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The Gender Pay Gap in Nursing

NurseJournal Staff
by
Updated March 23, 2023
    Although women dominate the field of nursing, men continue to earn higher salaries. This guide to the gender pay gap explores these disparities and ways to achieve income equity.
    Male and female nurse talking in a hospital loungeCredit: The Good Brigade / DigitalVision / Getty Images

    The gender pay gap describes the difference between men’s and women’s earnings. Although women continue to make up the largest segment of the nursing field, men earn higher salaries overall.

    The nursing pay gap has narrowed in recent years, but income disparities remain — especially for Black, Indigenous, and people of color (BIPOC). This guide explores the pay gap for registered nurses (RNs), provides ways for nurses to negotiate for higher salaries, and suggests ways to support equal pay in nursing.

    Fast Facts About the Nursing Gender Pay Gap

    • Men report making an average of $7,300 more than women as RNs.
    • The gender pay gap is even more significant and closing more slowly for BIPOC women who collectively comprise less than 17% of the RN workforce.
    • Women RNs are paid 91 cents for every dollar earned by men.
    • Among the top 10 nursing specialties, pediatric nurses report the largest pay gap.

    Unequal Wages in Nursing Is Nothing New

    The gender pay gap refers to the ratio of female-to-male annual earnings for full-time workers. Despite the passage of the 1963 Equal Pay Act to protect against wage discrimination based on sex or gender, progress toward closing the gender gap has slowed.

    The U.S. Bureau of Labor Statistics (BLS) reports that women in 2020 earned only 82.3% of men’s annual earnings, compared to 57% in 1973.

    According to the U.S. Department of Labor, women earn less than men in almost every occupation. Educational attainment does not significantly narrow the gender gap.

    • Women with advanced degrees earn less than white males with only a bachelor’s degree.
    • Black and Latina women with bachelor’s degrees earn 65% of what their white male counterparts earn.
    • Women of color with advanced degrees fare only slightly better, making 70% of what white males with the same degrees earn.

    While RNs make up one of the most employed and best-paid segments of the nation’s workforce, the gender gap reveals large pay disparities between female and male RNs. Women comprise more than 87% of the RN workforce but generally earn about $7,300 less a year than men.

    How Much More Do Male Nurses Make?

    Women working in the nursing profession continue to face pay disparities compared to men in similar positions, regardless of:

    • Education level
    • Age
    • Certification
    • Experience

    The 2020 Nurse Salary Research Report surveyed 7,431 nursing professionals from all 50 states, including RNs, advanced practice registered nurses (APRNs), and licensed practical and vocational nurses (LPN/LVNs).

    While the average yearly earnings for all respondents was $75,290, men in nursing made an annual salary of $80,000, compared to only $72,700 for women. Female RNs make 90 cents for every dollar earned by men in the same roles — nearly $7,300 less a year.

    The gap persists even as women move up the ladder into administrative roles. Women chief nursing officers make $127,050, while men in these same supervisory positions earn an average of $132,700. The pay differentials have grown even wider between male and female APRNs, with men earning $16,000 more annually.

    LPN/LVNs, who typically do not hold a bachelor’s degree, earn lower wages overall but show no gender differences in pay rates.

    Salary Differences of Men and Women Nurses by Position
    PositionWomenMenWomen’s Percentage of Men’s Earnings
    Advanced Practice Registered Nurse$104,000$120,00086.7%
    Registered Nurse$72,700$80,00090.9%
    Licensed Practical/Vocational Nurse$45,000$45,000100%
    Source: 2020 Nurse Salary Research Report

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    Annual Salary by Gender and Nursing Specialty

    While the gender pay gap has narrowed for many occupations across the United States, earnings for women nurses continue to lag behind men performing the same roles.

    The gender pay gap persists even after factoring in elements affecting salary differences, such as age, education, and experience. Recent research also indicates significant pay differentials between men and women in many clinical specialties.

    The specialties with the largest disparities include:

    • Home healthcare
    • Emergency/trauma
    • Pediatrics

    Nurses will find the smallest pay gap in:

    • Maternal-child health/obstetrics
    • Medical-surgical
    • Acute care/critical care
    • Psychiatric/mental health/substance abuse

    As the following information demonstrates, salaries for men surpassed those paid to women in almost all the 10 most common clinical specialties.

    Salary Differences for Men and Women RNs by Specialty

    Annual Salary by Race in Nursing

    The 2020 National Nursing Workforce Survey provides data on race and gender. Nearly 81% of RNs reported their race as white. Asian RNs make up 7.2% of the workforce, the largest non-white group in this nursing role, followed by Black/African American and Hispanic and Latino/a RNs.

    Among LPN/LVNs, white individuals make up over 65% of the workforce, followed by Black/African Americans, who comprise 17.2%, and Hispanic and Latino/a nurses, who account for 10%. Women make up the overwhelming majority of nurses in all racial categories.

    While the gender pay gap continues to affect nursing professionals, especially BIPOC nurses, recent data indicates variations in earnings and hours worked among races.

    The following information compares median salaries and overtime for racial groups with data from the recent Nurse Salary Research Report. RNs who identified as white reported working fewer hours than other racial groups. BIPOC nurses report earning higher median salaries and working longer hours, possibly resulting from higher rates of overtime.

    Median Salary and Overtime Hours Worked for RNs by Race
    RacePercentage of Nursing Workforce (Men and Women)Primary Median Salary (Men and Women)Average Overtime per Week
    Native American0.5%$72,5004 hours
    Asian7.2%$85,0007 hours
    Black or African American6.7%$78,0007 hours
    Hispanic, Latino/a, or Spanish5.6%$80,0006 hours
    Native Hawaiian or Pacific Islander0.4%$84,3205 hours
    White80.6%$72,0005 hours
    Sources: 2020 Nurse Salary Research Report | The 2020 National Nursing Workforce Survey

    Closing the Gender Pay Gap in Nursing

    The gender pay gap for Black and Latina women has closed more slowly than for white and Asian women compared to white males.

    The earnings ratio for Black women has only risen from 59% to 63% in the past 30 years. At this rate, the gender pay gap for Black women will not disappear for 350 years.

    Latinas fared even worse, with their earnings ratio rising only 53% to 55% in the same period. If this pace continues without strategies for change, the pay gap for Latinas will not close for 432 years.

    Negotiating Salary and Pursuing Nursing Certification

    The gender pay gap in nursing reflects longstanding national trends across all occupations, resulting from structural and economic discriminations beyond an employee’s control. However, women nurses can use a few strategies to help increase their earnings.

    According to the Nurse Survey Research Report, RNs, APRNs, and LPN/LVNs who negotiate their salaries with prospective employers before taking a position may improve their chances of earning a higher salary. However, in general, women nurses are less likely than their male counterparts to negotiate salary.

    For RNs, 46% of men compared to 34% of women negotiated their salaries most of the time or always. The percentage of women APRNs and LPN/LVNs who have engaged in salary negotiation also falls slightly below men in these roles.

    The gender pay gap narrows with advanced training and certification, but data suggests that fewer women than men in nursing have considered furthering their education and receiving certification. Only 49% of female respondents plan to pursue higher education and certification to boost their earnings, compared to 56% of male respondents.

    Advocating for Salary Equity in the Nursing Workplace

    In addition to individual efforts like negotiating and pursuing certification, nursing professionals can work together to advocate for better pay. Below are some action plans.

    • Mobilize through unions and join national nursing associations. Many nursing associations lobby for legislation eliminating gender-based discrimination. Nurses who join professional nursing associations and become union members find strength in numbers to advocate for equal pay for equal work policies and federal legislation such as the Paycheck Fairness Act.

      In states with high union representation, nurses who are union members typically earn higher salaries.

    • Create wage transparency. Nurses willing to work for change can begin this process by discussing salaries openly with colleagues to understand wage transparency and how pay scales operate in their workplaces.

    • Change workplace culture and employer policies, especially regarding childcare. Efforts to close the gender pay gap must include reforming labor policies and employer practices that penalize women for taking time off to tend to sick children or other personal responsibilities. Women continue to dominate the nursing profession, and, like other women in the U.S. workforce, they carry most of the caregiving roles in their families.

      In particular, nurses cite the need to expand paid sick days, institute comprehensive family and medical leave programs, and provide access to childcare.

    Support Equal Pay in Nursing

    Closing the gender pay gap in nursing poses a major challenge. Nurses, employers, and legislators can take the next step toward leveling the salary playing field through these additional measures:

    • You can help lobby for local and federal legislation that strengthens equal pay laws and policies that expand childcare availability. Contact public officials and monitor their voting records.
    • You can become active participants in professional associations and unions that represent the interests of nurses and their policy and lobbying initiatives.
    • You can advocate in the workplace for wage transparency with nursing colleagues, human resources managers, and administrators, pushing the organization to address inequities based on gender and race.
    • You can encourage women in nursing to take leadership roles at their workplaces, professional associations, and union chapters by working with male and BIPOC allies to address pay equity for all nurses.