sets - Nursing expertise and management expertise. And you have to be able to readily use both skill sets interchangeably and sometimes simultaneously. I have been in terrible management positions and I have been in two great management positions that I loved. I thoroughly enjoy my current position. Is it hard - you bet.
The last bit of advice I can give is to develop your interpersonal skills. I have worked with a slew of nurses who just couldn't see that being a great clinician is not enough. I have told many nurses that I don't care if they are the best clinicians on the face of this earth. If they can't work well with others, I don't need them.
Hope this info. helps you.
Jan 12, '03
Thanks for the response. I have been in leadership positions before, but in a totally unrelated industry. I have recently reentered nursing, went through the RN refresher thing, and am now working in a CCU. A couple of years there will fine tune my skills, I am sure. I am male, 48 yo, and that is a big advantage.
The hospital I am now employed by asked in the interview what I wanted to be in 5 years, and I unhesitantly stated "One of your nurse managers". Later I learned that was one of the decision criteria for my employment. I have had a BSN since 1977. I do not want to pursue another degree HCA or otherwise unless there is some financial gratification. I can also work as many nurses do, 60 hours a week if need be and yank down about 90k+. So my question is more a less a value question, would nurse mangement be feasible to pursue considering that the title of this thread is "Is your salary keeping up with your staff's?"
Is it worth it, or would you rather leave the beeper on your desk and forget about it? I had to carry a beeper and pager and a mobile phone for years, so I know what that is all about.
Thank you for bringing the publications to light and attending conventions and the like. I recognize their importance and attendant mingling with birds of a feather. Again, thanks for the so cordially sharing the information.
Jan 13, '03
I was happy to see this thread. We don't talk about these issues enough.
Personally, I work in the Staff Development Department -- the only department in which a Master's Degree is required -- but the story is similar to that of the Managers. We have gotten some of the raises that our staff has received, but not the bulk of them. It's no accident that our department has one of the highest vacancy rates in the hospital. We are finding that staff nurses who are willing/interested in going to graduate school either stay at the bedside for the bigger bucks, or seek a Nurse Practitioner position in which they don't have to deal with the politics of a hospital-based leadership position.
I hear of no one among our staff who aspires to be an educator or CNS. Where is our next generation of leaders going to come from?
Jan 13, '03
Well hello llg!
Good to see you joined in. Everthing I am hearing that is coming back to me is not real encouraging. I know you are a also involved in the ironies of this particular situation and when people I have come to respect view it simarlarly, that verifies that I am asking the right questions. I am not sure how I would tolerate the politics, as the leadership postions I have had were telling everyone else what to do. I may appreciate the autonomy of a NP more than a NM or DON, but feel somewhat sure I could adapt. Actually, it's a lot of fun motivating people and I may enjoy it more in some ways. But it still boils down to dinero. I have been laboring over this for a while, all the time knowing I could hit the streets and up my income substantially...but that takes lots of hours. I resigned myself to not do that again. What I need is a nice little highly educated position that pays $130-150k per year and I promise I will leave everyone alone...for a month...maybe:chuckle
Jan 14, '03
Hi, Glad2behere: We seem to participate in a lot of the same threads. It seems to me that you have a good handle on the situation: you just need to make up your mind. Not that making up your mind is an easy task! It's just that sometimes, more information isn't going to help ... what you need is to bounce your thoughts off people and digest their feedback.
Good luck with whatever you decide. I still don't know what I want to do with the remaining 15 years of my career. I have some ideas, but I am not sure how things will play out.
Jan 14, '03
Remember in earlier posts I had stated that I was good in managerial accounting, well, numbers don't lie. That is the issue I am having trouble with most, and apparently there are many others. You're right, I'll have to bounce it off some more folks and get additional opinions and try to persuade myself that the numbers just cannot be so! Terrible isn't?
If you have some ideas on what you are going to do with the remainder of your career, I'd like to hear them, as I feel you are much more knowledgeable in this arena than I, and by the way thanks for the input.
Jan 14, '03
To pull in 130-150K I'd say you would have to pursue a Administrator position, or corporate VP of some healthcare company (again depending on location and the local pay scales). I have to remember that I live in an area where the cost of living is drastically lower than the east or west coast areas or many other areas for that matter.
For me, I get a nice size bonus each year for meeting some organizational goals set for me. However, I have not been included in at least two across the board increases for RNs. I love the type of work I do and would no doubt lack fulfillment if I was in a staff position.
The purpose of this thread is not to discourage people from pursuing leadership positions, but to open a dialogue about something that I've had a hunch about for a few years and to hopefully get others in leadership positions to think about it and help get this negative change reversed.
I recently had a nurse manager resign because she said she could make more money as a staff nurse. When I hired my current nurse manager, I was able to negotiate a substantial increase for her starting salary because of the obvious inequities. That didn't help the nurse manager who resigned, but it sure helped the next candidate. I suspect that there is as much of a shortage of nursing leader candidates as there is a shortage of staff nurses. I hope the increased demand will help our situation as much as I see the demand helping the staff nurse salaries.
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