Women have made up the overwhelming majority of the nursing professionals, around 90% and often more, since formal nursing schools began in the early 20th century.
However, female nurses earn significantly less on average than their male or non-binary counterparts.
Seems unfair, doesn’t it?
Let’s take a look at:
- Overall nursing employment and salary trends
- The gender breakdown of employment and salary
- Why the nurse salary gender gap persists
- How to increase your income
- Nurse salary negotiation strategies
Median annual nursing salary growth since 2022
Source: The U.S. Bureau of Labor Statistics (BLS)
As you can see in the table, the salary increase was significantly greater for LPNs/LVNs than for RNs or NPs.
However, none of these averages beat the average inflation of 13% for the period from January 2022 to January 2025.
RNs and NPs have lost buying power, while LPNs have barely kept up. These averages vary by state, specialty, and gender.
For more information and deeper analysis of nursing earning power, including CNA, LPN/LVN, RN, and NP data, check out our state-by-state nurse salary comparison guide.
Registered nurse salary variations
Most RNs have an annual base salary between $66,030 and $135,320, from the lowest to the highest pay, with some beyond this range.
- The highest paying state is California at $148K, followed by Hawaii and Oregon, both over $120K.
- The lowest-paying state is South Dakota, followed by Alabama and Arkansas.
For a full state-by-state breakdown and variations in RN salaries, read the 2025 RN salary guide.
Licensed practical/vocational nurse salary variations
LVNs in California and LPNs in Washington average over $79K, in contrast to LPNs in Mississippi, Alabama, and South Dakota who average close to $50K.
Remember, the cost of living diverges immensely from state to state, and makes a big difference in your buying power.
For full information on LPN salaries by state, see the 10 best-paying states for LPNs.
Nurse practitioner salary
California, Alaska, and Hawaii, all in the high-cost-of-living Pacific region, are the top-paying states for NPs with salaries over $170K a year.
In contrast, the lowest-paying states are Tennessee and Alabama, around $109K.
Does a nursing specialty make a difference in how much you earn?
In some cases, yes, others are less easily defined.
- RNs: A CVOR nurse (cardiovascular operating room, a subspecialty of surgery nursing) earns an average salary of $152,404, almost $60k more a year than the median RN salary.
- NPs: A nurse anesthetist makes an average of $223,210—$106K more a year than the median NP salary.
- LPNs: LPN specializations such as pharmacology, IV therapy, geriatrics, hospice, and more may give you leverage in negotiations and boost your pay rates.
Are you wondering which specialty is best for you? Take a look at this guide on how to choose a nursing specialty.
Nursing employment gap by gender
The table below has been created using data from the 2020 and 2024 National Nursing Workforce Surveys. It shows the impressive size of the gender gap in nurse employment.
Share of self-identified nurse genders in 2020 and 2024
The number of women nurses far surpasses the number of men. The number of non-binary nurses is present but very small.
The change from 2020 to 2024 is slight but present.
Gender-differentiated data for NPs and nursing assistants is harder to find.
In 2024, 88.1% of the NPs and 88.6% of nursing assistants were women, but information on the percentages of men or non-binary nurses is not readily available.
Nursing’s gender pay gap
While women make up an overwhelming majority in nursing, 2024 gender-salary data provides a startling reality check.
- Male and non-binary RNs commanded a $9,000 salary premium over their female colleagues.
- That disparity persists for LPNs, where men and non-binary nurses out-earned women by roughly $7,000.
Nursing salaries are rising, and while the gender difference persists, it is closing, slowly. The percentage increase from 2020 to 2024 was greatest for female LPNs, and least for non-binary RNs.
Increases in LPN/LVN and RN salaries from 2020 to 2024
Calculations made based on annual salary data sourced from the 2020 and 2024 National Nursing Workforce Surveys.
The salary increases from 2020 to 2024 were greater for women than for men, indicating a reduction in the nurse wage disparities regarding gender. If this trend continues, the gender pay gap will gradually diminish.
In the following breakdown, you can see the details of the median annual salaries for LPNs/LVNs and RNs in 2020 and 2024.
Median annual nursing salaries in 2020 and 2024 by gender
Licensed Practical/Vocational Nurses (LPN/LVN)
2020
- Female: $43,000
- Male: $50,000
- Non-binary: $48,392
2024
- Female: $58,000
- Male: $65,000
- Non-binary: $65,000
Registered Nurses (RN)
2020
- Female: $68,291
- Male: $78,000
- Non-binary: $71,861
2024
- Female: $86,000
- Male: $95,000
- Non-binary: $86,000
Why are men paid more than women?
The gender pay gap is rarely the result of a single policy. Instead, it reflects a complex web of societal structures and career choices.
To understand more about why men out-earn women in nursing, we have to look at who holds the positions of power, which specialties they choose, and how they negotiate.
The leadership gap
The most direct driver of the wage gap is the disparity in leadership. Senior roles come with senior salaries, and men disproportionately occupy these seats.
As of September 2025, only 29 countries have women serving as Heads of State or Government.
This global trend mirrors the reality in healthcare.
According to the Johns Hopkins Bloomberg School of Public Health, while women make up nearly 70% of the healthcare workforce, they hold only 25% of senior leadership roles.
When the highest-paying administrative jobs go to men, the average income for male nurses skews upward, leaving women behind at the bedside.
Specialty & shift choices
Beyond leadership, men often gravitate toward the highest-paying clinical specialties.
- High-acuity units: Men represent roughly 17% of ICU nurses and a staggering 42% of Certified Registered Nurse Anesthetists (CRNAs)—one of the highest-paid roles in the industry.
- Shift differentials: Flexibility also plays a role. Men are more likely to work nights, holidays, and overtime shifts that offer lucrative differentials. Societal norms often place the burden of childcare and "unpaid labor" on mothers, making it harder for them to pursue these premium shifts.
The negotiation factor
Finally, the "ask" matters.
Men are historically more aggressive in salary discussions, with 46% of male RNs negotiating their pay compared to just 34% of female RNs.
However, this behavioral gap is narrowing as more women feel empowered to advocate for their worth.
Negotiation strategies based on current market signals
The best time to negotiate a nursing salary is upon receiving a job offer, particularly if you have competing offers. Knowledge of the shortage-driven competition to hire nurses gives you leverage.
Projected nursing shortages by year
Source: Health Resources Services Administration (HRSA), Nurse Workforce Projections 2023-2038
As you can see, the shortage of RNs is likely to decrease, while the shortage of LPNs is expected to increase. On the other hand, HRSA projects a surplus of NPs, but concerns remain regarding distribution.
For both LPNs and RNs, this means facilities will be competing to hire nurses. It’s also worth noting that this competition will be stronger in non-metro areas where the shortages are higher.
Another negotiation opportunity is during annual performance reviews, especially now amid concerns about high turnover rates and a lack of experienced nurses on staff.
With the current supply and demand dynamic in the nursing industry, nurses who have hesitated to negotiate salary should reconsider because the current marketplace is decidedly in their favor.
Tips for negotiating an increase
- Gather all relevant information, concrete evidence, and reports to build a strong profile.
- Keep a file of all your performance reviews that can highlight your capabilities and professionalism.
- Record and keep in mind any compliments related to skills or tasks that are above what’s expected in your current role, such as leadership or initiative.
- Don’t be hesitant to negotiate a compromise if the counteroffer is not on par with your expectations.
- Maintain a professional attitude and show appreciation for the counteroffer.
Learn more about how to negotiate your salary as a nurse.
How can you increase your total nursing compensation beyond base pay?
Nurses have the potential to increase their earnings in several ways.
- Advanced education: Nurses with an Associate Degree in Nursing (ADN) who go back to school and complete a Bachelor’s in Science in Nursing (BSN) or a Master of Science in Nursing (MSN) may be able to increase their annual salaries by as much as $5,000 and $26,000, respectively.
- Sharpened skills: By obtaining specialization, you validate your clinical expertise and commitment to professional growth. Specialty certifications garner respect from peers and employers and may come with higher pay.
- Experience in administrative roles: Roles such as charge nurse or nurse managers generally earn higher salaries as the job involves leadership and supervision, and requires extensive healthcare knowledge. These are steps towards becoming a chief nurse officer.
- Overtime: The usual for overtime pay is time-and-a-half or double-time.
- Differentials: A shift differential is additional per-hour compensation for certain less desirable shifts, such as mid-shifts (bridging day and night hours, covering peak evening hours), night, or weekend shifts. A shift differential may be anywhere from $2 to $8 per hour.
- Bonuses: Bonuses may be earned for accreditation, retention, specialization, performance, or, in some cases, for identifying ways to reduce the hospital's expenses, such as lowering hospital infection rates or improving patient outcomes.
- Change practice setting: Some settings pay more than others. RNs who work in hospitals and physician offices typically earn higher salaries than their counterparts in other settings.
- Become a PRN nurse: Look into how much you can earn with per diem shifts with Nursa.
How can PRN work increase your income?
You can pick up high-paying PRN shifts on top of your regular job, or you can cover your budget while keeping the flexibility to study or have time with your family.
True stories
Beatriz, a CNA mother of 5 children, finds she can earn more and work less with PRN nursing pay due to the higher hourly rates. She picks up the shifts that offer the pay she is willing to work for, and she has learned to handle her taxes. Beatriz says she was surprised that she doesn’t have high taxes to pay:
“When tax season comes around, I hardly get any taxes taken out because I write off everything that needs to be written off.”
Ken, an LPN who lives and works in the state of Washington, loves his PRN work, and he has plenty of experience, over 200 shifts with Nursa. In an interview, he clearly stated:
“I love working; I typically pick three to four shifts a week, something like that. Before PRN shifts, if you didn’t follow the schedule, you had to call off, which sometimes created tension with management. Now, I can decide my own schedule without any stress.”
You might also be interested in reading more about why more men are choosing PRN nursing.
Considering PRN or flexible work?
Inflation is outpacing the rise in salaries, and many nurses take advantage of the opportunity to augment their income with PRN shifts. Others seek PRN work to have greater flexibility and freedom, to avoid burnout, and to put their lives in balance, both women and men.
Still unsure about PRN nursing? Learn the truth about these common PRN misconceptions.
Sources:
- BLS Occupational Employment and Wage Statistics 2024
- The 2020 National Nursing Workforce Survey
- The 2024 National Nursing Workforce Survey
- Women’s leadership and political participation
- Johns Hopkins: Women’s Leadership in Global Health
- HRSA Nurse Workforce Projections, 2023-2038
- CPI Inflation Calculator
- Males in Nursing: The Future of a More Diverse Healthcare Workforce
