Admin_Adham
Tamara Hryshchuk, DNP, RNC-NIC, director of the Accelerated Bachelor of Science in Nursing and Registered Nurse-Bachelor of Science in Nursing program and clinical assistant professor of Nursing at the Oxley College of Health and Natural Sciences at The University of Tulsa, Tulsa, Oklahoma, teaches nursing students who are about to graduate into their first nursing jobs and has hired clinical faculty in her program. In the past 18 months, she said, she hired between 15 and 18 new employees; only three or four tried to negotiate their salary after she offered them the job.
“I think a lot of nurses don’t realize there is a salary range, so typically what you are offered is the bottom of the range,” she said, suggesting that nurses could ask for at least 5%-10% more than what they are initially offered, rather than simply accept a first offer. “It’s better to ask and have someone say no than to never ask. I think nurses just don’t know they have that option.”
About Medscape Insights
Medscape continually surveys physicians and other medical professionals about key practice challenges and current issues, creating high-impact analyses. For example, the Medscape Advanced Practice Registered Nurses (APRN) Compensation Report 2025 found that
- APRNs surveyed felt they were less often compensated fairly for their training and efforts.
- 2 in 3 nurses surveyed said future pay is important to them.
- Only 46% of the nurses surveyed said their compensation covered their needs.
Who Doesn’t Want More Money?
While everyone can use more, not everyone knows how to ask. But negotiating — not just for your base salary, but for other elements such as relocation packages, paid time off, tuition reimbursement, and more when you are offered a new role — is a skill too many nurses skip.
According to a 2024 Nurse Salary and Work-Life Report of 3600 nurses across the US conducted by Nurse.com, male nurses were more likely to say they negotiated salary either always or most of the time (40%) compared with female nurses (36%), while 17% of female nurses said they never negotiate salary. Titles play a part, too: 46% of APRNs/Advanced Registered Nurse Practitioners said they negotiated salaries always or most of the time compared to 35% of RNs and 38% of Licensed Practical Nurses/Licensed Vocational Nurses who said the same.
Age also can be a factor: Millennials (39%) and Gen X (37%) across all license types were more likely to negotiate salary, while 48% of Gen Z nurses said they negotiate either rarely or never.
Know What You Want
Nurses at any level seeking a new role should identify what will make them happy in their working life, said Hryshchuk, who has worked as a clinical nurse for 25 years and in nursing education for the past 15 years. “Despite all the benefit packages, salaries, and all the things that an employer can give you for financial happiness, it’s important the nurse finds employment where they will have joy in their career and that there is a good working environment,” she said. “At the end of the day, if you aren’t happy with what you do, it doesn’t matter what the benefits package is.”
Additionally, what you value is likely to differ throughout your working tenure. Early-career nurses, especially those seeking first roles, don’t have any experience, so salary negotiations may be minimal. Being flexible and keeping an open mind about opportunities is helpful, said Sarah K. Wells, MSN, RN, CEN, CNL, a clinical nurse and the founder of New Thing Nurse in Oakland, California, a nursing coaching company.
When negotiating at midcareer, nurses should highlight their prior experience, particularly in any charge roles, while late-career nurses typically look for how their employers might optimize retirement contributions as well as opportunities for precepting and to shift into other roles that aren’t as physically taxing as they may have held earlier in their careers, said Morgan Haynes, CEO and founding executive of Tribal Health, a healthcare staffing and practice management company in Scottsdale, Arizona. Haynes has placed thousands of nurses in varying roles over the past 12 years.
Research and Question
Experts agree that knowing as much as you can about the position, employer, and related issues can give you leverage to negotiate after an offer. Look at vacancy levels, staffing ratios, and turnover rates, said Haynes. Is the employer posting a lot of job openings? Is there any press on the institution, positive or negative, and what does its financial health and growth look like? Talk to area locum tenens firms to find out where there are more or fewer openings in companies or healthcare systems where you are interviewing. Use sites such as Glassdoor (glassdoor.com), Payscale (payscale.com), and the Bureau of Labor Statistics (bls.gov) to get a sense of compensation, growth opportunities, and other insights about the workplace, she added.
Because nursing has so many roles and places where one can work, Wells also recommended looking on social media, such as nursing-specific Facebook groups and subreddit threads, to get insights that the above resources might not drill down on, such as specifics about clinical differences or night differential rates. Always ask questions anonymously when posting specifics about job offers and negotiating.
“A lot of the information there is nurse-contributed data,” she said. Consider Nurse Pay (nursepay.co), Nurse Salaries (nursesalary.com), RNsight (ratedbynurses.com), and Transparent Nursing (transparentnursing.com) for salary details, Wells added.
You may have more leverage to negotiate for what you want if you are working in a specialty that is sought after, such as the operating room, emergency department, or critical care, said Haynes. Places that have harder-to-staff facilities may be more open to negotiations for a nurse who wants more scheduling flexibility, as opposed to an employer who is considered a more consistent healthcare system, she said.
Listen to Your Gut
Some people feel they know what they want but reconsider during the interview process, said Hryshchuk. Many of her students, about to enter the workforce for the first time, say they want a high-demand ICU setting and feel that if they are offered that role, they should take it because they won’t get the opportunity again. Instead, Hryshchuk said, “When you go for the interview, you typically get an opportunity to walk into the unit. Use your eyes and ears to take inventory of what is happening there. When you walk in, are people friendly and look up and say hi? When the manager walks by, do people look down and look nervous? You can often feel it in the air as you walk through. Take note — this might be an indicator that this may not be a great environment,” she said.
Another red flag is a lack of nurses. “There is a need for more nurses, and a lot of nurses are put into positions where they have to take a high volume of patients during the shift,” she said. With that high volume, they may not have the time to give them the care they need. “Taking care of 12 patients can be overwhelming if you misstep, and it is your license on the line,” she said. “You can’t go to the board of nursing and say, ‘My boss made me take 12 patients.’ You took the 12 patients, and you are liable” if a problem occurs.
Once you know what you want and where you can be more flexible, approach the conversation professionally. Don’t worry that your requests will be met with anger or that the offer will be rescinded.
“A lot of times nurses get emotional,” said Wells. “We get a lot of feelings in our job, and the narrative is, ‘This is a service, a passion, and a calling.’ Those narratives may resonate with people, but I think this can interfere with the practicality that this is a job.”
If it can’t pay your bills, it’s not the right job for you, no matter how excited you are about the position. Likewise, if the compensation is not enough, don’t feel bad about asking for more. Also, it is those up-front conversations that will set you up for success. Once that package is signed, sealed, and delivered, it’s too late to negotiate.
The offer isn’t the end of the road; the negotiation is. Once you have considered the offer and package, always ask for a few days to consider it, and do more research, then negotiate a professional counteroffer with a respectful tone, and know what your walk-away point is if you can’t agree on the final salary and package. “Take the opportunity to take your power back,” said Wells. “You always get to have a conversation about your compensation package.” Asking and advocating are part of the journey.
Cheryl Alkon is a seasoned writer covering healthcare and medicine. She is the author of the book “Balancing Pregnancy with Pre-Existing Diabetes: Healthy Mom, Healthy Baby.” Find her at CherylAlkon.com.
