Salary Breakdown: How
Much Do Nurses Make?
You might be excited by the idea of working directly with patients and making a difference in people’s lives as a future nurse. On top of being emotionally rewarding, being a nurse can be financially advantageous as well. Keep reading to find out how much you can expect your salary to be as a nurse.
Whether you’re just beginning to think about a career in nursing or you’re already a practicing nurse thinking about making a move up the career ladder, it’s important to have a clear idea of the kind of money you’ll make as a nursing professional. This is particularly true now, given the ongoing critical shortage of qualified nurses that is negatively impacting healthcare throughout the nation — but positively impacting nurses’ earnings.
We’ve put together this guide to provide you with a comprehensive review of current nursing salaries in the United States. Below, you’ll find lots of useful information on the earnings for many of the most common nurse types and specialties, including where in the U.S. salaries are the highest for those occupations. You’ll also learn about the various factors that have the biggest impact on salaries and what you can do to maximize your earnings potential.
Ready to get to the bottom line about nursing’s bottom line? Let’s dig in.
Common Factors Impacting Nurses’ Salaries
Not surprisingly, the single biggest factor impacting your salary as a nursing professional is your specific nurse occupation or type (RN, APN, LPN, nurse assistant, etc.), but this is far from the only factor. Below are descriptions of the most common factors that, along with specialty, will determine just what you’ll earn in your specific nursing job.
Certifications
Nursing certifications are professional credentials that allow nurses (most commonly RNs and APRNs) the ability to be recognized for advanced knowledge, skills, and experience in any of a number of specific nursing practice subfields. Earning professionally recognized certifications can add substantially to a nurse’s attractiveness in the job market and lead to higher paying positions in which specialized skills are required. There are a number of organizations offering nursing certifications. The most prominent among them is the American Nurses Association.
Education
Regardless of specialty, becoming a nurse means first completing some level of formal education. It’s a foundational requirement, for example, for eligibility to become a registered nurse or practical/vocational nurse in every U.S. jurisdiction. Generally speaking, the higher level of your formal education, the more you can expect to earn. To give you an idea of how education can impact salary levels, here are recent (June 2023) national average annual salaries for three common nursing degrees, according to ZipRecruiter:
- Associate Degree in Nursing (ADN): $77,801
- Bachelor of Science in Nursing (BSN): $87,304
- Master of Science in Nursing (MSN): $112,207
Experience
If you look at ads for nurse job openings, you’ll quickly discover that higher-paying positions typically require a substantially higher amount of previous job experience when compared to entry-level positions. What’s more, most of those certifications that we discussed above come with significant work experience requirements. For example, obtaining the ANA’s Informatics Nursing Certification requires applicants to have completed 200 to 2,000 hours (varying depending on other eligibility requirements) of informatics-related work experience.
Geographic Location
Apart from specialty, there may be no single factor impacting what you’ll earn more than where your job is located. It should be no surprise that, generally, jobs in areas with higher costs of living also provide higher salaries. Some states offer higher salaries than others, and another influencing factor is population size — jobs in urban areas tend to pay more than those in rural areas. For nurse salary figures by state and community, visit the Bureau of Labor Statistics’ Occupational Employment and Wage Statistics.
Specialty
There are practically an endless number of nurse specialties — that is, areas of specialized practice within the different types of nursing occupations — that you can focus on in your career. For example, Johnson & Johnson currently lists over 90 individual specialties in the broader nursing field. As we touched on above in our discussion of certifications, focusing on a particular nursing specialty can mean higher pay, especially in communities with larger populations.
Shift Differential
Shift differential refers to the increased pay received by an employee for working less desirable shifts, typically nights and weekends. It can also refer to extra pay received for taking on additional responsibilities during a shift, like precepting a new nurse. Shift differential pay may be calculated as an additional flat hourly rate over base pay or as a percentage of pay on top of base pay (10% to 15% is not uncommon for nurses working nights or weekends).
Registered Nurse Salary
According to the American Nurses Association, registered nurses (RNs) “form the backbone of health care provision in the United States.” Becoming an RN in the U.S. requires completion of a registered nurse education program (typically an ADN, BSN, or nursing diploma), passing the NCLEX-RN examination, and obtaining RN licensure in the jurisdiction in which you intend to practice. Common responsibilities include taking patient health histories, performing physical exams, administering medications, coordinating patient care in collaboration with doctors and fellow healthcare team members, and providing health education and counseling to patients and their families.
Top States for Registered Nurse Pay
According to May 2022 data from the U.S. Bureau of Labor Statistics, the mean annual salary for RNs in the U.S. is $89,010, which is much higher than the mean $61,900 salary for all occupations in total. The BLS lists these three states as having the highest mean annual salaries for RNs:
- California – $133,340
- Hawaii – $113,220
- Oregon – $106,610
Special Factors Influencing How Much Registered Nurses Make
Along with the common factors impacting salaries described above, RN salaries may additionally by affected by specified duties and responsibilities, hospital or healthcare facility size and patient load, and facility type (acute care hospital, long-term care, physician’s office, etc.).
Specialty
High-demand areas of specialization available to RNs include obstetrics, cardiac care, emergency room nurse, oncology, hospice care, and home health care. Other common RN specialty areas include ambulatory care, burn care, case management, dermatology, developmental disability, gastroenterology, geriatrics, infection control, infusion, labor and delivery, medical-surgical, occupational health, orthopedics, public health, radiology, rehabilitation, school nurse, toxicology, and urology.
Institution Type
Registered nurses work in all sectors and settings of the healthcare industry. Common institutional settings include hospitals, physician offices, ambulatory care facilities, nursing homes, long-term care facilities, outpatient and surgical clinics, correctional facilities, schools, camps, large corporate facilities and factories, fitness centers, and even private homes. RNs also find employment with government agencies (including the military), public and community health providers, legal services providers, health insurance providers, and more.
Nursing Assistant Salary
A nursing assistant (also known as a certified nursing assistant or CNA) provides basic nursing care to patients while working under the direct supervision of registered nurses, physicians, and other medical staff members. Typical CNA duties include assisting patients with routine daily tasks (eating, bathing, dressing, exercise, and toileting), and observing and documenting patient vital signs and conditions. Becoming a CNA requires completion of a state-approved education program (typically four to 16 weeks long) that includes classroom instruction and hands-on training with real patients.
Top States for Nursing Assistance Pay
The mean annual salary for nursing assistants in the U.S. (as of May 2022) is $32,220. The BLS lists these three states as having the highest mean annual salaries for nursing assistants:
- Alaska – $44,420
- District of Columbia – $43,820
- California – $43,570
Special Factors Influencing How Much Nursing Assistants Make
Along with the common factors impacting nurse salaries described above, what you’ll earn as a nursing assistant will likely depend on your specific employer and practice setting, whether you work full-time or part-time, and any additional training you have received that allows you to take on additional tasks and responsibilities.
Institution Type
You’ll likely find nursing assistants employed in practically any healthcare setting in which patients receive medical treatment. These include public and private hospitals, medical clinics, physician’s offices, long-term and assisted care facilities, skilled nursing facilities, retirement communities, government agencies, and home healthcare services.
Nurse Practitioner Salary
A nurse practitioner (also known as an advanced practice nurse or APRN) is a registered nurse who has received substantial additional education and training that allows them to take on advanced nursing responsibilities beyond those of an RN. Common duties include assessing and recording patient symptoms, conducting physical exams, performing diagnostic tests and analyzing the results, and diagnosing health conditions. Nurse practitioners also, in some cases, prescribe and administer medications. Specific requirements to become a nurse practitioner vary by state, but generally speaking requires completion of a graduate-level education program (MSN or nursing doctorate), passing a national certification exam, and obtaining a state APRN license.
Top States for Nurse Practitioner Pay
The mean annual salary for nurse practitioners in the U.S. (as of May 2022) is $124,680. The BLS lists these three states as having the highest mean annual salaries for nurse practitioners:
- California – $158,130
- New Jersey – $143,250
- Massachusetts – $138,700
Special Factors Influencing How Much Nurse Practitioners Make
Along with the factors impacting salaries for all nurses, nurse practitioner salaries can additionally be affected by the specific employer, practice setting, and designated job responsibilities.
Specialty
Nurse practitioners may provide general healthcare services, but most opt to focus their practices in any of a number of specialized sub-fields. Popular NP specialty fields include adult-gerontology, pediatrics, family nurse, neonatal nurse, and psychiatric/mental health. Median salaries for APRNs are impressive, but can vary substantially from specialty to specialty from just over $100,000 (Adult Gerontology NP) to over $200,000 (Certified Registered Nurse Anesthetist), according to the most recent figures from Salary.com.
Travel Nurse Salary
A travel nurse (or traveling nurse) is a qualified nursing professional who accepts temporary work assignments at hospitals and other healthcare facilities in a different geographic location from where they live, often in another state or even in another country. Travel nurses are registered nurses, but per private industry standards, are preferred to have a minimum of 1-½ years of clinical practice experience, although it is possible to work as a travel nurse with less or no clinical experience. Travel nurses must additionally be licensed to practice in the jurisdiction in which they’re contracted to provide their services. This is usually handled via a reciprocity agreement with the nurse’s home state board of nursing.
Top States for Travel Nurse Pay
The average annual salary for travel nurses in the U.S. (as of June 2023) is $105,021. The three states with the highest average annual salaries for travel nurses, according to ZipRecruiter, are:
- New York – $128,277
- New Jersey – $110,831
- Wisconsin – $110,128
Special Factors Influencing How Much Travel Nurses Make
Along with the common factors impacting salaries for all nurse types, salaries for travel nurses may vary substantially from individual to individual due primarily to the following:
Assignment Location
Not surprisingly, travel nurse salaries are greatly impacted by the job’s geographic location and the specific employer. Nevertheless, travel nurse earnings are almost always higher than those of regular staff nurses and often include additional payments for housing and to cover travel expenses.
Contract Negotiation
In most cases, travel nurses are paid through a travel nurse agency that places them in the temporary job assignment. The agency is, in turn, paid by the hospital or healthcare organization employing the nurse’s services. It is common practice for individual nurses to negotiate their pay rates — as well as other compensation components and benefits — with the travel nurse agency. The nurse’s skills in contract negotiations with the agency can play a significant role in just how much they earn, so be sure to brush up on negotiation skills before dealing with agencies.
Pediatric Nurse Salary
Simply defined, a pediatric nurse is a registered nurse who specializes in the care of children from birth through adolescence. Some pediatric nurses further focus their practices in sub-fields such as pediatric oncology, pediatric acute care, or pediatric ICU. The requirements for becoming a pediatric nurse are the same for RNs generally (diploma, ADN, or BSN degree, passing the NCLEX-RN exam, and obtaining state RN licensure). After gaining around two years of experience in a pediatric setting, obtaining board certification in pediatric nursing is advised and, for some employers, may be a requirement.
Top States for Pediatric Nurse Pay
The average annual salary for pediatric nurses in the U.S. (as of June 2023) is $109,762. ZipRecruiter lists these three states as having the highest average annual salaries for pediatric nurses:
- Minnesota – $120,241
- Nevada – $120,110
- Massachusetts – $119,081
Special Factors Influencing How Much Pediatric Nurses Make
Of the common factors impacting nurse salaries discussed above, pediatric nurses will find their earnings may be particularly impacted by their license level (RN or APRN) as well as pediatric nurse specialty and corresponding certifications obtained. Salaries may be further affected by the specific facility type (hospital, outpatient surgical, outpatient clinic, physician’s office, etc.).
Certifications
As we mentioned, pediatric nurses meeting eligibility requirements can obtain any of a number of professional certifications that can have a positive impact on their salaries. Examples include, among others, Certified Pediatric Nurse (CPN), Pediatric Nurse Certification (PED-BC), Acute/Critical Care Nursing (Pediatric), Acute/Critical Care Knowledge Professional (Pediatric), and Certified Pediatric Hematology Oncology Nurse (CPHON).
ICU Nurse Salary
Intensive care unit (ICU) nurses, also sometimes called critical care nurses, are highly trained and skilled RNs who work in hospital critical care units and ICUs treating patients recovering from life-threatening injuries and illnesses. ICU nurse duties are similar to those for all RNs, but are performed in the often high-intensity, high-demanding critical practice setting. RNs interested in becoming ICU nurses need to gain a minimum of two years of experience in an intensive care setting to obtain advanced certification related to the role of ICU or critical care nurse.
Top States for ICU Nurse Pay
The average annual salary for ICU registered nurses in the U.S. (as of June 2023) is $122,141. The three states with the highest average annual salaries for ICU registered nurses, according to ZipRecruiter, are:
- New York – $140,106
- Vermont – $126,466
- Maine – $126,118
Special Factors Influencing How Much ICU Registered Nurses Make
Registered nurses in general often work overtime hours, but this is especially true of ICU nurses. Overtime hours, therefore, can have a particularly substantial impact on total earnings. Also, critical care nurses working in settings other than ICUs (such as with private practices) will likely be paid less than those in hospitals.
Certifications
There are several professional certifications that ICU and critical care unit nurses may want to pursue to advance their careers and earn higher salaries. The American Association of Critical-Care Nurses offers a number of these certifications, the most popular of which is the Acute/Critical Care Nursing (Adult) or CCRN. Additional quality certifications for ICU/critical care unit nurses include, among others, the TeleICU Acute/Critical Care Nursing (CCRN-E), Cardiac Vascular Nursing Certification (CV-BC), and Adult-Gerontology Acute Care Nurse Practitioner Certification (AGACNP-BC).
ER Nurse Salary
As you might expect, ER nurses are skilled professionals who provide nursing care in the particularly stressful emergency room environment. Working with doctors and other specialists, ER nurses must quickly and effectively assess and respond to patients entering the ER with traumatic and often life-threatening illnesses and injuries. They may additionally be tasked with managing triage, making split-second decisions about which patients are most critical and need prioritized care. Like ICU nurses, emergency nurses are RNs and typically gain a minimum of two years of ER experience followed by obtaining one or more professional certifications. Those interested in advancing into leadership positions as ER nurses can return to school to receive the additional education and training needed to become an emergency nurse practitioner (ENP).
Top States for ER Nurse Pay
The average annual salary for ER nurses in the U.S. (as of June 2023) is $83,503. The three states with the highest average annual salaries for ER nurses, according to ZipRecruiter, are:
- New York – $96,533
- Vermont – $87,135
- Maine – $86,896
Special Factors Influencing How Much ER Nurse Make
Along with the common factors of location and experience, salaries for ER nurses are often substantially impacted by the nurse’s education level and the number and type of professional certifications they possess. For example, a major factor influencing ER nurse salaries is whether or not the nurse is an RN or has earned their ENP credential.
Certifications
A number of professional certifications are available for emergency nurses to pursue to boost their skill level and earnings. The most prominent certification is the Certified Emergency Nurse (CEN) available from the Board of Certification for Emergency Nursing (BCEN). The BCEN offers several additional certifications for ER nurses looking to further specialize their practice, including the Certified Pediatric Emergency Nurse (CPEN), the Trauma Certified Registered Nurse (TCRN), and — coming soon — the Certified Burn Registered Nurse (CBRN).
Labor and Delivery Nurse Salary
As the title implies, labor and delivery (L&D) nurses are RNs who work as part of a team (with doctors and midwives) to provide nursing care to mothers throughout the labor, delivery, and initial postpartum periods. Specific duties include providing mothers with information on what to expect during labor and delivery, timing and monitoring contractions, monitoring vital signs during the labor and delivery process, administering epidurals and other pain medications, assisting doctors in the induction of labor, and preparing for cesarean-section delivery, if needed. L&D nurses also instruct new mothers on newborn care and breastfeeding. RNs can begin working as L&D nurses upon receiving their RN licenses but are strongly advised to pursue professional certification after gaining a few years of labor and delivery nursing experience.
Top States for Labor & Delivery Nurse Pay
The average annual salary for labor and delivery nurses in the U.S. (as of June 2023) is $96,039. The three states with the highest average annual salaries for labor and delivery nurses, according to ZipRecruiter, are:
- New Jersey – $104,513
- Wisconsin – $103,605
- Nevada – $101,469
Special Factors Influencing How Much Labor & Delivery Nurses Make
Common factors that particularly impact salaries for L&D nurses include specific education credential (BSN or, more significantly, an MSN) and possession of one or more professional certifications that relate either directly or indirectly to nursing practice during and immediately after the labor and delivery process. Travel L&D nurses also typically earn higher salaries than those working long term on a specific hospital’s staff.
Certifications
Professional certifications that can have a positive impact on salaries for L&D nurses include Inpatient Obstetric Nursing (RNC-OB) and Electronic Fetal Monitoring (C-EFM). Many L&D nurses may also benefit from completing the Neonatal Resuscitation Program (NRP). In addition, L&D nurses seeking a major advance in their career may also return to school to earn their MSN degree and complete an accredited midwifery education program to pursue Certified Nurse-Midwife (CNM) certification.
Nurse Anesthetist Salary
A nurse anesthetist is an advanced practice nurse (APRN) who specializes in administering anesthesia to patients for surgery or other medical procedures requiring anesthesia. Nurse anesthetists are among the highest paid of all nursing professionals. Becoming a nurse anesthetist in the U.S. requires completion of an APRN education program (most commonly an MSN, DNP, or master’s with nurse anesthetist post-graduate certificate) and passing the National Certification Exam (NCE) to obtain CRNA certification.
Top States for Nurse Anesthetist Pay
The mean annual salary for nurse anesthetists in the U.S. (as of May 2022) is $205,770. The three states with the highest mean annual salaries for nurse anesthetists, according to the BLS, are:
- California – $246,510
- Connecticut – $240,580
- New York – $238,710
Special Factors Influencing How Much Nurse Anesthetists Make
Factors that particularly impact salaries for nurse anesthetists include specializing in a particular sub-field of nurse anesthesia practice, such as pediatric, obstetric, cardiovascular, neurosurgical, or dental anesthesia. Additionally, nurse anesthetists with a DNP degree often command higher salaries than those with an MSN degree.
Institution Type
Nearly half of all medical professionals administering anesthesia for surgeries and other procedures requiring anesthesia in the U.S. are nurse anesthetists. In fact, they’re the primary provider of anesthesia services in U.S. rural areas. Common institution types in which nurse anesthetists are employed include hospitals (operating rooms and ERs), outpatient surgical clinics, plastic surgery clinics, and dental clinics.
Additional Financial Incentives for Nurses
As we mentioned in the introduction above, there’s a critical shortage of qualified nursing professionals in the U.S. This shortage has led employers to not only pay higher salaries, but also to offer additional and enhanced incentives to attract new nurse employees. Here’s a look at some of the most popular of those incentives:
Benefits Packages
Most healthcare employers offer some form of benefits package to their nurse employees. These packages are often quite impressive, particularly when it comes to bigger healthcare organizations. Common benefits include:
- Health insurance (medical, dental, optical)
- Life insurance
- Malpractice insurance
- Retirement plans
- Licensure cost reimbursement
- Professional leave and paid time off
- Physical and mental health services
- Financial planning services
Examples of benefits packages for nurses include these from Munson Healthcare and WellSpan Health.
Continuing Education and Career Advancement
Nurses in all U.S. states and territories are required to complete a mandated number of continuing education (CE) hours each year or license renewal period in order to maintain licensure. Continuing education hours are typically required to maintain professional certifications as well. Nurse employers often pay for their employees CE classes or offer their own free programs, thus saving nurses from having to pay for those classes or programs themselves. Additionally, employers often help their nurse employees pay for advanced degree and certificate programs taken to advance their nursing careers (typically through employer tuition reimbursement programs), which, in turn, lead to higher paying positions.
Differential and Overtime Pay
While nurses are often expected to work long and arduous shifts, some employers offer attractive overtime and differential pay as additional incentives. Under federal law, nurses are entitled to, at minimum, overtime pay equal to 1-½ times their normal salary or hourly rate for hours worked over 40 in a seven-day period. Some states mandate even higher rates, and some employers bolster overtime pay to be more attractive to nursing employees. Differential pay, which we discussed above, is common for nurses; however, once again, some employers pay attractive differentials to attract and retain nursing talent.
Loan Forgiveness and Tuition Reimbursement Programs
Earning a postsecondary nursing diploma or degree is an expensive proposition that requires most students to take on some amount of loan debt to help pay for their education. Fortunately, there are a number of federal loan forgiveness programs available to qualifying nurses. In addition, many individual states (like California) offer similar loan forgiveness programs. Eligibility requirements vary by program. Employment-based tuition reimbursement programs, typically offered by hospitals and other healthcare organizations, may also be available to valued employees pursuing advanced nursing education.
Sign-On Bonuses
One of the most popular incentives currently being offered to prospective nurse employees is the sign-on bonus. These bonuses come in two forms: commitment bonuses (payments made in exchange for agreeing to work for the employer for a given duration) and relocation reimbursement (where the employer reimburses the employee for moving costs incurred to relocate for their new job). These two types of sign-on bonuses can add between thousands to tens-of-thousands of dollars to your first-year salary. Major healthcare providers offering such bonuses include HCA Healthcare and Advent Health.
