Female registered nurses still make less than the few men in the profession, and the pay gap widened significantly during the coronavirus pandemic, new data shows.
The findings come as hospitals face major hurdles recruiting and retaining enough staff — especially registered nurses — two years into the COVID-19 pandemic, and as healthcare workers and unions push for higher wages they say will help alleviate those challenges.
Median salaries for male RNs were $14,000 higher than female RNs in 2021, according to a report out this month from Nurse.com and Relias, a healthcare workforce training and performance solutions company. In 2020, male RNs' median salaries were $7,297 higher.
Hospital systems today face staffing shortages that could persist as more nurses leave for different occupations or retire, while a scarcity of nursing educators and clinical sites pose a looming threat to the nation’s pipeline of new nurses.
“They're struggling to find strong talent, they're struggling to retain that talent, and there are so many opportunities available to nurses which certainly increase the competitive landscape,” Felicia Sadler, patient safety and quality executive at Relias, who contributed to the report, said.
Projections from the Bureau of Labor Statistics estimate that U.S. healthcare organizations will have to fill almost 200,000 open nursing positions each year until 2030.
Most nursing jobs will be filled by women, who currently hold about 87% of the country’s RN positions, though more men have chosen the occupation over the past fourteen years, according to data from the Bureau of Labor Statistics.
The Nurse.com report — which draws on a survey conducted between November and December 2021 of more than 2,000 registered, advanced practice, licensed practical and vocational nurses — identifies a number of factors contributing to the wage gap.
One key reason is that male RNs are more likely to negotiate their salaries compared to female RNs, Sadler said.
Some 40% of male RNs in the survey reported trying to negotiate a higher salary “always” or “most of the time” compared to 31% of female RNs.
Male RNs also reported working more hours per week, at an average of 39 hours plus five hours of overtime, while female RNs reported working an average of 37 hours per week plus four hours of overtime.
Other factors contributing to the wage gap might include specialties and certifications among male RNs compared to female RNs, which the study did not explore, Sadler said.
The degree to which the gap widened from 2020 to 2021 might be due to some effects of the pandemic, though, said Marina Zhavoronkova, a senior fellow in workforce development at the Center for American Progress, a left-leaning think tank.
Family roles and caretaking responsibilities most often shouldered by women, came to a head as schools and other childcare services closed. In turn, male RNs may have had more flexibility than female RNs to pick up extra shifts and work overtime, leading to higher wages, she said.
Opportunities to receive additional education and certifications associated with higher wages are also more accessible “if you're not the primary caregiver,” Zhavoronkova said.
Pay gaps also vary for nurses at different practice levels. While smaller than among RNs, the gap among advanced practice registered nurses and licensed practical and vocational nurses is actually reversed, with women earning more than men in those roles, according to the report.
That may be due to the fact that those jobs are less specialty-focused than RN positions, Sadler said.
Racial pay gaps also exist in nursing, according to the report.
Nurses who identify as Black, American Indian or Alaska Native reported the lowest levels of satisfaction with their current salaries, while also reportedly working more hours per week than other racial and ethnic groups, the report found.
Amid today’s nursing shortages, systems and health system leaders should perform internal pay audits “to bring that organizational self awareness to the forefront,” Sadler said.
Zhavoronkova also recommended pay audits so employers can identify and reduce major pay gaps.
Using pay data to make adjustments is especially important in today’s labor market, and “particularly true if an employee is perceived as being less valuable than someone doing the exact same work as them,” she said.
Female nurses should also feel more empowered to advocate for themselves and negotiate higher salaries, according to the report.
“Given the current demand for nurses and the commitment by many healthcare organizations to invest in their core nursing staff as the pandemic wanes, nurses are well-positioned to negotiate better salaries,” the report said.