AONE Survey Looks at the Upper End of the Nursing Pay Scale

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By Debra Wood, RN, contributor

September 12, 2013 - Nurse leaders report high job satisfaction, but are not as happy about their benefits and compensation, according to the American Organization of Nurse Executives’ 2013 AONE Salary and Compensation Study. Their comments were made despite the fact that these leaders reported earning an average annual salary of $100,000-$130,000, and some earn two or three times that amount.

“Survey results underscore a diverse profession,” said the paper’s authors. “On the other hand, certain key themes emerge and illustrate core trends for nurse leader compensation.”

More than 4,600 nurse leaders participated in the nationwide survey and reported on their incomes from the calendar year 2012. Sixty-seven percent of the nurse leaders work in acute care, 13 percent in academia, 7 percent in a corporate office or for a health care system, and the balance in other settings.

Pamela Thompson, AONE: Nurse leaders pay relates to span of control.
Pamela A. Thompson, MS, RN, CENP, FAAN, said the primary factors contributing to higher earnings relate to a nurse leader's span of control, whether they work at an individual hospital or at the system corporate level, and their region.

The “average” responding nurse leader, according to AONE CEO Pamela A. Thompson, MS, RN, CENP, FAAN, in an email response:

• Has been in nursing leadership for at least six years;
• Is between the ages of 45 and 64; 
• Holds a master’s degree; and
• Earns between $100,000 and $130,000 annually.

Directors represented 32 percent of the survey respondents, managers 26 percent, and chief nursing officers (CNOs) or executives 17 percent. 

“The primary factors contributing to higher earnings relate to the span of control of the individual, if they work at an individual hospital or at the system corporate level, and their region,” Thompson continued. “Span of control--the number of individuals who ultimately report up to a position--is a primary factor, as those with a wider breadth of responsibilities are most likely in executive level positions.”

Eighty percent of managers and 84 percent of directors reported earning base salaries of between $80,000 and $160,000 each year. Seventeen percent of the managers and 6 percent of the directors earned less than $80,000. Clinical staff and specialists are most likely to make less than $80,000, with 69 percent of clinical staff and 51 percent of specialists and coordinators indicating they earn less than $80,000.

Sixty-one percent of the CNOs not employed at a health system earn a base salary of between $100,000 and $200,000; 19 percent earn from $200,000 to $250,000 each year; and 12 percent earn more than that. CNOs working in health systems earn even more, with 71 percent indicating a salary of $200,000 or more annually and 31 percent saying they earn $300,000 or more. 

Nurse leaders working for consulting firms also earn a good salary, with 62 percent indicating being paid $140,000 or more annually. Only 10 percent earned less than $100,000. 

Nurse leaders who work in branches of the U.S. military, the Department of Veterans Affairs and other government entities are more likely than other respondents to earn between $80,000 and $160,000. 

Rural and critical access hospitals tend to pay less, with 30 percent of nurse leaders reporting making less than $80,000 annually, 10 percent earning $140,000 or more, and none earning $250,000 or more. 

Nurses with higher educational degrees tend to earn more, with 38 percent of nurse leaders holding a doctorate and 22 percent with a master’s degree most likely to make more than $160,000 annually. No nurse leaders with associate’s degrees indicated they earned that much, and only a few with a bachelor’s degree said their incomes were that high. 

In addition to the base salaries, 58 percent of the nurses leaders--primarily those earning salaries at or higher than $120,000 and with greater management duties--indicated they were eligible for bonuses last year. However, only half of the responding nurses said they received a bonus. 

Most of those earning bonuses reported contributing factors included the organization’s financial performance, 66 percent; clinical performance measures, 54 percent; and customer or patient satisfaction, 44 percent. Among nurses earning bonuses, they said the financial incentive represented a small amount of their income, with 47 percent saying the bonus was 5 percent or less of their base pay. Another 23 percent indicated the bonus was more than 5 percent but less than 10 percent, and 10 percent of the nurse leaders said the bonus was more than 20 percent of their salary. 

“An interesting fact is the lack of compensation inequality based on gender,” Thompson said. “There is virtually no variation between compensation for males and females. While this isn’t surprising for the profession, it is an interesting comparison to the general workforce gender variations.”

When it comes to job satisfaction, nurse leaders like their work. Sixty-two percent reported feeling very satisfied and 29 percent somewhat satisfied. Forty-four percent said they find joy and meaning in their work. Ninety-five percent of CNOs report satisfaction with their jobs. 

“When looking at the satisfaction for aspects of their job, items such as ‘I find joy and meaning in my work’ and ‘relationship with co-workers’ are very high,” Thompson said. “I think these personal factors play more into job satisfaction than compensation. Nurses by nature are compassionate and caring people. Compensation is not the only driver for satisfaction.”

Although they liked their jobs, the nurse leaders were not thrilled with their compensation and benefits. Only 34 percent indicated being highly satisfied with their compensation and 48 percent with their benefits. 

AONE members can access the full report and an online reporting tool that will enable them to complete custom analyses. 

“The survey validated what we suspected as the current state of nurse leader compensation,” Thompson said. “The longer you are in nursing leadership and the more responsibility you have, the higher your compensation.”

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