Most nurses rank salary as the number one aspect of job satisfaction. Yet only 18% of RNs said negotiating salary is something they always do at the start of each new nursing job, according to Nurse.com's 2022 Nurse Salary Research Report.
More than 2,500 nurses from all 50 states, working in a wide range of settings, responded to online survey questions in late 2021. The data revealed regular merit increases were the No. 1 compensation factor for all RNs in relation to job satisfaction, followed by their ability to use their full scope of practice. Nurses also said their manager, the mission of the organization, and advancement opportunities were what they looked for most in a job.
Although APRNs (52%) and LPNs (41%) were more likely to negotiate their salaries, only 31% of RNs said negotiating salary is something they do all or most of the time. About 30% of all nurses surveyed said they never negotiate their salaries. Yet negotiating salary can result in higher compensation. And 40% of male RNs said they negotiate salary always or most of the time, compared with only 31% of female RNs.
How much wiggle room do nurses have when it comes to negotiating salary? And how should they go about it?
Ask about pay structures when negotiating salary
Salary negotiations are worthwhile and may be possible for experienced nurses seeking new jobs, but not likely for new nurses, according to Theresa Mazzaro, RN, CHCR, senior talent acquisition specialist at Suburban Hospital. Located in Bethesda, Md., Suburban Hospital is part of Johns Hopkins Medicine. Mazzaro also serves as a member of the board of directors of the National Association for Health Care Recruitment (NAHCR).
The reality is that many factors impact how much employers can vary on nurses' and other providers' salaries, according to Jessica Quezada Jackson, CHCR, a talent acquisition recruiter at a health system and NAHCR board member.
In a unionized environment, for example, the union determines employment parameters, including salary. But even in the absence of a union, employers like hospitals have to abide by Affirmative Action and U.S. Equal Employment Opportunity Commission guidelines, which promote equity in hiring practices, according to Jackson. Many employers pay nurses based on level of experience, with tiers built in for certifications, higher degrees, and more. It's not really a negotiation, according to Jackson, but rather a set, tiered pay structure.
The most important thing nurses can do to make sure they're leveraging their experience, education, and more is to understand a potential employer's pay structure. Then they can negotiate where possible, Jackson said.
"Nurses can get that information through their recruiters," she said. "A lot of recruiters are in-house, and they'll be able to tell you what you're going to make based on your background."
New graduate nurse pay
For new graduate nurses, there is typically no negotiation, Mazzaro said. Numerous factors can affect a new RN's salary. Credit for previous LPN experience is one factor for calculating the new nurse's base salary. The education level of the new graduate also might help that nurse earn more. Registered nurses with an associate degree in nursing might have a different starting salary than one entering the workforce with either a BSN or entry-level MSN, according to Mazzaro.
There are other ways to earn higher pay, even for a new nurse. Like a more experienced nurse, a new graduate nurse might be able to earn a differential by working the night shift, versus the day shift.
Experienced nurses' negotiating power
An experienced nurse might have greater negotiating power.
Some employers have policies where they pay according to a pay scale, based on years of experience in that nursing specialty. There is no room for negotiation or discussion, according to Mazzaro.
That's why it's important for experienced nurses to make clear the experience and value they might bring to a new role.
"From a negotiation standpoint, it would behoove the nurses to be able to tell their stories about the experiences of jobs they've had and what they've done," Mazzaro said. "Because if we're looking at just a resume and that's the only snapshot we have when we're calculating a salary, we might not have the whole picture."
It's also important to think about overall pay and compensation when starting a new job, according to Jackson. For example, nurses who are relocating to underserved areas may be able to negotiate more lucrative relocation packages versus higher base salaries.
Prepare now for a higher salary later
Nurses can work on boosting their salary potential at their current and future jobs in several ways, including becoming certified in their specialties.
"Getting that certification shows and proves via an evaluation and exam that you are competent and certified as a specialty nurse," Mazzaro said.
And that could lead to an increase in pay at a current job or a higher starting pay at a new job.
Salary increases and education levels often go hand in hand, experts say. Nurses with associate degrees, for example, should ask their employers if they pay more for a BSN and, if so, how much more. Sometimes the increase in pay for higher education is a differential, added to a nurse's pay, Mazzaro said. Sometimes it's worked into the base salary.
"The other thing I would recommend to nurses is to become a preceptor or a charge nurse," Mazzaro said. "Anytime that you increase your level of responsibility, like with being a preceptor or a charge nurse, there's typically a differential for that."
Mazzaro said it's usually best for nurses to talk about pay with their recruiters and not hiring managers.
"Work with your recruiter and make sure your resume is complete and up to date, especially for those nurses who are highly tenured and have lots of years of experience," Mazzaro said. "The more you can diversify and expand your knowledge base and skill set, the more opportunity you do have to ask [for higher pay]."
Editor's Note: This blog post was originally published 12/2/2021 and has been updated.
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