Medscape recently released its 2022 APRN Compensation Report, which surveyed more than 2,600 advanced practice registered nurses, including 1,500 nurse practitioners. The report offers important insights into 2021 earnings, work environment, training, and supplemental income among APRNs. Below, we’ve zeroed in on some nurse practitioner salary trends.
Gross income growth
In keeping with the prior year trend, average compensation for APRNs increased in 2020 by 1 – 10%. Sixty percent of NPs surveyed reported an increase in income over the prior year, and average gross income for NPs increased from $116,000 per year to $120,000 per year.
NP salary by setting, education, specialty
By practice setting, NPs who work in hospital-based inpatient care reported the highest annual incomes (average annual income of $126,000), followed by hospital-based outpatient settings or clinics (average annual income of $123,000) and non-hospital-based medical offices or urgent care clinics (average annual income of $119,000).
Eight in 10 NPs surveyed hold a master’s degree, compared to just 1 in 5 who hold a doctoral degree. And while income for NPs who hold a master’s degree has risen year over year, NPs who hold a doctoral degree out-earn their colleagues holding master’s degrees by 4% (average annual income of $124,000 compared to $119,000).
Among NPs holding advanced practice certifications, those with psychiatric and mental health certifications commanded the highest salaries in 2021 (average annual income of $132,000), owed in large part to the high demand for psychiatric mental health NPs for the past several years.
NP salary by region, community
The report also evaluated APRN salary by region. APRNs in the Pacific Region (Alaska, California, Hawaii, Oregon, and Washington) earned the most, while APRNs in the East South Central Region (Alabama, Kentucky, Mississippi, Tennessee) earned the least.
NP salaries mirrored the broader APRN trend, with an average annual income of $140,000 for NPs practicing in the Pacific Region compared with an average annual income of $108,000 for NPs practicing in the East South Central Region. NPs in all regions for which data was available experienced a lift in earnings in 2021 compared with the previous year.
The survey further explored the impact of community type on NP salary and found NPs in urban areas earned a modest increase in salary relative to suburban, exurban, and rural settings.
However, reported incomes were not adjusted for cost of living. When evaluating comparative pay, housing, transportation, and food costs are important to take into consideration. (For a look at cost-adjusted average NP wage by state, see this recent report from the U.S. Bureau of Labor Statistics occupational employment statistics survey.)
Gender disparities
Among APRNs surveyed, more than three quarters were female. And yet, male APRNs continue to out-earn their female peers across every practice type for which data was available.
Male APRNs reported higher salary-based incomes ($180,000) compared to female APRNs ($124,000). And while the discrepancy is owed, in part, to the fact more men are CRNAs (the highest paid practice type) and more male CRNAs earn supplemental income compared to their female counterparts, the trend still holds for NPs. Male NPs reported an average gross income of $130,000 compared to $119,000 for female NPs.
The survey further found male respondents were more likely to earn an hourly wage, work high-differential shifts, function as a charge nurse, and work in inpatient units compared to female respondents.
Amber Mashuta, MS, CPNP, a pediatric NP working in acute care inpatient settings who was interviewed for the report says, “unfortunately, this matches much of the country when it comes to male vs female pay. We have a long way to go to correct the wage gap.”
Supplemental Income
Nearly half of NP respondents have supplemental income, including overtime or holiday shifts, charge nurse responsibilities, teaching classes, or acting as a preceptor. Thirteen percent of NPs surveyed say they have a non-nursing second job or income-producing activity.
NPs who feel fairly compensated
When asked whether they feel fairly compensated, just 48% of NPs answered affirmatively — a proportion which has steadily declined over the last few years (53% and 61% in 2021 and 2020, respectively). In fact, NPs least often reported feeling fairly compensated relative to all other APRNs.
Mashuta observes, “with the amount of people that are leaving healthcare, NPs and APRNs are having to do more with less.”
The takeaway
NP salaries have been on the rise and showed continued growth in 2021. Despite financial gains, the challenges facing healthcare professionals continue to take an emotional toll on NPs and can lead to a feeling of not being fairly compensated. For NPs interested in increasing their income, the survey reveals that continuing education and focusing on certain specialties and work settings can have a positive impact on NP salary.
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