AORN Salary Survey: 6 Compensation Changes in 2021

Staff nurses saw a slight decrease in pay through 2021, while nurse executives saw a $1,600 bump, according to results from AORN’s 19th annual salary survey published in the December issue of AORN Journal.

Survey results also showed extras such as bonuses were top methods to recruit and retain nurses through the current staffing shortage.

The survey results come from member and non-member perioperative nurses in frontline and administrative roles across all care settings who were surveyed in June about compensation, benefits, and work environments. Based on responses from 1,895 individuals, the current salary situation for perioperative nurses is mixed.

Here are six changes in perioperative nurse compensation for 2021:

1. Job Title Matters Most
   Frontline nurses average base compensation was $75,600 (down $600 from 2020), while nurse leaders in VP, assistant VP, director, and assistant director roles averaged $125,300 annually (up $1,600 from 2020.)
   
   Despite this difference, all nursing roles measured 0.2% above inflation for annual base compensation over the past 19 years.
2. Location Still Makes a Difference
   Population setting dictated substantial changes in base compensation, with nurses in rural settings making $9,300 less than those working in urban or suburban facilities.
   
   Regionally, nurses working on the West Coast (Pacific Region) were paid the highest, edging out East Coast compensation that was higher in 2020. Nurses working in New England, Mid-Atlantic states (New Jersey, Delaware, Maryland, Pennsylvania, New York, District of Columbia), and Mountain States (Montana, Idaho, Wyoming, Nevada, Utah, Colorado, Arizona, New Mexico) also saw higher pay.
3. ASC Nurses Earned Less
   Nurses working in freestanding surgery centers earned $8,500 less in base compensation in 2021, when compared to nurses working in acute care hospitals or hospital outpatient departments. This is down more than in 2020 when nurses working in freestanding surgery centers earned $5,600 less in base compensation for the same comparison.
   
   In other facility-type comparisons, nurses in general and community hospitals earned $5,200 less than nurses working in critical access hospitals, specialty hospitals, and university/academic medical centers.
4. Men Made More
   While gender is not always a factor in AORN’s salary survey, it showed a significant difference in 2021 with men earning $3,200 more than women in base compensation. The last time survey results showed men earning more was in 2015.
5. Raises Down, Call-Pay Unchanged, Overtime and Hiring Bonuses Up
   Fewer respondents (65%) reported earning a salary raise in 2021, compared to 69% reporting raises in 2020. Pay for taking call remained at $3.50/hour, the same rate reported in the survey for the past five years.
   
   More nurses (77%) reported working overtime an average of three hours per week, compared to 72% of nurses working an average four hours of overtime per week in 2020. Of the 77% who worked overtime in 2021, 68% earned time-and-a-half pay. Directors and assistant directors reported working the most overtime (7.6 hours) per week. Hiring bonuses were also up modestly at 13%, compared to 12% in 2020.
6. Burnout is Up
   Respondents were asked several questions related to the nursing shortage, including reasons for the shortage; burnout ranked third for top reasons nurses are leaving their job. This is up from 2020 when burnout ranked sixth in reasons for the nursing shortage at individual facilities. Of all survey respondents, 50% reported experiencing burnout, with is a 20% increase in reported burnout compared to 2020 survey results.
7. Travel Nurses and Bonuses Are Top Ways to Address the Staff Shortage
   More respondents (60%) reported their facility is hiring travel nurses to fill staffing vacancies. This is up 14% from 2020. Bonuses were the next top strategy to stem the shortage, up 17% in 2021. Overall, 22% of respondents rated their facility’s response to the staffing shortage as “poor,” and 45% rated facility response to the shortage as “fair”—a 7% increase since 2020.
   
   As for the shortage outlook, 33% of respondents said they are likely or very likely to quit their current role. This is up 4% from the same question asked in the 2020 survey. The top reason for wanting to quit was dissatisfaction with salary, work environment or supervisor, followed closely by burnout.