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Nurses in rural Oregon take home better pay, study finds

Kevin Heinrich, a licensed practical nurse, at a workstation at Mirabella Portland’s skilled nursing facility on Feb. 13, 2023. Nurses and other health care workers have become increasingly hard to find after the pandemic.
Jake Thomas

A new study by the Oregon Center for Nursing suggests hiring outside Portland area shouldn’t be so tough and that retaining nurses is about more than wages.

Registered nurses take home smaller paychecks working in rural Oregon, but effectively have higher wages than their Portland area counterparts because of the lower cost of living.

That finding is billed as an unexpected one in a new study released by the Oregon Center for Nursing. Based on a survey late last year of roughly 1,800 registered nurses in Oregon, the study provides analysis its author, Richard Allgeyer, said is not captured in national data as employers struggle to fill nursing positions and lawmakers seek to expand the profession’s training pipeline.

The center is a nonprofit set up to research workforce issues. It’s headed by a board composed largely of nurses, including several who work for health systems. The study received funding from surcharges on nurse licensing fees.

Allgeyer, the center’s research director, told The Lund Report that the study seeks to clarify conversations among employers and policymakers that in the past have relied on anecdotes and incomplete data. Rural employers have complained of having to compete with higher wages offered to nurses in the Portland area, he said, adding that rural employers now can use the study’s findings as they recruit to fill jobs.

“You will make a higher dollar amount if you work in Portland,” he said. “But if you work out here in say, Baker City, your money’s going to have more power because it’s cheaper to live here.”

On average, registered nurses in Oregon earn about $55 an hour or about $114,694 annually, the study found. Oregon’s registered nurses are among the highest-paid in the country, though that ranking plummets once cost of living is taken into account.

Nurses working the Portland area’s three counties earn the highest average wage at $56 an hour, the study found.

Nurses working in Oregon’s rural areas earned less money, the study found. Eastern Oregon nurses earned the least $44 an hour. Southwestern Oregon nurses earned $49 an hour and in the Rogue Valley they earned nearly $51. Nurses in the east Cascades, a region that spans Hood River County to Lake County, earned $52.

However, those paychecks go farther in rural areas, the study found. Using cost-of-living data from the Massachusetts Institute of Technology, the study found that nurses in these regions earned roughly 300% of the region’s livable wage. Nurses in the Portland area earned 264% of the region’s livable wage, the study found.

Allgeyer said the study was prompted, in part, by the center’s earlier research on public health nurses. He said that public health nurses suspected they were paid less than other nurses but lacked data to confirm it.

The study analyzed wages by workplace setting and found public health nurses at the bottom, earning $47.55 an hour or $98,898 annually. At the top are hospital nurses, who earn $58.25 an hour or $121,163— a roughly $22,000 difference.

Residential care, or nursing home, nurses made the second-lowest wage by workplace setting at $49.86 an hour or $103,702 annually.

The study also analyzed wages by specific jobs. At the top are administrators, who earn on average $67 or $140,221. At the bottom are school nurses, who work nine-month contracts, and make $48 an hour or $75,500 annually.

“Unfortunately, when you look at both public health and school nurses, they’re paid differently,” he said. “They’re paid by taxpayers. And so those salary structures are kind of set. But even at $47 an hour, that’s still far and above a pretty decent wage.”

The second-lowest paid nursing jobs, according to the study, are nurse educators, who make roughly $52 an hour or $80,624 annually. The finding is notable because, in addition to a shortage of nurses, Oregon also doesn’t have enough nurse educators, in part, because of the pay gap.

Lawmakers and employers have been trying to bolster the ranks of nurses after many left the profession because of the stresses brought on by the pandemic. Registered nurses are one of the five hardest-to-fill positions in the state, according to Oregon Employment Department numbers published in March.

“We’re having what we’re calling a ‘vacancy crisis,’” said Allgeyer

He said Oregon’s number of registered nurses grew about 11% last year but he said employers are having a hard time retaining them. While some nurses are paid more than others, they are making a living wage across the board, he said.

He said that as lawmakers and employers look to retain nurses, they should look beyond wages.

“When you’re looking at retention efforts, the literature suggests that money is one factor,” he said. “And not even may not even be the most important factor because we’re looking at things like company culture, organizational culture, the ability to fit in, belonging, feeling appreciated. Those kinds of things are really, really important to nurses.”

The Lund Report is an independent, nonpartisan, nonprofit, online news source. We exist to provide people in Oregon and southwest Washington with high-quality journalism about health care that promotes awareness and understanding of pressing issues while holding government and industry accountable.

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