Why Nurses Leave the Bedside; A Bedside RN's perspective
RN Salaries 1987-2001. The  Poor Statistics behind "Nurses being better paid than Ever";
The Erosion in Nurses Salaries 1992-2000, the modest gains of 2000-2001
What Management says About RN Wages
What Nurses Say about RN Wages
Nurses salaries actually ERODED from 1992 to 2000, a terrible decade for nursing, and  a period marked by increasing patient ratios, increasing acuity of the patients under an RNs care,   increasing tasks not part of  the nurse practice act, less voice in the industry hegemony, and fear for patient and license safety. 
From 1995 to today,  RN unionization efforts are on the increase, and strikes are occuring more frequently with every year. 
2001 showed a modest gain in salary over 2000, the first increase in real salary that nurses have experienced in nearly a decade. Any increases in the 2001-2003 period MUST be evaluated next to the loss of income over the previous 10 years, a period of robust economic gain in large portions of the American market ,  and for some segments of the health care industry [Conglomerate hospital CEOs, upper level hospital management, The Pharmaceutical Industry, Managed Care CEOs] .
National Median Nurses Salaries 1987-2001Footnote One
Background: 1987-1992: 
The National median Nurses salaries experienced a 38% increase between 1987 and 1992 [Science and Engineer Indicators '93] . This followed  the acute Nursing Crisis Shortage of the 80s,  labor strikes excercised in that period, and  industry's delayed response to market demand, and was followed itself by an increase in nursing school enrollment, a cut back in bedside hospital  nurses  nationally,  and a subsequently  misidentified "nursing glut" perceived to have occured on this period's heels.
Graph of Nursing Salaries
Real/ vs Actual 1980-2000
Click on Thembnail to
enlarge
 
Adjusting for inflation and relying on the report of  E  Spratley  based on Findings from the National Sample Survey of Registered Nurses conducted by the U.S. Department of Health & Human Services ,full time staff RN salaries  eroded nationally by $1006.62 annually [ -2.286% ]  during this period. While spending power of the RN during this time diminished, nurses described the environment of their practise as  increasingly stressful, the job requirements alarming,  and the labor requirement detrimental to their patients,  their practice and their job satisfaction. This marks a period of layoffs and cutbacks.
Until 2000 and the stock market adjustment, this is a period of robust health in many sectors of the economy, and one in which one Oxford Managed Care's CEO received  30 million dollars in the year 1997 alone [see Managment salaries]. This period corresponds with the managed care era, and towards its middle, the Nursing Shortage was reidentified by nurses, while the Industry denied its existence. By year 2000, the current Crisis shortage was fully identified through the RN National Survey,  its negative attributes more pronounced than in any other period since the post World War I era when a nursing shortage was first identified, and a significant unique marker of which was a 28% attrition of nurses [that is, 28% of the nation's RNs were NOT employed in nursing].

2000-2001: a national mean  increase of 11% occurs in a [limited ] study of full time staff RNs. When added to the erosion of salaries having occured 1992-2000, the mean increase nationally for the period 1999-2001 reflects a change in buying power for the RN of $2,526.90 in the period  1992 to 2001, or  6.546 %  over  9 years and entirely owing to the period 2000-2001.

Methodology for the above is provided below


Footnote 1- These statistics do not provide a breakdown of differentials occuring within the salaries provided. The difference  in regional salary may in part reflect the highly variant  pay or lack of it  for periods of highest resource deficit  [nights/ weekends/ holidays] and/ or variance in charge pay for each hour a staff RN is assigned that demanding duty.  Identification of  hourly pay per shift in each region, and differential pay in each region,  would address this confusion.
[For clarification on Differentials and Holidays as utilized in these pages, see Terms]
 
 
Regional average annual salary for full-time RNs in staff positions year 2000 and the 1992 average** :
  • Pacific: Alaska, California, Hawaii, Oregon, Washington.  Regional average annual salary for full-time RNs in staff positions:
    • $49,825 in 2000 (still the   highest of all the regions); compared to  $41,315 in 1992.
  • Mountain: Arizona, Colorado, Idaho, Montana, Nevada, New Mexico,Utah, Wyoming. Regional average annual salary full-time RNs , staff positions:
    • $49,825 in 2000 (still the highest of all the regions); compared to$41,315 in 1992.
  • West South Central: Arkansas, Louisiana, Oklahoma, Texas. Regional average annual salary for full-time RNs in staff positions:
    • $40,222 in 2000; up from $33,641 in 1992.
  • East South Central: Alabama, Kentucky, Mississippi, Tennessee. Regional average annual salary for full-time RNs in staff positions:
    • $37,364 in 2000; compared to $32,227 in 1992. Was the lowest of all the regions for salaries but West North Central now is now  the lowest.
  • South Atlantic: Delaware, District Of Columbia, Florida, Georgia,  Maryland, North Carolina, South Carolina, Virginia, West Virginia Regional 
    • average annual salary for full-time RNs in staff positions:
    • $41,233 in 2000; compared to $34,058 in 1992.
  • West North Central: Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota. Regional average annual salary for full-time RNs 
    • in staff positions:
    • $36,958 in 2000; compared to  $33,641 in 1992.
  • East North Central: Illinois, Indiana, Michigan, Ohio, Wisconsin. Regional average annual salary for full-time RNs in staff positions:
    • $40,455 in 2000; up from $33,453 in 1992.
  • Middle Atlantic: New Jersey, New York, Pennsylvania. Regional average annual salary for full-time RNs in staff positions:
    • $45,435 in 2000; compared to $37,225 in 1992.
  • New England: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont. Regional average annual salary for full-time RNs in 
    • staff positions
    • in 2000: $45,534; up from $37,785 in 1992.
**From NursingWorld.com. Today's RN- Numbers and Demographics citing Spratley, E. (March 2000)
The Registered Nurse Population, Findings from the National Sample Survey of Registered Nurses,
U.S. Department of Health & Human Services, Bureau of Health Professions,
Division of Nursing, Health Resources and Services Administration.

 
  • National Median 1992 Full time Staff RN: $36,073  
    • [Based on the above, the median national income of full time RNs, staff positions ]
    • National Median 2000 Full time Staff RN: $42, 983 
    • [Based on the above, the median national income of full time RNs, staff positions ] 
  • These numbers when computed against Inflation show a LOSS IN INCOME  for the full time staff RN  from 1992 -2000: 
  •  
     
     
     
     
     
     
     

    What cost $36073 in 1992 would cost $43989.63 in 2000. Also, if you were to buy exactly the same productsin 2000 and 1992,  they would cost you $36073 and $29581.10 respectively. 

    • National Median RN Salaries 2001: The mean salary nationwide for RNs hits $48,972**
    **According to "Nurse and Allied Healthcare Annual Compensation and Benefits Report, April 2001, Martin/ Fletcher
    "A Survey of 3,960 hospitals in 48 states" reflects 43, 968 a mean 1999 salary for RNs and 48, 972 in 2001
    [1n 11% increase over two years]."
    Cited in "Hospitals scramble for Cutting Edge Personnel" MANAGED CARE November 2001

     
    The 11% increase from 1999 to 2001  given just above must be viewed in context of the erosion of buying power in the time frame of 1992-2000 reviewed previous. When accounting for inflation there emerges  a small gain in nurse's buying power from 1992-2001, the gain entirely dependant on the 2000-2001 period, as from 1992-2000 nurses had an erosion of  salary as shown above: 
    What cost $48972 in 2002 would cost $38599.90 in 1992. Also, if you were to buy exactly the same products
    in 1992 and 2002, they would cost you $48972 and $62131.17 respectively. 

     
    The increase for the period 1992-2001,  adjusted for inflation,  represents an increase in buying power  from  $2,526.90 in the period  1992 to 2001, or  6.546 %  over 9 years. 

     

    These numbers when computed against Inflation show a LOSS in income for the full time staff RN 

    from 1992 -2000. 
     

    Inflation  and Actual Buying Power 1992 vs 2001:
    in real earning power, nurses have gained, over from 1992 to 2002: an increase of $3,205$ annually. This represents a  6.54% increase in 9 years in REAL earning power.

    [What cost $36073 in 1992 would cost $45766.10 in 2002.  Also, if you were to buy exactly the same products in 2002 and 1992, they would cost you $36073 and $28432.86 respectively. (Results computed from "the Inflation Calculator") ]

     

    Let's see what happened to the salaries of managers of Hospitals during the period of "weathering the storm" and "Belt Tightening" we practicing nurses were told to endure during the early mid, mid and early later mid 90s
     

       
    What the 2000 RN Nationsal Survey stated regarding RN Earnings;

    "In examining the extent to which average RN earnings have increased over the years, and the related economic demand for RNs, it is important to consider how earnings have increased during times of relatively high inflation as well as during times of relative stability in the cost of living. However, inflation is only one of the factors influencing the size of increases in RN earnings over time.

    The highest increases in actual annual earnings (35.1 percent) were experienced during the period between November 1980 to 1984, followed by a 33.2 percent increase in average earnings between March 1988 and 1992. These were times of relatively high increases in the cost of living. These were also periods when nurses were being actively sought for employment. There were substantial increases in the supply of RNs in the workforce from 1977 to 1984. There was also a perceived nursing shortage from 1988 to 1992. For these reasons, the substantial increases in actual earnings, far greater than would be expected just from the CPI levels, may reflect economic demand by employers for RNs.

    The average actual annual earnings of RNs employed full-time in March 2000 was $46,782, 11.2 percent higher than in March 1996. This is similar to the 11.5 percent increase between 1992 and 1996. The eight years from 1992 to 2000 were relatively stable in the cost of living, where the CPI increased about 10 percent over each 4-year period. Thus, it appears that nearly all of the increases over each of these four-year periods may be due to inflationary factors. 
     

    The second measure for assessing trends in average earnings utilizes the consumer price index. Obtaining the trends over time in ërealí increases in RN earnings is possible after accounting for the changes in purchasing power of the dollar from the reported earnings found in each respective Sample Survey. For example, the increase in real earnings that RNs experienced between March 1988 to 1992 (11.2 percent) was large and almost equalled by the increase (9.7 percent) experienced between 1980 to 1984. These increases in earnings also occurred during periods when the supply of employed nurses increased substantially. These combined facts suggest that there was a significant economic demand for RNs over this period.

    In contrast to the large real earnings increases from 1980 to 1984 and 1988 to 1992, real earnings were relatively stagnant over the years from 1992 to 2000 ... On an annual basis, the CPI averaged about 2.4 percent annually over the 1996 to 2000 period, or about 10 percent over four years. At the same time, RNs who were employed full time in nursing saw earnings increases of roughly the same magnitude as the CPI; their actual earnings increased annually at an average rate of 2.7 percent. Any changes in earnings since March 2000, which may reflect changes in demand for RNs in the health care marketplace, are not reflected in these figures.....

    those whose highest nursing educational preparation was a diploma was $46,624, while it was $46,570 for those whose highest nursing education was a baccalaureate degree. Earnings for those with baccalaureate degrees and diplomas as their highest nursing educational preparation are about 10 percent higher than the average earnings for those with associate degrees ($42,676) as the highest nursing education. Earnings/education patterns appear to be more complex than simply assuming that higher levels of education automatically translate to higher earnings. Larger proportions of diploma nurses in the workforce have more years of experience than do those with baccalaureate or associate degrees. They also comprise a large percentage of those RNs in administrative positions ... These circumstances of the workforce may possibly explain why diploma earnings appear to be competitive with baccalaureate earnings.....

    Staff nurses, the largest group of employed nurses, had average earnings of $42,133. The staff nurse earnings level is about 10 percent below the overall average earnings for all RNs with full-time employment in nursing. To some extent, higher earnings can be attributed to highest education level at the masters degree and above which prevail in some positions. ...Growth in actual earnings from 1996 and 2000 were compared for selected positions. While the average reported earnings for all full-time nurses increased by 2.7 percent on an annual basis between the 1996 and 2000 Sample Survey, there was a broad range to the level of increase across positions. Categories of nursing positions that experienced annual rate increases which were higher than the average rate of increase include: administrators (3.7 percent), instructors (3.4 percent), supervisors (3.3 percent), and head nurses (3.3 percent).

    However, staff nurse earnings only increased on average by 2.2 percent annually. Furthermore, staff nurse earnings in hospitals only increased by 2.0 percent.This lower increase contrasts to the earnings increases of staff nurses in nursing homes, where the latter reported increases of 3.6 percent annually.It appears that demand for a high level of skills in staff nurse hospital service is not being compensated at a rate that meets even the CPI. Nevertheless, the larger rate of increases in earnings for nursing home staff RN services may begin to raise basic compensation levels for nursing home staff RNs who have been difficult to recruit and whose earnings have been historically-lower than comparative earnings in hospitals....
    Annual earnings varied according to the setting in which the RN was employed. At $47,759, the average annual earnings for those working full time in the hospital setting were higher than the overall full time earnings average across all types of settings. Those settings where RNs earned less than the overall average included ambulatory care, at $45,256 public health settings, at $45,150; nursing homes, at $43,779; and student health services, with the lowest average annual earnings of $38,204.
    National Survey, put in link