Pay is a top priority for a majority of job seekers across industries.
Gallup asked 13,085 US employees what they would look for in their next jobs, and 64 percent answered that a significant increase in income or benefits was “very important.” Pay also rose from number four on the list of priorities in 2015 to number one in 2022.
However, an increase in pay is not the only compensation-related demand nurses have. Nurses also demand fair compensation, which can only be determined through pay transparency.
What is nurse pay transparency?
Nurse pay transparency is the practice of divulging compensation scale information to current and potential employees. Not only does this practice contribute to pay equity, but it can also improve communication and build trust in the workplace.
Whether nurses can access pay scale information depends on numerous factors, including the state and city of employment, as well as the specific healthcare facility they work at or are applying to.
Are there salary transparency laws for nurses?
There is no federal pay transparency law in the United States—for nurses or any other type of professional. However, there is a federal minimum wage, and there are laws stipulating when nursing professionals are eligible for overtime pay.
In the absence of a federal law, many states and even some cities have established pay transparency policies.
In general, these regulations require employers to be more transparent with salary ranges and benefits. However, state and city laws vary and may impose different requirements on healthcare facilities.
Here are examples of pay transparency regulations nurses may benefit from:
- Healthcare facilities must disclose pay ranges to applicants at a specified point during the hiring process.
- Employers must disclose pay ranges to employees upon request.
- Facilities must disclose pay ranges in job postings.
States and cities with nurse pay transparency laws
Over the past few years, the following states have enacted pay transparency laws, encompassing regulations for transparency in nurse compensation:
- California
- Colorado
- Connecticut
- District of Columbia
- Hawaii
- Illinois
- Maryland
- Massachusetts
- Minnesota
- Nevada
- New Jersey
- New York
- Rhode Island
- Vermont
- Washington
In some cases, specific cities had established pay transparency laws before the state law was enacted. For instance, Jersey City had pay transparency laws before the state of New Jersey, and New York City, Ithaca, and Westchester County had these laws before the state of New York.
Interestingly, the state of Ohio doesn’t have nurse wage transparency policies, although Cincinnati and Toledo were pioneers in this area, enacting pay transparency laws as early as 2020. Columbus, Ohio, also joined the ranks in 2024.
Nurse pay secrecy vs. transparency
Facilities in states or cities that do not have pay transparency laws may opt for secrecy instead of transparency.
Pay secrecy allows facilities to attract highly experienced or specialized nurses with an impressive compensation package, while new graduates or international nurses may be offered significantly lower pay.
Many facilities also opt for pay secrecy to avoid resentment among internal staff when travel nurses typically receive significantly higher compensation.
Healthcare facilities undoubtedly have their reasons for choosing pay secrecy over transparency, but is this practice justified?
Is withholding pay information fair?
Importance of nurse pay transparency
The previous examples of experienced nurses vs. new grads and permanent staff vs. travel nurses may be justified. After all, compensation should align with a nurse’s years of experience and additional specialization, and travel nurses trade the benefit of additional pay for several disadvantages.
However, there is no justification for pay discrepancies based on race or gender, and these—unfortunately—are also prevalent.
For instance, a 2021 study titled “Examining Wage Disparities by Race and Ethnicity of Health Care Workers” found that non-Hispanics consistently made more than Hispanic licensed practical/vocational nurses (LPNs/LVNs), nursing aides/assistants, technicians, and community-based workers.
Furthermore, according to Medscape’s RN/LPN Compensation Report 2023, the following figures reflect nurse salary discrepancies that year based on gender:
Average registered nurse (RN) pay
- Women: $88,000
- Men: $99,000
Average LPN/LVN pay
- Women: $55,000
- Men: $61,000
Common justifications—such as men being more likely to work hourly, pick up extra shifts, or work in urban settings—do not fully account for the pay discrepancy.
It is essential for nurses to know how much their equally qualified counterparts are making in order to advocate for fair compensation.
Advocating for pay transparency is the first step toward solving nurse pay equity issues.
Challenges of implementing pay transparency in nursing
According to an independent research survey of 203 hospital executives commissioned by Nursa in 2023, nursing costs put significant pressure on healthcare facilities’ bottom lines and are among the top drivers of margin pressures.
Pay transparency in nursing may drive up staffing costs further. That said, nurse staffing costs are a complex issue, and facilities should not disregard the financial consequences of turnover, for example, which partially results from dissatisfaction with compensation.
Healthcare leaders may avoid pay transparency precisely for fear of turnover. However, higher pay is not the only factor determining nurses’ satisfaction with their jobs. Nurses also value jobs that offer flexibility and autonomy. Nurses want to be heard and want to have ongoing, open lines of communication with healthcare leaders.
Any change is challenging.
However, if there is one undeniable truth in healthcare staffing and workforce management practices, it is that change is necessary. Pay transparency is a step in the right direction.
How to promote pay transparency in nursing
If there is no pay transparency law in your state, you can contact a member of Congress to propose this law.
If you live in a state that has introduced bills regarding pay transparency, you can publicly support the proposed legislation on social media platforms and nursing forums.
If you are part of a shared governance committee or if your facility uses this system, you can propose implementing pay transparency in your healthcare organization. Otherwise, you can always speak directly to your nurse manager about adopting this practice.
Regardless of where you live or what type of facility you work in, you can promote pay transparency in nursing by sharing your own salary information.
For example, you can submit your pay details to the anonymous survey at nursesalary.com to contribute to a collective effort to improve transparency and equity in nursing.
Participation is as simple as taking a photo of your pay stub, as impactful as ensuring accurate data collection, and as beneficial as benefiting nurses throughout the industry.
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