How to Negotiate Your Best Nursing Compensation Package

 

Nearly two-thirds of nurses report being underpaid, according to a 2025 Nurse.org report. Twenty-six percent share that they intend to leave their role within the next year, and their top motivation for leaving is inadequate compensation.

Underinvestment in nursing is rampant, explains Kim Dupree Jones, PhD, RN, FNP, FAAN, Tenured Professor and Associate Dean of Academic Advancement at Emory University Nell Hodgson Woodruff School of Nursing in Atlanta, GA. This underinvestment includes nursing practice needs like personal protective equipment and supplies—and it extends to nursing staffing and salaries.

Emory Nursing and Nurse.org partnered to host a podcast mini-series on the high-impact leadership skills they often do not teach you in nursing school, and negotiation is one of them. This episode is for nurses who are wondering if they are being paid fairly, with expert tips on how to secure your best possible compensation package.

A systemic problem

Nurses are at a strong systemic disadvantage when it comes to negotiating, says Catarina Fernandes, PhD, MBA, BA, Assistant Professor of Organization and Management at Emory University Goizueta School of Business in Atlanta, GA. “Nursing compensation is not a problem of individual nurses’ , but rather a systemic and societal problem.”

“I am a strong believer in the power of diagnosis,” she adds. “Just knowing the system is working against you can be empowering. In other words, it’s not you, it’s not that you weren’t trained or you don’t have it in you . There are often forces working against you.”

Nursing is a historically female-dominated and increasingly racially diverse profession, meaning pay gaps based on gender and race can play a major role in salary stagnation for nurses. Despite women comprising the majority of the nursing workforce, male registered nurses earn an average of $14,000 more annually than their female counterparts. Nurses of color make 60 to 65 cents for every dollar earned by nurses who are white men.

“There are also strong hierarchy dynamics,” says Dr. Fernandes. “Nurses are often positioned in lower ranks, even when that doesn't correspond to the value they bring.”

Dr. Jones elaborates: A challenge is that it is difficult to quantify and show nurses’ value due to healthcare billing practices. Nursing services have historically been billed as a lump sum with other services such as housekeeping or room and board. As a result, it can be analytically complex (or impossible) to quantify lives and costs saved due to nursing care.

“Geographically there are big pay gaps as well,” says Ama Mathewos, MPA, BSN, RN, NEA-BC, CTA-CC, Certified Coach, Board Certified Advanced Nurse Executive, and a host of the Nurse Converse Podcast. “Nationally, salaries for the same nursing roles can easily range within a $100,000 difference.”

It follows that nurses often must commute long distances to access affordable housing since salaries do not always cover the cost of living within the communities they serve. “I'm based in New York City, and I know many nurses who travel into NYC from Long Island, Pennsylvania, New Jersey, Connecticut, etc. to provide care,” Mathewos says.

Fixing a broken system

Because it is so common for nurses to receive inadequate compensation, each individual negotiation can help to set new expectations and contribute to a culture shift that benefits other nurses.

“Remember, negotiations are not just about you,” emphasizes Dr. Fernandes. “They’re also a step in changing stereotypes and assumptions that are strongly ingrained in the field. By negotiating, you can help to make the system better for those around you and those who come after you.”

Negotiation is not selfish

In popular media, negotiations are often portrayed as rude, abrasive, or selfish. The vast majority of real-life negotiations, however, are not like that.

A small number of negotiations, called distributive negotiations, are forceful or focused on taking something away from the other person. “The idea behind that is negotiation entails a fixed pie,” Dr. Fernandes explains. “Anything I gain is my counterpart's loss, and anything that my counterpart gains is invariably my loss.”

Most negotiations, however, are called integrative negotiations. “Integrative negotiation is a process where you can work together,” she says. “You share a pie that you can grow . At the end of the process, both sides should end up in a better place with more value created than if they had just gotten into the negotiation right away and split a fixed amount.”

In other words, when your employer invests in your health, happiness, or career growth, they also invest in things like long-term nursing retention, a more dynamic workforce, a healthier workplace culture, and more. On-site childcare, for example, might help to save large long-term costs through improved nursing retention, attendance, and focus at work.

Consider your employer’s position

Remember that compensation packages include more than a salary. Your other benefits have dollar values, and some may be more significant to you, depending on your personal needs and circumstances. Retirement matching, tuition coverage, student loan repayment, protected time for parental and caregiving leave, on-site childcare, and even laundry service are all factors to weigh when negotiating.

Know that non-salary compensation may be more feasible for your employer to adjust than monetary compensation. “If you are a registered nurse in a large health system there might be thousands of other people in your role,” explains Dr. Jones. “When there are so many people with the same essential skillset and function as you, the salary range for your role may be highly standardized.”

As you move into advanced or mixed-function roles, your institution might have greater flexibility to alter your salary. If you eventually become an advanced practice nurse, for example, you will directly bill third-party payers like insurers to bring in a portion of your income. That allows you to negotiate incentive or bonus plans based on the funds you bring.

If you are not ready to pursue an advanced degree, or if that is not the right next move for you, know that there are things you can do right now to boost your bargaining power.

Negotiation tips for nurses

One of the most important strategies for a successful negotiation is to bring data. Be ready to back up your ask. Data might come from financial or clinical outcomes in your immediate practice area, national or regional salary databases, or the nursing literature.

“Several years ago, some brilliant nurses did research to demonstrate that the more bachelors prepared and masters prepared nurses you had in the health system, the better the patient outcomes,” says Dr. Jones. If you have recently completed a degree, these insights can help to build your financial case.

You might also consider:

• Looking for comps: Just like when you buy a house or a car, your research should include gathering market data to assess how your offer compares with similar roles at other institutions.
• Gathering alumni data: Ask your nursing school for relevant data such as the current average salary for your graduating class.
• Creating your own database: Team up with a group of friends from different institutions and commit to sharing your compensation data over time. That transparency can help all of you understand what reasonable offers should look like.

“There's this term in negotiations called BATNA, and it stands for ‘best alternative to negotiated agreement,’” adds Dr. Fernandes. “It refers to knowing what you could (or have) been offered at another institution.” Your BATNA is theoretically a negotiation starting point to leverage in discussions.

What would you tell a friend?

While there are salary bands that restrict certain employers’ flexibility to adjust monetary compensation, you should still try to match or exceed your BATNA. Always enter a negotiation with an evidence-informed offer or counter-offer.

“No matter how much you think you are worth, I can be pretty sure that you are undervaluing it,” says Dr. Fernandes.

Look at your role and the context with objectivity. Imagine you are advising a colleague or mentee rather than evaluating yourself. Studies show that we tend to undervalue our own contributions while being more balanced and fair when negotiating for others.

Change the game

Just because something has not been done before does not mean that it is not worth the ask. In fact, your ask could be genuinely needed by others too. 

“When you speak up for yourself, it gives other people that empowerment to do so for themselves, too. And then there's that ripple effect,” says Mathewos.

Negotiation can be intimidating at first, but with an empathetic, shared pie mindset, the experience can be positive and the benefits can be profound.

🤔Nurses, what negotiation strategies have worked for you in the past? Share your thoughts in the discussion forum below!