Medscape’s annual survey of the yearly compensation of registered nurses reveals that their full-time earnings don’t reflect what one would expect with the steadily growing job market.
The average 2018 earnings for a full-time RN was $80,000, with no significant wage increase in the past three years, according to the Medscape research. While the exact reason for the stagnation is unclear, the outlet speculates it could be because older and more highly paid nurses are retiring. It also may be reflective of slow wage growth overall.
(The job outlook for 2018-2028 is expected to grow 12 percent, much faster than average, according to the Bureau of Labor Statistics.)
Salaried vs. Hourly
More than half the RNs surveyed (56 percent) say they are paid by the hour, while the rest are salaried. The average hourly rate for full-time RNs who are paid hourly is $38, according to the survey, about a dollar more than last year. Nearly three quarters of RNs are working full-time (at least 36 hours per week), which has been the case for the past several years, the survey notes.
RNs who get a salary have a higher annual gross income than RNs who are paid by the hour. Salaried RNs earned $83,000 on average in 2018, versus hourly RNs, who earned an average of $78,000.
Men vs. Women
Another noteworthy finding: Male nurses report earning more than female nurses. In fact, male RNs earn an average of 4 percent more than women ($83,000 vs. $80,000). Medscape speculates that the pay gap is due to different work habits of men and women.
For example, men tend to work in settings that pay higher wages, like intensive care and hospital in-patient units. Plus, they tend to hold positions that pay hourly rather than a fixed salary, which provides more opportunities to supplement income. Some 70 percent of male RNs are paid hourly compared to 56 of female RNs.
Additionally, men are more likely than women to work in urban rather than rural areas, and to work overtime on a routine basis. Slightly more than half, 53 percent, of male RNs work in an urban setting compared 44 percent of female RNs.
Although male RNs’ annual gross income was higher in 2018 regardless of whether they were salaried or hourly, there was one piece of potentially good news. While male RNs in salaried positions reported earning $6,000 (or 7 percent) more than women in 2018, that difference has decreased somewhat. In 2019, salaried male RNs reported an average annual income that’s just $2,000 (2.5 percent) higher than that of salaried female RNs.
Male and female RNs who are paid by the hour report similar hourly rates, with men getting $39 and women getting $38 per hour. But hourly pay rates tend to be based on years of experience, with higher earnings correlating with more experience. Female RNs on average have been practicing longer and thus should be more highly paid, but statistics show that this isn’t true, Medscape notes. Some 9 percent of the respondents in this year’s survey were male.
Pay by Practice Setting, Region
Some 37 percent of RNs work in in-patient care at a hospital, while 13 percent work in a hospital-based outpatient setting or clinic and 6 percent at a school or college health service. Just 5 percent of RNs work at a non-hospital-based medical office or urgent care office, while another 5 percent work in a public health setting or community health setting and 5 percent work at an academic setting (either faculty or research.) Some 3 percent of the RNs in the survey work as a home health/visiting nurse and 3 percent work in an industry setting (e.g., insurance health plan.)
How much an RN makes also depends on where they live, according to the Medscape survey. The highest paid region is the most western region of the U.S. (California, Oregon, Washington, Alaska, and Hawaii), and the lowest paid region is the East South Central region (Alabama, Kentucky, Mississippi, and Tennessee). Overall, the average salary for a full-time RN ranges from $70,000 to $96,000. (Regional incomes are not adjusted for cost of living.)
While the Medscape survey was conducted in 2019, the respondents were instructed to report their earnings from 2018. All the annual salaries and hourly rates reported in the survey are averages, Medscape notes, with some RNs earning less while others earn more.