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The State of Salaries for Nurses in North Carolina

North Carolina is in the middle of a nursing shortage, and there may be a good (and green) reason for it. Nobody likes to work when they aren’t fairly compensated, and nurses in North Carolina are underpaid in comparison to their peers in other states. Luckily, things are starting to shift. Nurses across North Carolina are advocating for and experiencing more pay raises in 2023 than in the past decade.


Nurses in North Carolina are underpaid

According to the Bureau of Labor Statistics, the annual median salary of nurses across the United States is $82,750 a year while the average in North Carolina is $71,200. While the cost of living in North Carolina is lower than in some states like California and New York, the pay disparity is bigger than the cost of living difference. Nurses in North Carolina are not being paid what they’re worth.


Not only is nursing pay in North Carolina low, but advocacy around improving the situation is also lacking. The North Carolina Nurses Association (NCNA) should be an advocate for nurses, but their recent call for legislation reform does not include higher pay for nurses.


There’s a large disparity between executive and nurse pay

North Carolina nurses aren’t only paid below the national average; their salaries are also disproportionate to what healthcare executives are making. The Johnston County Report revealed some shocking statistics about hospital CEO pay. Hospital CEOs have doubled their compensation faster than previously thought, earning 1.65 billion in the last decade in North Carolina alone. Other reports speculate that hospital CEOS have quadrupled their salaries since 2020.


To put this into perspective, 11 hospital CEOs in North Carolina make the same wages as 572 RNs.


This extravagant pay is part of a larger issue—hospital systems not treating nurses well. Workplaces that have a larger pay disparity between top executives and their nursing staff are less likely to respect the expertise of their nurses.


But these workplaces can be hard to identify and avoid since most healthcare executives don’t publicly discuss their salary. Luckily, there are green flags you can look for during the hiring process that indicate an employer will respect you and most likely pay you fairly. Healthcare offices with plenty of green flags are more likely to have pay equity between different roles.


There’s hope for the future

Research done by a couple of major players, including the John Hopkins School of Public Health and the North Carolina State Health Plan for Teachers and State Employees, suggests that the way forward might be legislative action. If a state law were to be put in place to demand pay transparency, patients could see if hospitals were valuing executive pay or valuing quality care–and paying those who provide that care fairly.


South Carolina is currently debating legislation around raising nurse pay, a move that could inspire North Carolina’s legislative body to debate a similar raise should the legislation pass. However, as of now, there is no similar legislation in our state.


Even without that legislation in place, there is some hope that North Carolina nurses’ pay is rising. Mission Health, a healthcare-owned hospital system in western North Carolina, announced a 22 million dollar pay raise for nurses last year.


More pay raises could occur throughout the state if nurses take a page from the Mission Health union’s playback: know their worth and ask for it, whether in nursing job interviews or through organized action.


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