By Jennifer Larson, contributor
November 5, 2010 - Which nurses are making the most money?
Typically, the top salaries in the nursing profession are earned by nurses in an advanced practice specialty or, in some cases, in higher-level management positions, according to the recently released National Sample Survey of Registered Nurses.
That’s logical, noted Joanne Spetz, Ph.D, a health economist, labor expert and faculty researcher at the Center for the Health Professions at UCSF. Typically, a graduate degree means higher earnings, and with the exception of nursing faculty, that’s generally true for nurses.
Peter McMenamin, Ph.D., senior policy fellow for the American Nurses Association, agreed.
“It looks like supply and demand to me,” he said. “The advanced practice nurses are fewer. They have more education. They can also do more under their own authority.”
In fact, even staff nurses garner higher wages if they have more education under their belts; the survey found that staff nurses with a master’s or doctorate degree made, on average, $69,616 in 2008, while nurses with an associate degree made $59,310. The average RN, working as a staff nurse, made $61,706 in 2008.
The top ten
The top ten nursing salaries, according to the 2008 National Sample Survey of Registered Nurses:
1. Nurse anesthetist: $154,221
2. Management/administration: senior management: $96,735
3. Nurse practitioner: $85,025
4. Nurse midwife: $82,111
5. Management/administration: $78,356
6. Consultant: $76,473
7. Informatics nurse: $75,242
8. Management/administration: middle management: $74,799
9. Clinical nurse specialist: $72,856
10. Management/administration: first-line management: $72,006
Health economists like Spetz were not surprised at all that nurse anesthetists topped the list.
“They have a very, very specialized education,” she said. “And the liability risks are high.”
Additionally, certified registered nurse anesthetists (CRNAs) are paid for providing a type of care that also generates substantial compensation for the physicians who provide this type of care. For comparison, anesthesiologists’ mean annual wage in 2009 was $211,750, according to data from the U.S. Bureau of Labor Statistics (BLS).
“I would expect that to continue,” Spetz said of their list-topping salaries.
The nurse faculty salary conundrum
Unfortunately, some experts are concerned that nursing faculty salaries are not keeping up. Regardless of their education, nursing faculty members rarely seem to crack the $70,000 mark. The average salary for nurses engaged in instruction as their primary job in 2008 was $65,844, according to the sample survey data.
“There is a disparity,” said Beverly Malone, Ph.D., RN, chief executive officer of the National League for Nursing.
Malone noted that it’s a challenge to attract the best and the brightest into teaching because they will not be as well compensated as they would be if they went into another specialty. That poses problems for the entire nursing profession because a shortage of faculty means a shortage of people to educate an appropriate number of future nurses to meet the demands of an aging population.
“It’s very difficult right now,” she said. “But I see pathways opening up.”
It could help to establish programs to prepare academic faculty to be qualified for promotion to full professorships. With a more prestigious title comes a higher salary, Malone noted. For example, the National League for Nursing holds writing retreats to help faculty members prepare papers for publication, which can help them on the path to those higher salaries and titles.
Nursing, like most other health care professions, weathered the recent recession better than most other industries. Although wages did not grow as fast as they once did, the profession didn’t experience mass layoffs or other major unemployment problems, Spetz said.
“Nursing has done very well,” she said.” And nursing will probably continue to do well in an economic recovery.”
Salaries for RNs tend to be inching upward each year, something that not many other professions can boast. More recent employment statistics from the BLS show that the median salary for RNs in 2009 was $63,750, more than $10,000 more than the median salary of $52,330 five years earlier in 2004.
As the future unfolds, the demand for nursing care is expected to increase. The general population will continue to age and require increasing amounts of care. In fact, the first of the baby boomers will turn 65 next year, which means they will gain access to Medicare. Also, more than 30 million people will be added to the insurance rolls as a result of the federal Patient Protection and Affordable Care Act, which Congress passed earlier this year.
“We project RNs from 2008 to 2018 to add more jobs in that profession than any other profession,” said Adam Bibler, economist for the Office of Occupational Statistics and Employment Projections with the BLS.
And with an increased demand for primary care in a post-health care reform era, there may also be an even higher demand for advanced practice nurses, McMenamin said. The big question is whether most states will expand their scopes of practice to allow nurse practitioners to practice more independently, as recommended recently by the Institute of Medicine.
But if there is increased demand for these graduate-prepared nurses, their wages will likely increase, too, he added. And that, in turn, could drive more nurses toward seeking out graduate degrees.
“It’s going to avalanche,” he said.
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