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Executive Summary As the primary organization for nurse leaders, the American Organization of Nurse Executives (AONE) is committed to the development of nurse leaders. As such, AONE has embarked on several initiatives to help its members and the nursing leadership community advance in their careers and achieve their desired level of job satisfaction. In 2012, AONE members expressed an interest in learning more about the salaries of various positions within nursing leadership. To meet this need, AONE developed a salary and compensation survey and the following findings for its members and the nursing leadership field. The online survey was sent to 22,440 emails which included AONE members and nonmembers. In total, 4,638 respondents completed or partially completed the survey for a response rate of 21 percent. Respondents completed the survey in the spring of 2013, reporting data from calendar year 2012. DIRECTORS 32% MANAGERS 26% Respondent Profile The typical survey respondent has been in a leadership position for at least six years, is a Caucasian female and works full time at an acute care facility. The majority of respondents (67%) work at acute care hospitals, with another 13 percent in academic institutions, and seven percent in a health care system or corporate office. The remaining 13 percent work in other settings. The three job titles most represented by respondents include directors (32%), managers (26%) and chief nursing officer (CNO)/chief nursing executive (CNE) (17%). A majority (80%) of the respondents have been in leadership roles for six or more years. Ninety one percent of the respondents are female. CNO/CNE 17% 2
Salaries As shown in Figure 1, annual salaries from responding nurse leaders vary largely, with about half, or 52 percent, falling between $80,000 and $130,000. Only 14 percent earn less than $80,000. The remaining respondents (34%) earn $130,000 or more, broken down as follows: 12 percent earn between $130,000 and $150,000, 13 percent earn between $150,000 and $200,000, and nine percent earning $200,000 or more (Figure 1). The survey also details salary level as it correlates to years of leadership experience. The 10 year mark appears to be the tipping point in terms of higher salaries for nurse leaders. The majority of respondents with zero to 10 years of leadership experience including 73 percent of those with six to 10 years report a salary less than $120,000 per year. This leaves 27 percent of respondents with six to 10 years of experience reporting a salary of $120,000 or greater. Salaries for those with more than 10 years of leadership experience demonstrate a significant shift: 52 percent of those with 11 to 20 years and 64 percent of those with more than 20 years report salaries equal to or greater than $120,000 per year. Not surprisingly, nurse leaders with senior level titles earn higher incomes than other nurse leaders. Directors and managers are most likely to earn between $80,000 and $160,000 annually, with 84 percent and 80 percent falling into that range, respectively. It s noteworthy that only six percent of directors and 17 percent of managers have annual salaries of less than $80,000. For non system CNOs, more than half (61%) earn from $100,000 to $200,000. Nearly one-fifth (19%) earn between $200,000 and $250,000, while only 12 percent earn higher than $250,000. Other non system C suite titles show a similar pattern, with the majority of chief executive officers (CEOs), chief operating officers (COOs) and vice presidents, earning between $120,000 and $250,000 (Figure 2). Predictably, system CNOs tend to earn higher salaries than their non system counterparts, with 71 percent earning $200,000 or more. Clinical staff and specialists/coordinators are the most likely (69% and 51%, respectively) to be at the lower end of the salary scale, earning less than $80,000. Figure 1: Overall Salary Ranges (annually) Salary Distribution Total Percentage Under $40,000 1% 1% $40,000 $49,999 1% 2% $50,000 $59,999 2% 4% $60,000 $69,999 4% 8% $70,000 $79,999 6% 14% $80,000 $89,999 10% 24% $90,000 $99,999 11% 35% $100,000 $109,999 12% 47% $110,000 $119,999 9% 56% $120,000 $129,999 10% 66% $130,000 $139,999 7% 73% $140,000 $149,999 5% 78% $150,000 $159,999 4% 82% $160,000 $169,999 3% 85% $170,000 $179,999 2% 87% $180,000 $189,999 2% 89% $190,000 $199,999 2% 91% $200,000 $249,999 5% 96% $250,000 $299,999 2% 98% Cumulative Percentage $300,000 or more 2% 100% n 4,399 4,399 Q: What is your current base salary (excluding additional income and bonus money)? 3
Figure 2: Salary by Job Title * Total Salary CEO COO CNO (non system) CNO (system) Clinical Staff Director Manager Specialist/ Coordinator Vice President Under $40,000 $40,000 $59,999 $60,000 $79,999 $80,000 $99,999 $100,000 $119,999 $120,000 $139,999 $140,000 $159,999 $160,000 $179,999 $180,000 $199,999 $200,000 $249,999 $250,000 $299,999 $300,000 or more 6% 2% 1% 3% 2% 30% 1% 2% 16% 1% 3% 2% 33% 5% 15% 33% 1% 8% 2% 6% 6% 16% 18% 36% 27% 14% 4% 10% 1% 9% 29% 28% 13% 5% 19% 19% 14% 3% 2% 25% 12% 5% 16% 11% 7% 11% 10% 12% 4% 2% 11% 11% 16% 13% 1% 1% 5% 1% 1% 20% 3% 9% 13% 4% 2% 1% 12% 11% 14% 19% 18% 1% 1% 1% 24% 6% 12% 7% 22% 7% 8% 16% 5% 31% 4% n 36 57 759 67 141 1,403 1,176 128 152 Q: What is your current base salary (excluding additional income and bonus money)? 4
Salary by employer type and geographic region According to survey data, nurse leader salaries are fairly similar across employer types. With the exception of nurse leaders employed at consulting firms, the majority earn salaries between $60,000 and $140,000. More than half of nurse leaders employed by consulting firms, 62 percent, garner salaries of $140,000 or more. As mentioned earlier, nurse leaders employed by health systems or corporate offices are most likely (22%) to earn the highest salaries, at $200,000 or more, followed by consulting firms (15%). Predictably, rural/critical access hospital nurse leaders are the most likely to have the lowest salaries, with 30 percent earning less than $80,000, and only 10 percent earning $140,000 or more (Figure 3). Figure 3: Salary Distribution by Employer * Salary Distribution by Employer Academic Acute Care Hospital Ambulatory Care Facility Consulting Firm Health Care System / Corporate Office Military/VA/ Government Rural/ Critical Access Hospital Under $40,000 2% 1% 1% $40,000 $59,999 $60,000 $79,999 $80,000 $99,999 $100,000 $119,999 $120,000 $139,999 $140,000 $159,999 $160,000 $179,999 $180,000 $199,999 $200,000 $249,999 $250,000 $299,999 $300,000 or more 4% 3% 3% 4% 4% 2% 8% 11% 10% 15% 2% 10% 4% 22% 17% 21% 24% 4% 19% 18% 29% 22% 22% 24% 18% 15% 22% 17% 17% 17% 15% 9% 13% 27% 15% 9% 9% 3% 29% 7% 18% 5% 5% 6% 4% 9% 5% 4% 2% 4% 4% 3% 9% 3% 4% 1% 5% 5% 6% 5% 8% 2% 2% 2% 1% 1% 5% 7% 1% 1% 5% 7% n 541 2,955 67 55 299 55 120 Q: What is your current base salary (excluding additional income and bonus money)? 5
Figure 4: Eligible for Bonus Award by Title * Eligible for Bonus Award by Title Yes, discretionary Yes, non-discretionary Eligible for both Not eligible Unsure 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 10% 13% 63% 13% CNO (system) (n = 67) 1% 2% 2% 4% 9% 5% 9% 6% 7% 5% 16% 23% 25% 27% 13% 33% 38% 46% 8% 9% 47% 53% 53% 4% 4% 41% 79% 12% 5% 62% 53% 49% 3% 5% 50% 5% 41% 29% 31% 29% 26% 23% 2% 9% 8% 10% 13% 9% 9% 8% 9% 9% 9% 8% 6% Vice president (n = 151) CNO (nonsystem) (n = 756) Other C-suite (n = 124) Director (n = 1,398) Manager (n = 1,170) Consultant (n = 84) Other (n = 475) APRN (n = 110) Specialist/ coordinator (n = 123) Clinical staff (n = 142) Professor/ dean (n = 132) Among the nine AONE geographic regions, nurse leaders in Region 9, including Alaska, California, Hawaii, Nevada, Oregon and Washington, have the greatest percentage of respondents (70%) earning $120,000 or more. This is followed by the New England states in Region 1, which includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont. Half of all the nurse leaders in Region 1 earn $120,000 or more. According to survey data, the lowest percentage of nurse leaders earning $120,000 or more (22%) work in Region 6. This region includes the Great Plains states: Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota and South Dakota, and is home to many rural facilities. Bonus Awards More than half (58%) of all respondents said they were eligible for bonus awards in 2012. Nurse leaders with higher salaries and greater management responsibilities were more likely to be eligible. The tipping point appears to be $120,000. Those who report salaries at or above this mark were more likely to be eligible for some type of financial incentive. Similarly, those with a span of control involving more than 50 employees were more likely to be eligible for a bonus. That said, a percentage of nurse leaders across all titles, including clinical staff, indicate they were eligible for a bonus. However, the percentages of nurse leaders eligible with each title follows an expected hierarchy. In the case of non discretionary bonuses, nurse leaders with C suite titles were most likely to be eligible (63% to 49%), followed by directors (50%), managers (41%), specialist/coordinators (26%) and clinical staff (23%) (Figure 4). Of the respondents who were eligible for a bonus in 2012, only about half said they received one. Of those who received a bonus, organization financial performance was listed by 66 percent as a contributing factor, followed by clinical performance measures (54%) and customer or patient satisfaction (44%). Although some of nurse leader respondents received bonuses, the financial incentives are a relatively small contribution to their income. Nearly half, 47 percent, said the bonus was five percent or less of their base salary. Another 23 percent said the bonus was more than five, but less than 10 percent of their salary. Only 10 percent of nurse leaders indicated the bonuses were more than 20 percent of their salary (Figure 5). 6
Figure 5: 2012 Bonus Award as Percentage of Base Salary 2012 Bonus Award as a Percentage of Base Salary 28% 19% 10% 13% 18% 6% 2% 1% 1% 2% 0% - 2.5% 2.6% - 5% 5.1% - 7.5% 7.6% - 10% 10.1% - 20% 20.1% - 30% 30.1% - 40% 40.1% - 50% More than 50% Not Sure Q: How large was your bonus as a percentage of your 2012 base salary? (n = 2,155) Job Satisfaction Overall job satisfaction is high among nurse leaders, with 62 percent stating they are very satisfied and another 29 percent responding they are somewhat satisfied. When asked why they choose to stay in their current job, the top response (44%) is I find joy and meaning in my work. However, respondents indicate they are less satisfied with their benefits and compensation. The percentage of nurse leaders highly satisfied with benefits is nearly half (48%) and only one third (34%) are highly satisfied with their compensation. However, combining the categories of very satisfied and somewhat satisfied, nurse leaders seem largely satisfied with benefits and compensation, with percentages in those two categories at 82 and 73 percent, respectively (Figure 6). very satisfied 62% somewhat satisfied 29% find joy/meaning in work 44% 7
Figure 6: Job and Compensation Satisfaction * Satisfaction with Job and Compensation Very satisfied Somewhat satisfied Neutral Not very satisfied Not at all satisfied N/A 62% 48% 39% 29% 34% 34% 4% 4% 0 13% 10% 9% 6% 3% 0 1% 1% 2% Your job overall (n = 4,100) Your compensation (n = 4,096) Your benefits (n = 4,099) Q: How satisfied are you with the following aspects of your job? When this same information is broken out by title, the pattern is repeated. System CNOs and non system CNOs are generally satisfied, with 96 and 95 percent, respectively claiming they are somewhat or very satisfied overall. However fewer nurse leaders holding these titles report satisfaction with compensation. Only 76 percent of non system CNOs report they are somewhat or very satisfied, and 72 percent of system CNOs fall into these two satisfaction levels. In fact, only three other nurse leader titles had fewer respondents in the very or somewhat satisfied categories for compensation: manager (69%), clinical staff (68%) and professor/dean (64%) (Figure 7). The position with the fewest respondents indicating overall satisfaction is specialist/coordinator, with only 88 percent saying they are very or somewhat satisfied. This position also has the lowest percentage of respondents satisfied with their job security (64%). And although directors and managers generally reported satisfaction overall, both of these title s respondents are among the lowest for satisfaction with job security. Titles show similarity in satisfaction with nursing departments receiving equal treatment with non nursing departments within their organization. While a majority of nurse leaders in all titles are very or somewhat satisfied, this percentage hovers at or below 70 percent for 10 of the job titles. The only title with respondents expressing a higher percentage of satisfaction in this regard is vice president (76%). Specialist/coordinators have the lowest percentage of respondents satisfied with equal treatment of nursing (63%). Some intangibles of a nurse leader s career, such as the respondent s relationship with co workers, and finding joy and meaning in their work, received high satisfaction ratings across all job titles (Figure 7). 8
Figure 7: Satisfaction of Job Aspects by Title % of Somewhat or Very satisfied APRN Clinical Staff CNO (non system) CNO (system) Consultant C suite (other) Director Manager Prof./ Dean Specialist/ Coordinator Vice President Job overall 92% 90% 96% 95% 96% 94% 92% 90% 92% 88% 95% Compensation 73% 68% 76% 72% 81% 79% 75% 69% 64% 75% 81% Benefits 79% 76% 88% 88% 69% 82% 84% 81% 80% 75% 96% Organization 81% 79% 88% 88% 92% 90% 87% 86% 76% 84% 88% Industry work 88% 93% 90% 93% 87% 91% 88% 86% 82% 84% 88% Areas of responsibility Amount of authority Opportunity for growth 87% 84% 92% 97% 81% 94% 89% 85% 85% 80% 95% 85% 75% 89% 91% 80% 91% 87% 81% 81% 71% 87% 73% 73% 77% 83% 63% 78% 72% 73% 71% 71% 76% Job security 80% 78% 81% 83% 74% 83% 76% 75% 79% 64% 82% Relationship with supervisor Equal treatment with other non nursing functions Relationship with co workers Relationship with direct reports Joy and meaning 77% 89% 85% 85% 82% 82% 84% 80% 84% 84% 85% 67% 66% 70% 70% 65% 69% 70% 64% 65% 63% 76% 93% 90% 93% 94% 90% 89% 92% 92% 91% 92% 92% 65% 56% 95% 94% 49% 90% 93% 91% 65% 50% 94% 89% 85% 91% 94% 92% 84% 87% 82% 93% 82% 90% n 101 123 705 64 80 115 1,320 1,088 129 113 142 Q: How satisfied are you with the following aspects of your job? 9
As seen throughout the executive summary, survey results underscore a diverse profession. On the other hand, certain key themes emerge and illustrate core trends for nurse leader compensation. The full report of the AONE Salary and Compensation Study will describe these and other characteristics in detail. Additionally, the descriptive study will provide information related to other components of a nursing leadership career, including employer benefits, job satisfaction and personal fulfillment. The AONE Salary and Compensation Study and online reporting tool will be made available to members free of charge and for purchase to non members in Fall, 2013. The online tool filters survey results according to title, geographic location and other factors. We thank you for your support and trust you will find this information to be valuable to your work in nursing leadership. Like all surveys, there are multiple sources of potential errors which exist beyond sampling error, such as measurement bias and survey non-response. These factors should be considered in the interpretation of the results. The researchers have taken careful steps to eliminate and/or minimize survey errors where possible. In some instances, participants were given the opportunity to select more than one response. In these cases, the corresponding charts and graphs have been noted with an asterisk (*). Additionally, percentages have been rounded to the nearest whole number. In cases where rounding has occurred, percent totals may not equal 100%. Data for this survey and corresponding reports was collected confidentially and has been shared throughout in aggregate form. The collection of data and presentation in this report follows the safety zone requirements described in the Statement of Department of Justice and Federal Trade Commission Enforcement Policy on provider participation in exchanges of price and cost information. American Organization of Nurse Executives (AONE) 155 N Wacker Drive, Suite 400 Chicago, IL 60606 www.aone.org 10 Copyright 2013, by the American Organization of Nurse Executives. All rights reserved.