Nurse salary is only part of the pie

By | 2021-05-07T15:13:01-04:00 August 7th, 2017|Tags: , , |3 Comments

Besides nurse salary, take a hard look at the total benefits package

Marie Nolan, PhD, MPH, RN, FAAN, likes to relay her personal experience in negotiating work benefits to her doctoral and undergraduate students at Johns Hopkins School of Nursing in Baltimore, where she is a professor and executive vice dean.

Nolan tells students that as a new nurse in 1980, she was told by a nurse manager that she’d have to work the night shift. “I said, ‘I couldn’t possibly work nights because I want to learn all I can as fast as I can. You really don’t learn as much working at night because patients are sleeping and you don’t want to wake them up.’”

The nurse manager responded, “Well, OK, you can work days then,” Nolan said.

“Three new graduates who were hired just before me were incensed,” she said. “They asked why didn’t I have to work the night shift? And I said, ‘Because I said I wouldn’t.’”

That simple story illustrates a couple of important points that Nolan stresses to her students. First, nurses — even new nurses — often have more negotiating power than they realize. Second, it’s important for nurses to understand their professional and personal goals before negotiating benefits.

Salary is only one component nurses need to consider when job hunting or reviewing their total compensation package. Hospitals and other organizations can offer nurses a wide range of benefits, including medical, dental and vision insurance; short- and long-term disability insurance; retirement benefits; and life insurance. Other benefits can include family leave (which can be important to nurses expecting add to their family), gym memberships, mobile phone discounts and free lunch or snacks.

However, Nolan said the most important benefit for nurses, especially young nurses, is tuition assistance because of the skyrocketing cost of education. Nolan said one hospital might offer $15,000 a year in tuition assistance, whereas another hospital might offer only $5,000 a year. That kind of difference can really add up. “If they would have selected their employment based on tuition remission, they could end up being $30,000 or $60,000 ahead,” Nolan said. Tuition remission differs from reimbursement in that the financial benefits or waivers are often secured before the school semester begins.

A strong nursing candidate also might be able to negotiate the wait time required before going back to school. Nolan said the nurse can tell her prospective employer that because she is very energetic and driven, she should be allowed to return to school on a part-time basis within six months rather than waiting the customary year or two to receive tuition remission. Or she can say she is ready to go back to school immediately, but only to take one class that will not interfere with her orientation on the unit.

Nurses also might want to consider whether their employer offers tuition assistance for their children. For example, Johns Hopkins Medicine offers to help full-time employees who have worked two continuous years pay for their dependent children’s college education, up to 50% of the value of Johns Hopkins University’s freshman undergraduate tuition.

Benefits for the golden years

Another important benefit to consider is the percentage of one’s contributions to a retirement account, such as a 401k, that an employer will match. Nolan notes there could be a huge difference in the retirement accounts after 30 years or so between a person whose employer matches 6% of one’s contributions versus a person whose employer matches 12%.

If a nurse has multiple job opportunities, Nolan suggests making a list of such things as salary, retirement benefits and career opportunities offered by each potential employer. One employer might end up paying significantly more in salary and benefits over the course of a career than another employer, but the other employer might offer a work atmosphere that better suits one’s professional and personal goals.

A community hospital, for example, might not be the place for a nurse who has lofty career ambitions and seeks ample opportunity to collaborate with physicians, but it might be perfect for one who wants a flexible schedule and would rather avoid the number of medical crises one might encounter at a large teaching hospital.

“The problem,” Nolan said, “is when people are not informed and they choose one hospital over another for the wrong reasons.”

Barbra Drenski, OnCourse Learning senior human resources generalist-benefits and compensation, said benefits beyond salary can make up as much as 27% of an employee’s total compensation package.

Drenski said there are a couple of benefits that many people overlook or don’t examine closely enough when interviewing for a job, including the specifics of the company’s 401k or other retirement plan beyond the employer match percentage. “People overlook the vesting schedule,” Drenski said. “The employer may match, but then they don’t ask, ‘Is it vested immediately? Is it vested over a five-year time frame?’ If you only stay with a company for three years and your vesting schedule is over five, then you’re not going to get 100% of that employer match.”

Drenski also stresses the importance of making sure the employer offers a health savings account, especially if a high-deductible medical plan is part of the benefits package. “It’s a great way to save money on a pre-tax basis for out-of-pocket medical, dental and vision expenses,” Drenski said.

Ask — then dig deeper

Because benefits play such a key role in total compensation, there is no wrong time to discuss them during an interview process, Drenski said. The higher the level of one’s job, the more important a benefits package usually becomes in determining whether a prospective employee accepts an offer.

Being informed about benefits an employer offers before beginning negotiations also is important. This process often starts with looking at a potential employer’s website, where basic benefits usually are listed. But Nolan suggests digging a little deeper. She said nurses can call the HR department and ask for specifics about such things as salary ranges and tuition reimbursement. This will allow a nurse to realize she or he has room to negotiate.

And a simple phone call to a friend — or a friend of a friend — often is the best way to determine the work environment of a hospital or other organization. Some hospitals even will allow prospective employees to share a day with a nurse to get a firsthand experience.

Once a nurse has all the information she or he can get, the negotiating process becomes a little easier, but it’s still necessary to know where to draw the line. Nolan said once you tell an employer what it is you can’t live without, you have to be serious. If you aren’t willing to actually walk away from a job because of a certain benefit, then don’t say that’s what you are going to do.

Freelance writer Tom Clegg contributed to the writing and research of this article.


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About the Author:

Sallie Jimenez
Sallie Jimenez is content manager for healthcare for from Relias. She develops and edits content for the blog, which covers industry news and trends in the nursing profession and healthcare. She also develops content for the Digital Editions. She has more than 25 years of healthcare journalism, content marketing and editing experience.


  1. Avatar
    Gooch August 20, 2017 at 2:22 pm - Reply

    The real issue seems to be that seasoned RN’s who get promoted to Charge nurse or DON forget what was and is like hourly and are more interested in new found administrative power and usually provide favors to those who bow down to wishes of leaders. One bad apple can destroy all team concepts, especially when favoritism to a selected individual is felt.

  2. Avatar
    shirley hursh August 22, 2017 at 9:25 pm - Reply

    Another ignorant nurse who thinks everyone sleeps at night!She should try it- she’d be surprised at what she learns.

    • Avatar
      Victoria September 9, 2019 at 2:07 pm - Reply

      Yes, night shift isn’t necessarily less busy. I worked mainly ICU and step-down units. People don’t decide to stop being sick when the sun goes down. Plus a lot of our patients seemed to have days and nights mixed up. Not to mention sundowning. At night you also have much less resources and often less help. Days and nights are both tough for different reasons. It is ignorant however to say that patients are sleeping all night. I’ve floated to a lot of different units and I haven’t seen this. The only exception is when I’ve been on an observation unit with people that are very stable and need vitals Q8 and are fairly independent. This is something that is very rare. I will say however that during the day you often learn more because you can round with the doctor and you feel like you are part of “the team” more.

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