Recently the National Labor Relations Board issued a ruling (3-to-2) that will re-classify registered nurses — and possibly 8 million other workers — as “supervisors” if they perform certain types of duties. The National Labor Relations Board ruled that a worker would be a supervisor if he or she: exercised “independent judgment,” oversaw another worker, could be held accountable for another worker’s performance or spent 10 to 15 percent of total work time in supervisor-type duties.
How will this affect the average nurse salary? In the nursing world, that would mean that a nurse overseeing a shift (the charge nurse) would be considered a “supervisor” if she assigns another nurse to a patient. Ultimately, workers that are re-classified as “supervisors” are excluded from union membership, which will likely affect their pay rate.
According to our salary calculator, a (non-union) registered nurse in Michigan makes an average salary of $45,438. Is a non-union nurse salary significantly different from a nurse with union membership?
According to Jeff Baur of RNWeb.com, “Without a doubt… nurses in unions make more money. These RNs (nationwide) average almost $60,000 per year, about $6,100 (11%) more than their non-union counterparts. The wage gap between union and non-unionized nurses has held steady for years.”
What are the other differences in nurses salaries?
Hourly Wage vs. Annual Salary
In a 2005 earnings survey taken by RNWeb.com , nurses paid by the hour have (on the average) enjoyed a 13% increase in pay rate, up from 10% in their two previous surveys. For salaried nurses (management, administrative) their pay rate tended to stay the same without a notable significant increase. The money is clearly going to hourly nurses who are the ones usually working at bedside.
Generally, part-time hourly nurses also make more than salaried nurses because they are unlikely receive health insurance (there's some irony) and other employee benefits. At least if they have an emergency on the job, they are in the right place. Night shift nurses may earn an increase in salary and pay.
Nurse Salary and Specialty
Another variable in average pay is which medical discipline nurses specialize in. For instance, in a Michigan hospital of 50-199 employees, our salary calculator shows the difference in the pay rate of nurses with different specialties:
- Nurse Anesthetist (CRNA) $131,596
- Nurse, Intensive Care Unit (ICU) $46,578
- Family Nurse Practitioner $71,494
- Nurse Case Manager $68,478
CRNA and Nurse Practitioner require significant additional education beyond what is needed to be a registered nurse (RN). These are "physician extender" positions that fall between the traditional roles of nurses and doctors.
Nurse Case Manager is a fascinating position: it exists simply because of the complexity of modern medicine. While there are programs that teach nurse case management, the additional education beyond what is required to be a RN is modest.
Town and Country: Nurses Salary
According to the RNWeb.com survey, facilities can also play a role in pay. Registered nurses in suburban hospitals make an average hourly wage of $30.30 per hour. However, registered nurses in urban hospitals clocked in at $29.25 and rural hospitals paid an average of $25 an hour. Even the number of beds in a hospital bed can affect pay. For nurses at hospitals with at least 100 beds, the pay was about $29 an hour, but nurses at smaller facilities made $25.60 an hour.
Union Membership and National Geographic
Location has a great deal to do with average salary as well. Using our salary calculator we see that registered nurses who work in an emergency room in Alabama make an average salary of $40,985. However, in California the same nurses would make $71,742. (Note to self: In case of career change, choose San Francisco over Selma).
According to the RNWeb.com survey, the south has less unionization than the east and west coasts. In the west, especially, union membership has reportedly climbed to 55%. However, this ruling by the National Labor Relations Board may result in a drop in union membership.
In reaction to the ruling, the head of the American Organization of Nurse Executives, Pamela Thompson, says, “Since hospital staffing can vary, not only hospital to hospital but hour by hour, this decision will play out differently hospital by hospital.”
How does your salary play out these days? Find out with our salary calculator.
Dr. Al Lee