Nursing

Note: Of the 12,188 nurses invited to reply to the online survey, 685 nurses participated (a response rate of 5.6%). The information presented in this article applies to both full-time and part-time RNs working in acute care hospitals—a subset of total sample size—unless otherwise specified. Figures in charts are rounded and, where expressed as percentages, may not total 100%. Our companion analysis of nurses' benefits appears here and in the September 2009 RN.

FOR MANY AMERICAN WORKERS, the past two years have seen a growing storm of stagnant wages, eroding benefits, and feared or actual layoffs. But as recession swamped the economy, the majority of nurses who participated in RN's biennial earnings survey enjoyed rising fortunes. Their average wages have echoed the double-digit percentage increases of the mid-2000s—with even sharper raises for select nursing specialties and settings.

Defying the grim statistics, just over half of our respondents received a raise in the past seven months, with the other half getting a raise more than seven months ago. On average, raises were 3.2% over their previous wages, which beat or matched 79% of participants' last increases. Since our 2007 survey, the average annual base pay of salaried nurses (who typically hold management or administrative positions) grew 10%, or $6,746, to $75,180. Nurses paid by the hour fared even better; their average base earnings rose 13% ($7,460), to $64,018. Combined, hourly and salaried nurses received $7,270 more on average, for a 12% raise to an overall base pay of $65,653.

Hourly and salaried pay in depth

Mean wages for RNs paid hourly rose almost 6% in our survey, to $33.09. Full-time nurses (defined as working 36 or more hours per week) comprised 87% of our sample, versus 80% of 2007's sample. Part-time nurses continued to make more per hour on average than full-timers ($34.80 versus $32.79), owing to part-timers not receiving health insurance or other employer benefits. But full-time nurses' hourly wages rose by 7% over their 2007 level, as compared to improvement of just under 3% for part-timers. And the gap between the two narrowed to $2.01, down from $3.26 in the last survey and reversing a widening trend since 2003. (For a PDF of the tables that illustrate all of the statistics in this article, please click here).

The $11,162 spread between the average annual income of salaried nurses and that of nurses paid hourly shrank below the gaps in 2007 ($11,876) and 2005 ($11,470). The bottom range of pay improved too; no salaried nurses in our sample, and fewer than half of nurses paid hourly, earned less than $40,000 per year.

Workloads changed little. Nurses worked a 36.9-hour week on average, slightly more than the 36 hours per week they worked in 2007. Hours of overtime dropped to 3.7, from 5. The most common shift type was a 12-hour shift (46%), followed by day shift (32%). Among nurses receiving overtime, 75% of respondents were paid time-and-a-half for it, with 17% earning no extra compensation.

The most frequent distinction besides overtime for which nurses received pay differentials was working the night shift, followed by working an evening shift, weekends, or assuming charge duty. Holding a specialty certification garnered nurses an average of $12.81 more per hour, followed by working holidays ($8.03) or weekends ($3.79). Including overtime and differentials, full-time acute care hospital RNs earned an average of $70,264 in total nursing income; part-timers in the same setting made $45,628 ($3,254 less than last survey), and both shift styles combined earned an average of $67,282.

Union membership, long on the decline in America, actually rose slightly since our last survey, to 12.4% of all workers in 2008.¹ Among our participants, 18% reported being covered by a collective bargaining agreement, versus 19% in 2007's survey. Just over half of unionized nurses (53%) belong to a local of their national labor union; the remainder work through their state nursing association.

Impact of setting and hospital demographics

Fewer nurses reported working at an acute care hospital this year (57.9%), but they remained a majority. They led in average annual nursing income ($65,653), enjoying a 12% gain and edging out 2007's leading setting, ambulatory care/HMO nursing, by $2,383. Ambulatory/HMO nurses actually suffered a 3% decline in income since the last survey. The other three most popular settings—community/home health agency, extended care/psychiatric facilities, and physicians' offices—ranked the same in pay as in 2007, and all gained ground.

Office nurses being paid hourly earned 14% more in 2009 (though the sample size was smaller than in 2007), and those paid a salary closed the gap between their pay and that of acute care hospital nurses to $11,458, down from $16,498. Among settings with smaller response rates (schools, HMOs, health insurance companies, and psychiatric hospitals), mean annual income was $60,130.

Status of the hospital, as opposed to its size or location, had the biggest impact on nurses' pay in 2009. Hourly wages of public-hospital nurses topped the list with a 14% surge to $36.65. University-hospital nurses, last survey's winners, improved 2.7% but dropped to last at $31.86. Compared by location, nurses at rural hospitals received the biggest raise (7%), although urban hospitals again offered the highest hourly pay. The gap between urban and rural hourly wages increased by only four cents, however, to $4.99; urban wages widened their lead over those at suburban hospitals, to $1.16 from $0.77.

As for size, hospitals with 300 to 499 beds again led the pack at $33.99, but only by 39 cents over the largest hospitals—a gap close to our 2007 results. Although hourly pay across all sizes rose, the gap between the smallest and largest hospitals reversed trend, opening to $3.65 this year and exceeding 2005 and 2007's spreads.