Equal Pay Day: Exploring the gender pay gap for NPs

Today is Equal Pay Day, one of the last important events for this year’s Women’s History Month.

Sadly, we can say that today the gender pay gap is far from fixed.

Equal Pay Day is an initiative that aims to show how far into the current year women need to work to “fill the gap” and earn the same money men earned the previous year alone. Equal Pay Day is celebrated every year the day in which “the goal” is achieved.

However, don’t be confused by the word celebration. There’s nothing to celebrate about the fact that women in the same positions and doing the exact same work for the exact same amount of time as men have to work extra to earn as much as men.

The most recent data shows that women received 82 cents for every dollar a man made across thousands of jobs.

Because of this, we have to ask: is there still a gender disparity in NP salaries? The number of male nurses is growing, but it’s still less than 15% of the entire NP workforce.

Are they still earning more in a female-dominated field?

Let’s take a look at the current state of affairs, and what we can do to help.

Do male nurse practitioners make more money?

The short answer is: yes.

The gender pay gap for APRNs is well documented. There is statistical evidence of male NPs already earning more in 2011, when the U.S. Census Bureau reported that female NPs were paid 87 cents to the dollar.

These female NPs were working exactly the same jobs, full time, which reignited the discussion about possible gender discrimination in nursing.

Earlier studies did not focus too much on this topic, but it’s good to remember that the Equal Pay Act was established in 1963. Don’t let anybody tell you that this is a 21st century issue.

A 2017 survey published in the AANP Journal found that male NPs outearned female NPs by $15,205, in general.

That pay gap remained even after taking demographic differences into account, going as high as $12,859.

This means that it really didn’t matter if you were a Black, Hispanic, Asian or Caucasian NP woman working full time, part time, outpatient, or whatever. You were still going to make less money than your male colleagues.

Fast forward to 2019, there aren’t a lot of peer-reviewed studies covering this issue. However, many nonprofits and companies published unofficial surveys, and this is what they found:

Medscape polled more than 3,500 APRNs (of which 2,000 were NPs) and found that only 9% of them were male, but they still earned $8,000 more on average.

Their most recent survey, this time in 2020, found that the wage gap had grown to $9,000, or about 8% less money than what male NPs were making.

Clinical Advisor released a different salary survey in 2019, and they found that their gender pay gap amounted to $11,023 for NPs, and a similar amount for PAs.

So why is this happening?

Why we still have a gender pay gap in nursing

The studies and surveys we just mentioned don’t share a lot of insight into the different variables that might cause this disparity, but their results remain.

The 2017 study, for example, found that salary issues existed “…at all levels of seniority and in all types of clinical practice,” which leads to the conclusion that this is an industry problem.

Many people, however, have pointed out that there might be other reasons for the pay gap.

Is it because men seem to choose better paid jobs in nursing? Is it possible that men just work more? Are male nurses better educated?

Let’s look into these questions.

The CRNA gender pay gap: an example case study

It is true that men choose higher paying jobs in nursing. According to the 2011 report, 41% of male nursing professionals were working as nurse anesthetists, and that was ten years ago.

It’s worth noting that this makes anesthesia the nursing field with the highest concentration of men.

As you might already know, CRNAs make the most money out of all APRNs. If you’re a male, of course you will earn more than other APRNs. It’s only natural, right?

Well, the thing is… Can we really say that this is a valid reason when this field also has a gender pay gap?

The same 2011 report revealed a disparity of 89 cents to the dollar for nurse anesthetists.

Medscape’s surveys pointed out a $19,000 gap in 2019, and $28,000 in 2020.

Are these male CRNAs better educated? Do they work harder?

Well, we have a 2020 salary report from the American Association of Nurse Anesthetists that actually explored the gender disparities in the CRNA workforce. They found that:

• There was no significant difference in continuing education for both genders.
• Male CRNAs only worked 3.3 hours more a week.
• Males work full-time more than females, but only 5% more.
• Males have about 4 more years of experience than females, on average.
• The turnover ratio was higher for female CRNAs.

So, there you have it. Male CRNAs have slightly more experience (in this sample), and they work a little bit more.

Does this really help to explain a salary difference of almost $30,000?

Salary.com says the median hourly salary for CRNAs is $91. Three more hours of work gives us an average difference of about $13,600 a year.

Where is the rest?

Some food for thought for you there. Let’s move on.

Other considerations apart from salary

In the spirit of fairness, we should mention that there are some other considerations that might contribute to the wage gap.

These considerations are not necessarily negative, nor they have to do with gender discrimination.

For example, the Medscape surveys showed that male APRNs worked more in acute care settings (see above), did more overtime, and supplemented their regular income with something else more than female APRNs did.

Male APRNs also own more private practices, though the difference is only 5% more. Their results from 2019 are consistent with those of 2020.

However, supplemental income and private businesses do not count when talking about yearly salaries. The gender pay gap persists because there’s always extra money that’s not accounted for when talking about male workers.

With this in mind, all of our cards are now on the table. Men seem to do a bit more, but it still doesn’t justify the fact that women doing the same (or almost the same) amount of work as them earn A LOT less money.

Also worth pointing out: we’re talking about APRNs here. We have to push for more NP-specific research on this topic, but that comes later.

These considerations are important, but don’t rule out gender discrimination as an important factor. Thus, we continue.

What you can do to help eliminate the gender wage gap

Another interesting thing about Medscape’s reports is that they asked APRNs the following question: do you feel like you’re properly compensated?

54% of NPs in 2019 said yes, a number that grew to 61% in 2020. For CRNAs, which we mentioned earlier, that percentage was 68% in 2019 and 76% in 2020.

On the surface, we could suggest that only male respondents answered “yes,” and that the remaining 30 or 40 percent of NPs and CRNAs were females who didn’t feel okay with their salaries.

However, this might not be the case. The numbers don’t really add up.

It’s possible that there’s a large number of female respondents who felt comfortable with their salaries, even after earning 20 or 30 thousand less a year.

Now, male nurses are not to blame for this problem at all.

We should blame clinics and institutions, or actually the healthcare industry in general, but we can’t keep waiting on them to take action while the work of women is under-appreciated every day.

We can’t blame those women who felt comfortable with their salaries either, but we can try to help them understand why they shouldn’t settle for less!

So, what could we all do to not allow this injustice to perpetuate?

Step one: Discuss and practice salary negotiation

This particular idea might seem contentious for some nurses. “Are you telling me that it’s my fault I’m not earning more?! Just because I didn’t negotiate my salary in the beginning?!”

We don’t believe this is the main cause of the gender pay gap in nursing. That would amount to victim blaming.

We are mentioning this, in particular, because female professionals tend to negotiate their salaries less than men, which leads to women earning less in general, adding up to the gender pay gap problem that is already there.

There are a lot of reasons why female NPs don’t negotiate. Are men more assertive? Sure, but that’s not because they’re males.

It’s because society doesn’t reward this kind of behavior in women, and they learn not to do it.

The fact that men negotiate their salaries more doesn’t mean they’re successful 100% of the time.

They just do it more than women, and thus, they get a higher chance of earning more as a group.

One of the ways that we can change that is to empower other female NPs to negotiate more often. In every NP job, across all specialties.

Companies and clinics will always try to pay you less, regardless of gender. Even though they might consider paying men a higher salary, it will still be less.

So, yes, it’s harder for women to negotiate due to societal judgement, but we’re living in a new era, and it’s time to do things differently.

One of the reasons we have Women’s History Month is to remember that the only way society ever changes is when women do the things they aren’t supposed to do according to orthodox rules, like fighting for their right to vote.

However, negotiating salaries is not a panacea for the gender pay gap in nursing, or anywhere. That’s just step one.

Step two: Raise your voice

As a nurse practitioner, you have a myriad of options to start doing some activism.

This might sound like a very big word… Am I supposed to organize a march? Or something?

Well, no, but getting involved with the different initiatives to bridge the gender pay gap is a good start.

You’re already doing well by reading this article, and by learning a little bit more about the fact that, yes, male nurses seem to go harder (which is great) but that’s not the whole picture. Many female nurses work as hard, or even harder, and are still underpaid in comparison.

The gender pay gap can be seen in RNs, LPNs, physicians, CNSs, ER nurses, you name it.

It’s important to share this information with NPs of all genders. We all can be allies and advocate for a fair treatment!

If you find arbitrary discrepancies between your salary and that of your male colleagues, here are some things you can do:

• Call the National Committee on Pay Equity to learn more.

• If you have the means, file a charge with the EEOC.

• Talk to your colleagues about it (we’re serious). It might have consequences, but the worst thing you can do is stay silent. Find out what’s going on.

• Check out this guide on Pay Discrimination by Equal Rights Advocates. Know your rights!

Get involved with nursing associations like the AANP to find out more about the current legislation affecting NPs. There, you will also find a community of people concerned about issues like this one.

The future of the gender pay gap in nursing

While we were doing research for this article, we came across a source which stated that the gender pay gap in nursing wouldn’t be solved until 2039, or something like that.

That sounds terrible, doesn’t it? But things doesn’t necessarily have to go that way. Don’t worry.

To be honest, when you tally up some of the wage differences from the surveys above, you could make the case that the wage gap is actually being reduced. Not enough, but it is lower.

However, that is also not always the case. Sometimes it’s bigger.

When it comes to clinicians, this process is ongoing. The road ahead looks wider, but there’s still a lot of work to do.

Women earn less for a variety of reasons concerning womanhood itself. And yes, women can become better at negotiating, but that doesn’t eliminate how orthodox people think about women, and the consequences that carries for women.

If you’re a male NP reading this: thank you. Your support is appreciated. Nobody’s mad at you for earning more, and we know that you suffer from discrimination too!

All NPs working in the same position for the same amount of time should earn the same amount of money. Gender should not be a determining factor in salary allocation!

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