What determines RN pay? Not education or skills, survey finds

How much a nurse makes generally depends on specialty, workplace setting and experience

From pediatrics to primary care, registered nurse pay can vary from specialty to specialty. Health care pros can earn nearly triple Georgia’s average salary as nurse midwives or rank their salaries up even higher by becoming anesthetists, the highest paid nurses of 2023.

A new survey revealed how much RNs are getting paid across a wide range of specialties and — in the process — ruled out skill level, education and role complexity as significant reasons why pay varies.

In collaboration with consulting firm Korn Ferry, Advancing High Performance Health conducted a survey of 39 U.S. organizations across nearly 4,000 locations that included more than 127,000 nurses. As reported by Becker’s Hospital Review, surgical nurses working in hospitals make the most — averaging salaries of $94,110. Nurses working in clinics or ambulatory care often average the lowest among their peers ($81,187).

While a nurse’s specialty can significantly affect their salary, workplace setting can matter just as much. Workplace setting dictating nurse pay is not a new discovery, but it does reaffirm previous reports. According to the U.S. Bureau of Labor Statistics, for instance, nurses who work directly for the government often make 16% more than those in other settings.

But — as far as the pay scale is concerned — skill, job difficulty and education may never truly enter the equation.

“Variations in registered nurse compensation indicates differences based on practice setting and clinical specialty,” Mike Coppola, AMGA consulting chief officer, reported in the survey.

“As we look deeper into these differences, there is no indication participating organizations rely on factors such as role complexity, education, or skill level as significant determinants of base pay.”

The survey concluded that years of experience was the most important factor when determining salary. Considering that a significant sum of nurses leave the workforce due to burnout, workplace violence and other factors, it’s perhaps no surprise that RNs capable of garnering lengthy work experience can dictate higher salaries.

None of the nurse specialties reported in the survey guarantee enough pay to live comfortably in Georgia, which SmartAsset equated to $96,886 a year. That’s $2,776 more than what AMGA reported surgical nurses, the best paid, are making.

“Variations in employee needs by age and the persistent staffing challenges indicate that healthcare organizations will need comprehensive solutions such as strategic workforce planning and redefined employee value propositions in addition to market competitive pay practices to attract and retain the nursing talent they need,” Marc Hallee, Korn Ferry’s senior client partner to AMGA, said in the survey.

These are the 16 registered nurse specialty salaries featured by AMGA, as reported by Becker’s Hospital Review:

Hospital

Surgery-OR/pre-op/recovery: $94,110

Inpatient mental health: $88,504

Hospital outpatient department: $88,275

Emergency department: $87,526

Critical care/ICU-specialty: $87,339

Telemetry/monitored: $87,100

MedSurg-specialty: $86,507

Pediatrics: $86,507

Labor and delivery: $85,894

Critical care/ICU-general: $85,831

MedSurg-general: $84,906

Clinic/ambulatory care

Surgical: $86,507

Primary care: $81,557

Medical: $81,187

Other

Hospice/palliative care: $86,012

Home health: $85,030