Results of the 2009 AORN Salary Survey

Article Outline

• ABSTRACT
• Respondent Profile
• Base Compensation
  • Job title
  • Facility type
  • Facility size
  • Facility ownership
  • Population setting
  • Geographic region
  • Time spent on direct patient care
  • Work experience
  • Compensation basis
  • Certification
  • Education level
  • Collective bargaining
  • Household status and gender
  • Other variables
• Other Forms of Compensation
  • Overtime compensation
  • Hiring bonuses
  • Shift and other differentials
• Benefits
• The Effect of the Economic Downturn on the Perioperative Nursing Work Environment
• Update on the Perioperative Nursing Shortage
• Open-ended Comments about Perioperative Nursing Compensation
• Copyright

ABSTRACT 

AORN conducted its seventh annual compensation survey for perioperative nurses in August of 2009.

A multiple regression model was used to examine how a variety of variables including job title, education level, certification, experience, and geographic region affect nursing compensation. Comparisons between the 2009 data and previous years' data are presented.

The effects of other forms of compensation, such as on-call compensation, overtime, bonuses, and shift differentials on average base compensation rates also are examined.

Additional analyses explore the effect of the current economic downturn on the perioperative work environment. AORN J 90 (December 2009) 829–844. © AORN, Inc, 2009.

Key words:  nurse salaries , compensation , economy

In August of 2009, AORN surveyed its members and some nonmembers to examine the status of perioperative nursing compensation in the United States. This market research study tracks compensation changes on a yearly basis and seeks to identify factors that influence how much perioperative nurses are presently paid. The survey also addresses the perioperative nursing shortage, focusing on perceived changes in staffing-related aspects of the perioperative nursing workplace during the last several years. This year, additional questions were asked and additional analyses conducted to explore the effect of the recent economic slowdown on the work environment of perioperative nurses.

Back to Article Outline

Respondent Profile 

For the sixth consecutive year, AORN conducted its survey online. In late July, about 64,000 potential respondents, including about 28,000 AORN members, were sent an e-mail invitation to participate in the survey. This group of potential respondents is substantially larger than that invited in past years. By late August, 4,345 unique responses were received. Because the focus of this survey is perioperative nursing compensation, respondents who did not answer any compensation-related questions were excluded from the sample. This criterion reduced the usable sample to 3,277 individuals, for a 5.1% net response rate. This sample is almost exactly the same size as the sample collected for the 2008 survey.

As shown in Figure 1, 42% of the respondents are staff nurses; 23% are managers; 13% are high-level managers (ie, vice presidents [VPs]/directors/assistant directors, and hospital/facility administrators); 8% are educators (ie, faculty members or staff development personnel); and 6% are RN first assistants (RNFAs). Twelve percent of respondents are in their 60s, 48% are in their 50s, 26% are in their 40s, 12% are in their 30s, and 4% are younger than age 30. Approximately 90% of the sample is female, and 10% is male. Hourly-paid employees comprise 65% of the sample; 35% are salaried employees.

• 
  • View Large Image
  • Download to PowerPoint

• Figure 1. 

  Percentage of Survey Respondents by Job Title

Most of the respondents work in acute care hospitals (72%), and 23% work in an ambulatory surgery center whether it be free-standing (12%), hospital-based (10%), or office-based (2%). About 1% of the respondents work in the nursing industry, in a school of nursing, or as an independent consultant. About 4% of the sample is employed in other positions.

Geographically, the sample is well dispersed across the country. As shown in Table 1, 19% of the respondents live in the upper eastern coastal area (ie, New England and the Mid Atlantic), 18% reside in the South Atlantic area, and 26% are located in the East and West North Central regions. About 16% reside in the East and West South Central regions, and 20% are located in the western (ie, Mountain) and Pacific states. About 81% work in an urban or suburban area, and about 19% work in a rural location.

Table 1. Geographic Region

More than one-third of the respondents hold a bachelor's degree in nursing, and about 8% have a bachelor's degree in another field. About 39% percent of the respondents have a diploma or associate degree. A master's degree in nursing (MSN) is held by 8% of respondents, and 8% hold a master's degree in another field. About 2% have a doctorate in another field or some other type of degree (Table 2).

Table 2. Respondents' Education Levels

About 48% of the respondents have more than 20 years of experience as a perioperative nurse and about 32% have more than 25 years of experience. About 27% of the respondents have 11 to 20 years of experience, and about 26% have 10 or fewer years of experience as a perioperative nurse.

Overall, the respondents' demographic profile is quite similar to the 2008, 2007, and 2006 survey samples. The one notable difference is the 8% increase in the number of respondents with more than 20 years of experience in perioperative nursing in the last year. Figure 2 represents some of the demographic information from the sample.

• 
  • View Large Image
  • Download to PowerPoint

• Figure 2. 

  Profile of Survey Respondents

Back to Article Outline

Base Compensation 

Statistical analyses were performed to identify which factors have the most influence on perioperative nurse compensation. It should be noted that the sample is not perfectly random because the net response rate was modest (5.1%). Still, the sample is sufficiently representative of the perioperative nurse population that statistical tests can provide insight.

A summary of the salary findings, categorized by job title and size of facility, is shown in Table 3. This analysis and the salary analyses that follow include only nurses who were employed full time in the United States. Facilities are categorized as small or large based on a median split of the number of ORs reported. These findings show the calculated average salary for nurses who spend an average amount of time on direct patient care for their title. As can be seen, nurses generally receive more compensation in larger facilities.

Table 3. Estimate of Average Base Compensation by Job Title and Facility Size^*

Dollar amounts are rounded to the nearest hundred.

* The small net subsample sizes for educator/faculty member, nurse practitioner, and consultant resulted in their exclusion from the regression analysis. Other samples with fewer than 30 observations are noted with a **.

On closer examination, the relationship between facility size and compensation may also be influenced by facility type. Table 4 shows how the average number of ORs varies by facility type, and how the number of ORs is related to staff nurse compensation. Taking facility size into account, the university or academic facilities tend to be larger than other facility types. The ambulatory care facilities pay somewhat less than the acute care facilities.

Table 4. Size and Compensation by Facility Type

The challenge in understanding perioperative nursing compensation is in estimating the simultaneous influence of the many different variables that can affect compensation. Multiple regression was used as the primary analytical tool in this study because so many variables are involved. The multiple regression model makes it possible to estimate the effects of one variable on compensation while statistically holding the other variables constant. The influence of each variable can then be identified, independent of the others. The analysis used hierarchical regression where the variables expected to explain the most variance were entered first in the model, followed by less important variables. Several variables with related effects were entered initially and simultaneously. These variables are

Other variables were then entered one at a time. These secondary variables are

To obtain the most reliable results, the sample for the regression analyses was limited to respondents who are full-time employees and who work in the United States. Statistical outliers were also eliminated (eg, unusually high or low pay reported by a very small number of nurses) to avoid skewing the results. Checks were conducted to ensure that the statistical assumptions behind the regression model were met (eg, linear relationships and normally distributed errors). The final model explains 52% of the variation in base compensation.

What follows is an overview of the results concerning each variable included in the regression analysis that was found to be significantly related to base compensation level. All variables were significant at the P ≤.05 level. Readers can easily obtain the estimates of compensation for any particular nursing position by using the compensation calculator on the AORN web site at http://www.aorn.org/CareerCenter.

Job title 

More than any other variable, differences in job title are linked to differences in compensation. The average staff nurse, for example, earns $64,400 ($2,900 more than in 2008), and the average VP/director/assistant director of nursing makes $101,800 ($4,500 more than in 2008). Part of the difference in salary across titles is explained by the difference in the percentage of time spent in direct patient care versus the percentage of time spent on other tasks such as management or administration.

To explore the trends in salary for nurses and nurse managers over time, data were combined from seven years of AORN salary surveys. Figure 3 shows that staff nurses and VPs/directors/assistant directors of nursing have seen increases in average compensation during this time period. The rate of growth appears to be slightly higher for staff nurses (averaging 4.1% per year) than for VPs/directors/assistant directors of nursing (averaging 3.0% per year) during this time period.

• 
  • View Large Image
  • Download to PowerPoint

• Figure 3. 

  Trends in Base Compensation During a 7-Year Period

On average, staff nurses spend 89% of their time delivering direct patient care, and nurse managers spend 38% of their time providing direct care. As expected, high-level managers spend a relatively small amount of time in patient care (18% for facility/hospital administrators and 16% for VPs/directors/assistant directors). Facility and hospital administrators spend about 5% less time in direct patient care than was reported by the 2008 sample. The percentage of time spent in direct patient care varies among nurses with the same title. For example, some nurse managers spend as much time on direct patient care as does the average staff nurse, while other nurse managers spend as little time on patient care as does the typical director or VP.

Facility type 

The regression model indicates that nurses in acute care hospitals earn more compensation than do nurses in ambulatory surgery centers. For example, those working in university or specialty acute care hospitals average $3,800 more than nurses working in other types of facilities. These findings imply that nurses in other acute care hospitals or other ambulatory surgical centers generally see less compensation than the nurses in the facilities mentioned above. Compared to their counterparts in acute care hospitals, nurses in higher-level management positions in any kind of ambulatory surgery center average $13,700 less in compensation, and staff nurses in ambulatory surgery centers earn $2,700 less.

Facility size 

The facility size is an important differentiator in nursing compensation. This difference is particularly pronounced for those who work in higher-level management positions. After controlling for facility type, staff nurses receive $200 more per OR for working in larger facilities, but hospital/facility administrators and VPs/directors/assistant directors of nursing earn on average $1,500 more per OR in the facility (compared to $1,600 in 2008). This difference may be the result of the greater number and range of responsibilities that these upper-level positions entail.

Facility ownership 

About 29% of facilities in the sample are private, investor-owned, for-profit organizations. The findings indicate that nurses in these facilities earn $3,200 less than nurses in facilities with different ownership structures (eg, nongovernment, nonprofit). Those few members of our sample (3%) working in government or federally owned facilities (eg, Veteran's Administration hospitals) earn $6,600 more, on average, than do other nurses.

Population setting 

The location of the facility, in an urban, suburban, or rural area substantially influences compensation. Nurses earn an estimated $9,000 less per year if they work in rural settings ($7,200 less in 2008) as opposed to suburban settings. Also, nurses in urban areas earned $1,700 less than those in suburban settings.

Geographic region 

Controlling for all variables previously discussed, geographic region explains significant differences in compensation levels across the United States. While nurses in the South Atlantic, West North Central, and East North Central all earn about the same income, nurses working in the Pacific region receive $20,600 more. The other regions with higher incomes are the New England ($18,800 more), Mid Atlantic ($8,000 more), Mountain ($6,700 more), and West South Central ($2,100 more) regions. Nurses in the East South Central region made $4,200 less than others.

Time spent on direct patient care 

Nurses in a particular position who spend more or less time than the average for direct patient care in that position should expect to receive different compensation than the estimated average compensation. On average, staff nurses earn about $410 more per year than the average staff nurse compensation for each 10% decrease in time spent on direct patient care per week, and correspondingly for each 10% increase in time spent doing managerial tasks. This relationship is the same for nurse managers, educators, RNFAs, nurse practitioners, private scrub nurses, and other nurses. Hospital/facility administrators and VPs/directors/assistant directors of nursing earn $340 per year more for every 10% decrease in time spent on direct patient care.

Work experience 

The polynomial regression model suggests that nurses generally see large increases related to experience early in their careers but much smaller increases later. For example, the jump in compensation from the first to the second year is close to $800, but the jump from the 25th to the 26th year is only about $150. In this sample, the average nurse has 19 years of experience (compared to 17 years in 2008). Nurses with more or less experience should add or subtract some amount per year of experience to estimate their base compensation. Interestingly, hospital/facility administrators and VPs/directors/assistant directors of nursing earn about $380 per year of experience, and this relationship continues up through 30 years of experience. On average, these individuals report 22 years of work experience.

Compensation basis 

Whether a nurse is paid on an hourly basis or on salary is related to base compensation level, even after all of the factors mentioned above are controlled for in the regression model. Salaried employees earn $2,300 more per year than do hourly employees. This amount is less than the $3,500 additional compensation reported in the 2008 study.

Certification 

Eleven types of certification were examined:

This year, only one of these certifications, CRNFA, is related to significant differences in compensation. Nurses with a CRNFA credential receive $4,700 more per year in compensation than do non-CRNFA nurses.

Of particular note, these findings are qualified by the small number of nurses in the sample who hold other types of certification. While 61% of respondents are CNOR certified, only a small percentage held BC, C, CPAN, CAPA, CPSN, CNA, CNAA, ONC, CNS, or NP certifications. Only CRNFA is held by more than 1% of the sample (4%). Thus, the number of some certifications was too small to render a statistically significant effect in regression analysis. However, in this regard, 37% of the respondents said that their facility pays more for holding a nursing certification (38% in 2008).

In response to a follow-up question, of those who said their hospital offers more compensation for some certifications, 84% of the respondents said they receive extra compensation for CNOR, 9% for CRNFA, and 5% for CPAN and/or CAPA. Three percent or less mentioned one of the other certifications. Thus, although it appears that some nurses receive extra compensation for a variety of certifications, this compensation may vary by hospital. Also, nurses with some certifications such as CNOR may find work in facilities that offer more compensation, or they may spend more time on management tasks. After we control for facility type and time spent on direct patient care, the effect of certification by itself is less pronounced.

Education level 

Nurses with an MSN add an additional $3,900 in annual base compensation. Nurses holding a master's degree in another field make $5,100 more. When asked directly, only 26% of the respondents said that their facility pays more for having a degree in nursing.

It may seem surprising that education has so little effect on compensation in this analysis, but it should be noted that the analysis has already controlled for job title, and a nurse's education level may well affect the level of responsibility to which he or she may rise. Table 5 provides an analysis of education by selected job titles, including staff nurses, nurse managers, and higher-level directors and hospital administrators. The table shows that the higher-paying jobs, especially the directors and administrators, are less likely to have only a diploma or associate degree and are more likely than others to have an MSN or a master's degree in another field. Thus, while level of education does not always have a strong direct effect on compensation for nurses with the same title, education may well affect the title each nurse holds.

Table 5. Education by Selected Job Titles

Collective bargaining 

Relatively few respondents report working in an environment with a union or collective bargaining unit (10.3% this year, 9.4% in 2008). However, nurses working in a unionized setting earn an average $7,100 more in annual base compensation than do nurses employed in a nonunion workplace. Working in a unionized environment does not appear to affect the compensation of managers.

Household status and gender 

Being married, single, or divorced is not significantly linked to base compensation. Like last year's results, the variables “gender” and “having children younger than 18 at home” are also not significant. The varying results across the last few years of studies suggest that there might be a gender effect, but the effect is inconsistent and small relative to all of the other factors that influence perioperative nursing compensation.

Other variables 

As a cautionary note, the results from the regression analysis represent general patterns and do not address several variables that can affect compensation, such as the unique needs of facilities, interpersonal skills, and leadership ability. The results are generally accurate enough that two-thirds of nurses or managers who fit a particular profile will see an annual base compensation within $16,500 of base compensation estimated by the model.

In questions unrelated to the base compensation model, 69% of the respondents report receiving a raise this year, down from the 84% who reported getting a raise last year. For those receiving raises, the mean pay raise for staff nurses is 3.1% (3.4% in 2008). As shown in Table 6, raises are slightly higher for those with greater management responsibilities, although raises were lower than last year in every category. Hospital/facility administrators received an average 5.3% pay raise (5.8% in 2008 and 6.1% in 2007); VPs/directors/assistant directors averaged a 3.8% raise (4.3% in 2008). Nurse managers averaged a 3.4% pay raise compared to 4.0% in 2008.

Table 6. Mean Pay Raises by Job Title^*

* Nurse practitioner, educator/faculty member, and consultant were excluded because of the small sample size.

Back to Article Outline

Other Forms of Compensation 

The regression analysis previously described applies to base compensation. In the present sample, 68% of the respondents receive additional compensation from a variety of sources including overtime, shift differential, on-call compensation, and bonuses (the same percentage as in 2007 and 2008). The amount of additional pay differs substantially by title. The average percentage of additional compensation, by title, is shown in Figure 4.

• 
  • View Large Image
  • Download to PowerPoint

• Figure 4. 

  Additional Compensation by Job Title^*

As shown, RNFAs received the largest compensation relative to base pay (16.4% compared to 15.1% in 2008) followed by staff nurses (12.1% compared to 16.0% in 2008). Vice presidents/directors/assistant directors received the smallest additional compensation relative to base pay (4.0% compared to 4.1% in 2008).

More than half of the respondents (55%) report that they take call (unchanged from 2008). The median number of hours per week on call is 16 (the same as reported in the previous four surveys). Among the on-call respondents, 68% receive a dollar per hour amount for being on call (compared to 69% in 2008), 6% receive a percentage of their base pay (5% in 2008), and 20% receive no compensation (21% in 2008). Among those who receive dollar-per-hour pay, the median pay is $3.00 per hour ($2.75 in 2008). If called in, 60% receive time-and-a-half pay (59% in 2008), and 5% get straight-time pay (unchanged from 2008 and 2007). Instead of pay, 3% of the on-call respondents receive comp time (4% last year).

Overtime compensation 

A large majority of respondents work overtime (76% compared to 80% in 2008 and 83% in 2007), working an average of 6.2 hours each week (compared to 6.8 hours in 2008 and 6.9 hours in 2007). About 62% of those who work overtime receive time-and-a-half pay (60% in 2008), but 30% receive no additional compensation (31% in 2008). Almost all of those not compensated for overtime are salaried (98% compared with 97% in 2008). As shown in Table 7, VPs/directors/assistant directors average the most overtime (6.8 hours per week compared to 6.4 hours in 2008), followed by RNFAs (5.6 hours compared to 7.4 hours in 2008), and nurse managers (5.3 hours compared to 5.9 hours in 2008). Respondents working the least amount of overtime are educator/staff development employees (3.7 hours a week compared to 4.2 hours in 2008).

Table 7. Average Overtime Hours Per Week and Percentage of Respondents Who Are Salaried^*

* Educator/faculty member, nurse practitioner, and consultant were excluded because of the small sample size.

Hiring bonuses 

Relatively few of the respondents received a hiring bonus when they were hired (14%, unchanged from 2008), and only 12% report that their employer now offers a hiring bonus for their position (down from 19% in 2008 and 21% in 2007) with half the bonuses in the $1,000 to $5,000 range (range $2,500 to $7,500 in 2008). The employees who are most likely to receive a hiring bonus are clinical nurse specialists (20%), staff nurses (13%), educator/staff development employees (11%), nurse managers (11%), and RNFAs (10%). Hospital/facility administrators are least likely to receive the bonus, with none reporting receiving hiring bonuses this year (the same as in 2008).

Shift and other differentials 

Among the respondents, 92% work the day shift, and 4% work afternoons/evenings. Very few respondents work nights, weekend days, or weekend nights (less than 5% for the three categories combined). For those working the afternoon/evening shift, the median differential is $2.72 per hour or 10% of base pay (compared to $2.50 and 10% of base pay in 2008).

Back to Article Outline

Benefits 

Almost all of the respondents receive benefits as part of their compensation. As shown in Table 8, the most frequently received benefit in 2009 is health insurance (92%), followed by earned time or paid time off (89%), dental insurance (87%), life insurance (85%), and bereavement leave (78%). This year there is a decrease in the percentage of respondents receiving many benefits, likely due to the economic downturn. In particular, there are decreases in support for continuing education since 2008, including tuition reimbursement (dropping from 67% to 56%), paid certification exams (from 40% to 36%), and paid conference travel (from 44% to 29%). Related to the decreases noted above in hiring bonuses, there has also been a decrease in referral bonuses, from 37% to 23%.

Table 8. Percentage of Respondents Receiving Benefits

Several of the written comments revealed that nurses were particularly concerned with retirement benefits. Data from the last several years of salary surveys were combined to explore trends in this important benefit over time. As shown in Figure 5, the trends are mixed. There has been a general increase in the percentage of nurses receiving 401(k) contributions, although this dropped slightly in the past year. There has also been a corresponding decrease in the percentage of nurses receiving a pension plan.

• 
  • View Large Image
  • Download to PowerPoint

• Figure 5. 

  Changes in Retirement Benefits Over Time

Back to Article Outline

The Effect of the Economic Downturn on the Perioperative Nursing Work Environment 

The economic downturn that started in the fall of 2008 had widespread effects on the perioperative nursing environment. To understand how this downturn affected perioperative nurses, we asked our respondents if they had seen any change in activity at their facilities. More than half (53%) of the respondents reported a decrease in activity, while 33% reported no change and 14% reported an increase in activity. These findings are consistent with the slight decrease in overtime hours reported, the decline in hiring bonuses, and the decrease in referral bonuses.

The generally decreasing level of activity led many facilities to make adjustments. We asked the respondents what steps, if any, their employers took to deal with the downturn. The results, shown in Figure 6, indicate that a hiring freeze was the most frequent step taken (50%), followed by reduced or eliminated reimbursement for conference travel (37%) and reduced hours for nurses still employed (31%).

• 
  • View Large Image
  • Download to PowerPoint

• Figure 6. 

  Changes Made by Employer to Deal with the Economic Downturn

We also wondered how the economic downturn affected each respondent's own position. Fortunately, half of the respondents (51%) reported no change in their positions, but 22% experienced reduced or eliminated conference travel reimbursement. Several nurses experienced other effects, as shown in Figure 7.

• 
  • View Large Image
  • Download to PowerPoint

• Figure 7. 

  How the Current Economy Affected the Respondent's Position

Back to Article Outline

Update on the Perioperative Nursing Shortage 

Changes in the perception of the nursing shortage may be related to the downturn in the economy. The hiring freeze that many facilities have implemented may explain the increase in the median percentage of vacant full-time nursing positions, which, at 4.5% this year, is up from 3.7% in 2008 and 4.3% in 2007. However, the perception of the effect that the shortage is having on patient care has moderated somewhat, perhaps due to the decreased activity level that many hospitals are experiencing.

This year, 30% of high-level managers report a moderate to crisis level of effect that the shortage has had on their working environment compared to 46% last year. Among nurses in this year's sample, 56% report a moderate to crisis effect, down from 66% in 2008 and 72% in 2007. As expected, the shortage's effect on patient care tends to be rated more severely by those with the most patient contact. About 60% of staff nurses rate the shortage as having a moderate to crisis level effect compared with 47% of nurse managers, 33% of VPs/directors/assistant directors of nursing, and 14% of facility/hospital administrators. When the economy picks up again and the amount of perioperative activity returns to previous levels, it remains to be seen whether facilities will be able to hire fast enough to meet the increase in demand.

Again this year, respondents rated their agreement with several statements about their work environment. Several of these statements were phrased as satisfaction measures. The results, broken out by nurses and managers, are shown in Figure 8. Overall, managers are more satisfied with their jobs than are nurses. Overall satisfaction ratings are similar to last year, with managers rating their satisfaction as 5.2 on a 6-point scale (5.1 in 2008), and nurses rating their satisfaction as 4.8 (the same as in 2008). Some of the largest gaps in satisfaction between the two groups are support from hospital management, adequate number of staff, and sufficient help from support staff. Nurses are least satisfied with management support, the number of nursing staff, pay, and the education/training for coworkers. Managers are least satisfied with the pressure they feel to work more hours than they prefer to work.

• 
  • View Large Image
  • Download to PowerPoint

• Figure 8. 

  Overall Satisfaction with Aspects of the Work Environment

The respondents were also asked to identify their top three priorities for improving the workplace. Nurses who are not in management rate their top priorities as more pay (39% rated this as one of three top priorities), more support from management (36%), and education or training for coworkers (28%). Managers rate their top priorities as more education and training for coworkers (38%), more pay (34%), and more education and training for themselves (31%). The priority placed on education and training by nurses and management may be in response to the cutbacks in conference travel and tuition reimbursement that many facilities have instituted because of the economic downturn.

Back to Article Outline

Open-ended Comments about Perioperative Nursing Compensation 

Respondents were asked to provide any comments about compensation that they would like to express. More than 460 nurses offered their views. A plurality of respondents said they are underpaid, especially given the amount of knowledge, responsibility, and stress that perioperative nursing entails. Wrote one respondent,

We don't make enough for all we do and for all we know. I'm tired of hearing upper management say they can't afford to give us more when we see the profitability reports of our units and we hear the surgeons talk about their own quarterly profit dividends.

Another nurse wrote, “Given everything that we do, perioperative RNs should be considered for ‘combat pay.’” A third nurse commented,

We are not compensated for the amount of continuing education and call required to keep our jobs. Nurses are burning out and moving on to other areas. We are a dying breed.

A few respondents derisively compared their compensation to that of professional actors and athletes. Wrote one nurse,

Health care workers save lives. So why do athletes get paid millions and nurses get so little?

Concerns were expressed about OR nursing experience not being fairly compensated especially when compared to pay for new OR nurses. One nurse commented,

Employers need to value the experienced OR staff nurses and offer a retention bonus. The length of time and amount of money it takes to orient a new nurse is considerable. Long-term OR nurses save the facility money.

Another nurse wrote,

I am very disappointed with my hospital, which does not have a balanced pay scale for nurses based upon experience. Presently, I am working with a nurse who has six years of OR experience compared to my 29 years, and she makes $6 more an hour and has more schedule flexibility than I do.

A number of respondents were dissatisfied with call compensation and scheduling especially when they must work their regular shift right after completing call work. Others expressed concerns about call requirements for older nurses.

There should be a ruling that states that no nurse over 55 years of age should take call. It is taxing on older bodies, and it takes so much more time to recoup.

Concern was also expressed by a number of respondents about the lack of compensation for nursing certifications.

Some respondents believe that individuals at their facilities who make decisions about OR nurse compensation have little understanding about what the perioperative nurse does. One nurse wrote,

Those making the decisions have no idea about what really goes into the work. If you don't understand what a job is about, how can you compensate adequately?

Another nurse lamented,

Because we are “hidden away” from the rest of the hospital, no one realizes how important the perioperative nurse is and the variety of jobs that we do daily.

A number of nurses described the workplace changes that have occurred because of the economic downturn—hiring freezes, pay cuts or freezes, layoffs, and increased workloads to compensate for position cuts. However, relatively few nurses who reported the changes actually complained about them. There seemed to be a tacit acceptance of the changes among some respondents, at least for the time being, considering the current state of the economy. Some nurses who said they have witnessed the hardships that others are experiencing wrote that they were thankful to have a job. A representative comment was “I am grateful to have a job in these hard economic times.”

Relative to previous surveys, there were more positive comments about union effects on compensation and benefits from those who are union members or work in a unionized workplace. For example, a nurse manager wrote,

I work in a union environment. Even though I am management and not a union member, the relationship with the union keeps all salaries and benefits at a very high level.

A union member wrote,

I am glad to be in a collective bargaining unit, particularly in these economic times. The employer did request a wage re-opener this summer, but our union declined. We see too much fiscal waste every day to consider nurses taking a pay freeze or reduction.

Despite wide-ranging concerns about compensation and other workplace issues, there was praise and pride expressed for the nursing profession and its value, however inadequately compensated. As one nurse declared,

All perioperative RNs should be canonized for working very hard to do their work—with poor pay, outdated equipment, being stepped on by doctors, and not having enough vacation time. Our patients love and appreciate us. They are who we are there for. God bless the OR nurse!

Compared to past surveys, more respondents expressed thanks to AORN for the compensation survey and for the compensation calculator on the AORN web site. Wrote one nurse, “Thank you for doing this survey. It helped me get the salary that I am making.”

• 
  • View Large Image
  • Download to PowerPoint

• * Educator/faculty member, nurse practitioner, and consultant were excluded because of the small sample size.