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RN Salaries Remain Flat Since 2016

Analysis  |  By Jennifer Thew RN  
   October 11, 2018

Despite occupational growth projections for nurses, their salaries appear to be stagnant, according to a new survey of RNs and LPNs.

Nursing ranks third on the Bureau of Labor Statistics' list of occupations with the most job growth. While employment of RNs is projected to grow by 15% between 2016 and 2026, their salaries are not increasing at the same booming rate.

In fact, Medscape's newly released "RN/LPN Compensation Report 2018" finds that salaries for both RNs and licensed practical nurses have remained flat for two years. The study was conducted in 2018 and 5,011 RN and 2,002 LPN respondents reported their 2017 salaries.

In addition to salary, the survey looked at factors that influence compensation including practice setting, gender, unionization, and geography.

Below are some highlights from the study:

Average Earnings

For 2017, full-time RNs' average annual earnings were $81,000, up slightly from $80,000 in 2016. Full-time LPNs earned $46,000 in 2017 and saw no change from 2016.

The study's authors point out that if they had adjusted for inflation, both groups of nurses would have seen a decrease in wages.

Interestingly, RNs' acute care hospital wages did not rise from 2016 to 2017, but wages of RNs working in other settings did see an increase.  

Salaried Nurses Make More

The average hourly wage of a full-time RN in 2017 was $37 and $38 for part-time RNs. Full-time LPNs were paid an average of $22 per hour, and part-time LPNs earned $23 per hour.

RNs and LPNs paid on a salaried basis had greater gross annual incomes than their hourly counterparts. Salaried RNs made 8% more than RNs paid an hourly wage while LPNs made 13% more.

Additionally, RNs who were salaried saw an increase in their gross annual wages from 2016 to 2017 ($82,000 to $84,000) while those who were paid hourly did not.

Place of Employment

Though the healthcare industry continues its march toward preventive, outpatient, and community-based care, hospitals are still the main employers of RNs.

  • 39% of RNs reported working in hospital-based inpatient care
  • 13% of RNs reported working in a hospital-based outpatient setting or clinic

Skilled nursing facilities or another type of long-term care setting were the primary employers of LPNs (24%).

Full-time vs. Part-time

The majority of RNs (75%) and LPNs (81%) reported working full-time in 2017. Still, compared to 2016, this is a 5% drop in the number of RNs working full-time and a 1% decrease for LPNs. The decrease in full-time RNs corresponded to an increase in part-time or per-diem RNs.

Practice Setting Matters

It's a common assumption that hospitals pay the highest, but some other settings are giving that notion a run for its money.

The insurance industry and occupational health settings pay full-time RNs as much as the hospital setting ($84,000 on average).

Medical offices, public health, and school nursing pay the least.

The Gender Gap Remains

Despite women significantly outnumbering men in nursing, men still earn more money.

Men make an average of 7%, or $6,000 per year, more than women

Interestingly, men and women RNs reported the same hourly page wage of $37.

However, 51% of men reported working overtime compared to 41% of women.

Unions Influence Pay

While 16% of RNs report union membership, nurses who work in hospitals have higher union membership (59%) than in other settings.

RNs belonging to a union made 13% more than their non-union counterparts.

Geographic Differences

Pay varies significantly by region.

  • RNs in the Pacific region (California, Oregon, Washington, Alaska and Hawaii) earn the most (an average $102,000 per year).
  • The lowest paid RNs made $69,000 and were in the East South Central region (Tennessee, Kentucky, Mississippi, Alabama).

Of note, nearly 45% of Pacific region nurses belong to a union, which influences salary rates.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.


Nurses paid on a salaried basis make more than those paid annually.

Men who are nurses out earn women nurses.

Hospital RN wages did not increase from 2016 to 2015.

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