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Nurse Wage Trend: How RN Pay Has Changed and Where It's Headed

How registered nurse pay has moved in recent years, what drives the gaps by degree, union status and setting, and how to read BLS wage data without being misled.

By the Salary Atlas editorial team · Published

Registered nurse pay has gone up in dollars, but it has not gone up much once you subtract inflation. A 2025 Health Affairs study of 2012 to 2023 found that inflation-adjusted wages rose in every healthcare occupation it examined, and RNs saw the smallest gain, at 0.51%. Demand for nurses, meanwhile, keeps climbing. That gap between a growing need and slow real pay growth is the core of the nurse wage trend.

This guide explains what the long-run picture looks like, why two nurses in the same city can earn very different amounts, how to read a wage trend without fooling yourself, and what the job outlook says about the years ahead. We also cover the teacher job outlook briefly, because readers comparing helping professions often ask about both.

TL;DR

  • Real (inflation-adjusted) RN pay grew only 0.51% from 2012 to 2023, the smallest increase among the healthcare occupations in one 2025 Health Affairs study.
  • Degree, union status and work setting are linked to large pay differences: bachelor's-prepared RNs earned about 5% more than associate or diploma RNs, and master's or higher about 11.9% more.
  • Demand is strong. The AACN expects the RN workforce to grow from 3.46 million in 2025 to 3.66 million in 2035, with 194,700 openings a year.
  • Compare nominal and real wages, the same data year, and the same job title before you call anything a trend.
  • For teachers, national projections show a small decline in employment but tens of thousands of openings a year from replacement needs.

Table of Contents

What the long-run nurse wage trend actually shows

There are two ways to describe nurse pay over time, and they tell different stories.

Nominal wages are the dollar figures printed on a paycheck or in a data table. They almost always rise, because prices and pay generally rise over time. A nurse who earned a given hourly rate a decade ago and earns more today has seen a nominal increase. Real wages adjust those dollars for inflation. They tell you what the paycheck buys. This is where the nurse wage trend gets less flattering. The Health Affairs analysis covering 2012 to 2023 compared RNs with other health occupations and found that RNs' inflation-adjusted growth of 0.51% was the lowest of the group, even though pay rose in real terms for every healthcare occupation in the study.

The honest summary: a typical RN today is paid more in nominal dollars than a decade ago, but has barely gained purchasing power over that span. Other health roles pulled ahead of nursing in relative terms.

What the long-run nurse wage trend actually shows, overview diagram

Why the headline salary numbers you see online disagree

Search for nurse pay and you will find a spread of figures: some pages say an RN averages in the low $80,000s, others say the high $80,000s or above, and hourly figures range widely. They are not all wrong. They differ because they measure different things:

  • Survey type. Federal wage statistics come from a large employer survey. Many commercial pages rely on user-submitted or scraped salary reports, which skew toward whoever chooses to post.
  • Mean versus median. A mean (average) is pulled up by a few very high earners. A median is the middle worker. For pay, the median is usually the fairer picture.
  • Job title scope. "Nurse" can mean a licensed practical nurse, an RN, a nurse practitioner or a nurse anesthetist. These are different occupations with different pay.
  • Data year. A figure from three years ago will not match one from this year, and calling the difference a trend is a mistake if the two sources used different methods.
  • Geography. A national figure blends high-cost coastal metros with low-cost rural areas.
At Salary Atlas we use only Bureau of Labor Statistics figures, and we link every number to its origin. That keeps one variable constant: the method. If you want to pull the figures for registered nurses yourself, our guide to finding BLS salary data by job and state walks through mean, median and percentiles.

What explains pay differences between nurses

If the national trend is slow, the gaps between individual nurses are not. Research on nurse earnings points to a handful of consistent predictors.

Education level

A study of RN employment and earnings found that RNs with bachelor's degrees earned 5% more, and those with master's or higher degrees earned 11.9% more, than RNs with associate or diploma degrees00239-8/fulltext). Those are averages after the study's adjustments, not guarantees. A master's degree does not automatically raise your hospital's pay scale, since many employers pay on a fixed grid. But the figure shows why many nurses use an RN-to-BSN program as a first step.

Union representation

The same study indicates that unionized RNs earn roughly 8.4% to 9% more than non-union counterparts00239-8/fulltext). Part of that gap is negotiated wages, and part may reflect where unions are strong, such as large urban hospital systems. Either way, if you are comparing two offers, ask whether the unit is covered by a collective bargaining agreement and read the pay scale attached to it.

Work setting

Research in Nursing Outlook on earnings predictors found that higher wages were associated with union membership and with working outside long-term care settings, along with other factors the authors examined. In plain terms, a nurse in a hospital and a nurse in a nursing home are in the same occupation on paper but often in different pay brackets. When you read a wage figure, check what settings it includes.

Advanced practice

Many nurses who want a bigger jump move into advanced practice. A median salary for a nurse anesthetist, for instance, sits in a different bracket than for an RN, but the training is long and the path is selective. If you are weighing the nursing ladder, this CRNA and CNA career comparison sets out how the roles differ so you can see where each rung leads before you commit to the schooling.

State and metro area

Location matters more than most nurses expect. Wages differ by state, and so does cost of living, so a higher salary does not always mean more money left over. Compare the BLS state figure with local rent and taxes before you move for a job. Our piece on checking state pay first shows why a state's job outlook and its wage level are two separate questions.

How to read a nurse wage trend without being misled

A "trend" is a direction over time. It needs at least two comparable data points. Here is a checklist we use before calling any change a trend.

  • Same source, same method. Compare a BLS figure to a BLS figure from a later year, not to a job-board average.
  • Same job title. RN to RN, not RN to "nurse".
  • Same measure. Median to median, or mean to mean.
  • Adjust for inflation. A 3% raise in a year when prices rose 3% is a flat real wage.
  • Watch the starting point. A dip in one year followed by a rebound can look like growth when it is only recovery.
  • Know the survey timing. Federal occupational wage data is collected over a multi-year panel and published with a lag, so the newest number describes a past reference period, not today.
Some sources in the search results do not pass this test. One commonly cited chart reports a flat average RN salary for a run of years, using a different dataset each time. A reader sees a pattern that may be mostly noise from changing samples. We would rather show you fewer numbers that line up than many that do not.

A worked example

Suppose a nurse earned $70 an hour-equivalent salary figure in one year and 15% more ten years later. That is a 15% nominal raise. If prices rose by more than 15% over those ten years, the real wage fell. The Health Affairs result is more favorable than that hypothetical, since real RN wages did rise slightly, but it is a reminder that a growing paycheck and growing buying power are not the same thing. Always ask which one a chart is showing.

The demand side: why nurse jobs keep growing

Slow real pay growth sits next to rising demand. The American Association of Colleges of Nursing reports that the RN workforce is expected to grow from 3.46 million in 2025 to 3.66 million in 2035, an increase of 166,100, with 194,700 annual openings when retirements and other exits are counted.

Projected RN workforce growth and annual openings

That last part matters. Most openings in any large occupation come from people leaving, not from net new positions. A nurse who retires or moves into another field opens a seat for someone else. So even a modest growth rate yields a lot of hiring.

If you want to see where healthcare sits among all U.S. occupations, our report on the fastest growing jobs covers the healthcare projections through 2034.

What strong demand does and does not mean for your pay

In a textbook labor market, scarce workers get raises. Nursing shows why it is not that simple. Hospitals set pay through budgets, reimbursement rates and union contracts, and many fill gaps with overtime and temporary staffing rather than raising base wages. So strong demand tends to improve your negotiating position, your choice of shifts and your sign-on options, more than it lifts the entire median wage in a clean line.

Perspective: what we see in the wage data

We look at wage tables for a living, and nursing is one of the occupations where the table alone can mislead. The national median is a useful anchor, but it hides the things that decide what a given nurse takes home: the state, the setting, the degree, the contract, and the shift. When someone tells us "nurse pay is up X%", our first question is up from what, measured how, and adjusted for what.

We also hold a firm line on method. We do not publish estimated wages, self-reported figures or scraped postings, and we do not invent a trend where the federal data does not support one. The most defensible reading of the research is modest: nominal pay rises, real pay is close to flat, and the premium for credentials and for union coverage is where the clearest differences show up.

If you are a nurse deciding whether to go back to school, look at the percentile table for your state before the national average. If you are an employer setting an offer, look at the median and the 75th percentile for your metro, not a single average. Both questions are answerable from public BLS data, and neither requires a subscription.

, Joelen Zyoktova

Use sourced BLS data for your own nurse pay check

If you are negotiating an offer, advising a student or benchmarking a pay band, start from the numbers that come with their sources attached. Salary Atlas publishes BLS wage data by job title, percentile, state and experience level, with no paywall and no signup. Browse the Salary Atlas homepage to look up your occupation, or read our overview of 2026 wage trends to see how pay across the economy has moved.

Teacher job outlook: a short comparison for readers weighing careers

Readers who search for nurse pay often look at teaching in the same session, so here is the outlook in brief. It comes from the federal employment projections for 2024 to 2034, which CareerOneStop republishes.

For secondary school teachers, excluding special and career/technical education, CareerOneStop reports 1,094,500 jobs in 2024 and 1,076,700 projected for 2034, a 2% decline, with 66,200 projected annual openings.

How can an occupation shrink and still have tens of thousands of openings? CareerOneStop defines annual openings as the average yearly openings resulting from both growth and net replacement, so openings can stay substantial even when total employment declines. Teachers retire and change careers just as nurses do.

Two cautions for anyone reading a teacher outlook:

  • "Teacher" is many occupations. The federal outlook covers preschool, kindergarten and elementary, middle, secondary, special education, career and technical, and many postsecondary teaching occupations, as the O*NET educational services listing shows. Each has its own projection.
  • Older projections can differ. The National Center for Education Statistics projected 304,000 new teacher hires in 2030, 18% below the 358,000 in 2019. That is a different measure and period from the 2024 to 2034 figures above, so do not stack the two into one trend.
The nurse and teacher outlooks look different in shape. Nursing combines projected growth with heavy replacement demand, while the secondary school teaching projection shows slight decline with a steady stream of openings. If you want to understand why those two words, outlook and growth, are not interchangeable, see our explainer on job outlook versus job growth.

Practical steps if you are a nurse thinking about pay

  • Find your occupation's percentiles in your state. Know where you sit in the 10th to 90th range, not just against the median.
  • Check your setting. If your pay is below your state's median and you work in long-term care, consider whether a hospital or outpatient role in your area pays differently.
  • Price a degree honestly. A 5% premium for a bachelor's degree is an average. Work out tuition, time and what your employer's pay grid actually does for a BSN or MSN.
  • Ask about the contract. Union coverage and its scale can explain a large share of the difference between two similar jobs.
  • Compare real, not just nominal, offers. A higher salary in a high-cost metro may leave you with less.
  • Revisit every year. Federal wage figures refresh on an annual cycle, so rechecking once a year is enough.

Practical steps if you are an employer or HR professional

  • Benchmark each role against the median and a higher percentile for your metro, so you know what a competitive offer looks like, not only a typical one.
  • Separate RN roles from licensed practical and advanced practice roles in your benchmarks.
  • Remember that openings from replacement are large. Retention may do more for your staffing than a one-time hiring push.
  • Document the source and year for every benchmark so a pay decision can be explained later.

FAQ

Is nursing a high paying job in the USA?

It depends on the comparison. Registered nursing generally requires only an associate or bachelor's degree, and pay is competitive for that level of education. But the 2025 Health Affairs study found RNs had the smallest real wage growth among healthcare occupations from 2012 to 2023. Check the BLS percentile table for your state and setting to see where you would land.

Have nurse wages kept up with inflation?

Only just. Inflation-adjusted RN wages grew by 0.51% over 2012 to 2023 in the Health Affairs analysis, which is positive but small. Dollar wages rose more, but much of that increase went to higher prices.

What raises a nurse's pay the most?

In the research we cite, the clearest differences come from education, union representation and setting. RNs with a bachelor's degree earned about 5% more than those with an associate or diploma, and those with a master's or higher about 11.9% more. Unionized RNs earned roughly 8.4% to 9% more than non-union RNs.

Will there be enough nursing jobs in the next decade?

The AACN projects the RN workforce growing from 3.46 million in 2025 to 3.66 million in 2035, with 194,700 annual openings including retirements and exits. That points to steady hiring, though local conditions vary by state and employer.

What is the teacher job outlook for 2026?

The federal projections cover 2024 to 2034. For secondary school teachers, excluding special and career/technical education, employment is projected to fall 2% with 66,200 annual openings, mostly from replacement. Other teaching occupations have their own projections, so look up the specific one you care about.

Sources

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Occupation wage figures on Salary Atlas come from the U.S. Bureau of Labor Statistics. Figures in this article that are not linked to a source are estimates. See our methodology.