Between 2019 and 2020, the workforce of registered nurses (RNs) decreased by 1.8%, according to research by industry publication Health Affairs. The COVID-19 pandemic and other key service and patient population factors have placed enormous stress on nurses and the health care system in general. However, this has created more demand for nurses and a strong job outlook.

This demand for nurses also affects salaries of full-time positions. Other factors that impact salary include education, geography, specialization/certification, experience, and the type of employer.

• 41% of employers require nurses to have a bachelor’s degree (BSN), and 77% strongly prefer it, according to The American Association of Colleges of Nursing (AACN).
• The AACN reports registered nurses are most in demand in private practices, public health agencies, primary care clinics, nursing homes, and schools.
• Nurse salaries in eight of the nine U.S. regions defined by the American Hospital Association increased between 2020 and 2022, according to a study by Nurse.com.

Salary varies, even within a specific nursing role. Additionally, certifications, education, and experience may increase a nurse’s salary over time. Another consideration involves multi-state licensure. A nurse who is licensed in several states has more career opportunities and can choose to change location for a higher paying job.

Nurse practitioners (NPs) must have a Master of Science in Nursing (MSN), are required to pass the NCLEX exam, and must keep their nursing license active. NPs often specialize in a specific patient population, such as adults and geriatric health, pediatrics, or psychological health.

• Median Annual Salary (according to the U.S. Bureau of Labor Statistics [BLS], 2021): $120,680
• Job Outlook: Projected 46% increase between 2020 and 2030
• Education: Master’s degree

According to the BLS, 47% of nurse practitioners work in doctor’s offices, while the rest are in hospitals, outpatient clinics, and educational settings. Nurse practitioners often provide primary care, including prescribing medication, depending on state laws.

Travel nurses work on a temporary basis, taking positions where they are needed. This may include remote areas, rural locations, or underserved communities where a hospital or clinic is not easily reachable.

• Median Annual Salary (Payscale, November 2022): Approximately $81,000
• Job Outlook: Expected 6% increase between 2020 and 2030 (for all RNs, including travel nurses)
• Education: Associate Degree in Nursing (ADN), Bachelor of Science in Nursing (BSN), or Master of Science in Nursing (MSN)

Registered nurses (RNs) are required to pass the NCLEX exam and keep their nursing license active. RNs assess patients, record their medical histories, operate medical equipment, and administer medications.

• Median Annual Salary (BLS, 2021): $77,600
• Job Outlook: Projected 6% increase between 2021 and 2031
• Education: ADN or BSN

According to the BLS, 60% of RNs work in hospitals. RNs may specialize in fields such as addiction care, critical care, or pediatrics, and may pursue certifications such as Cardiopulmonary Resuscitation (CPR) and Basic Life Support (BLS).

Pediatric nurses are RNs who specialize in caring for children from birth to adolescence. Through clinical work, these nurses gain experience with pediatric medicine and can find work in areas such as cardiology, endocrinology, neonatology, or trauma.

• Median Annual Salary (Payscale, November 2022): Approximately $60,000
• Job Outlook: Estimated 6% increase between 2021 and 2031 (for all RNs, including pediatric nurses)
• Education: ADN or BSN

Schedules and hours for pediatric nurses vary depending on where they work and what they specialize in. They usually work as part of a health care team.

Labor and delivery (L&D) nurses are registered nurses who provide care during pregnancy, labor, and delivery. Sometimes, L&D nurses work as travel nurses. They often work under the supervision of nurse-midwives, and often work with several patients at once.

• Median Annual Salary (Payscale, November 2022): Approximately $67,800
• Job Outlook: Projected 6% increase between 2021 and 2031 (for all RNs, including L&D Nurses)
• Education: ADN or BSN

L&D Nurses are required to be Cardiopulmonary Resuscitation (CPR) and Basic Life Support CPR and (BLS) certified, as well as be certified in neonatal resuscitation and inpatient obstetric nursing (RNC-OB).

Psychiatric and mental health nurse practitioners (PMHNPs) are nurse practitioners who specialize in assessing, diagnosing, and helping treat the mental health needs of patients. Many PMHNPs provide therapy and may prescribe medications for patients who have mental health disorders or substance abuse problems.

• Median Annual Salary (Payscale, November 2022): Approximately $114,000
• Job Outlook: Anticipated 46% increase between 2020 and 2030 (for all NPs, including PMHNPs)
• Education: MSN

Some APPNs go on to earn PhDs, MDs, or JDs. APPNs work in hospitals, private practices, and behavioral health/addiction clinics.

Location greatly impacts nursing salaries, so it’s important to research locations before accepting a position. Factors such as cost of living, quality of facilities, and job demand affect what employers offer full-time nurses.

According to the BLS, in May 2021 registered nurses, including travel nurses, pediatric nurses, and labor and delivery nurses, had the highest employment in California, Texas, New York, Florida, and Pennsylvania. However, they were most concentrated in South Dakota, West Virginia, North Dakota, and Delaware. The highest paying locations were California, Hawai‘i, Oregon, Washington DC, and Alaska.

• California: $124,000
• Hawai‘i: $106,530
• Oregon: $98,630,
• Washington DC: $98,540
• Alaska: $97,230

The states with the lowest salaries were Alabama, South Dakota, Mississippi, Iowa, and Arkansas.

• Alabama: $60,230
• South Dakota: $60,960
• Mississippi: $61,250
• Iowa: $62,570
• Arkansas: $63,640

According to the BLS, in May 2021 nurse practitioners and psychiatric nurses were in need everywhere, but they were mostly employed in Texas, California, New York, Florida, and Tennessee. Tennessee, Mississippi, West Virginia, Alaska, and Missouri had the highest concentration of nurse practitioners. The highest-paying locations for nurse practitioners were:

• California: $151,830
• New Jersey: $137,010
• New York: $133,940
• Washington: $130,840
• Massachusetts: $129,540

In contrast, the lowest salaries were in Hawai‘i, Tennessee, Alabama, Florida, and South Carolina.

• Hawai‘i: $82,490
• Tennessee: $99,370
• Alabama: $99,790
• Florida: $101,060
• South Carolina: $101,190

Salary depends on many factors, but considering geography highlights a specific issue. Publicly-funded health care facilities depend on lawmakers who determine how much funding facilities receive. States that have well-funded healthcare facilities can afford to pay their nurses better. At the same time, some states with nursing shortages are willing to pay more for new hires.

Nurses can work in a variety of different settings. Hospitals, government organizations, and outpatient clinics all pay different rates. Another factor that can affect salary is whether or not an employer is private or public.

A registered nurse can work in a full range of settings. They may choose a specific health care facility based on their experience, specialization, and interest in advancing to nursing leadership. According to the BLS, in May 2021 the industries and sectors that paid the highest median annual RN salaries were:

• Government: $85,970
• Hospitals: $78,070
• Ambulatory health care services: $76,700
• Nursing or residential care: $72,420
• Educational settings: $61,780

Nurse practitioners may have more education and experience than registered nurses, but their pay is also dependent on where they work. According to the BLS, in May 2021 the industries that paid the highest median annual RN salaries were:

• Outpatient clinics: $128,190
• Hospitals: $128,190
• Physicians’ offices: $104,790
• Other health care offices: $104,790
• Educational settings: $102,680

Funding is the largest factor that impacts how much a particular employer can or will pay a nurse annually. Rural facilities face nursing shortages, so they may offer sign-on bonuses to encourage nurses to stay in their communities. Job competition is high in urban areas, but jobs may pay better. A 2022 study by the Chartis Group found 53% of rural facilities are hiring more travel nurses as permanent nurses move to better paying jobs.

Public facilities need to apply for funding, and how much they receive will influence how much they are able to pay their nurses. Finally, a facility may also choose to spend funds in other areas, such as on equipment, instead of paying nurses more. They may also allocate funding for continuing education, certifications, and training, rather than give that money to nurses directly as salary.

Your potential salary depends on a variety of factors that may or may not be in your control. These include location, facility, your nursing specialization, and experience. Before accepting a job offer, research the facility and what other nursing professionals make in a similar position. Consider the cost of living and potential career expenses, such as the need for continuing education and future certifications. If you’re currently working as a nurse, explore potential ways to increase your salary and gain more experience.