Written by David McNamee

Male registered nurses are earning more than female registered nurses across settings, specialties and positions, and this pay gap has not narrowed over time, says a new analysis of salary trends published in JAMA.

Although the salary gap between men and women has narrowed in many occupations since the introduction of the Equal Pay Act 50 years ago, say the study authors, pay inequality persists in medicine and nursing.

Previous studies have found that male registered nurses (RNs) have higher salaries than female registered RNs. In their new study, researchers from the University of California, San Francisco, sought to investigate what employment factors could explain these salary differences using recent data.

The researchers analyzed nationally representative data from the last six quadrennial National Sample Survey of Registered Nurses studies (1988-2008; including 87,903 RNs) and data from the American Community Survey (2001-13; including 205,825 RNs). In both studies, the proportion of men in the sample was 7%.

During every year, both of the studies demonstrated that salaries for male RNs were higher than the salaries of female RNs. What is more, the researchers found no significant changes in this pay gap - which averaged as an overall adjusted earnings difference of $5,148 - over the study period.

In ambulatory care the salary gap was $7,678 and in hospital settings it was $3,873. The smallest pay gap was found in chronic care ($3,792) and the largest was in cardiology ($6,034). The only specialty in which no significant pay gap between men and women RNs was detected was orthopedics. The salary difference was also found to extend across the range of positions, including roles such as middle management and nurse anesthetists.

Employers and physicians 'need to examine pay structures'

"The roles of RNs are expanding with implementation of the Affordable Care Act and emphasis on team-based care delivery," the authors write. 

They conclude:

"A salary gap by gender is especially important in nursing because this profession is the largest in health care and is predominantly female, affecting approximately 2.5 million women. These results may motivate nurse employers, including physicians, to examine their pay structures and act to eliminate inequities."

The results of a 2010 survey looking at the impact of the economic crisis on nursing salaries published in Nursing Management found that a nurse leader's average salary fell by $4,000 between 2007 and 2010. In the same survey, almost 60% of nurse leaders felt that they were not receiving appropriate compensation for their level of organizational responsibility.

However, that survey found no evidence that workload for nurse leaders had increased. The respondents reported that they were still working the same number of hours per week as they had traditionally and were not responsible for more staff members than before the economic crisis.

"If you thought nursing was immune to the downturn, think again. The poor economy is keeping us working longer than we'd anticipated," said Nursing Management editor-in-chief Richard Hader, "and in addition to wage cuts, organizations are freezing or eliminating retirement benefits, further negatively impacting employee morale."

Source: www.medicalnewstoday.com

By Nursing at Ohio University 

By Heather Stringer

 

Atkins is not alone. Most nurses throughout the country are feeling the impact of significant national factors, such as the recession and healthcare reform, that are changing the landscape of nursing jobs.

“Nurse salaries — and really salaries for any profession — are generally determined by supply and demand,” said Joanne Spetz, PhD, a noted healthcare and nursing economics researcher and professor at the Institute for Health Policy Studies, University of California, San Francisco. “What we’ve been seeing in California is that the wages of nurses really flattened out and may have even dropped in the past four years after a period of rapid wage growth.”

According to data from a 2012 survey from the California Board of Registered Nursing, the annual salary of nurses in California increased from $45,073 to $81,428 between 1997 and 2008. In the past five years, however, salaries flattened and even dropped between 2010 and 2012. 

 

RNs across the nation are experiencing a similar trend, according to data from the U.S. Bureau of Labor Statistics. Starting in 2009, the median annual wage increases were 2% or less, compared with double or triple that percentage the previous five years. Between 2011 and 2012, the latest data available, the median annual wage for RNs nationally increased only 1%, from $69,110 to $69,935. Data from the American Association of Colleges of Nursing shows that nurse faculty salaries are stagnating as well.

Although many hospitals have become more conservative in hiring nurses, Spetz suggested there are strategies nurses can use to increase their chances of securing a desirable position in the long run. “I know a lot of new graduates like to look for the perfect job, but if the labor market is tight in your area, just get a job because some experience will make you more competitive and help you get that perfect job in the future,” she said. “If you are an associate-degree graduate and can go back to school, do it.”

For Atkins, the willingness to be flexible paid off in the short term. After a year as director of an ED in Louisiana, he was recruited to fill an interim ED director position at a larger hospital system in Missouri. Although the position was short-term, he hoped the experience would help him eventually land a position in California. Then the call came: A traveling company recruited him for an interim position in California. This interim position eventually turned into a full-time permanent role as house and bed control supervisor at Kaiser Permanente in Hayward, Calif., with an annual salary well above any of his previous salaries.

“During my previous director roles, I tried to learn everything possible about budgets, audits and the hospital, such as how to set up an incident command center and emergency response teams,” Atkins said. “Now I absolutely love my job, and my hours allow me to be home with my children in the evening.”

Forces at work

While recessions and salary changes tend to be cyclical, the future is less predictable with the convergence of several national trends.

“The first factor is the real impact healthcare reform will have, and a lot of that is relatively unknown,” said Terry Bennett, RN, MS, CHCR, president of the National Association for Health Care Recruitment, based in Lenexa, Kan. “Organizations are struggling to predict the impact of decreasing physician and Medicare reimbursements, and they are really trying to maintain financial security. They are not giving the same type of market adjustments that they used to [give nurses], and some are decreasing the amount of merit increases given to nurses.”

In addition, the supply of nurses has increased in the past decade as a growing number of nursing school graduates join baby boomers still on the job, Spetz said. “The baby boomers have been more career-focused than any generation preceding them,” she said. “They might not want to fully retire even if the recession lifts.” 

 

However, other factors could increase demand for RNs and drive up salaries. “What we would expect is that as the economy improves and as the Affordable Care Act allows more people with insurance to seek healthcare, we would see demand for nurses go up,” said Spetz. “Also, as baby boomers age and require more healthcare, this could also drive up demand for services.”

Nurse staffing ratio laws also may increase the number of positions available in hospitals, said Brannen Betz, general manager of Aureus Medical Group, a national nurse staffing company. According to the American Nurses Association, 15 states have enacted legislation or adopted regulations to address nurse staffing. “Many states are moving toward mandating nurse-to-patient ratios, and this could be the best thing that happens to nurses,” Betz said. 

 

Maximum trajectory

As healthcare employers prepare for these changes, nurses can position themselves to stand out from their competition.

“We are no longer just putting someone in the job because they have a credential,” said Julie Hill, RN, BSN, CHCR, RACR, recruitment coordinator for Georgetown Hospital System in South Carolina and vice president of NAHCR. “Now we have a larger applicant pool, so we can select the best nurse for the job. Many hospitals use behavioral assessment tools so they can make sure that an individual has the positive service attributes that lead to good hospital consumer assessment scores and less likelihood of turnover.”

Georgetown uses a behavioral assessment tool combined with a separate reference assessment tool, Hill said. Hospitals are looking for nurses who are flexible, customer-focused, compassionate, have a strong work ethic and work well with team members, she said.

Nurses with specialty training also are in higher demand, said Kay Cowling, CEO of Fastaff Travel Nursing, based in Denver. Nurses with experience in ORs, labor and delivery, cardiovascular ICUs or pediatric areas have more options, Cowling said. RNs who know how to use electronic health record systems also have an advantage in the job market, she said. 

Source: Nurse.com

by Molly Mattison

As more Americans gain access to healthcare, and fewer physicians are available, family nurse
practitioners (FNPs) can play a valuable role in providing families with access to primary care. 

What is an FNP? 

FNPs work autonomously and as part of a primary-care health team to:

• Manage patients’ overall care
• Diagnose/treat acute and chronic conditions
• Prescribe medications
• Educate patients on disease prevention/health management

What is the salary of a family nurse practitioner?

Nurse practitioners enjoy an average, full-time, total salary of $98,760, according to the American Association of Nurse Practitioners.

Named one of the best jobs in America by CNNMoney/Payscale.com in 2012, FNPs also enjoy increased autonomy, expanded responsibilities and time to spend with patients. Check out the infographic below for more reasons why family nurse practitioners are today’s healthcare superheroes:

Infographic by Chamberlain College of Nursing

By: Jessica Opoien

School psychologists and nurse assistants in Oshkosh will receive the school district’s first-ever market-driven salary increases.

The school board approved a resolution, which grants three currently-employed school psychologists $20,000 raises each and boosts the hourly pay for nurse assistants by $1.50 or $2.50, depending onexperience, at its Wednesday meeting. The raises for school psychologists range from 37 percent to 43 percent more per employee.

The district has struggled to fill substantial vacancies throughout the last year-and-a-half. Five out of seven psychologists and five out of nine licensed practical nurses have left the district in that time, with three psychologists leaving since August. Postings for LPNs have yielded one applicant per vacancy, and there is virtually no candidate pool for psychologists.

There are 15 districts across Wisconsin with open psychologist positions, according to postings on the Wisconsin Educator Career Access Network. However, districts are in direct competition with medical facilities and private firms that employ psychologists, and no applicants have responded to Oshkosh’s four vacancies for psychologists.

The district is obligated to employ school psychologists for special education assessment and placement, said Superintendent Stan Mack during the meeting.

“As we well know just dealing with the issues in the last week, supporting students in crises demonstrates the need for psychologists well beyond the need of special ed assessment and special ed placement,” Mack said.

Six districts surrounding Oshkosh pay their psychologists an average salary of $67,000, according to a survey conducted by the Oshkosh district. Psychologists in Oshkosh earn an average salary of $47,000.

School nurse assistants face a similar situation. In Oshkosh, they earn between $14.98 and $15.85 per hour, while the regional average pay is between $16.33 and $20.77 per hour, depending on experience.

Mack said responsibilities for school nurses have increased as students’ medical conditions have grown more complex, adding that the current compensation rate is inadequate to recruit and retain LPNs in the district.

The raises follow a series of other compensation-related resolutions aimed at curbing turnover and attracting new employees to Oshkosh schools. The board over the past three years raised salaries for its top administrators 24 percent in direct response to difficulty retaining employees. Last month, the board voted to spend up to $350,000 next school year on raises for teachers who earned graduate credits during pay freezes.

Article from Jackson University

In economically challenging times, many nurses are looking for ways to boost salary and increase the versatility of their valuable skill set. Keeping skills current is a mandatory part of nursing but even with superior skills there is intense competition for top jobs.

Broadening your résumé with additional credentials can make you attractive to employers who want a versatile staff able to fill in where needed. As a result, nurses are finding creative ways to gain experience that makes their skills more attractive and, at the same time, opens the door to increased salary.

Boost Credentials

Many highly ranked and regionally accredited online programs provide a win-win situation for nurses, allowing them to bolster their résumé while remaining with their current employer.

Completing a BSN or MSN can increase employment flexibility and earning potential. Opportunities also exist for nurses who undertake additional training in specialty areas such as: Certified Nurse Midwife (CNM), Certified Registered Nurse Anesthetist (CRNA) and Certified Nurse Practitioner (CNP).

Consider the Whole Package

The versatility of nursing is a great selling point for those who enter the field. Qualified nurses with a reputable education and strong experience may find themselves comparing more than one employment offer at some point in their career.

Carefully examining benefit packages at prospective employers will help you choose the best fit for your needs. Better health insurance coverage, comprehensive tuition assistance packages and top-notch retirement plans have long-term financial advantages that can augment a salary offer.

The ability to adjust a compensation package as your needs change over the course of your professional career is also an important factor to consider.

When looking to increase salary, you may be overlooking options at your current employer. For instance, many employers offer a wide range of training and ongoing educational opportunities. There might be in-house technology or software training available that could bring extra income over time. Flex time while taking courses or tuition assistance for online and traditional courses is a common benefit in healthcare settings.

It is often more economical for an employer to invest in current employees than to hire someone new. Meet with a supervisor or HR professional to determine which advancement opportunities are available.

Be Creative

If you need extra money consider working night, weekend and holiday shifts. Becoming a traveling nurse where need is great also may boost your salary. If you prefer to stay close to home, many nursing training programs hire tutors or maintain a list of tutors for students who need extra help.

Some community organizations need health speakers and may pay for your services; community event organizers also often need to hire a nurse to work at a first aid station during a foot race or other special event.

In recent years, some health plans have begun offering work to nurses willing to field online questions, return phone calls or offer intermittent services to outpatients and those recovering from surgery.

In short, there is often a diversity of part-time opportunities available for making extra money once you take the time to start looking.

Taking a Holistic Approach

Nursing remains a great investment of tuition dollars even in a tough economy. Many top-notch, online nursing programs offer the versatility needed for busy nurses to boost their résumé and earning power.

Solid increases in salary typically coincide with securing additional skills and credentials that make you more valuable in the marketplace. For nurses, a holistic approach and a little creativity can often reveal short- and long-term ways to gain training and boost income potential for years to come.

Article from U.S. News

#1 in U.S. News Best Jobs 2012

Overall Score: 8.2

Number of Jobs: 711,900	Median Salary: $64,690
Unemployment Rate: 5.5%	Job Satisfaction: MEDIUM

Salary Outlook

The Bureau of Labor Statistics reports the median annual wage for a registered nurse was $64,690 in 2010. The best-paid 10 percent of RNs made approximately $95,130, while the bottom 10 percent made approximately $44,190. The highest wages are reserved for personal care nurses, or those working for private-sector pharmaceutical or medical device manufacturers. By location, the highest-paid positions are clustered in the metropolitan areas of northern California, including municipalities in and around San Jose, Oakland, and San Francisco.

Average Registered Nurse Pay vs. All Healthcare Jobs

Registered nurses make an average salary of $64,690, which is pretty good pay compared with some of the other Healthcare Jobs on this year's list of The Best Jobs of 2012. That's comparable to the pay of occupational and physical therapists. Medical assistants take home far less money in a year—approximately $35,830 less in 2010 than the average RN earned that same year. And with an average salary that's a little more than $30,000 per year, paramedics also have a lower average salary than nurses.

Best Paying Cities for Registered Nurses

The highest paid in the registered nurse profession work in the metropolitan areas of San Jose, Calif., Oakland, Calif., and San Francisco. The Salinas, Calif. area also pays well, as does the city of Napa, Calif..

San Jose, Calif.

Salary: $116,150

The annual median wage of a registered nurse working in San Jose, Calif. is $116,150, which is $51,460 more than the average pay in the profession.

» See Registered Nurse Jobs in San Jose, Calif.

Oakland, Calif.

Salary: $100,900

The annual median wage of a registered nurse working in Oakland, Calif. is $100,900, which is $36,210 more than the average pay in the profession.

» See Registered Nurse Jobs in Oakland, Calif.

San Francisco

Salary: $97,600

The annual median wage of a registered nurse working in San Francisco is $97,600, which is $32,910 more than the average pay in the profession.

» See Registered Nurse Jobs in San Francisco

Salinas, Calif.

Salary: $97,450

The annual median wage of a registered nurse working in Salinas, Calif. is $97,450, which is $32,760 more than the average pay in the profession.

» See Registered Nurse Jobs in Salinas, Calif.

Napa, Calif.

Salary: $97,090

The annual median wage of a registered nurse working in Napa, Calif. is $97,090, which is $32,400 more than the average pay in the profession.

» See Registered Nurse Jobs in Napa, Calif.

By TESS VIGELAND

Published: March 21, 2012

How far would you go for a financial comeback? Heading to North Dakota’s oil boom and other stories of post-recession striving.

IN 2007, Kurt Edwards figured he would be stacking and racking 80-pound boxes of dog food and celery in the back of a grocery store for the rest of his working life. And he was fine with that.

But that June, after nine years on the job, layoff notices arrived on the warehouse floor at the Farmer Jack store in Detroit where he worked. His employer, Great Atlantic and Pacific Tea Company, closed the Farmer Jack chain. Today he still does a lot of lifting, but of people, not boxes. Mr. Edwards joined the ranks of former warehouse, factory and autoworkers trading in their coveralls and job uncertainty for nurses’ scrubs.

At 49, divorced with no children, he now tends to patients on the graveyard shift at Sheffield Manor Nursing and Rehab Center, a two-story, gray brick building in a ramshackle neighborhood on Detroit’s west side. Interviewed last month, he says he is making about $70,000 annually, $20,000 more than he did at the warehouse.

The story of how he made the transition is one that men like him appear to be telling with increasing frequency, and the demand for their services is what is setting so many of them on similar paths.

Hard figures are elusive, but the Michigan Department of Energy, Labor and Economic Growth estimates a shortage of 18,000 nurses in the state by 2015 — and the labor force is adapting.

Oakland University in nearby Rochester, Mich., has established a program specifically to retrain autoworkers in nursing — about 50 a year since 2009. And the College of Nursing at Wayne State University in Detroit is enrolling a wide range of people switching to health careers, including former manufacturing workers, said Barbara Redman, its dean. “They bring age, experience and discipline,” she said.

David Pomerville brings a few more years than Mr. Edwards. A 57-year-old nursing student, he spent most of his career as an automotive vibration engineer, including almost 10 years at General Motors. His pink slip arrived in April 2009.

At the time, Mr. Pomerville was earning almost $110,000 a year at the General Motors Milford Proving Ground in Milford Township, Mich.

But having watched another round of bloodletting at G.M. three years earlier, he had already decided on nursing as his Plan B. “I thought, ‘Well, I worked on cars for this long, now I’m going to work on people for a while,’ ” he said.

A married father of two and grandfather of two, Mr. Pomerville had almost no money saved when he was laid off. But the federal Trade Readjustment Act, which aids workers who lose their jobs as a result of foreign competition, paid for nursing school tuition. His wife is a teacher, and he receives unemployment benefits. He hopes to graduate at the end of this year, and he expects his salary will be about half what he used to make.

Timothy Henk ultimately decided not to try to stick it out as long as Mr. Pomerville did. Mr. Henk, 32, worked for eight years at the Ford Sterling Axle Plant in Sterling Heights, Mich., installing drive shafts in the F-150 truck, and was making about $25 an hour by 2007. With overtime, he earned $70,000 a year.

But as he and his wife contemplated having children, he worried that income would not last. So in 2007, he took a buyout, which included $15,000 a year for four years to put toward education. Two friends in nursing — both women — had suggested he look into joining their profession. He researched the demand for nurses in Michigan and used the buyout money to pay his tuition at Wayne State.

The amount of schooling required to be a nurse depends on the level of nursing a student chooses to pursue. Mr. Henk went through Wayne State’s four-year program to obtain a bachelor of science in nursing and then took a licensing exam to become a registered nurse, or R.N. Other levels of nursing include the C.N.A., or certified nurse’s aide, which can require as little as eight weeks of training plus a certification exam, and L.P.N., or licensed practical nurse, which requires one or two years of schooling and a licensing exam.

All of that assumes acceptance in a nursing program. The American Association of Colleges of Nursing said more than 67,000 applicants were turned away in 2010 for lack of faculty or classroom space — not a good sign with a national nursing shortage projected to be as high as 500,000 by 2025.

Mr. Henk now works in the critical care unit at Beaumont Hospital in Royal Oak, Mich. He makes about $50,000 annually for a 36-hour workweek, though Ford’s health insurance was better.

The choice to make this switch was probably least likely for Mr. Edwards, the former grocery worker. He dropped out of college and spent four years in the Army as a paratrooper with the 82nd Airborne Division. He found his unionized warehouse job after a stint working for his father, an accountant.

“You have this plan, this goal,” he said. “I was going to be at this warehouse; all the guys were retiring with great benefits. I was part of the middle class, and I was going to make it.”

When it became clear that he would not make it to retirement there, someone he was dating suggested nursing.

Though he wrote it off as woman’s work at first, he realized he was getting a bit old for manual labor. So he returned to school, living on unemployment checks and occasional groceries from by his mother. He spent the last four months of his L.P.N. training with no electricity because he could not afford to pay any bills except rent.

Once he finished, the Sheffield Manor administrator, LaKeshia Bell, pretty much hired him on the spot. “They are like a hot commodity,” she said. “A male presence actually helps us in the facility.” At 5 feet 9 inches tall and 220 pounds, Mr. Edwards lifts patients as easily as he stacked boxes.

But he still appears to be a rarity. Just 7 percent of employed registered nurses are men, according to a 2008 Department of Health and Human Services survey. It did not count licensed practical nurses. Still, the percentage of people certified in nursing in some way who are men has risen to 9.6 percent since 2000 from 6.2 percent before, according to the department.

Ms. Bell noted that new nurses coming from manufacturing had unusual adjustments to make. When dealing with parts on the factory floor, she said, repetition is a major part of the job. “These are not parts. They’re people, so you can’t just have a set regimen like in a plant setting,” she said.

That cultural shift goes both ways. Mr. Edwards’s supervisor, Yvonne Gipson, provided an example. “I mean Kurt is not an ugly man, O.K.?” she said. “You got all these female workers, and they’re all looking at him like, ‘Oh! Potential husband!’ So, yes, it does change.” Her voice trailed off, erupting into peals of laughter as Mr. Edwards slipped a $20 bill into her pocket.

While these success stories point to opportunity, Michigan’s unemployment rate is still 9 percent. And Nelson Lichtenstein, director of the Center for the Study of Work, Labor and Democracy at the University of California, Santa Barbara, says history is a cruel taskmaster when it comes to struggling industries.

“When one industry goes in decline and another comes to the fore, you don’t have a one-to-one employment replacement at all,” he said. “It takes a decade, two decades. In the meantime, some people find their careers are ended, ruined, and they never get them back.”

For these new nurses, the advantage is the demand in Michigan. Mr. Edwards knows he is lucky. “You know I wake up every day and I’m very proud,” he said. “I’m looking in the mirror. I’m happy. I’m proud. I’m saying, you know, this turned out great. The lights are on!”