2011 Midwest Nursing Salaries

Some nurse leaders who spoke with ADVANCE identified some early indicators of improvement in the nursing job market. "The nurses we thought might retire are staying in their jobs longer; [but] over the past 6 months, maybe because the economy has improved a bit or partners are back to work, a few nurses have requested to reduce their hours," reported Paula Carynski, MS, RN, NEA-BC, vice president of patient care services and chief nursing officer for OSF Saint Anthony Medical Center, Rockford, IL.

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Marsha King, MBA, MS, RN, NEA-BC, chief nursing officer of Saint Joseph Regional Medical Center in Mishawaka, IN, described some improvement in the Michiana economy over the past year.

"The RV industry has started to rebound and unemployment has improved somewhat," she said. "We're 1 year post-move into our new hospital, and have seen an increase in our ED and surgical volumes. We've hired more nurses due to the increases in patient volumes and changes in the some of the unit workflows post-move.

"[However], our vacancy rate is still low at 1.3 percent with very few job openings. We haven't used agency nurses for 3 years, and I still don't see nurses retiring or dropping down to part time."

Sharon Baughman, MSN, RN, vice president of patient services and chief nursing officer for Wheaton Franciscan - St. Joseph, Milwaukee, The Wisconsin Heart Hospital in Wauwatosa, and Wheaton Franciscan Healthcare - Elmbrook Memorial, Brookfield, WI, also noted the hesitancy of nurses to retire.

"Nurses' financial portfolios took a huge hit, so many are still trying to at least partially rebuild those portfolios before retiring. Many nurses also have spouses who are unemployed, so they want to remain or move to full-time positions for financial stability and a lower cost for health benefits."

Regional Variations

ADVANCE readers reported salaries are highest in metropolitan Chicago and a bit lower in surrounding areas of northern Illinois and southeast Wisconsin. From Chicago down to Peoria, nurses made a little less money, and northwest Indiana had the lowest nursing salaries in the region.

Brian Haggard, MBA, vice president of human resources at Provena St. Mary's Hospital, Kankakee, IL, described his organization's benchmark surveys. "To ensure we are paying competitively within the industry, annually we work with Provena's centralized salary and benefits structure on market-specific salaries," he said. "We use the market data from multiple survey sources to target our salaries to meet the market at the 50th percentile, recognizing that some variation may exist for individual jobs based on local market pressures and recruitment and retention needs, [and] some jobs are targeted higher than median."

Carynski urged nurses to look at the big picture. "Rockford is very close to the Chicago suburbs and we use Chicago Metropolitan salary comparison data when evaluating our salary structure," she said. "We're highly competitive when you consider the very reasonable cost of living in our geographic area. We have not had any problem recruiting nurse leaders because of our salaries."

Lydia Ostermeier, MSN, RN, CHCR, director of nurse recruitment for Indiana University Health in Indianapolis, discussed Indiana's draw for nurses. "The cost of housing in Chicago is 3 times what it is in Indianapolis. We see a lot of nurses who want to relocate here because the cost of living is so much lower."

Clinical Ladders

Salary survey data clearly identified a correlation between years of experience, achievement of national specialty certification or nursing degrees, including the BSN and MSN. "In today's market, it's always important to set yourself apart, and these achievements help nurses differentiate themselves and stand out from the pack," said Ostermeier.

When nurses apply for positions at OSF Saint Anthony, they're offered a base salary determined by their years of experience as well as their educational level. "We've had a clinical ladder in place for at least 10 years, designed on Pat Benner's Novice to Expert model," said Carynski. "It's an annual program, not mandatory, that allows nurses to complete a portfolio based on their clinical expertise, years of practice, participation in education and inservices, and involvement in giving back to the nursing community. There are four levels with accompanying amounts of financial reimbursement."

Magnet Forces

Magnet forces heavily influence the focus on education and certification. Within Trinity Health System, Mercy Medical Center in Dubuque, IA, has achieved Magnet designation, four other hospitals have turned their applications in and all others are working toward that goal.

"We had our first Nursing Congress in April and June 2010, and established 2011 nursing strategic goals. One of those is to increase the percentage of nurses with a BSN, as well as those nationally certified in their specialties," said King.

Shawn Ray, MSN, RN, CCRN, director of talent acquisition, Barnes-Jewish Hospital, St. Louis, noted the focus on education and certification within her Magnet facility, which sponsors a three-tiered clinical ladder program that awards higher education, specialty certification, participation in shared governance and involvement in the nursing community.

"If you submit a résumé to us, we look at whether you have a BSN, and we preferentially hire nurses with that degree," she said. "This decision is based on research showing improved patient outcomes in hospitals with a larger percentage of BSN nurses at the bedside."

Wheaton Franciscan nurses on shared governance councils asked to have their evaluation tool combined with the clinical ladder criteria. "We made those changes and are introducing the tool now to be used in fiscal year 2012," said Baughman. "Specialty certification is recognized at the clinical nurse IV level right now, but as a Magnet-designated organization, St. Joseph may need to change that requirement to the clinical nurse III level."

Other Factors

The survey demonstrated higher salaries for nurses in some specialty areas, including management, perioperative nursing, maternal/child health and critical care. "About half of the hospitals in Milwaukee offer a differential for nurses working in ICU and NICU, while the other half are moving away from this differential," said Baughman. "However, the base pay across nursing units is the same."

Amy Lafine, MSN, RN, vice president of clinical operations at Provena St. Mary's and Region 2 president for the Illinois Organization of Nurse Leaders, noted, "When it comes to salaries, it's not just about achievement, but it's about pay for performance. We do an enormous amount of education and training on-site, have a BSN cohort that meets here at the hospital and encourage a certain number of nurses each year to achieve national certification. We make a big deal of recognizing that certification, awarding each nurse with a white lab coat embroidered with the nurse's name, title, degree or certification. We also provide additional compensation for certified nurses who fill roles as preceptors or who expand their scope of practice to serve as charge nurse."

Provena nurses benefit from a career path that's established when they first come on board. "New graduates don't ask first about money - they want to know about the professional practice model, the nursing culture and their opportunities for advancement within the organization," Lafine said. "Nurses choose who represents them on our Patient Care Council that advises me and the nursing leadership about staffing by acuity, professional practice around quality and safety, and professional development."

Sandy Keefe is a frequent contributor to ADVANCE.