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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019
| Contributor Information
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Medscape US nurse members were invited to participate in a 10- to 15-minute online survey about their annual earnings. Respondents were required to be practicing nurses identifying as registered nurses (RNs), licensed practical nurses (LPNs), or advanced practice registered nurses (APRNs). After a recruitment period lasting from June 10 through August 26, 2019, a total of 7145 nurses met the screening criteria and completed the survey.
The following slides report survey findings from two subgroups of respondents: RNs (n = 5143) and LPNs (n = 2002). In a few instances, we compare findings from the current year with those of last year's compensation survey. A future report will focus on findings about the compensation of APRNs.
Notes:
1. Although the survey was conducted in 2019, respondents were asked to report earnings from 2018.
2. LPNs are referred to as "licensed vocational nurses" (LVNs) in some states, but the positions are similar. We combine LPNs and LVNs in this survey.
3. It's important to remember that the annual salaries and hourly rates reported here are averages. Some nurses make less and some make more than what is reported here.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Despite predictions that healthcare is shifting out of hospitals, the acute-care hospital continues to be the primary employment setting for half of all full-time RNs (37% in inpatient settings and 13% in hospital-based outpatient settings). The other half of the RN workforce represented in this survey is divided among various outpatient and health-related industry settings. Most full-time LPNs report working in skilled nursing/long-term care, private medical offices/clinics, hospital-based outpatient settings, or in home health.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Although jobs are growing for nurses, wages don't appear to be keeping pace. The average 2018 earnings of full-time RNs and LPNs were $80,000 and $48,000, respectively, showing little change from 2017 earnings. In fact, earnings for full-time RNs have been flat, with no significant increase in wages during the past 3 years. However, this year, LPNs saw a significant increase ($2000 annually) from their 2017 earnings.
We don't know the reason for the apparent wage stagnation in nursing. We have speculated that this trend is related to the retirements of older, more highly paid nurses, which would tend to dampen average wages of the younger RN workforce, or it may reflect slow wage growth in general.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
About three fourths of working RNs are employed full-time (at least 36 hours weekly), a proportion that has been consistent for the past few years.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Most RNs (56%) report being paid by the hour, while 44% are salaried. Among LPNs, only 15% have salaried positions; the remaining 85% are paid on an hourly basis (data not shown). Hourly wages do not include differentials.
For full-time RNs paid by the hour, the average hourly wage was $38, about a dollar more than last year. Similarly, full-time LPNs' hourly wages rose from $22 to $23. Part-time RNs and LPNs reported the same hourly rates as those working full-time.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Salaried nurses reported significantly higher annual gross incomes (approximately 5% for RNs and 15% for LPNs) than nurses paid by the hour. A small drop in average earnings of full-time salaried RNs between last year ($84,000) and this year ($83,000) was not statistically significant, but nor did we see evidence of a wage increase for these nurses. Full-time salaried LPNs, however, had a significant increase in average earnings (from $51,000 last year to $53,000 this year).
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Traditionally, acute care, inpatient hospital positions have been the most sought after and highest-paying jobs for RNs. Last year we began to see incomes of RNs in a few non-hospital work settings that matched or exceeded hospital salaries. This year, earnings of RNs in occupational health and industry positions ranked highest, and were competitive with wages for inpatient hospital positions.
Full-time RNs employed in schools and non-hospital-based outpatient settings reported the lowest annual earnings. Those in public health, non-hospital medical offices, hospices, and home health reported higher incomes compared with 2017.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Full-time LPNs working in skilled nursing facilities reported the highest incomes, and those in school health facilities reported the lowest. Average incomes of LPNs in skilled nursing and public health settings increased slightly over 2017 figures.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
One of the most consistent findings in our annual nurse compensation survey is that among both RNs and LPNs, men report higher annual earnings than women. In this year's survey (based on 2018 earnings), male RNs earned (on average) 4% more than female RNs ($83,000 vs $80,000) and male LPNs earned about 10% more than female LPNs ($51,000 vs $47,000). We don't fully understand why men earn more for the same job, but the pay gap might be explained by different work habits of men and women, as detailed in the next few slides. About 9% of our respondents were men.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
The annual gross income of male RNs was higher in 2018 regardless of method of pay (salary or hourly). However, this year we see a glimmer of hope for pay equity among nurses in salaried positions. Last year, men in salaried RN positions earned $6000 (7%) more than women, but based on 2018 earnings, the difference has contracted somewhat. Among RNs, salaried men reported an average annual income that is only $2000 (2.5%) higher than that of salaried women.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Male and female RNs reported a similar average hourly rate ($39 vs $38, respectively). LPNs also reported similar hourly rates for men and women ($24 vs $23). These findings suggest that the higher annual gross incomes of hourly-paid men are not related to a difference in base pay. The problem is that hourly pay rates are typically predicated on years of experience; you earn more as you gain more experience. On average, women have been practicing longer and should be more highly paid, but they aren't. However, it's no victory for either sex if nursing wages aren't growing overall.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Some of the work characteristics of men and women could explain the profession's persistent gender pay gap. Men more often work in healthcare settings that pay higher wages, such as hospital inpatient units and intensive care. Men are more likely to hold positions that pay hourly (rather than a fixed salary), which provides more opportunities for income supplementation. Men are also more likely to work in urban, rather than rural, areas. We found that men were more likely than women to routinely work overtime, and when they did, they worked more hours of overtime per week. Men were more likely to supplement their regular income by taking call, working shifts that paid a higher differential, or functioning as charge nurses. Any of these factors could contribute to a higher annual gross income for men in nursing, despite their hourly rates of pay being equivalent to those of women.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Among RNs, 49% reported having a bachelor's degree (BSN), a proportion that is unchanged from last year's survey. The proportions of RNs with hospital diplomas, associate degrees (ADN), master's degrees (MSN), or doctoral degrees have remained relatively stable. Among LPNs, 83% in this year's survey reported having had formal practical nurse training, similar to in the previous year (data not shown).
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
The annual earnings of RNs increase, as expected, with their level of education. From BSN to MSN, and from MSN to doctorate in nursing, each step is linked with a 9% increase in pay. As a group, associate degree RNs earn the least. An exception to this pattern is the diploma in nursing. Although we found that diploma RNs earn more than associate degree–prepared RNs, the difference is more likely related to age and years of experience rather than to any effect of education.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Specialty certifications have been earned by slightly more than half of RNs. Specialty certification carries financial rewards for 40% of certified nurses, in the form of a higher rate of pay or a bonus. Although typically optional, specialty certification may be required for nurses to advance on a clinical ladder or assume new roles.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
The earnings of nurses also generally rise with years of experience, regardless of method of pay (salary or hourly), and this trend was apparent in our survey. Nurses with the most experience reported the highest incomes. Among early-career nurses, the average hourly rate they received for their first job in nursing was $26 per hour for RNs and $19 per hour for LPNs.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Union membership has not changed appreciably in the past year, currently at 16% of RNs and 9% of LPNs. Although it's typically believed that union membership translates into higher wages, we saw little evidence of this in our data. In fact, in 2018, compensation for RNs who are union members was statistically lower than in 2017. And LPNs who aren't union members reported higher incomes than last year.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Nurse wages depend partly on where they happen to live. The highest-paid region is the most western (Pacific) region of the United States (California, Oregon, Washington, Alaska, and Hawaii), and the lowest-paid were the East South Central (Alabama, Kentucky, Mississippi, and Tennessee) and West North Central (North Dakota, South Dakota, Minnesota, Nebraska, Iowa, Kansas, Missouri) regions. Overall, average full-time RN incomes ranged from $70,000 to $96,000. (Note: Regional incomes are not adjusted for cost of living.)
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
The pattern of highest- and lowest-paying regions differed slightly for LPNs, whose average full-time incomes ranged from $43,000 (East South Central region) to $55,000 (New England region).
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Like pay, union membership among nurses varies regionally throughout the United States. Union membership is highest in the Pacific region (42%), followed by the New England (37%) and Mid-Atlantic (25%) regions. The number of respondents wasn't adequate to analyze the salary differences between unionized and non-unionized RNs for the entire United States, but in the regions with enough respondents, hourly-paid RNs who belonged to unions reported higher annual incomes than non-unionized nurses in the Pacific, Mid-Atlantic, and New England regions.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
We often receive comments from nurses who claim that the average incomes reported for the region where they live don't reflect what they are being paid. For both RNs and LPNs, pay decreases as the type of community shifts from urban (most populated areas/highest wages) to rural (least populated areas/lowest wages), explaining why two nurses working in the same state might have vastly different annual incomes. The average difference in wages reported between urban and rural RNs was 15%, and for LPNs it was 19%.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Nurses report working slightly less overtime than last year. This year, 40% of hourly-paid RNs reported working overtime, compared with 42% last year. Among LPNs, 49% report working overtime in this year's survey, compared with 50% last year. Most, but not all, overtime worked is voluntary for both groups, and nearly all is compensated, allowing nurses to increase their income. It will be interesting to see whether the trend of working less overtime will hold as the anticipated nursing shortage worsens.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Working more overtime could be one reason that men earn more than women in nursing. Not only do a higher proportion of male RNs work overtime, but they clock more weekly overtime hours than women. Because we don't know how much of a nurse's income is attributable to overtime, it's impossible to say whether this is the primary reason for the gender pay gap.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
We first noticed a lack of wage growth among nurses in last year's Medscape survey, which was based on 2017 income data. That trend appears to be continuing this year. But do nurses perceive their own wages to be stagnating? We asked whether nurses' 2018 income had increased, decreased, or remained the same compared with the previous year. More than half of RNs and LPNs saw an increase in their income. Cost-of-living increases, which aren't considered wage growth, could play a role in higher incomes.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Nurses are often able to increase their regular full-time pay by assuming additional responsibilities in their primary nursing positions. This year, apart from working extra hours or shifts, RNs often reported taking call and performing charge nurse or preceptor functions to supplement their nursing income. Having a second job or another income-producing activity also boosted earnings for small proportions of nurses. Overall, women were less likely than men to seek supplemental work.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Although it's common for early-career nurses to be carrying a heavy student loan burden, nurses of all ages report that they are still paying off their nursing school loans. In fact, this number has been increasing annually (35% in 2019, from 29% in 2018 and 26% in 2017). Like in previous years, a significant proportion (20%) of nurses older than age 55 are still paying off nursing school loans.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
In keeping with our findings on lack of wage growth, nurses are increasingly reporting dissatisfaction with their pay. This year, we saw a significant drop in the proportion of nurses who feel that they are fairly compensated for their work. Satisfaction has been steadily declining for the past 3 years. Factors associated with higher pay satisfaction include being a salaried employee, higher annual earnings (at least $86,000 for RNs and $51,000 for LPNs), age > 35, having at least 20 years of experience, and union membership.
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
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Medscape RN/LPN Compensation Report, 2019
Laura A. Stokowski, RN, MS; Mary McBride; Emily Berry | October 9, 2019 | Contributor Information
Tell us what you think. Do the incomes reported by this year's survey respondents match your own experience? Have you received a wage increase? And is there anything else you would like us to ask nurses in next year's survey?
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Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
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Laura A. Stokowski, RN, MS
Clinical Editor
Medscape
Mary McBride
Associate Director, Market Research
Medscape
Emily Berry
Editor
Medscape
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