Within Market Analysis of Salary and Compensation for Public Health Nurses and Hospital Nurses

Background: The general wisdom is that lower compensation paid by local health departments (LHDs) for public health nurses (PHNs) compared to hospital nurse contributes to the difficulty in recruiting registered nurses (RNs) in to PHN positions. However, no studies appear to have substantiated this belief. Anecdotally, LHDs benchmark PHN salaries against other LHDs, rather than the local market for RNs. The purpose of this descriptive study was to quantify the extent of the differences in compensation for RNs working in LHDs as PHNs and in hospitals.

Methods: Telephone surveys were conducted in Illinois and Washington State with 5 LHDs and 10 hospitals within the same county as the LHDs. RN salary and benefits data were collected. Descriptive across group comparisons were done.

Results: For new graduates, PHNs' average wage was $5.26 per hour lower than for hospital RNs. After 18 years of experience, PHN salaries at the LHDs were $16.29 less for hospital RNs. However, 3 out of 5 LHDs paid an additional $1.00 per hour for the BSN, compared to only 1 of 10 hospitals. None of the LHDs provided pay differential for specialized certifications or for RNs acting as a preceptor, whereas 8 out of 10 of the hospitals did so. Only 2 of the 5 LHDs paid a differential for a lead/supervisory role, whereas all 10 hospitals did so. The 2 LHDs that pay tuition reimbursement paid an average of $2,265 more than the 9 hospitals with tuition reimbursement.

Conclusions: For PHNs, salary comparison and lack of a career ladder both seem to exist, but LHDs more generously supported obtaining education. Some hospitals were reluctant to share data due to market competition for workers and concerns regarding price fixing. Although the small sample size precludes generalization, this exploratory study suggests that LHDs need to consider market forces that influence RN job searches when recruiting for PHN positions.