Nurse salaries are stagnant or decreasing, we already knew NPs were taking a decrease

Specialties NP

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Nursing Salaries Are Stagnant, New Survey Shows

Troy Brown, RN

October 11, 2018

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Nurse income may be falling, according to Medscape's 2018 RN/LPN Compensation Survey of 5011 registered nurses (RNs) and 2002 licensed practical nurses (LPNs). In 2017, for the first time, average annual nurse wages and hourly rates of pay failed to increase significantly. After adjusting for inflation, income may even be falling, according to the report's authors.

The percentage of RNs (56%) and LPNs (46%) who believed they were compensated fairly for their work fell slightly from the previous year.

During previous years, there have been small but steady increases in compensation. Average annual gross income for RNs was $81,000 in 2017 compared with $80,000 in 2016. For LPNs, annual income was $46,000 in 2017 and 2016. Hourly wages in 2017 were $37 for full-time RNs compared with $22 for full-time LPNs.

Nurses in salaried positions - a much smaller group when compared with those in hourly positions - were the only group whose average salaries increased.

The reasons for this lack of wage growth are unclear.

Registered nurses living in the Pacific region (Alaska, California, Hawaii, Oregon, and Washington) of the United States had the highest average annual income, at $102,000 per year, whereas those in the East South Central region (Alabama, Kentucky, Mississippi, and Tennessee) reported the lowest ($69,000 per year) - a difference of 33%. Licensed practical nurses in the New England region (Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont) reported the highest annual pay, at $56,000 per year, compared with $42,000 in the South Central region.

Among RNs, income was highest for those working in hospital inpatient and occupational/employee health settings ($84,000) and lowest for those working in school/college health services ($66,000). Licensed practical nurses working in skilled nursing facilities or other long-term care reported the highest annual income, at $48,000, compared with $37,000 per year for LPNs working in school/college health services.

Although more than half of nurses (RNs, 61%; LPNs, 58%) said their income had risen from the previous year, the survey did not show the amount of this increase or the source of the increase - whether it resulted from a raise or from working overtime or extra shifts. Approximately one third of nurses (30% of RNs and 34% of LPNs) reported working extra hours or shifts. To supplement their income, 13% of RNs worked on-call shifts, 12% assumed charge nurse responsibilities, and 11% worked a second job or had a non-nursing income-producing activity.

Most RNs worked for employers that provided paid time off (96%), health insurance (95%), contributions to retirement savings (84%), and education allowance or reimbursement (65%). Almost one third of nurses (RNs, 29%; LPNs, 39%) still had student loan debt.

Where Are the Nurses?

Nurses were most likely to work in hospitals (RNs, 52%; LPNs, 20%), which paid the highest wages. Nurses in the insurance industry and occupational health reported annual income that was comparable to that of nurses in hospitals; however, relatively few nurses work in those sectors.

Demand will still be there....there will just be too many of us willing to do the job so it starts eroding wages. I've already seen it happen personally to me and a dozen other NPs I work with in California. Wage deflation is real.

BUT xyzzy just got a job making ten billion with 56 weeks of vacation a year so you must be wrong!

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Specializes in FNP.

I'm making twice what I made as an RN, and every year it keeps going up. Every NP I know makes more and more each year.

Specializes in ACNP-BC, Adult Critical Care, Cardiology.
Demand will still be there....there will just be too many of us willing to do the job so it starts eroding wages. I've already seen it happen personally to me and a dozen other NPs I work with in California. Wage deflation is real.

California is an anomaly so what happens here unfortunately doesn't translate to the rest of the US. We have strong RN unions and is the only state that enacted a law that mandates staffing ratio in most hospital settings. RN pay is at the highest here with San Francisco Bay area RN's making top wages anywhere in the US. NP's for the most part do not have unions representing them unless they also work in an institution where they are part of collective bargaining as part of nursing.

Places like Kaiser Permanente, some Sutter Health facilities in NorCal, the UC Medical Centers have NP's on the union. Certainly NP salaries in those places are not going down. However, NP's in private practice or community settings are at the mercy of physicians and practice managers who will low ball their pay and in desperation to be employed will take such an offer.

I see too many new grad NPs who compete with handful jobs in big cities in TX, good opportunities in rural areas but not in big cities.

On 10/12/2018 at 3:18 PM, Spadeforce said:

goes in line with the HHS predictions of too many NPs/RNs by 2025. everybody caught the wave to go to nursing school. the economy is doing relatively well right now and there are STILL too many nurses, so if we do have another down turn in the next ten years there will just be more saturation since the health field has always sort of been the "mattress to fall on" in downturns.

There aren't many other decent paying middle class jobs out there that do not require hard science knowledge/math such as nursing so its a good field for many and people caught on.

I agree, I was working for a hospital as an Lpn while I finished my BSN. While I was waiting to take the NCLEX Rn the hospital eliminated shift differentials and required everyone with less then so many years to rotate... since this was the major hospital system in the area the other hospitals began doing this as well. They also like to rotate calling people off regularly so you don’t get your full 36 hours a week. I’m making $26/hr -36 hours a week to work the night shift which comes out to a little over $49,000 a year. Not a whole lot of overtime because they have us take more than recommended patient load. Currently 5:1 on PCU... one night I had dka with accuchecks every 15 min to one hour on an insulin drip, another patient on dobutamine, bumex and bipap, another receiving heparin with boluses and frequent titrates, another on sepsis protocol and then I got a second dka admit. I’ve applied to other hospitals in the area and they offer me the same wage or less. Might just be my area but this is awful. If I didn’t have these student loans Im like 95% certain I wouldn’t be working as a nurse. All I ever hear about is the profit margin and the budget but when you take hours away from employees who have agreed to a specific number of hours per week that’s profiting off the back of your employees.

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