Medscape’s annual survey of the yearly compensation of registered nurses reveals that their full-time earnings don’t reflect what one would expect with the steadily growing job market.

According to Medscape research, the average 2019 earnings for a full-time RN was $81,000, with no significant wage increase in the past three years. While the reason for the stagnation is unclear, the outlet speculates it could be because older and more highly paid nurses are retiring. However, it also may be reflective of slow wage growth overall. According to the Bureau of Labor Statistics, the job outlook for 2018 to 2028 is expected to grow 12%, much faster than average.

Salaried vs. Hourly

More than half the RNs surveyed (56%) say they are paid by the hour, while the rest are salaried. The average hourly rate for full-time RNs who are paid hourly is $38, according to the survey, the same as last year. The survey notes that a little over three-quarters of RNs are working full-time (at least 36 hours per week), which has been the case for the past several years. RNs who get a salary have a higher annual gross income than RNs who are paid by the hour. Salaried RNs earned $84,000 on average in 2019 versus hourly RNs, who made an average of $79,000.

Men vs. Women

Another noteworthy finding: Male nurses report earning more than female nurses. In fact, male RNs earn an average of nearly 5% more than women ($85,000 vs. $81,000). This pattern has been relatively unchanged for the past four years that Medscape has been running the survey. In addition, men tend to work in settings that pay higher wages, like intensive care and hospital in-patient units. Plus, they tend to hold hourly positions rather than fixed salaries, providing more opportunities to supplement income. Some 68% of male RNs are paid hourly compared to 55% of female RNs.

Additionally, men are more likely than women to work in urban rather than rural areas and to work overtime on a routine basis. Slightly more than half, 53%, of male RNs work in an urban setting compared to 43% of female RNs. Male and female RNs who are paid by the hour report the same hourly rates, with men and women getting $38 per hour. But hourly pay rates tend to be based on years of experience, with higher earnings correlating with more experience. Female RNs, on average, have been practicing longer and thus should be more highly paid, but statistics show that this isn’t true, Medscape notes. Some 9% of the respondents in this year’s survey were male. 

Pay by Practice Setting & Region

Some 43% of RNs work in in-patient care at a hospital, 12% work in a hospital-based outpatient setting or clinic, and 7% at a school or college health service. Only 4% of RNs work at a non-hospital-based medical office or urgent care office, another 4% work in a public health or community health setting, and 4% work in an academic environment (either faculty or research.) Some 3% of the RNs in the survey work as home health/visiting nurses, and 3% work in an industry setting (e.g., insurance health plan.)

According to the Medscape survey, how much an RN makes also depends on where they live. The highest paid region is the most western region of the U.S. (California, Oregon, Washington, Alaska, and Hawaii), and the lowest paid region is the East South Central region (Alabama, Kentucky, Mississippi, and Tennessee). Overall, the average salary for a full-time RN ranges from $72,000 to $100,000. (Regional incomes are not adjusted for cost of living.)

While the Medscape survey was conducted in 2020, the respondents were instructed to report their earnings from 2019. Medscape notes that all the annual salaries and hourly rates reported in the survey are averages, with some RNs earning less while others earn more.