Pay Disparities in Nursing

By Emily Largent

I’ve mentioned on this blog before that I had a past life as a nurse.  Therefore, I wanted to call attention to an important new study that has just come out in JAMA: Salary Differences Between Male and Female Registered Nurses in the United States.  The study found that “[m]ale RNs outearned female RNs across settings, specialties, and positions.”  On average, male nurses make $5,150 more per year than female colleagues in similar positions.  This salary gap affects 2.5 million female RNs.

There is speculation that a male nurse may be perceived as more expert simply because he is a man. This explanation is deeply ironic.  Decades  of legal barriers kept men out of the field, and historically, some nursing schools refused to admit men due to sex stereotypes that categorized caring as a feminine trait.  The Supreme Court deemed this practice unconstitutional in Mississippi University for Women v. Hogan.  While that decision came down in 1982, research suggests that men continue to face pervasive barriers in nursing school (e.g., hearing anti-male remarks from faculty).

Ongoing identification of nursing as “women’s work” and the presence of gender bias in nursing can affect male nurses in different, seemingly contradictory ways.  On the one hand, the 2000 National Sample Survey of Registered Nurses found that men leave nursing at a higher rate in their first four years of practice.  Some have attributed that attrition to the harmful effects of gender bias.  On the other hand, it has been observed that–unlike women who enter male-dominated professions–male nurses who enter this female-dominated profession typically encounter structural advantages that tend to enhance their careers.

There is a need for more nurses.  According to the Bureau of Labor Statistics’s Employment Projections, the RN workforce is expected to grow to 3.24 million in 2022.  That is a 19% increase.  Nursing is a context that highlights how gender stereotyping hurts everyone–men who encounter discrimination, women who earn less than their male counterparts, and patients who benefit most when nursing recruits and retains excellent people.

I personally found nursing to be very rewarding.  I hope this study motivates employers to scrutinize their pay structures but also to appreciate and address the broader effects of gender bias on the profession.

Emily Largent

Emily Largent is an Assistant Professor of Medical Ethics and Health Policy at the Perelman School of Medicine. She also teaches at the University of Pennsylvania LawSchool. Her research examines ethical and regulatory issues arising in human subjects research and when integration of clinical research is integrated with clinical care; she has a particular focus on Alzheimer’s disease research. Emily received her PhD in Health Policy (Ethics) from Harvard and her JD from Harvard Law School. Prior to that, she received her BS in Nursing from the University of Pennsylvania School of Nursing and completed a fellowship in the Department of Bioethics at the National Institutes of Health.

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