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Background: Every two years, the National Council of State Boards of Nursing (NCSBN) and the National Forum of State Nursing Workforce Centers (Forum) conduct the only national-level survey focused on the entire U.S. nursing workforce. The survey generates data on the supply of registered nurses (RNs) and licensed practical nurses/licensed vocational nurses (LPNs/LVNs). These data are especially crucial in providing information on emerging nursing issues, which in 2022, was the impact of the (COVID-19) pandemic on the nursing workforce. Purpose: To provide data critical to planning for enough adequately prepared nurses and ensuring a safe, diverse, and effective healthcare system. Methods: This study used a mixed-mode approach, involving mailing a national, randomized sample survey to licensed RNs and LPNs/LVNs in most jurisdictions, supplemented by a national, randomized sample survey emailed to licensed RNs and LPNs/LVNs in four jurisdictions and data from the e-Notify nurse licensure notification system for five jurisdictions. Data from RN and LPN/LVN respondents were collected between April 11, 2022, and September 30, 2022. Data included nurse demographics, educational attainment, employment, practice characteristics, and trends. Results: The total number of active RN and LPN/LVN licenses in the United States were 5,239,499 and 973,788, respectively. The median age of RNs was 46 years and 47years for LPNs/LVNs, which reflects a decrease of 6 years for each cohort from the 2020 data. This decline was associated with estimated losses to the workforce of at least 200,000 experienced RNs and 60,000 experienced LPNs/LVNs. An average of 89% of all nurses who maintain licensure are employed in nursing with roughly 70% working full-time. Hospitals and nursing/extended care facilities continue to be the primary practice setting for RNs and LPNs, respectively. Increased proportions of male and Hispanic/Latino nurses have introduced greater racial diversity in the nursing workforce. The nursing workforce is becoming increasingly more educated with more than 70% of RNs holding a baccalaureate degree or higher. More than one-quarter of all nurses report that they plan to leave nursing or retire over the next 5 years. Increased demand from the COVID-19 pandemic and inflation led nursing incomes to rise significantly across the country. Nurses were also specifically asked how the COVID-19 pandemic impacted them, and more than 60% of all nurses reported an increase in their workload because of the pandemic. Conclusion: In the wake of the COVID-19 pandemic, the nursing workforce has undergone a dramatic shift with the loss of hundreds of thousands of experienced RNs and LPNs/LVNs. The nursing workforce has become younger and more diverse with increases reflected for Hispanic/Latino and male nurses. An increasing proportion of the RN workforce holds a baccalaureate degree or higher, moving closer to goals established by the National Academy of Medicine. Salaries have notably increased for nurses, likely due to inflation and increased demand for nursing services. With a quarter of the population contemplating leaving the profession, the impact of the pandemic may still be felt in the future.
The National Council of State Boards of Nursing (NCSBN) has collaborated with the National Forum of State Nursing Workforce Centers (Forum) to conduct the National Nursing Workforce Survey since 2013. The 2022 survey added questions pertaining to the COVID-19 pandemic and travel nursing. Data are comparable to the 2013, 2015, 2017, and 2020 datasets, which facilitated trend analyses. This study is the only continuous national, randomized survey of this size specifically focused on nurses, and it is the only comprehensive and updated study that includes registered nurses (RNs) as well as licensed practical nurses/licensed vocational nurses (LPNs/LVNs). The evidence generated from the National Nursing Workforce Survey fills a critical gap in supply-side information about nurses in the United States.
Demographics
In the wake of the COVID-19 pandemic, the nursing workforce has undergone a dramatic shift, with many older nurses opting to leave the profession. In 2020, nurses aged 55 years or older accounted for 43% of the RN workforce and 42% of the LPN/LVN workforce. In 2022, this same age cohort accounted for 31% of RNs and 30% of LPNs/LVNs. This decline was associated with estimated losses to the workforce of at least 200,000 experienced RNs and 60,000 experienced LPNs/LVNs.
The losses in the experienced workforce have been somewhat offset by gains in the lowest age ranges. In 2020, nurses aged 29 years or younger accounted for 8% of the RN workforce and 7% of the LPN/LVN workforce. In 2022, this same age cohort accounted for 11% of RNs and 10% of LPNs/LVNs. This increase was associated with estimated gains to the workforce of 130,000 RNs and 16,000 LPNs/LVNs.
The workforce in 2022 is more demographically diverse and representative of the country’s population than in any year in which this study was previously conducted. Women continue to account for a large majority of nurses; however, the proportion of men licensed as RNs or LPNs/LVNs in the country has increased steadily since at least 2015. Currently, men account for 11% of the RN workforce, an increase from 8% in 2015. Though less pronounced, the same pattern holds true for the proportion of men in the LPN/LVN workforce.
RNs are more likely to report identifying as an underrepresented racial minority. Overall, the RN workforce is 80% White/Caucasian, a slight decrease from 81% in 2020. In contrast, 72% of the U.S. population identifies as White/Caucasian (
). RNs who reported being of Hispanic or Latino ethnicity comprised 7% of the workforce in 2022, whereas in 2015 they represented 4% of the workforce. It is unclear whether this increase in diversity will continue. After years of decline, the proportion of RNs identifying as White/Caucasian in the youngest age ranges has risen back to the level of the overall population mean.
LPNs/LVNs are also more likely to report identifying as an underrepresented racial minority. Overall, the LPN/LVN workforce is 66% White/Caucasian, a decrease from 70% in 2020. LPNs/LVNs who reported being of Hispanic or Latino ethnicity comprised 12% of the workforce in 2022, an increase from 6% in 2015. As with the RN workforce, the proportion of LPNs/LVNs identifying as White/Caucasian in the youngest age ranges has risen back to the level of the overall population mean.
Employment
Since the onset of the COVID-19 pandemic, nursing employment has jumped significantly. Reporting data suggest an estimated 89% of RNs who maintain licensure are employed in nursing; among these nurses, 70% work full time, 11% work part time, and about 8% work per diem shifts. This is an increase from the 84% who reported working in nursing in 2020. Likewise, the 88% of LPNs/LVNs who reported being employed in nursing in 2022 was an increase over the 82% of LPNs/LVNs who did so in 2020.
Despite these gains, the COVID-19 pandemic may still have an impact on future employment. Survey data indicate that 28% of all nurse respondents plan to retire in the next 5 years, an increase from the 21% who responded positively in 2020.
Hospitals continue to be the primary practice setting for RNs, followed by the ambulatory care setting, home health, and nursing homes. The primary practice setting for LPNs/LVNs is nursing homes/ extended care settings followed by hospitals and nursing homes. In comparison to 2020, increased proportions of RNs and LPNs/LVNs reported providing direct patient care in their jobs.
Education
In the 2022 survey, the educational accomplishment of RNs increased with more than 70% of the workforce holding a baccalaureate degree or higher. The proportion of LPNs/LVNs holding an associate degree or higher remained steady at around 16%.
There is evidence that RNs and LPNs/LVNs are continuing their nursing education after obtaining their initial nursing license. Comparing the highest level of nursing education to the educational attainment when first licensed shows that proportionally more RNs hold a baccalaureate or graduate degree than did at initial licensure (51% vs. 47%). Additionally, proportionally more LPNs/LVNs hold an associate or baccalaureate as their highest level of nursing education than at initial licensure (16% vs. 8%).
Licensure
Overall, RNs and LPNs/LVNs are less experienced now than in previous years because of the COVID-19 pandemic. The proportion of RNs with 10 or fewer years licensed jumped from 31% in 2020 to 38% in 2022, while the proportion of LPNs/LVNs with 10 or fewer years practicing rose from 37% in 2020 to 42% in 2022. As in previous years, most RNs (96%) and LPNs/LVNs (99%) obtained their initial nursing license in the United States.
Salary
Increased demand from the COVID-19 pandemic and inflation led nursing incomes to rise significantly across the country, with the median RN annual earnings increasing from $70,000 in 2020 to $80,000 in 2022 and the median LPN/LVN annual earnings rising from $44,000 in 2020 to $50,000 in 2022.
COVID-19
Nurses were also specifically asked how the COVID-19 pandemic impacted them. More than 60% of all nurses reported an increase in their workload, while 16% of RNs and 11% of LPNs/LVNs reported changing their practice settings. More than half of all nurses reported feeling “emotionally drained from work” at least a few times each week, while more than a quarter of all nurses reported feeling “like they were at the end of their rope” at least a few times each week.
Methods
Sample
A mixed-mode sampling plan was employed to capture data for the 2022 National Nursing Workforce Survey. The e-Notify nurse licensure notification system helps nurses track their licenses and discipline statuses and provides license renewal reminders. The information is provided as it is entered into the Nursys database by participating nursing regulatory bodies. After a comprehensive review of data collected through the e-Notify system, it was determined that five participating jurisdictions (Missouri, North Carolina, New Mexico, Washington, and Wyoming) had entered data of sufficient volume and quality so that a separate survey of nurses was unnecessary. Data for four jurisdictions (Alabama, New Hampshire, New York, and Rhode Island) were obtained from an email survey of the state nurse membership. Data for the remaining jurisdictions were collected through a direct mail survey that offered nurses the opportunity to respond via filling out and mailing back a paper survey (using a prepaid business reply envelope) or going online and accessing an online version of the survey.
Mailing Address Lists
For the U.S. jurisdictions and territories involved in the mailout portion of the survey, all RNs and LPNs/LVNs with an active license were eligible survey participants. A portion of the sample was drawn from Nursys, NCSBN’s licensure database. This database contains basic demographic and licensure information for RN and LPN/LVN licensees. Licensee lists and addresses were obtained directly from the following boards of nursing (BONs): (a) California (LPN/LVN), (b) Colorado, (c) Hawaii, (d) Indiana, (e) Michigan, (f) Pennsylvania, (g) Utah, and (h) Wisconsin. Georgia’s licensee lists and addresses were purchased from MMS, Inc. The BONs for American Samoa, Guam, and the Virgin Islands chose not to participate in this survey.
As of December 31, 2021, the total number of active RN licenses in the United States was 5,239,499, and the total number of active LPN/LVN licenses was 973,788 (NCSBN, 2022). Separate RN and LPN/LVN samples stratified by state were randomly selected from among RN and LPN/LVN licensees. Surveys were mailed to 154,757 RNs and 154,490 LPNs/LVNs. Tables 1A and 2A present the sampling by jurisdiction/state for the mailout portion of the survey. Each jurisdiction is listed with the actual number of active licenses at the time of sampling. Approximately 1,000 nurses needed to respond from each jurisdiction to construct a 95% confidence of plus or minus 3% error. To calculate the number of surveys that needed to be mailed out to reach the target survey response, response rates to the online and paper surveys from the previous 2020 survey administration were used as estimates. For example, in 2020, Alaska had a 29.1% response rate for the RN survey. Given this estimated response rate, 3,340 RNs in Alaska were selected to be survey recipients in order to receive the target of 1,000 surveys. The actual response from Alaskan RNs to the current survey (i.e., the number of responses returned) was 742, a response rate of 22.1%.
For the four jurisdictions in the email portion of this survey, separate RN and LPN/LVN samples stratified by state were randomly selected from among RN and LPN/LVN licensees. Surveys were emailed to 26,697 RNs and 18,710 LPNs/LVNs. Tables 1B and 2B present the sampling by jurisdiction/state for the email portion of the survey. We again targeted receiving 1,000 responses from each jurisdiction and selected up to 8,000 nurses per jurisdiction for the mailing.
For the five jurisdictions in the e-Notify portion, the already-collected sample information was selected and unduplicated. Tables 1C and 2C show the number of nurses who contributed data to the e-Notify system.
The survey instrument is based on the Forum’s Minimum Nurse Supply Dataset (MDS), which was approved in 2009 after an intensive process of consensus-building and data compilation to collect data on the nursing workforce at the state level. The MDS was last updated by the Forum in 2016 to account for the transformations that had occurred in healthcare and nursing over the previous 7 years. Additionally, the 2022 survey instrument includes new questions about the impact of the COVID-19 pandemic and a question about travel nursing (Appendix A). The survey was a four-page Scantron fillable document with 39 questions. Data elements from the latest revision of the MDS were incorporated, resulting in the following changes to the survey between the 2020 and 2022 waves of data collection:
•
Response options for the race and gender questions were updated
•
A question about travel was added
•
Questions about the impact of the COVID-19 pandemic were added
•
The question about secondary specialty were removed.
Procedures
Mailing Address Lists
The Western Institutional Review Board granted approval for the current study. A unique identification number was generated and assigned to each sampled participant. The identification number was only used to record that the survey had been returned. This prevented unnecessary and expensive duplicate mailings to those selected to participate in the study. The unique access code identifier was also used for the online survey option. Once materials were developed and the sampling file was complete, surveys were distributed over a 20-week period starting the week of April 11, 2022, that included the following steps:
•
Week 1: A cover letter and paper survey were mailed via first-class U.S. mail to all nurses selected to participate. The letter included a URL and access code to take the survey online.
•
Week 10: For half of the nurses who had not responded, a cover letter reminder and paper survey were mailed via first-class U.S. mail. For the other half of the nonresponders, only the cover letter reminder was sent.
•
Week 20: For nurses who still had not responded, an additional cover letter and paper survey were mailed via first-class U.S. mail.
•
Week 25: Participants could submit their responses via mail or online until the survey closed on September 30, 2022. Once the survey was closed, the final data file was compiled separately for RNs and LPNs/LVNs.
At weeks 1, 10, and 20, a prepaid business reply envelope was included in the mailing. Survey response data are kept on department-secured servers. NCSBN’s research staff, three key members of the Forum, and key personnel at Scantron and its strategic partner, R. R. Donnelley, had initial access to the identifiable data. Scantron no longer has access to identifiable data.
Email Lists
Beginning in April, Qualtrics surveys were emailed to the nurses selected for the email portion of the study. Follow-up reminders were sent to nonresponders on a weekly basis. Participants could submit their responses online until September 2022.
e-Notify
Data for the e-Notify portion of the survey were collected from the system in October 2022.
Nonresponse
A formal nonresponse bias analysis was conducted after the survey closed and weighting was applied in the analysis process. The weights adjust the distribution across states, age, and gender but sum to the actual number of RNs and LPNs/LVNs in the subsets of completed responses.
To create the weights, an analysis of basic demographic data (i.e., gender, age, and race/ethnicity) for all RN and LPN/LVN licensees sampled from the Nursys database was used to compare survey respondents to survey nonrespondents. Results revealed that nurses who were White/Caucasian, female, and age 55 years or older may have been slightly overrepresented in both the RN and LPN/LVN samples. Because of missing or incomplete data on race/ethnicity, only gender and age were used to make nonresponse weighting adjustments. Additionally, since sampling was stratified by state, to prevent smaller states from being overrepresented in the overall analysis, a weighting variable was constructed to adjust for differing nursing population sizes across states. A description of this process can be found in Appendix B.
Analysis
Mailing Address Lists
At the close of the survey, 26,757 of 150,698 successfully delivered RN surveys were completed and returned, yielding a response rate of 17.8%. There were 22,634 of 149,169 successfully delivered LPN/LVN surveys returned, resulting in a 15.2% response rate.
Email Lists
A total of 26,697 RNs were randomly selected for participation in the email portion of the study. The overall response rate was 9.2% or 2,458 nurses.
A total of 18,710 LPNs/LVNs were randomly selected for participation in the email portion of the study. The overall response rate was 11.6% or 2,176 nurses.
e-Notify
The data for a total of 249,416 RNs and 30,693 LPNs/LVNs were collected in the e-Notify portion of the study.
For an accurate and comprehensive view of the statistics drawn from the sample, the number of actual valid answers to each question is reported for every table. Missing data were not imputed; hence, the presented statistics represent the actual responses from participants who responded to each respective survey item. If a participant did not respond to a certain item, they were not part of the analysis for that item. Additionally, some tables display data for all responding nurse licensees while other tables display data for employed nurses. If a table is specific to nurses employed in nursing, it is explicitly stated. Many tables include bar graphs to help readers easily visualize and comprehend the data presented.
Population Estimate
For each question on the survey, the listed frequencies reflect the nonresponse weighting adjustments. For some of the questions, an additional set of frequencies are shown that displays the data scaled up to reflect estimates of the nursing population in the subgroup identified. For example, the 487,526 males reported in the 2022 column of Table 3 reflect the number of male respondents adjusted to the population level of the number of RNs after the nonresponse weighting adjustments were made to the survey results and after adjusting the population number to account for nurses having licenses in multiple states.
Table 3Gender Distribution of Registered Nurses (RNs), 2015–2022
Gender
2015
2017
2020
2022
n
%
n
%
n
%
n
%
RN Survey Respondents
N = 43,330.9
N = 48,084.9
N = 41,698.8
N = 273,894.8
Male
3,459.6
8.0
4,369.3
9.1
3,915.2
9.4
30,555.8
11.2
Female
39,871.4
92.0
43,715.5
90.9
37,739.9
90.5
242,508.4
88.5
Nonbinary
-
-
-
-
43.6
0.1
830.6
0.3
U.S. RN Population
Male
277,542
8.0
354,453
9.1
391,141
9.4
487,526
11.2
Female
3,198,650
92.0
3,546,321
90.9
3,770,336
90.5
3,869,290
88.5
Nonbinary
-
-
-
-
4,356
0.1
13,252
0.3
Note. “Other” was added as a response option with the 2020 survey and was renamed “nonbinary” in 2022.
Respondents were asked to identify their gender. From 2015 through 2022, the percentage of male nurses grew from 8.0% to 11.2% while the percentage of female nurses decreased from 92.0% to 88.5%. The 2020 and 2022 surveys included a response option of “other” and “nonbinary,” respectively. In 2020 and 2022, this third response option represented 0.1% and 0.3% of responses, respectively. The percentage of respondents answering the question is converted to frequency data (as in all subsequent tables) of the entire U.S. RN population in the second half of Table 3.
Age
In 2015, the largest percentage of RNs were aged 55 to 59 years (13.6%). In 2017 and 2020, the largest percentage of RNs were aged 65 years or older (14.6% and 19.0%, respectively). In 2022, the largest percentage of RNs were tied between the age group of 30 to 34 years and 65 years or older (13.2%). While older nurses are remaining in the workforce, we are making headway on increasing younger nurses in the profession (Table 4 and Figure 1).
Table 4Age Distribution of Registered Nurses (RNs), 2015–2022
The distribution of female RNs was relatively flat across all age cohorts. Interestingly, the largest cohort of female nurses was the oldest age group (≥65 years). This was markedly different than the male and nonbinary genders where the age distribution skewed toward younger age groups (Table 5).
Table 5Age Distribution of Registered Nurses by Gender, 2022
From 2017 to 2022, those who identified as White/Caucasian decreased from 80.8% to 80%. Nurses who reported being Asian decreased from 7.5% to 7.4%. Nurses who responded as Black/African American increased from 6.2% to 6.3%. The multiracial category increased over the same time from 1.7% to 2.5% (Table 6).
Table 6Race of Registered Nurses (RNs), 2017–2022
Race
2017
2020
2022
n
%
n
%
n
%
RN Survey Respondents
N = 47,966.3
N = 41,702.0
N = 272,713.6
American Indian or Alaska Native
176.0
0.4
194.1
0.5
1,209.8
0.4
Asian
3,605.6
7.5
2,996.3
7.2
20,036.9
7.4
Black/African American
2,995.9
6.2
2,800.7
6.7
17,273.7
6.3
Native Hawaiian or Other Pacific Islander
226.3
0.5
175.9
0.4
1,136.9
0.4
Middle Eastern/North African
-
-
89.4
0.2
-
-
White/Caucasian
80.8
33,595.1
80.6
218,133.9
80.0
Other
2.9
967.7
2.3
8,133.1
3.0
More than one race category selected
828.5
1.7
882.8
2.1
6,789.3
2.5
U.S. RN Population
American Indian or Alaska Native
14,276
0.4
19,391
0.5
19,303
0.4
Asian
292,497
7.5
299,340
7.2
319,695
7.4
Black/ African American
243,032
6.2
279,799
6.7
275,607
6.3
Native Hawaiian or Other Pacific Islander
18,362
0.5
17,573
0.4
18,139
0.4
Middle Eastern/North African
-
-
8,931
0.2
-
-
White/Caucasian
3,144,812
80.8
3,356,257
80.6
3,480,388
80.0
Other
110,960
2.9
96,676
2.3
129,766
3.0
More than one race category selected
67,214
1.7
88,195
2.1
108,325
2.5
Note. Respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the “more than one race category selected” category.
Respondents were asked to identify whether they were of Hispanic/Latino origin. Between 2015 and 2022, the percentage of RNs identifying as Hispanic or Latino increased from 3.6% to 6.9%. The frequency numbers represented by these percentages increased from 136,707 in 2015 to 299,640 in 2022 (Table 7).
Table 7Hispanic or Latino Ethnicity of Registered Nurses (RNs), 2015–2022
Ethnicity
2015
2017
2020
2022
n
%
n
%
n
%
n
%
RN Survey Respondents
N = 45,989.3
N = 47,852.6
N = 41,483.3
N = 271,920.8
Hispanic or Latino origin
1,654.0
3.6
2,528.1
5.3
2,335.9
5.6
18,780.0
6.9
Not of Hispanic or Latino origin
44,335.3
96.4
45,324.5
94.7
39,147.4
94.4
253,140.8
93.1
U.S. RN Population
Hispanic or Latino origin
136,707
3.6
205,088
5.3
233,364
5.6
299,640
6.9
Not of Hispanic or Latino origin
3,556,764
96.4
3,676,844
94.7
3,910,949
94.4
4,038,933
93.1
Note. In the 2015 surveys, the Hispanic/Latino ethnicity and race categories were combined into one question. The categories were separated beginning with the 2017 survey.
Male RNs tend to be more racially diverse than their female colleagues. For instance, about 81% of female RNs identify as White/Caucasian, while 74% of their male colleagues identified as such. Also, male RNs identified as Asian (11.7%) almost twice as often as female RNs (6.8%) (Table 8).
Table 8Race of Registered Nurses by Gender, 2022
Race
Male (n = 30,223.1)
Female (n = 240,368.0)
Nonbinary (n = 821.3)
Total (N = 271,412.0)
n
%
n
%
n
%
n
%
American Indian or Alaska Native
118.0
0.4%
1,074.7
0.5%
13.0
1.6%
1,205.7
0.4%
Asian
3,534.8
11.7%
16,322.1
6.8%
64.1
7.8%
19,921.0
7.3%
Black/African American
1,704.8
5.6%
15,377.2
6.4%
38.5
4.7%
17,120.6
6.3%
Native Hawaiian or other Pacific Islander
172.2
0.6%
927.5
0.4%
14.9
1.8%
1,114.7
0.4%
White/Caucasian
22,396.1
74.1%
194,534.0
80.9%
455.7
55.5%
217,386.0
80.1%
Other
1,324.1
4.4%
6,413.4
2.7%
184.9
22.5%
7,922.4
2.9%
More than one race category selected
973.0
3.2%
5,718.6
2.4%
50.2
6.1%
6,741.8
2.5%
Note. Respondents were asked to select all that apply, and responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents who selected multiple race categories were reclassified into the “more than one race category selected” category.
While younger RNs tend to be more racially diverse than older nurses, the youngest two cohorts (age groups 18–29 years and 30–34 years) are less diverse than those in slightly older cohorts. RNs between the ages of 35 and 54 years are the most diverse of all age groups (Table 9).
Table 9Race Distribution of Registered Nurses by Age Group, 2022
Age, y
n
n (%)
American Indian or Alaska Native
Asian
Black/ African American
Native Hawaiian or other Pacific Islander
White/ Caucasian
Other
More than one race
18–29
28,826.5
71.6 (0.3)
1,977.4 (6.9)
947.9 (3.3)
149.8 (0.5)
23,551.0 (81.7)
1,083.6 (3.8)
1,045.3 (3.6)
30–34
34,200.6
71.0 (0.2)
3,008.1 (8.8)
1,731.2 (5.1)
176.3 (0.5)
27,125.9 (79.3)
915.2 (2.7)
1,173.0 (3.4)
35–39
29,832.4
215.5 (0.7)
2,952.7 (9.9)
1,756.1 (5.9)
180.5 (0.6)
22,842.8 (76.6)
1,028.3 (3.5)
856.6 (2.9)
40–44
27,513.5
115.2 (0.4)
2,369.0 (8.6)
1,856.0 (6.8)
57.9 (0.2)
21,330.7 (77.5)
1,150.3 (4.2)
634.5 (2.3)
45–49
27,728.2
203.1 (0.7)
2,237.1 (8.1)
2,448.1 (8.8)
181.1 (0.7)
21,311.8 (76.9)
685.2 (2.5)
662.0 (2.4)
50–54
30,356.1
185.0 (0.6)
3,203.3 (10.6)
2,117.7 (7.0)
132.4 (0.4)
23,267.9 (76.7)
912.4 (3.0)
537.4 (1.8)
55–59
23,513.9
109.2 (0.5)
1,115.1 (4.7)
1,745.0 (7.4)
40.6 (0.2)
19,462.0 (82.8)
657.8 (2.8)
384.2 (1.6)
60–64
23,116.1
85.6 (0.4)
872.0 (3.8)
1,381.0 (6.0)
57.7 (0.3)
19,663.4 (85.1)
564.7 (2.4)
491.8 (2.1)
≥65
34,214.0
136.5 (0.4)
1,183.0 (3.5)
1,951.2 (5.7)
16.0 (0.1)
29,863.7 (87.3)
563.4 (1.7)
500.3 (1.5)
Total
259,301.0
1,192.6 (0.5)
18,917.4 (7.3)
15,934.1 (6.1)
992.3 (0.4)
208,419.0 (80.4)
7,560.9 (2.9)
6,284.8 (2.4)
Note. Respondents were asked to select all that apply, and responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents who selected multiple race categories were reclassified into the “More than one race” category.
Type of Nursing Degree or Credentials for First U.S. Nursing License
From 2015 to 2022, LPN/LVN certificates ranged from 5.3% to 6%, RN diplomas decreased from 14.3% to 7.6%, associate degrees decreased from 38.5% to 35.6%, baccalaureate degrees increased from 39% to 47.2%, and master’s degrees increased from 2.8% to 4.3% (Table 10 and Figure 2).
Table 10Type of Nursing Degree or Credential of Registered Nurses (RNs) for First U.S. Nursing License, 2015–2022
Type of Nursing Degree or Credential for First U.S. Nursing License by Age
A baccalaureate degree was the most common degree for initial U.S. licensing for nurses younger than 40 years. A diploma, associate degree, and vocational/practical certificate were more common among older nurses, with 42% of RNs aged 65 years or older holding a diploma when first licensed in the United States (Table 11).
Table 11Type of Nursing Degree or Credential of Registered Nurses for First U.S. Nursing License by Age, 2022
From 2015 through 2022, diplomas in nursing decreased from 9.2% to 4.1%, associate degrees decreased from 30.1% to 24.3%, baccalaureate degrees increased from 43.4% to 51.1%, master’s degrees increased from 15.8% to 17.9%, doctoral degrees (PhD) remained static at 0.9%, doctor of nursing practice (DNP) degrees increased from 0.6% to 1.6%, and other nursing doctoral degrees increased slightly from 0.1% to 0.2% (Table 12 and Figure 3).
Table 12Highest Level of Nursing Education of Registered Nurses, 2015–2022
Nursing Education Level
2015 (N = 38,625.9)
2017 (N = 48,140.7)
2020 (N = 41,571.5)
2022 (N = 273,272.8)
n
%
n
%
n
%
n
%
Diploma
3,551.3
9.2
3,547.7
7.4
2,782.8
6.7
11,124.2
4.1
Associate degree
11,608.8
30.1
13,729.1
28.5
11,683.2
28.1
66,312.1
24.3
Baccalaureate degree
16,762.5
43.4
21,744.1
45.2
19,998.5
48.1
139,614.9
51.1
Master’s degree
6,085.1
15.8
8,238.3
17.1
6,200.5
14.9
49,011.8
17.9
Doctoral degree: PhD
340.2
0.9
284.1
0.6
281.2
0.7
2,345.7
0.9
Doctoral degree: DNP
239.1
0.6
551.2
1.1
569.1
1.4
4,272.7
1.6
Doctoral degree: other
39.0
0.1
46.1
0.1
56.1
0.1
591.3
0.2
Note. DNP = doctor of nursing practice. In the 2015 surveys, a single question “What is your highest level of education?” was asked with the set of possible responses including both nursing and non-nursing degrees. The degree types were separated beginning with the 2017 survey.
Proportionally, more males were awarded doctoral degrees (PhD = 14.0% and DNP = 13.2%) relative to any other degree (Table 13).
Table 13Gender of Registered Nurses by Highest Level of Nursing Education, 2022
Weighted Sample Values
Male
Female
Nonbinary
Nursing Education Level
n
%
n
%
n
%
N
Diploma
780.7
7.1%
10,174.0
92.8%
12.3
0.1%
10,966.9
Associate degree
7,704.0
11.7%
58,073.5
88.0%
181.6
0.3%
65,959.1
Baccalaureate degree
15,639.0
11.3%
122,797.0
88.5%
398.8
0.3%
138,835.0
Master’s degree
5,247.9
10.8%
43,155.7
88.8%
224.2
0.5%
48,627.8
Doctoral degree: PhD
321.7
14.0%
1,974.5
85.8%
4.9
0.2%
2,301.2
Doctoral degree: DNP
565.3
13.2%
3,703.5
86.8%
0.0
0.0%
4,268.8
Doctoral degree: other
61.5
11.3%
485.5
88.8%
0.0
0.0%
547.0
Total
30,320.1
11.2%
240,363.0
88.5%
821.9
0.3%
271,505.0
Note. DNP = doctor of nursing practice. In the 2015 surveys, a single question “What is your highest level of education?” was asked with the set of possible responses including both nursing and non-nursing degrees. The degree types were separated beginning with the 2017 survey.
The baccalaureate nursing degree was the most common highest level of education across all racial groups. For RNs identifying as Asian, about 71% reported holding a baccalaureate degree, which is the highest proportion across all racial categories. A little less than half of White/Caucasian, Black/African American, and American Indian or Alaska Native respondents held a baccalaureate degree (Table 14).
Table 14Highest Level of Nursing Education of Registered Nurses by Race and Ethnicity, 2022
Race
Nursing Education Level, n (%)
n
Diploma
Associate
Baccalaureate
Master’s
Doctoral (PhD)
Doctoral (DNP)
Doctoral (other)
American Indian or Alaska Native
61.2 (5.1)
346.6 (28.7)
586.3 (48.5)
165.7 (13.7)
14.9 (1.2)
33.3 (2.8)
0.0 (0.0)
1,208.0
Asian
549.2 (2.8)
1,919.5 (9.6)
14,175.0 (71.1)
3,119.0 (15.6)
35.0 (0.2)
145.8 (0.7)
6.4 (0.0)
19,949.9
Black/African American
452.6 (2.7)
3,718.6 (21.8)
8,405.9 (49.3)
3,868.0 (22.7)
220.7 (1.3)
339.6 (2.0)
45.6 (0.3)
17,051.0
Native Hawaiian or Other Pacific Islander
69.0 (6.1)
113.5 (10.0)
662.4 (58.4)
278.7 (24.6)
4.8 (0.4)
6.3 (0.6)
0.1 (0.0)
1,134.7
White/Caucasian
9,535.9 (4.4)
56,320.0 (26.0)
106,344.0 (49.1)
38,608.1 (17.8)
1,910.2 (0.9)
3,343.2 (1.5)
473.9 (0.2)
216,535.0
Other
171.1 (2.2)
1,705.9 (21.4)
4,347.7 (54.6)
1,487.5 (18.7)
60.5 (0.8)
181.6 (2.3)
10.3 (0.1)
7,964.6
More than one race category selected
138.9 (2.1)
1,438.0 (21.6)
3,767.2 (56.7)
1,051.5 (15.8)
68.4 (1.0)
171.6 (2.6)
10.9 (0.2)
6,646.6
Total
10,977.7 (4.1)
65,562.1 (24.2)
138,288.0 (51.1)
48,578.7 (18.0)
2,314.5 (0.9)
4,221.4 (1.6)
547.3 (0.2)
270,490.0
Hispanic/Latino
279.3 (1.5)
4,570.7 (24.6)
9,776.5 (52.5)
3,411.9 (18.3)
90.3 (0.5)
445.6 (2.4)
39.5 (0.2)
18,613.7
Note. DNP = doctor of nursing practice. In the 2015 surveys, a single question “What is your highest level of education?” was asked with the set of possible responses including both nursing and non-nursing degrees. The degree types were separated beginning with the 2017 survey. For the race question, respondents were asked to select all that apply, and responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the “more than one race category selected” category.
Younger nurses (aged 18–39 years) tended to hold a baccalaureate degree as their highest level of nursing education while older nurses tended to have a nursing diploma or associate degree as their highest level of nursing education. RNs older than 35 years were somewhat more likely to hold an advanced nursing degree (i.e., master’s, PhD, or DNP) than their younger colleagues (Table 15).
Table 15Age of Registered Nurses by Highest Level of Nursing Education, 2022
Weighted Sample Values
Age, y, n (%)
n
Nursing Education Level
18–29
30–34
35–39
40–44
45–49
50–54
55–59
60–64
≥65
Diploma
377.2 (3.6)
349.2 (3.3)
301.6 (2.8)
331.1 (3.1)
369.6 (3.5)
1,023.2 (9.6)
1,160.0 (10.9)
1,736.1 (16.3)
4,990.6 (46.9)
10,638.5
Associate degree
4,184.5 (6.6)
6,457.3 (10.2)
5,649.1 (8.9)
6,953.4 (11.0)
7,273.2 (11.5)
8,172.8 (12.9)
7,140.5 (11.3)
7,435.2 (11.8)
9,928.6 (15.7)
63,194.6
Baccalaureate degree
22,559.8 (17.0)
21,493.3 (16.2)
16,956.4 (12.8)
13,505 (10.2)
13,520.9 (10.2)
14,217.4 (10.7)
9886 (7.5)
8930.1 (6.7)
11,570.3 (8.7)
132,639.0
Master’s degree
1,621.2 (3.5)
5,229.0 (11.3)
6,279.2 (13.6)
6,117.1 (13.2)
5,858.2 (12.7)
6,049.4 (13.1)
4,526.8 (9.8)
4,250.9 (9.2)
6,356.4 (13.7)
46,288.1
Doctoral degree: PhD
19.2 (0.9)
112.4 (5.0)
233.6 (10.3)
7,273.2 (8.5)
271.7 (12.0)
210.6 (9.3)
378.1 (16.7)
323.4 (14.3)
519.9 (23.0)
2,261.8
Doctoral degree: DNP
176.5 (4.3)
558.3 (13.5)
561.3 (13.6)
540.9 (13.1)
432.7 (10.5)
593.3 (14.3)
465.7 (11.3)
361.6 (8.7)
449.5 (10.9)
4,139.7
Doctoral degree: other
0.0 (0.0)
27.7 (5.5)
78.4 (15.5)
29.5 (5.8)
48.8 (9.7)
46.1 (9.1)
17.4 (3.5)
66.3 (13.1)
191.6 (37.9)
505.8
Total
28,938.3 (11.1)
34,227.3 (13.2)
30,059.5 (11.6)
27,669.8 (10.7)
27,775.1 (10.7)
30,312.7 (11.7)
23,574.6 (9.1)
23,103.6 (8.9)
34,006.7 (13.1)
259,668.0
Note. DNP = doctor of nursing practice. In the 2015 surveys, a single question “What is your highest level of education?” was asked with the set of possible responses including both nursing and non-nursing degrees. The degree types were separated beginning with the 2017 survey.
From 2017 through 2022, non-nursing associate degrees decreased from 35.3% to 33.9%, baccalaureate degrees increased from 45.8% to 50.2%, master’s degrees decreased from 15.8% to 13.9%, and doctoral degrees decreased from 3.1% to 2.1% (Table 16 and Figure 4).
Table 16Highest Level of Non-nursing Education of Registered Nurses, 2017–2022
Nursing Education Level
2017 (N = 19,904.5)
2020 (N = 17,698.1)
2022 (N = 113,020.7)
n
%
n
%
n
%
Associate degree
7,025.9
35.3
6,578.1
37.2
38,275
33.9
Baccalaureate degree
9,115.4
45.8
8,141.5
46.0
56,706
50.2
Master’s degree
3,150.8
15.8
2,547.4
14.4
15,660
13.9
Doctoral degree
612.4
3.1
431.1
2.4
2,380
2.1
Note. In the 2015 surveys, a single question “What is your highest level of education?” was asked with the set of possible responses including both nursing and non-nursing degrees. The degree types were separated beginning with the 2017 survey.
Like previous years, less than 1% of responding RNs held an LPN/LVN license, while 9.8% held an advanced practice registered nurse (APRN) credential. The percentage of RNs holding an APRN credential has recovered from 6.6% in 2020 but is still lower than the 10% in 2017 (Table 17 and Figure 5).
Table 17Type of License Currently Held by Registered Nurses (RNs), 2015–2022
License
2015
2017
2020
2022
n
%
n
%
n
%
n
%
RN Survey Response
N = 46,047.8
N = 48,128.0
N = 41,601.8
N = 252,623.7
RN
43,730.2
95.0
45,971.3
95.5
40,378.3
97.1
239,838.6
94.9
LPN/LVN
330.8
0.7
386.2
0.8
323.6
0.8
2,109.2
0.8
APRN
3,974.7
8.6
4,788.6
10.0
2,763.2
6.6
24,633.4
9.8
U.S. RN Population
RN
3,508,219
95.0
3,729,318
95.5
4,033,920
97.1
3,826,692
94.9
LPN/LVN
26,534
0.7
31,328
0.8
32,329
0.8
33,653
0.8
APRN
318,870
8.6
388,461
10.0
276,052
6.6
393,032
9.8
Note. RN = registered nurse; LPN/LVN = licensed practical nurse/licensed vocational nurse; APRN = advanced practice registered nurse. Respondents were asked to select all that apply.
RN respondents were licensed for a median of 15 years, as compared to 20 years in the 2020 survey. More than one-third (37.9%) were licensed for 10years or less, the highest since 2015. An additional 24.6% were licensed between 11 and 20years, resulting in more than 62% of RNs reporting fewer than 20years of being licensed. The percent licensed for more than 20years was at the lowest level in 2022 (37.6%) since 2015 (47%)—nearly 10 percentage points less (Table 18 and Figure 6).
Table 18Number of Years the Registered Nurse Has Been Licensed, 2015–2022
Most RNs (94.8%) reported obtaining their entry-level nursing education in the United States in 2022, a slight increase from the 93.9% who reported the same in 2020. Another 2.8% obtained their entry-level nursing education in the Philippines, 0.5% in Canada, and 0.4% in India (Table 19).
Table 19Country of Entry-Level Nursing Education of Registered Nurses (RNs), 2020–2022
Respondents were asked whether they were credentialed as an APRN in their state, enabling them to practice in any of the four APRN roles: nurse practitioner (NP), clinical nurse specialist (CNS), certified registered nurse anesthetist (CRNA), or certified nurse midwife (CNM). Most respondents (88.4%) indicated they were not credentialed to practice as an APRN. This represents a lower proportion of RNs not credentialed as an APRN compared to 91.6% in 2020. In 2022, 8.6% of respondents reported being credentialed as a NP, compared to 5.5% in 2020 (Table 20 and Figure 7).
Table 20Registered Nurse (RN) Credentials to Practice as an APRN, 2015–2022
From 2020 through 2022, multistate licensure among RNs increased by 6.3% from 24.0% to 30.3% (Table 21).
Table 21Registered Nurses Holding a Multistate License, 2020–2022
Multistate License
2020 (N = 34,825.9)
2022 (N = 214,686.7)
n
%
n
%
Yes
8,367.4
24.0
65,087.7
30.3
No
26,458.5
76.0
149,599.1
69.7
Note. Respondents were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
In 2022, 32.2% of RNs with multistate licenses had used them. In addition to telehealth, distance education, and disaster support, they were used for travel nursing and multistate practice Table 22).
Table 22How a Multistate License is Used by Registered Nurses, 2022
Use of Multistate License
2022 (N = 66,014.3)
n
%
Telehealth
5,850.0
8.9
Distance education
1,686.0
2.6
Disaster support
1,800.6
2.7
Have not used
44,777.2
67.8
Other
13,472.2
20.4
Note. Respondents were asked to select all that apply. Respondents were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
The majority of responding RNs (88.9%) were actively employed in nursing, with 70.2% employed full time. Compared with 2020 survey results, this represents a 4.8% increase in the proportion of RNs actively employed and a 5.3% increase in those working full time. The proportion of RNs who are actively employed in nursing is at the highest level since 2015 (Table 23 and Figure 8).
Table 23Employment Status of Registered Nurses (RNs), 2015–2022
Employment Status
2015
2017
2020
2022
n
%
n
%
n
%
n
%
RN Survey Respondents
N = 46,210.2
N = 48,146.9
N = 41,783.4
N = 277,034.9
Actively employed in nursing full time
29,088.5
62.9
31,476.6
65.4
27,101.0
64.9
194,565.3
70.2
Actively employed in nursing part time
6,088.0
13.2
5,820.9
12.1
4,901.7
11.7
30,268.8
10.9
Actively employed in nursing per diem
3,675.2
8.0
3,424.9
7.1
3,133.6
7.5
21,526.3
7.8
Actively employed in a field other than nursing full time
1,576.1
3.4
1,108.9
2.3
882.4
2.1
5,098.3
1.8
Actively employed in a field other than nursing part time
850.8
1.8
605.7
1.3
438.5
1.1
2,727.8
1.0
Actively employed in a field other than nursing per diem
377.7
0.8
267.5
0.6
188.5
0.5
1,521.2
0.6
Working in nursing only as a volunteer
564.5
1.2
645.6
1.3
517.1
1.2
2,553.8
0.9
Unemployed, seeking work as a nurse
1,070.7
2.3
1,030.2
2.1
809.1
1.9
5,443.9
2.0
Unemployed, not seeking work as a nurse
1,611.6
3.5
1,616.2
3.4
1,362.4
3.3
7,223.8
2.6
Retired
4,993.7
10.8
4,916.9
10.2
4,824.7
11.6
23,038.1
8.3
U.S. RN Population
Actively employed in nursing full time
2,333,606
62.9
2,553,467
65.4
2,707,476
64.9
3,104,344
70.2
Actively employed in nursing part time
488,405
13.2
472,204
12.1
489,695
11.7
482,946
10.9
Actively employed in nursing per diem
294,837
8.0
277,834
7.1
313,057
7.5
343,458
7.8
Actively employed in a field other than nursing full time
126,445
3.4
89,956
2.3
88,155
2.1
81,345
1.8
Actively employed in a field other than nursing part time
68,255
1.8
49,139
1.3
43,808
1.1
43,522
1.0
Actively employed in a field other than nursing per diem
30,298
0.8
21,702
0.6
18,832
0.5
24,271
0.6
Working in nursing only as a volunteer
45,288
1.2
52,374
1.3
51,660
1.2
40,746
0.9
Unemployed, seeking work as a nurse
85,896
2.3
83,573
2.1
80,832
1.9
86,859
2.0
Unemployed, not seeking work as a nurse
129,287
3.5
131,114
3.4
136,108
3.3
115,258
2.6
Retired
400,613
10.8
398,871
10.2
482,003
11.6
367,580
8.3
Note. Respondents were asked to select all that apply.
Taking care of home and family was the most frequently reported reason for being unemployed (reported by 46.8% of respondents). About 22% attributed their unemployment to the COVID-19 pandemic. Almost 12% of RNs stated they were unemployed because of “inadequate salary.” This represents a marked increase in the reporting of an inadequate salary, as the proportion of RNs reporting an inadequate salary in 2020 was 2.5%. The percentage of RNs who indicated unemployment because they had trouble in finding a nursing position was 10.7%, which was down from 14.6% in 2020. The percentage of RNs who listed “disabled” as the reason for unemployment was 7.2%, and 9.5% listed “school” as the reason for unemployment (Table 24 and Figure 9).
Table 24Reasons for Unemployment of Registered Nurses, 2015–2022
Reasons for Unemployment
2015 (N = 2,272.4)
2017 (N = 2,567.2)
2020 (N = 2,122.1)
2022 (N = 12,397.1)
n
%
n
%
n
%
n
%
Taking care of home and family
1137.3
50.0
1226.8
47.8
1,039.5
49.0
5,805.8
46.8
Disabled
298.5
13.1
347.6
13.5
226.4
10.7
893.9
7.2
Inadequate salary
48.2
2.1
73.7
2.9
53.7
2.5
1,477.7
11.9
School
143.1
6.3
186.0
7.2
172.2
8.1
1,171.1
9.5
Difficulty in finding a nursing position
352.0
15.5
395.0
15.4
310.3
14.6
1,327.6
10.7
COVID-19 pandemic
-
-
-
-
-
-
2,433.5
22.6
Other
557.4
24.5
758.9
29.6
680.2
32.1
4,486.6
36.2
Note. Survey participants were asked to answer this question only if they were unemployed. Respondents were asked to select all that apply.
More than a quarter (28.7%) of RNs reported they plan to retire within the next 5 years. This finding represents a 6.6% increase over the proportion who thought they would retire within 5years (22.1%) in the 2020 survey (Table 25).
Table 25Registered Nurse (RN) Plans to Retire or Leave Nursing, 2020–2022
Plan to Retire Within 5Years
2020
2022
n
%
n
%
RN Survey Respondents
N = 34,360.2
N = 216,831.7
Yes
7,584.5
22.1
62,234.8
28.7
No
26,775.8
77.9
154,597.0
71.3
U.S. RN Population
Yes
757,716
22.1
992,974
28.7
No
2,674,987
77.9
2,466,639
71.3
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
Respondents were asked to identify the number of positions in which they were currently employed as a nurse. Most respondents (82.4%) reported holding just one position as a nurse, which represents a 0.5% increase when compared to 2020. The percentage of RNs who reported working in two positions increased from 13.7% in 2020 to 15.0% in 2022. The percentage of respondents who indicated that they held three or more positions in nursing also slightly increased from 2.4% in 2020 to 2.6% in 2022 (Table 26).
Table 26Number of Positions Currently Held by Registered Nurses (RNs), 2015–2022
Number of Positions Held
2015
2017
2020
2022
n
%
n
%
n
%
n
%
RN Survey Respondents
N = 37,114.2
N = 39,414.3
N = 33,992.6
N = 235,732.0
1
31,499.3
84.9
32,827.2
83.3
28,516.3
83.9
194,280.1
82.4
2
4,744.0
12.8
5,496.7
13.9
4,664.1
13.7
35,280.2
15.0
≥3
870.8
2.4
1,090.5
2.8
812.2
2.4
6,171.7
2.6
U.S. RN Population
1
2,527,010
84.9
2,663,030
83.3
2,848,869
83.9
3,099,794
82.4
2
380,585
12.8
445,905
13.9
465,958
13.7
562,905
15.0
≥3
69,861
2.4
88,463
2.8
81,141
2.4
98,471
2.6
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
Number of Hours Worked During a Typical Week in All Nursing Positions
More than half (54.6%) of responding RNs reported working 32 to 40hours in a typical week in all positions. This is a decrease from the results from the 2020 (58.7%) and the 2017 survey findings (58.6%). The second most frequently reported category was 41 to 50hours (19%), which is higher than that reported for 2020 (14.5%) and 2017 (15.8%) (Table 27 and Figure 10).
Table 27Number of Hours Registered Nurses (RNs) Worked During a Typical Week in All Nursing Positions, 2015–2022
Hours Worked per Week
2015
2017
2020
2022
n
%
n
%
n
%
n
%
RN Survey Respondents
N = 36,327.6
N = 39,293.3
N = 33,847.5
N = 235,197.9
1–15
1,697.7
4.7
1,903.7
4.8
1,624.0
4.8
8,482.5
3.6
16–23
1,655.7
4.6
1,728.1
4.4
1,402.3
4.1
7,897.3
3.4
24–31
3,536.9
9.8
3,765.0
9.6
3,251.0
9.6
20,715.0
8.8
32–40
21,174.3
58.4
23,012.6
58.6
19,850.6
58.7
128,375.1
54.6
41–50
5,957.3
16.4
6,198.0
15.8
4,915.1
14.5
44,684.8
19.0
51–60
1,636.9
4.5
1,851.3
4.7
1,479.9
4.4
14,197.5
6.0
≥61
578.8
1.6
834.7
2.1
1,324.5
3.9
10,845.7
4.6
U.S. RN Population
1–15
136,200
4.7
154,434
4.8
162,243
4.8
135,340
3.6
16–23
132,826
4.6
140,190
4.4
140,094
4.1
126,004
3.4
24–31
283,745
9.8
305,426
9.6
324,785
9.6
330,513
8.8
32–40
1,698,692
58.4
1,866,841
58.6
1,983,138
58.7
2,048,261
54.6
41–50
477,918
16.4
502,796
15.8
491,034
14.5
712,959
19.0
51–60
131,318
4.5
150,180
4.7
147,847
4.4
226,525
6.0
≥61
46,432
1.6
67,712
2.1
132,322
3.9
173,046
4.6
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
About 57% of RNs indicated that a hospital was their primary nursing practice. This represents an increase of 2.7 percentage points from 2020. Ambulatory care setting was the second most frequently selected setting by 10.4% of RNs, followed by nursing home/extended care at 3.9% and home health setting selected by 3.4%. School health service as a selection dropped from 3.1% in 2020 to 2.3% in 2022. Nurses selecting public health also increased to 1.7% in 2022, up from 1.2 in 2020. Insurance claims/benefits respondents dropped to 2.0% in 2022, down from 2.5% in 2020 (Table 28 and Figure 11).
Table 28Primary Nursing Practice Position Setting of Registered Nurses (RNs), 2015–2022
Practice Setting
2015
2017
2020
2022
n
%
n
%
n
%
n
%
RN Survey Respondents
N = 37,372.1
N = 38,870.1
N = 33,640.6
N = 232,872.0
Hospital
20,311.9
54.4
21,646.5
55.7
18,441.8
54.8
133,911.7
57.5
Nursing home/extended care
1,807.2
4.8
1,859.7
4.8
1,486.7
4.4
9,024.8
3.9
Assisted living facility
233.3
0.6
211.2
0.5
177.5
0.5
1,187.3
0.5
Home health
2,288.0
6.1
1,685.9
4.3
1,501.7
4.5
7,818.4
3.4
Hospice
-
-
757.8
2.0
674.3
2.0
4,175.6
1.8
Correctional facility
259.6
0.7
294.8
0.8
277.7
0.8
1,525.4
0.7
School of nursing
1,357.0
3.6
1,028.9
2.7
954.1
2.8
4,908.9
2.1
Public health
595.4
1.6
539.3
1.4
407.5
1.2
3,832.2
1.7
Dialysis center
-
-
493.6
1.3
386.8
1.2
2,643.9
1.1
Community health
786.9
2.1
780.8
2.0
565.3
1.7
4,655.2
2.0
School health service
1,092.8
2.9
1,025.3
2.6
1,057.8
3.1
5,441.8
2.3
Occupational health
250.3
0.7
292.6
0.8
230.7
0.7
1,642.9
0.7
Ambulatory care setting
4,201.1
11.2
3,649.2
9.4
3,271.6
9.7
24,267.2
10.4
Insurance claims/benefits
673.7
1.8
694.1
1.8
841.1
2.5
4,642.6
2.0
Policy/planning/regulatory/licensing agency
148.7
0.4
86.9
0.2
88.1
0.3
746.5
0.3
Other
3,366.3
9.0
3,823.6
9.8
3,278.0
9.7
22,447.4
9.6
U.S. RN Population
Hospital
1,629,506
54.4
1,756,021
55.7
1,842,394
54.8
2,136,599
57.5
Nursing home/extended care
144,982
4.8
150,865
4.8
148,526
4.4
143,994
3.9
Assisted living facility
18,718
0.6
17,132
0.5
17,733
0.5
18,943
0.5
Home health
183,553
6.1
136,765
4.3
150,025
4.5
124,744
3.4
Hospice
-
-
61,471
2.0
67,365
2.0
66,623
1.8
Correctional facility
20,828
0.7
23,918
0.8
27,743
0.8
24,338
0.7
School of nursing
108,863
3.6
83,466
2.7
95,318
2.8
78,324
2.1
Public health
47,763
1.6
43,748
1.4
40,711
1.2
61,143
1.7
Dialysis center
-
-
40,040
1.3
38,643
1.2
42,185
1.1
Community health
63,128
2.1
63,337
2.0
56,475
1.7
74,275
2.0
School health service
87,666
2.9
83,178
2.6
105,678
3.1
86,826
2.3
Occupational health
20,080
0.7
23,736
0.8
23,048
0.7
26,213
0.7
Ambulatory care setting
337,028
11.2
296,030
9.4
326,843
9.7
387,190
10.4
Insurance claims/benefits
54,046
1.8
56,306
1.8
84,029
2.5
74,075
2.0
Policy/planning/regulatory/licensing agency
11,930
0.4
7,050
0.2
8,801
0.3
11,910
0.3
Other
270,057
9.0
310,178
9.8
327,483
9.7
358,155
9.6
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
More than half (56%) of RNs reported their nursing position title as a staff nurse in 2022. This is down slightly from 2020, when 60% identified as a staff nurse. The title of case manager accounted for 10.9% of nursing titles, which is an increase from 7.4% in the 2020 survey. Additionally, the proportion of APRNs grew in 2022 to 9.7% from 6.3% in 2020 (Table 29 and Figure 12).
Table 29Primary Nursing Position Title of Registered Nurses (RNs), 2015–2022
Primary Title
2015
2017
2020
2022
n
%
n
%
n
%
n
%
RN Survey Respondents
N = 37,711.1
N = 39,063.1
N = 33,713.7
N = 233,841.4
Consultant
672.4
1.8
577.4
1.5
531.7
1.6
2,782.6
1.2
Nurse researcher
247.2
0.7
235.9
0.6
155.6
0.5
1,140.6
0.5
Nurse executive
881.4
2.3
725.3
1.9
647.7
1.9
4,326.3
1.9
Nurse manager
3,045.8
8.1
3,126.2
8.0
2,673.3
7.9
17,149.0
7.3
Nurse faculty/educator
1,422.2
3.8
1,558.2
4.0
1,392.5
4.1
7,673.0
3.3
APRN
3,069.1
8.1
3,946.1
10.1
2,130.2
6.3
22,782.1
9.7
Staff nurse
21,920.7
58.1
22,673.0
58.0
20,265.9
60.1
132,070.7
56.5
Case manager
2,524.8
6.7
2,519.2
6.4
2,485.3
7.4
25,478.9
10.9
Other – health related
3,685.1
9.8
3,561.9
9.1
3,277.4
9.7
17,964.2
7.7
Other – not health related
242.5
0.6
139.7
0.4
154.2
0.5
2,474.0
1.1
U.S. RN Population
Consultant
53,944
1.8
46,844
1.5
53,119
1.6
44,397
1.2
Nurse researcher
19,830
0.7
19,139
0.6
15,545
0.5
18,199
0.5
Nurse executive
70,706
2.3
58,836
1.9
64,707
1.9
69,027
1.9
Nurse manager
244,343
8.1
253,609
8.0
267,071
7.9
273,617
7.3
Nurse faculty/educator
114,099
3.8
126,408
4.0
139,115
4.1
122,425
3.3
APRN
246,214
8.1
320,121
10.1
212,814
6.3
363,495
9.7
Staff nurse
1,758,573
58.1
1,839,294
58.0
2,024,628
60.1
2,107,225
56.5
Case manager
202,546
6.7
204,368
6.4
248,289
7.4
406,523
10.9
Other – health related
295,637
9.8
288,950
9.1
327,423
9.7
286,625
7.7
Other – not health related
19,453
0.6
11,332
0.4
15,405
0.5
39,473
1.1
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
In the 2022 survey, a new question was added: “Are you currently a travel nurse?” About 6% of RNs reported currently being a travel nurse (Table 30).
Table 30Registered Nurses in Travel Nursing, 2022
Travel Nurse
2022
n
%
RN Survey Respondents
N = 215,429.5
Yes
13,296.0
6.2
No
202,133.5
93.8
U.S. RN Population
Yes
212,142
6.2
No
3,225,097
93.8
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
In 2022, 16.5% of RNs reported that their primary practice specialty was acute care/critical care. This increased from the 13.4% reported in 2020. The second most reported specialty position in 2022 was medical-surgical at 10.0% (compared to 8.5% reported in 2020). Emergency/trauma was the third most often reported practice specialty (8.1%), an increase from 5.6% reported in 2020. The proportion of RNs reporting other nonclinical specialties grew to 5.6% of respondents in 2022 from the 3.2% reported in 2020 (Table 31 and Figure 13).
Table 31Primary Nursing Position Specialty of Registered Nurses, 2015–2022
Primary Specialty
2015 (N = 36,424.1)
2017 (N = 37,484.3)
2020 (N = 32,364.8)
2022 (N = 199,133.7)
n
%
n
%
n
%
n
%
Acute care/critical care
4,159.1
11.4
5,239.2
14.0
4,338.5
13.4
32,897.2
16.5
Adult health
756.1
2.1
1,447.1
3.9
1,172.9
3.6
5,069.8
2.6
Anesthesia
549.9
1.5
705.5
1.9
379.4
1.2
3,516.5
1.8
Cardiology
-
-
1,291.0
3.4
1,086.0
3.4
7,394.4
3.7
Community
356.7
1.0
386.6
1.0
300.9
0.9
1,920.1
1.0
Emergency/trauma
2,026.7
5.6
2,027.3
5.4
1,818.4
5.6
16,108.5
8.1
Family health
-
-
1,243.4
3.3
801.2
2.5
5,251.3
2.6
Genetics
40.6
0.1
-
-
-
-
328.6
0.2
Geriatric/gerontology
1,754.7
4.8
1,918.5
5.1
1,614.2
5.0
8,796.8
4.4
Home health
1,604.0
4.4
1,360.1
3.6
1,226.1
3.8
5,890.7
3.0
Informatics
318.2
0.9
-
-
-
-
1,071.7
0.5
Information technology
-
-
-
-
-
-
255.7
0.1
Maternal-child health/obstetrics
1,633.9
4.5
1,778.1
4.7
1,422.3
4.4
8,892.7
4.5
Medical-surgical
3,695.7
10.1
3,203.1
8.6
2,757.8
8.5
19,876.0
10.0
Neonatal
808.4
2.2
809.5
2.2
725.4
2.2
4,750.5
2.4
Nephrology
476.4
1.3
555.7
1.5
500.7
1.6
3,237.7
1.6
Neurology/neurosurgical
337.1
0.9
-
-
-
-
1,924.3
1.0
Occupational health
280.7
0.8
339.8
0.9
314.4
1.0
1,892.8
1.0
Oncology
1,044.0
2.9
1,046.9
2.8
955.9
3.0
6,514.0
3.3
Orthopedic
436.1
1.2
-
-
-
-
2,373.4
1.2
Palliative care/hospice
529.1
1.5
643.3
1.7
522.2
1.6
4,099.7
2.1
Pediatrics
1,570.3
4.3
1,774.1
4.7
1,345.9
4.2
9,652.4
4.9
Perioperative
2,195.7
6.0
2,187.7
5.8
2,173.2
6.7
12,690.4
6.4
Primary care
1,092.5
3.0
-
-
-
-
4,661.5
2.3
Public health
466.0
1.3
472.3
1.3
428.9
1.3
3,440.5
1.7
Psychiatric/mental health/substance abuse
1,418.4
3.9
1,534.1
4.1
1,206.8
3.7
5,036.1
2.5
Radiology
191.2
0.5
-
-
-
-
376.8
0.2
Rehabilitation
717.3
2.0
725.4
1.9
541.4
1.7
1,847.2
0.9
School health
1,025.1
2.8
945.5
2.5
980.0
3.0
2,469.0
1.2
Urology
87.5
0.2
-
-
-
-
65.7
0.0
Women’s health
651.7
1.8
567.1
1.5
490.5
1.5
2,111.8
1.1
Other - clinical specialties
-
-
4,507.7
12.0
4,229.5
13.1
3,566.0
1.8
Other - nonclinical specialties
-
-
775.1
2.1
1,032.1
3.2
11,154.0
5.6
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
Providing Direct Patient Care—Primary Nursing Position
In 2022, 72.5% of RN respondents reported providing direct patient care in their primary nursing position. In 2020, the first year this question was asked, 68.6% of nurses said they provided direct patient care in their primary nursing position (Table 32).
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
Of the 17.6% of RNs who reported having more than one nursing position (Table 26), 34.7% reported practicing in a hospital setting, 9.2% in a nursing home/extended care, and 8.8% in an ambulatory care setting. Of the more common practice settings, the proportion of RNs practicing in a nursing home/extended care setting grew 2% and those practicing in nursing schools dropped by 1.6%, from 8.7% in 2020 to 7.1% in 2022 (Table 33 and Figure 14).
Table 33Secondary Nursing Practice Position Setting of Registered Nurses, 2015–2022
Secondary Practice Setting
2015 (N = 4,877.3)
2017 (N = 6,153.3)
2020 (N = 5,121.6)
2022 (N = 39,004.5)
n
%
n
%
n
%
n
%
Hospital
1,632.6
33.5
2,213.4
36.0
1,879.1
36.7
13,548.1
34.7
Nursing home/extended care
277.2
5.7
456.7
7.4
363.8
7.1
3,575.2
9.2
Assisted living facility
58.9
1.2
58.4
1.0
58.3
1.1
815.6
2.1
Home health
577.5
11.8
555.7
9.0
430.1
8.4
2,977.1
7.6
Hospice
-
-
185.9
3.0
139.3
2.7
1,122.3
2.9
Correctional facility
72.2
1.5
68.3
1.1
46.2
0.9
403.5
1.0
School of nursing
519.7
10.7
493.6
8.0
446.2
8.7
2,776.4
7.1
Public health
38.1
0.8
89.2
1.5
68.9
1.3
935.7
2.4
Dialysis center
-
-
87.7
1.4
54.7
1.1
521.7
1.3
Community health
191.1
3.9
209.6
3.4
121.6
2.4
1,002.7
2.6
School health service
171.7
3.5
173.0
2.8
113.2
2.2
1,006.0
2.6
Occupational health
39.0
0.8
57.1
0.9
36.3
0.7
564.0
1.5
Ambulatory care setting
451.2
9.3
556.7
9.1
492.6
9.6
3,438.9
8.8
Insurance claims/benefits
39.4
0.8
51.7
0.8
44.1
0.9
565.5
1.5
Policy/planning/regulatory/licensing agency
6.1
0.1
7.1
0.1
22.5
0.4
145.2
0.4
Other
802.5
16.5
889.3
14.5
806.9
15.8
5,606.5
14.4
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
Of those RNs who had more than one nursing position, 52.9% of respondents were staff nurses. This represents a decline from 2020 when 57.6% of nurses were staff nurses. About 15% of RN respondents had other health-related titles and 12.6% were APRNs. As with the primary position titles previously listed, the proportion of respondents reporting being an APRN increased by 3.9% from 2020 (Table 34 and Figure 15).
Table 34Secondary Nursing Practice Position Title of Registered Nurses, 2015–2022
Secondary Title
2015 (N = 4,857.8)
2017 (N = 6,145.9)
2020 (N = 5,080.8)
2022 (N = 38,665.7)
n
%
n
%
n
%
n
%
Consultant
216.0
4.5
201.2
3.3
165.6
3.3
1,085.5
2.8
Nurse researcher
28.9
0.6
36.2
0.6
21.9
0.4
300.4
0.8
Nurse executive
46.6
1.0
34.6
0.6
40.3
0.8
245.2
0.6
Nurse manager
143.2
3.0
235.4
3.8
196.2
3.9
1,408.7
3.6
Nurse faculty/educator
482.0
9.9
601.5
9.8
547.0
10.8
3,135.3
8.1
APRN
521.8
10.7
743.0
12.1
443.9
8.7
4,887.6
12.6
Staff nurse
2,767.9
57.0
3,430.8
55.8
2,924.9
57.6
20,461.2
52.9
Case manager
157.8
3.4
256.3
4.2
205.5
4.1
866.9
2.2
Other – health related
475.0
9.8
573.7
9.3
490.2
9.7
5,800.5
15.0
Other – not health related
18.6
0.4
33.3
0.5
45.3
0.9
474.2
1.2
Note. Survey participants were asked about their secondary nursing practice title only if they were actively employed in nursing.
Providing Direct Patient Care—Secondary Nursing Practice Position
In 2022, 75.4% of RN respondents reported providing direct patient care in their secondary nursing position. In 2020, the first year this question was asked, 72.0% of nurses said they provided direct patient care in their secondary nursing position (Table 35).
Table 35Providing Direct Patient Care—Secondary Nursing Position of Registered Nurses, 2020–2022
Providing Direct Patient Care
2020 (N = 5,076.1)
2022 (N = 35,791.8)
n
%
n
%
Yes
3,653.3
72.0
26,985.5
75.4
No
1,422.7
28.0
8,806.3
24.6
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
2022 Pretax Annual Earnings From Primary Nursing Position
The median pretax annual earnings for RNs grew to $80,000 in 2022. Pretax wages grew by 14% since 2020 when the median pretax annual wage was $70,000. The percentage of respondents earning less than $40,000 annually (7.5%) decreased by 3.9%; those earning between $40,000 and $60,000 (13.9%) decreased by 5.3% between 2020 and 2022. The percentage of respondents in categories making between $60,000 and $80,000 per year (27.7%) also showed a decline of 2.2%. Between 2020 and 2022, the proportion of RNs making between $80,00 and $100,000 (22.3%) increased by 3.2%, and those making more than $100,000 per year (28.7%) increased by 8.2% (Table 36 and Figure 16).
Table 36Annual Earnings of Registered Nurses (RNs) From Primary Nursing Position, 2015–2022
Annual Earnings
2015
2017
2020
2022
n
%
n
%
n
%
n
%
RN Survey Respondents
N = 32,455.7
N = 35,745.6
N = 29,453.8
N = 181,491.9
<$40,000
4,711.3
14.5
4,217.8
11.8
3,355.6
11.4
13,599.2
7.5
$40,000 to <$60,000
8,436.8
26.0
8,243.4
23.1
5,639.5
19.2
25,203.8
13.9
$60,000 to <$80,000
9,202.0
28.4
10,213.3
28.6
8,808.0
29.9
50,193.6
27.7
$80,000 to <$100,000
5,279.8
16.3
6,386.3
17.9
5,617.0
19.1
40,376.6
22.3
≥$100,000
4,825.7
14.9
6,684.8
18.7
6,033.8
20.5
52,118.8
28.7
U.S. RN Population
<$40,000
377,964
14.5
342,160
11.8
335,235
11.4
216,979
7.5
$40,000 to <$60,000
676,837
26.0
668,729
23.1
563,404
19.2
402,133
13.9
$60,000 to <$80,000
738,224
28.4
828,530
28.6
879,947
29.9
800,853
27.7
$80,000 to <$100,000
423,568
16.3
518,071
17.9
561,156
19.1
644,220
22.3
≥$100,000
387,136
14.9
542,292
18.7
602,796
20.5
831,570
28.7
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Annual earnings include overtime and bonuses but do not include sign-on bonuses.
The specialty with the highest median annual wage was anesthesia at $188,000. Men have higher earnings across most specializations, where women earn 85% of men’s median wage. In 2022, women earned more in the specialties of genetics, geriatrics, neonatal, nephrology, neurology, rehabilitation, and radiology (Table 37).
Table 37Median Annual Earnings of Registered Nurses for Primary Nursing Position by Nurse Gender and Specialty, 2022
Specialty
Male
Female
Nonbinary
Total
n
Mdn
n
Mdn
n
Mdn
n
Mdn
Acute care/critical care
349
$90,000
2,123
$80,000
10
$74,000
2,482
$80,000
Adult health
27
$90,000
337
$75,000
2
$109,000
366
$75,500
Anesthesia
91
$220,000
171
$180,000
1
$130,000
263
$188,000
Cardiology
80
$90,000
540
$75,000
2
$64,000
622
$75,500
Community
6
$70,500
157
$67,000
1
$74,000
164
$67,500
Emergency/trauma
184
$88,000
991
$78,000
8
$90,000
1,183
$80,000
Family health
20
$117,500
426
$81,150
1
$3,500
447
$84,000
Genetics
4
$73,000
27
$75,000
-
-
31
$75,000
Geriatric/gerontology
57
$70,000
861
$75,000
2
$90,000
920
$75,000
Home health
42
$77,500
518
$73,500
3
$90,000
563
$74,000
Informatics
12
$102,500
92
$95,500
-
-
104
$96,000
Information technology
3
$93,500
22
$89,250
-
-
25
$93,500
Maternal-child health/obstetrics
4
$112,500
795
$70,000
-
-
799
$70,000
Medical-surgical
145
$79,000
1,376
$70,000
2
$92,000
1,524
$70,000
Neonatal
6
$68,500
336
$78,000
-
-
342
$78,000
Nephrology
24
$80,000
234
$84,000
-
-
258
$82,500
Neurology/neurosurgical
18
$79,000
169
$80,496
1
$54,000
188
$80,000
Occupational health
14
$97,500
163
$85,000
-
-
177
$86,000
Oncology
29
$80,000
512
$77,500
4
$72,500
545
$78,000
Orthopedic
15
$89,000
175
$72,500
1
$30,000
191
$75,000
Palliative care/hospice
22
$72,250
333
$76,000
1
$85,000
356
$75,000
Pediatrics
30
$83,500
719
$70,000
4
$82,500
753
$70,000
Perioperative
98
$90,000
985
$75,000
6
$63,000
1,089
$75,000
Primary care
39
$100,000
443
$83,000
1
$72,000
483
$85,000
Public health
27
$90,000
305
$73,000
-
-
332
$74,875
Psychiatric/mental health/substance abuse
69
$95,000
287
$80,000
1
$345,000
357
$82,000
Radiology
4
$64,000
29
$82,000
-
-
33
$80,000
Rehabilitation
17
$72,000
123
$77,000
-
-
140
$76,500
School health
7
$59,000
191
$54,000
-
-
198
$54,500
Urology
2
$82,250
12
67000
-
-
14
$67,000
Women’s health
1
$120,000
125
$65,000
2
$78,500
128
$65,050
Other - clinical specialties
16
$92,250
160
$83,000
-
-
176
$84,750
Other - nonclinical specialties
102
$92,750
899
$77,000
5
$55,000
1,006
$78,000
Total
1,564
$89,000
14,636
$76,000
59
$74,000
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Annual earnings include overtime and bonuses but do not include sign-on bonuses.
As in previous surveys, the 2022 results show increases in median wages with higher-level degrees. RNs holding a DNP reported the highest earnings at $110,000 per year. RNs with a PhD reported an annual media wage of $105,000, while RNs holding a master’s or doctorate other than a DNP or PhD earned $100,000. Baccalaureate-educated RNs earned $75,000, while their associate degree in nursing (ADN) and diploma education colleagues made $70,000 per year. Overall, wages across educational attainment rose in 2022 over their 2020 earnings (Table 38).
Table 38Median Annual Earnings of Registered Nurses for Primary Nursing Position by Nurses’ Highest Education, 2017–2022
Highest Education
2017
2020
2022
n
Mdn
n
Mdn
n
Mdn
Diploma
1,358
$72,900
1,318
$65,000
635
$70,000
Associate degree
8,303
$65,000
8,308
$63,000
4,847
$70,000
Baccalaureate degree
12,714
$68,000
14,964
$67,000
10,183
$75,000
Master’s degree
4,999
$95,000
4,617
$90,000
3,620
$100,000
Doctoral degree – PhD
200
$100,000
209
$93,600
151
$105,000
Doctoral degree – DNP
413
$104,000
519
$100,000
411
$110,000
Doctoral degree – nursing other
37
$96,000
40
$96,000
43
$100,000
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Annual earnings include overtime and bonuses but do not include sign-on bonuses. Regarding education, in the 2013 and 2015 surveys, a single question of “What is your highest level of education?” was asked with the set of possible responses including both nursing and non-nursing degrees. The degree types were separated beginning with the 2017 survey.
Annual median wages grew in 2022 over 2020 earnings in every state except for New Hampshire and Tennessee. As in previous surveys, the states with the highest reported median wages were California ($104,000), Hawaii ($100,000), Oregon ($91,500), New York ($90,000), and the District of Columbia ($90,000). States with the lowest annual median wages were Iowa ($68,000), Alabama ($70,000), North Dakota ($70,000), Tennessee ($70,000), and Nebraska ($70,441). In contrast to previous reports where the lowest earning state saw the largest percent increase, in 2022, the highest wage states tended to also see the largest percent increases (e.g., California at 15.6%, Oregon at 14.4%, and New York at 12.5%) while the lowest earning states saw the lowest percent increase (e.g., Alabama at 2.9%, Nebraska at 3.6%, and Tennessee at 0%) (Table 39).
Table 39Median Annual Earnings in Primary Nursing Position by Jurisdictions Where Registered Nurses Are Currently Practicing, 2015–2022
Missouri did not participate in the 2015 and 2017 surveys.
-
-
$68,640
$81,000
Montana
$58,000
$60,000
$66,000
$74,800
Nebraska
$54,000
$60,000
$68,000
$70,441
Nevada
$72,000
$77,000
$78,000
$83,750
New Hampshire
$64,000
$66,500
$75,000
$75,000
New Jersey
$76,000
$75,915
$80,000
$88,000
New Mexico
$62,000
$69,500
$73,000
$81,125
New York
$77,000
$80,000
$80,000
$90,000
North Carolina
$58,890
$61,000
$69,000
$78,316
North Dakota
$54,000
$60,000
$65,000
$70,000
Ohio
$58,000
$65,000
$70,000
$74,000
Oklahoma
$58,326
$64,000
$70,000
$75,000
Oregon
$75,000
$80,000
$80,000
$91,500
Pennsylvania
$62,000
$70,000
$75,000
$81,000
Rhode Island
$70,000
$70,000
$77,400
$82,000
South Carolina
$57,000
$64,000
$69,609
$78,000
South Dakota
$51,000
$54,000
$62,000
$71,025
Tennessee
$55,000
$62,000
$70,000
$70,000
Texas
$68,700
$72,000
$75,000
$80,000
Utah
$53,000
$65,000
$68,000
$73,000
Vermont
$62,000
$61,000
$73,492
$76,000
Virginia
$60,000
$69,000
$75,000
$79,000
Washington
$70,000
$75,000
$80,000
$86,000
West Virginia
$55,000
$62,000
$68,000
$72,000
Wisconsin
$60,000
$63,000
$70,500
$75,000
Wyoming
$64,000
$65,000
$70,000
$81,000
Northern Mariana Islands
$35,000
$41,600
$60,000
$64,000
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Annual earnings include overtime and bonuses but do not include sign-on bonuses.
A Missouri did not participate in the 2015 and 2017 surveys.
Median annual earnings tended to increase with both age and experience. However, an examination of Table 40 suggests these increases are more dependent on experience than on age. Earnings grow consistently with experience, while growth with age varies and begins to decrease after the age of 60years (Table 40).
Table 40Median Annual Earnings of Registered Nurses for Primary Nursing Position by Nurses’ Years Licensed and Age, 2022
Age, y
Number of Years Licensed
0–1
2–5
6–10
≥11
Total
n
Mdn
n
Mdn
n
Mdn
n
Mdn
n
Mdn
18–29
362
$57,000
1,137
$65,000
301
$70,000
3
$90,000
1,803
$64,000
30–34
118
$60,000
603
$66,000
1,098
$71,000
263
$75,000
2,082
$70,000
35–39
66
$58,350
355
$70,000
596
$75,000
1,194
$80,000
2,211
$75,000
40–44
51
$62,000
225
$70,000
446
$78,000
1,353
$81,000
2,075
$80,000
45–49
39
$60,000
151
$70,000
263
$78,000
1,459
$85,000
1,912
$80,626
50–54
22
$59,000
97
$72,000
203
$78,000
1,731
$88,000
2,053
$85,000
55–59
9
$60,000
58
$76,500
135
$84,000
1,914
$87,341
2,116
$86,000
60–64
2
$77,500
22
$79,000
74
$77,362
2,201
$84,000
2,299
$84,000
≥65
7
$65,000
19
$63,000
33
$69,000
1,906
$79,500
1,965
$70,000
Total
676
$60,000
2,667
$68,000
3,149
$75,000
12,024
$82,000
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Annual earnings include overtime and bonuses but do not include sign-on bonuses.
CRNAs continue to report the highest earnings among APRNs (Mdn, $197,500 in 2022), with NPs reporting the second highest wages (Mdn, $108,000 in 2022). While earnings grew in each APRN role in 2022, earnings for CNMs and CNSs grew the fastest in 2022 at 18.3% and 11.3%, respectively (Table 41).
Table 41Median Annual Earnings for Primary Nursing Position by APRN Role, 2017–2022
APRN role
2017
2020
2022
n
Mdn
n
Mdn
n
Mdn
CNP
2,982
$100,000
1,958
$100,000
1,755
$108,000
CNS
644
$88,000
448
$80,000
399
$89,000
CRNA
557
$171,000
341
$180,000
244
$197,500
CNM
186
$97,750
116
$86,000
74
$101,739
Note. APRN = advanced practice registered nurse; CNP = certified nurse practitioner; CNS = clinical nurse specialist; CRNA = certified registered nurse anesthetist; CNM = certified nurse midwife. Survey participants were asked to answer this question only if they were actively employed in nursing. Annual earnings include overtime and bonuses but do not include sign-on bonuses.
Telehealth utilization by RNs remains relatively unchanged from previous years, with about half of RNs (49.9%) not providing services via telehealth. However, the proportion of nurses who reported utilizing telehealth all of the time rose to 11.8%, an increase of 1.8% from the 2020 survey. It remains likely that the increase in telehealth utilization is only among advanced practice degrees and those practicing in ambulatory and primary care settings (Table 42 and Figure 17).
Table 42Percentage of Time Registered Nurses (RNs) Reported Providing Telehealth, 2015–2022
Provides Telehealth
2015
2017
2020
2022
n
%
n
%
n
%
n
%
RN Survey Respondents
N = 37,354.6
N = 39,441.6
N = 33,582.4
N = 203,074.2
Never
19,119.1
51.2
18,095.1
45.9
17,460.2
52.0
101,365.6
49.9
1%–25%
11,710.7
31.4
12,490.6
31.7
8,960.8
26.7
52,667.1
25.9
26%–50%
2,560.5
6.9
2,851.2
7.2
2,184.9
6.5
17,701.3
8.7
51%–75%
1,785.3
4.8
2,201.6
5.6
1,634.5
4.9
7,307.6
3.6
76%–100%
2,179.1
5.8
3,803.2
9.6
3,341.9
10.0
24,032.6
11.8
U.S. RN Population
Never
1,533,811
51.2
1,467,920
45.9
1,744,329
52.0
1,617,317
49.9
1%–25%
803,549
31.4
1,013,268
31.7
895,212
26.7
840,319
25.9
26%–50%
175,691
6.9
231,294
7.2
218,278
6.5
282,429
8.7
51%–75%
122,502
4.8
178,602
5.6
163,292
4.9
116,595
3.6
76%–100%
149,519
5.8
308,529
9.6
333,866
10.0
383,446
11.8
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
As with the provisioning of services via telehealth in general (Table 42), more than half (54.7%) of RNs do not utilize telehealth to provide services to patients across state lines. Thirty-one percent of RNs report spending between 1% and 25% of their time providing services to patients in other states through telehealth. Utilization of services across state borders through telehealth is similar to utilization reported in 2020 (Table 43 and Figure 18).
Table 43Percentage of Time Registered Nurses Spend Providing Telehealth Across State Borders, 2015–2022
Provides Telehealth
2015 (N = 18,456.1)
2017 (N = 17,573.3)
2020 (N = 13,965.3)
2022 (N = 77,135.0)
n
%
n
%
n
%
n
%
Never
11,186.7
60.6
9,535.0
54.3
7,395.6
53.0
42,175.6
54.7
1%–25%
5,843.2
31.7
6,294.5
35.8
4,663.6
33.4
23,898.1
31.0
26%–50%
626.8
3.4
692.2
3.9
678.0
4.9
4,913.7
6.4
51%–75%
298.5
1.6
414.0
2.4
366.9
2.6
1,352.0
1.8
76%–100%
500.9
2.7
637.6
3.6
861.2
6.2
4,795.6
6.2
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
Less than 10% of RNs in the United States provide services via telehealth across international borders. This rate has changed little from previous surveys (Table 44 and Figure 19).
Table 44Percentage of Time Registered Nurses Spend Providing Telehealth Across International Borders, 2015–2022
Provides Telehealth
2015 (N = 18,096.1)
2017 (N = 16,369.8)
2020 (N = 13,208.2)
2022 (N = 64,434.9)
n
%
n
%
n
%
n
%
Never
16,707.2
92.3
14,548.6
88.9
12,087.2
91.5
58,397.1
90.6
1%–25%
1,194.7
6.6
1,488.2
9.1
965.9
7.3
4,681.2
7.3
26%–50%
96.3
0.5
129.4
0.8
74.0
0.6
616.4
1.0
51%–75%
33.7
0.2
103.7
0.6
32.9
0.3
278.1
0.4
76%–100%
64.3
0.4
99.8
0.6
48.3
0.4
462.2
0.7
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
As seen in previous years, the use of the telephone is the most common mode (88.0%) of communication for telehealth provision. The use of video calls was the second most common mode (35.4%) and has increased markedly in use since 2020 (11.0%). Email was the third most common mode at 33.4% and was relatively unchanged since 2020. The use of electronic messaging was used in 32.7% of telehealth service provision and had increased by 8.2% since 2020 (Table 45 and Figure 20).
Table 45Modes of Communication Used for Telehealth by Registered Nurses, 2015–2022
Mode of Telehealth
2015 (N = 15,864.1)
2017 (N = 17,066.0)
2020 (N = 13,775.4)
2022 (N = 83,950.6)
n
%
n
%
n
%
n
%
Electronic messaging
2,954.0
18.6
3,599.6
21.1
3,379.3
24.5
27,458.1
32.7
VoIP
528.7
3.3
817.3
4.8
11,297.7
8.7
0.0
0.0
Virtual ICU
167.7
1.1
276.9
1.6
316.3
2.3
3,046.7
3.6
Telephone
15,406.7
97.1
16,143.9
94.6
12,893.3
93.6
73,855.0
88.0
Email
5,128.2
32.3
5,574.4
32.7
4,497.9
32.7
28,028.3
33.4
Video call
463.7
2.9
619.8
3.6
1,517.1
11.0
29,677.6
35.4
Other
1,070.9
6.8
926.4
5.4
753.5
5.5
5,561.9
6.6
Note. VoIP = voice over internet protocol; ICU = intensive care unit.
The coronavirus pandemic affected RNs mostly through its impact on their workload. More than 60% of RNs reported an increase in their workload due to the pandemic. The next most-reported impact was a change in practice setting (16%). About 12% of RNs reported that the pandemic had no impact on their employment (Table 46).
Table 46Impact of COVID-19 Pandemic on Registered Nurse (RN) Employment, 2022
Impact
2022
n
%
RN Survey Respondents
N = 250,709.3
My workload increased
154,905.6
61.8
I became a travel nurse
13,434.5
5.4
I changed my practice setting
39,109.8
15.6
I started doing telehealth
15,268.1
6.1
I left nursing
6,719.7
2.7
I retired
15,035.5
6.0
No impact
31,184.7
12.4
Other
43,185.8
17.2
U.S. RN Population
My workload increased
2,471,562
61.8
I became a travel nurse
214,351
5.4
I changed my practice setting
624,007
15.6
I started doing telehealth
243,606
6.1
I left nursing
107,215
2.7
I retired
239,895
6.0
No impact
497,561
12.4
Other
689,042
17.2
Note. Respondents were asked to select all that apply. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
About a quarter (24%) of RNs reported they were emotionally drained from work every day and another 27% reported they were emotionally drained a few times a week. Thus, more than half of RNs reported they were emotionally drained from work at least few times every week. Only 5% reported never feeling emotionally drained from work (Table 47).
Table 47Registered Nurses Who Reported Feeling Emotionally Drained From Work, 2022
Felt Emotionally Drained
2022 (N = 239,525.5)
n
%
Never
11,997.6
5.0
A few times a year
22,007.6
9.2
Once a month or less
18,481.9
7.7
A few times a month
37,914.3
15.8
Once a week
27,374.7
11.4
A few times a week
64,472.9
26.9
Every day
57,276.6
23.9
Note. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
Two-thirds of RNs reported feeling used up at the end of their workday at least one day a week. Only 5.6% reported never feeling used up at the end of their workday (Table 48).
Table 48Registered Nurses Who Reported Feeling Used Up at the End of Their Workday, 2022
Felt Used Up
2022 (N = 238,535.4)
n
%
Never
13,423.1
5.6
A few times a year
17,208.9
7.2
Once a month or less
15,702.6
6.6
A few times a month
30,373.2
12.7
Once a week
26,609.1
11.2
A few times a week
62,924.5
26.4
Every day
72,293.9
30.3
Note. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
More than a quarter (26.3%) of RNs reported feeling fatigued when they get up and have to face another day on the job every day. Another 23.3% reported feeling fatigued when they get up and have to face another day on the job a few times a week. Only 8.2% reported never feeling fatigued when they get up and must face another day on the job (Table 49).
Table 49Registered Nurses Who Reported Feeling Fatigued When They Get Up, 2022
Felt Fatigue
2022 (N = 238,780.7)
n
%
Never
19,594.7
8.2
A few times a year
21,548.7
9.0
Once a month or less
19,788.0
8.3
A few times a month
31,919.5
13.4
Once a week
27,482.0
11.5
A few times a week
55,652.9
23.3
Every day
62,795.0
26.3
Note. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
A quarter (25.8%) of RNs reported feeling burned-out from work every day and 19.4% also reported feeling burned-out a few times a week. About 11% reported never feeling burned-out from work (Table 50).
Table 50Registered Nurses Who Reported Feeling Burned-Out From Work, 2022
Felt Burned-Out
2022 (N = 238,420.3)
n
%
Never
26,003.5
10.9
A few times a year
29,406.4
12.3
Once a month or less
21,739.6
9.1
A few times a month
30,730.1
12.9
Once a week
22,876.1
9.6
A few times a week
46,233.6
19.4
Every day
61,431.0
25.8
Note. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
How Often Did You Feel You Were at the End of Your Rope?
About 28% of RNs reported they felt they were at the end of their rope at least a few times per week, with half of this group feeling like that every day. About 9.2% felt they were at the end of their rope once per week. Slightly over a quarter never felt like they were at the end of their rope (Table 51).
Table 51Registered Nurses Who Reported Feeling at the End of Their Rope, 2022
Felt at End of Rope
2022 (N = 238,187.0)
n
%
Never
66,571.2
28.0
A few times a year
31,951.3
13.4
Once a month or less
21,266.7
8.9
A few times a month
26,454.6
11.1
Once a week
21,834.0
9.2
A few times a week
35,017.1
14.7
Every day
35,092.1
14.7
Note. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
Respondents were asked to identify their gender. From 2015 through 2022, the percentage of male LPNs/LVNs nurses increased from 7.5% to 10.2% while the percentage of female nurses decreased from 92.5% to 89.6% (Table 52).
Table 52Gender Distribution of Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs), 2015–2022
The median age for LPNs/LVNs in 2022 was 47years. In 2015, the largest proportion of LPNs/LVNs were aged 55–59 years (12.9%). In 2017 and 2020, the largest proportion of LPNs/LVNs were aged 65 years or older (13.2% and 18.2%, respectively). In 2022, the largest proportion of LPNs/LVNs were aged 50–54 years (15.0%), but every younger age group increased in 2022 compared with 2020. While older LPNs/LVNs are remaining in the workforce, the profession is making headway in increasing the proportion of younger nurses in the profession (Table 53).
Figure 21Age Distribution of Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs)
The distribution of female LPNs/LVNs was relatively flat across all age cohorts. Interestingly, the largest cohort of female nurses was the oldest age group (≥65 years) at 12.1%. This was markedly different than the male and nonbinary genders where the age distribution is skewed towards younger age groups (Table 53).
Table 53Age Distribution of Licensed Practical Nurses/Licensed Vocational Nurses by Gender, 2022
From 2017 to 2022, the proportion of White/Caucasian LPNs/LVNs decreased from 71.4% to 65.9%, while the proportion of Asian LPNs/LVNs increased from 2.6% to 6.3%. The proportion of LPNs/LVNs in the other racial categories remained largely unchanged between 2017 and 2022 (Table 54).
Table 54Race/Ethnicity of Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs), 2017–2022
Race
2017
2020
2022
n
%
n
%
n
%
LPN/LVN Survey Respondents
N = 34,467.5
N = 39,397.4
N = 53,913.0
American Indian or Alaska Native
219.8
0.6
316.6
0.8
673.1
1.3
Asian
897.4
2.6
1,980.6
5.0
3,415.1
6.3
Black/African American
6,372.4
18.5
6,790.7
17.2
9,482.5
17.6
Native Hawaiian or Other Pacific Islander
62.4
0.2
225.2
0.6
309.3
0.6
White/Caucasian
24,604.0
71.4
27,385.1
69.5
35,527.2
65.9
Other
1,568.5
4.6
1,743.9
4.4
2,915.6
5.4
More than one race category selected
743.1
2.2
921.6
2.3
1,590.2
3.0
U.S. LPN/LVN Population
American Indian or Alaska Native
5,024
0.6
7,522
0.8
11,205
1.3
Asian
20,517
2.6
47,059
5.0
56,848
6.3
Black/African American
145,692
18.5
161,346
17.2
157,844
17.6
Native Hawaiian or Other Pacific Islander
1,427
0.2
5,351
0.6
5,149
0.6
White/Caucasian
562,524
71.4
650,668
69.5
591,382
65.9
Other
35,860
4.6
41,435
4.4
48,533
5.4
More than one race category selected
16,990
2.2
21,897
2.3
26,471
3.0
Note. Respondents were asked to select all that apply. Responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the “more than one race category selected” category.
In 2022, 11.5% of LPNs/LVNs identified as being of Hispanic/Latino origin. Between 2015 and 2022, the percentage of RNs identifying as Hispanic/Latino increased from 6.4% to 11.5% (Table 55 and Figure 22).
Table 55Hispanic or Latino Ethnicity of Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs), 2015–2022
Ethnicity
2015
2017
2020
2022
n
%
n
%
n
%
n
%
LPN/LVN Survey Respondents
N = 30,620.8
N = 34,449.3
N = 39,335.6
N = 53,914.9
Hispanic or Latino origin
1,964.6
6.4
2,558.6
7.4
3,912.8
10.0
6,219.1
11.5
Not of Hispanic or Latino origin
28,656.3
93.6
31,890.6
92.6
35,422.9
90.0
47,695.8
88.5
U.S. LPN/LVN Population
Hispanic or Latino origin
59,079
6.4
58,498
7.4
92,968
10.0
103,522
11.5
Not of Hispanic or Latino origin
861,746
93.6
729,119
92.6
841,645
90.0
793,940
88.5
Note. In the 2013 and 2015 surveys, the Hispanic/Latino origin and race categories were combined into one question. The categories were separated beginning with the 2017 survey.
Male LPNs/LVNs tend to be more racially diverse than their female colleagues. Only 47.5% of male LPNs/LVNs identified as being White/Caucasian compared to 68.1% for female LPNs/LVNs. Also, 20.9% of male LPNs/LVNs identified as Black/African American and 14.9% identified as Asian, while female LPNs/LVNs were 17.2% and 5.4%, respectively (Table 56).
Table 56Race of Licensed Practical Nurses/Licensed Vocational Nurses by Gender, 2022
Race
Male (n = 5,526.9)
Female (n = 48,091.0)
Nonbinary (n = 105.2)
Total (N = 53,723.1)
n
%
n
%
n
%
n
%
American Indian or Alaska Native
147.7
2.7
509.8
1.1
9.1
8.7
666.7
1.2
Asian
822.3
14.9
2,572.1
5.4
4.1
3.9
3,398.5
6.3
Black/African
1,154.8
20.9
8,275.3
17.2
4.9
4.7
9,435.0
17.6
Native Hawaiian or other Pacific Islander
89.1
1.6
212.9
0.4
0.0
0.0
302.0
0.6
White/Caucasian
2,626.3
47.5
32,739.1
68.1
69.9
66.5
35,435.3
66.0
Other
389.2
7.0
2,498.6
5.2
12.5
11.9
2,900.3
5.4
More than one race category selected
297.5
5.4
1,283.2
2.7
4.7
4.4
1,585.4
3.0
Note. Weighted sample values. Respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the “more than one race category selected” category.
Like the results seen for RNs, younger LPNs/LVNs tend to be more racially diverse than older nurses. However, the youngest cohort (age 17–29 years) are less diverse than those in slightly older cohorts. LPNs/LVNs between the ages of 30 and 54 years were the most diverse of all age groups (Table 57).
Table 57Race of Licensed Practical Nurses/Licensed Vocational Nurses by Age, 2022
Age, y
n (%)
American Indian or Alaska Native
Asian
Black/African American
Native Hawaiian or other Pacific Islander
White/Caucasian
Other
More than one race
n
17–29
135.6 (2.8)
218.4 (4.5)
538.4 (11.0)
48.0 (1.0)
3,509.7 (71.8)
263.8 (5.4)
176.5 (3.6)
4,890.4
30–34
72.0 (1.3)
526.2 (9.2)
789.7 (13.8)
49.5 (0.9)
3,596.3 (62.9)
431.3 (7.5)
254.2 (4.5)
5,719.2
35–39
75.2 (1.4)
448.2 (8.3)
1,090.8 (20.1)
46.6 (0.9)
3,221.6 (59.4)
360.3 (6.6)
185.5 (3.4)
5,428.2
40–44
67.9 (1.1)
458.2 (7.4)
1,335.7 (21.5)
59.8 (1.0)
3,700.1 (59.6)
322.3 (5.2)
259.5 (4.2)
6,203.6
45–49
54.1 (0.9)
393.8 (6.4)
1,364.2 (22.1)
46.0 (0.8)
3,781.2 (61.4)
305.0 (5.0)
217.6 (3.5)
6,162.0
50–54
110.9 (1.4)
576.2 (7.5)
1,574.8 (20.4)
25.7 (0.3)
4,855.5 (62.9)
408.6 (5.3)
169.1 (2.2)
7,720.8
55–59
56.0 (1.1)
246.3 (4.9)
750.0 (14.9)
14.9 (0.3)
3,550.1 (70.7)
289.9 (5.8)
113.8 (2.3)
5,021.0
60–64
29.4 (0.7)
163.1 (3.9)
591.6 (14.3)
9.4 (0.2)
3,120.0 (75.5)
154.0 (3.7)
66.8 (1.6)
4,134.4
≥ 65
47.0 (0.8)
156.6 (2.6)
876.9 (14.4)
6.8 (0.1)
4,719.0 (77.7)
178.4 (2.9)
86.0 (1.4)
6,070.6
Total
648.1 (1.3)
3,187.1 (6.2)
8,912.1 (17.4)
306.7 (0.6)
34,053.5 (66.3)
2,713.6 (5.3)
1,529.2 (3.0)
51,350.2
Note. Weighted sample values. Respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the “more than one race category selected” category.
Type of Nursing Degree or Credentials for First U.S. Nursing License
In 2022, 82.0% of LPNs/LVNs held a vocational/practical certificate when they were first licensed in the United States. This rate is mostly unchanged from 2015 to 2022. A little more than 10% held a nursing diploma when first licensed, while 8.0% held either a baccalaureate or associate degree (Table 58 and Figure 23).
Table 58Type of Nursing Degree or Credential of Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs) for First U.S. Nursing License, 2015–2022
Type of Nursing Degree or Credential for First U.S. Nursing License by Age
Across all age groups, the vocational/practical certificate was the most commonly held credential when respondents obtained their first U.S. LPN/LVN license. The second most-held credential was the nursing diploma, and it was more common among LPNs/LVNs between the ages of 40 and 54 years (Table 59).
Table 59Type of Nursing Degree or Credential of Licensed Practical Nurses/Licensed Vocational Nurses for First U.S. Nursing License by Age, 2022
In 2022, 71.8% of LPNs/LVNs’ highest level of nursing education was a vocational/practical certificate. Additionally, 12.2% of LPNs/LVNs held a diploma, 13.1% were awarded an associate degree, and 2.9% held a baccalaureate degree (Table 60 and Figure 24).
Table 60Highest Level of Nursing Education Among Licensed Practical Nurses/Licensed Vocational Nurses, 2015–2022
2015 (N = 25,626.5)
2017 (N = 34,208.6)
2020 (N = 38,746.1)
2022 (N = 49.455.0)
Nursing Degree or Credential
n
%
n
%
n
%
n
%
Vocational/practical certificate
19,481.3
76.0
26,615.3
77.8
27,899.9
72.0
35,510.0
71.8
Diploma
3,882.5
15.2
4,900.8
14.3
4,732.5
12.2
6,051.6
12.2
Associate degree
1,888.6
7.4
2,509.6
7.3
4,910.1
12.7
6,473.3
13.1
Baccalaureate degree
308.5
1.2
182.8
0.5
1,203.5
3.1
1,420.1
2.9
Note. In the 2015 surveys, a single question “What is your highest level of education?” was asked with the set of possible responses including both nursing and non-nursing degrees. The degree types were separated beginning with the 2017 survey. A very small number (<0.1%) of Licensed Practical Nurses/Licensed Vocational Nurses earned a master’s degree.
The vocational/practical certificate was the most common highest level of education across all racial groups. For LPNs/LVNs identifying as Asian, 59.0% held a vocational/practical certification, 7.0% had an associate degree, and 24.0% held a baccalaureate. Overall, only 2.9% of the LPN/LVN workforce held a baccalaureate degree and 13.1% held an associate degree (Table 61).
Table 61Highest Level of Nursing Education of Licensed Practical Nurses/Licensed Vocational Nurses by Race, 2020
Race
n (%)
n
Vocational/Certificate
Diploma
Associate
Baccalaureate
American Indian or Alaska Native
440.6 (71.2)
56.1 (9.1)
77.9 (12.6)
44.6 (7.2)
619.2
Asian
1,886.8 (59.0)
224.5 (7.0)
319.6 (10.0)
766.6 (24.0)
3,198.2
Black/African American
5,438.6 (64.6)
1,576.9 (18.7)
1,236.8 (14.7)
169.5 (2.0)
8,421.8
Native Hawaiian or Other Pacific Islander
246.5 (83.9)
8.9 (3.0)
29.5 (10.1)
8.7 (3.0)
293.7
White/Caucasian
24,335.6 (75.7)
3,600.8 (11.2)
3,946.6 (12.3)
252.1 (0.8)
32,136.5
Other
1,819.2 (66.6)
308.5 (11.3)
536.0 (19.6)
66.5 (2.4)
2,730.2
More than one race category selected
871.3 (61.0)
215.2 (15.1)
246.0 (17.2)
97.0 (6.8)
1,429.5
Total
35,038.5 (71.8)
5,991.0 (12.3)
6,392.3 (13.1)
1,405.0 (2.9)
48,829.2
Note. Weighted sample values. In the 2015 surveys, a single question “What is your highest level of education?” was asked with the set of possible responses including both nursing and non-nursing degrees. The degree types were separated beginning with the 2017 survey. For the race question, respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the “more than one race category selected” category.
When asked about their highest level of non-nursing education, 69.2% of LPNs/LVNs reported an associate degree non-nursing education. While 25.0% held a baccalaureate degree, 4.8% held a master’s degree, and 1.1% obtained a doctorate (Table 62).
Table 62Highest Level of Non-nursing Education of Licensed Practical Nurses/Licensed Vocational Nurses, 2017–2022
Degree
2017 (N = 9,832.6)
2020 (N = 12,497.8)
2022 (N = 18,469.8)
n
%
n
%
n
%
Associate degree
6,762.0
68.8
8,719.7
69.8
12,786.6
69.2
Baccalaureate degree
2,460.1
25.0
3,008.1
24.1
4,612.7
25.0
Master’s degree
515.6
5.2
674.0
5.4
877.0
4.8
Doctoral degree
95.0
1.0
95.9
0.8
193.5
1.1
Note. In the 2015 surveys, a single question “What is your highest level of education?” was asked with the set of possible responses including both nursing and non-nursing degrees. The degree types were separated beginning with the 2017 survey.
In 2022, LPN/LVN respondents reported they were licensed for a median of 13years, as compared to 17years in the 2020 survey. More than four of every 10 respondents (42.1%) were licensed for 10years or less, a 5.2% increase from the 36.9% reporting the same in 2020. An additional 27.3% were licensed between 11 and 20years, which also increased from 23.4% in 2020. Nearly 70% reported they have been licensed for 20years or less, the highest percentage since 2015 (Table 63).
Figure 25Number of Years Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs) Have Been Licensed
Almost 99% of LPN/LVN respondents were initially licensed in the United States, the same proportion as in 2020. Another 0.7% were initially licensed in the Philippines, 0.1% in Canada, and 0.1% in India. These results are nearly identical to the results in 2020 (Table 64).
Table 64Country in Which Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs) Were Initially Licensed, 2020–2022
In 2022, 28.7% of LPN/LVNs reported having a multistate license. This represents a 7.5% increase in the possession of a multistate license by LPN/LVNs since 2020 (Table 65).
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
In 2022, a new question was added to the survey to inquire about the use of the multistate license among LPNs/LVNs. About three quarters of respondents (76.6%) reported not using their multistate license. For LPNs/LVNs who have a multistate license, 4.4% used it for telehealth, 2.4% used it for disaster support, 1.0% for distance education, and 17.6% used their multistate license for another purpose (Table 66). Additional uses were for travel nursing and multistate practice.
Table 66How Multistate License is Used by Licensed Practical Nurses/Licensed Vocational Nurses, 2022
Use of Multistate License
2022 (N = 12,135.0)
n
%
Telehealth
531.0
4.4
Distance education
115.2
1.0
Disaster support
293.1
2.4
Have not used
9,296.3
76.6
Other
2,134.6
17.6
Note. Survey participants were asked to answer this question only if they were actively employed in nursing and had a multistate license. Respondents were asked to select all that apply. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
The major portion of responding LPNs/LVNs (87.7%) were actively employed in nursing, with 71.0% employed in nursing full time. This represents a 5.3% increase in the proportion of LPNs/LVNs actively employed and a 5.3% increase in those working full time from 2020 (65.7%). In 2022, the proportion of LPNs/LVNs who were actively employed in nursing was at the highest level since 2015 (Table 67).
Figure 26Employment Status of Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs)
Respondents were asked to select all the reasons for being unemployed. Taking care of home and family was the most frequently selected reason for being unemployed (41.9%). Other respondents cited the COVID-19 pandemic (20.2%), school (14.2%), and disability (13.0%) as reasons for being unemployed. Almost 11% of LPNs/LVNs stated they were unemployed due to inadequate salary. This represents a marked increase in the reporting of an inadequate salary as the reason for being unemployed (4.8% in 2020 was 4.8% and between 3.0% in 2015 to 4.1% in 2017). The percentage of LPNs/LVNs who indicated unemployment because they experienced difficulty in finding a nursing position was 8.9% in 2022, which was down from 13.8% in 2020 (Table 68 and Figure 27).
Table 68Reasons for Unemployment Among Licensed Practical Nurses/Licensed Vocational Nurses, 2015–2022
Reasons for Unemployment
2015 (N = 2,644.5)
2017 (N = 2,696.8)
2020 (N = 2,781.4)
2022 (N = 3,672.8)
n
%
n
%
n
%
n
%
Taking care of home and family
1,033.0
39.1
1,117.4
41.4
1,203.2
43.3
1,537.9
41.9
Disabled
463.3
17.5
570.0
21.1
470.5
16.9
478.7
13.0
Inadequate salary
77.9
3.0
111.5
4.1
133.7
4.8
401.8
10.9
School
393.9
14.9
288.4
10.7
336.5
12.1
521.2
14.2
Difficulty in finding a nursing position
610.4
23.1
419.6
15.6
384.5
13.8
325.6
8.9
COVID-19 pandemic
-
-
-
-
-
-
658.4
20.2
Other
600.1
22.7
713.0
26.4
812.3
29.2
1,309.7
35.7
Note. Survey participants were asked to answer this question only if they were unemployed. Respondents were asked to select all that apply.
When asked about their plans to retire in the next 5 years, a quarter (25.6%) of LPNs/LVNs reported they plan to retire within the next 5 years. This finding represents a 5.4% increase over the proportion who thought they would retire within 5years (20.2%) in the 2020 survey. This question was new in the 2020 survey (Table 69).
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
Respondents were asked to identify the number of positions in which they were currently employed as a nurse. The majority of LPNs/LVNs (79.2%) reported holding just one position as a nurse, which represents a 3.2% decrease compared to 2020. The percentage of LPNs/LVNs who reported working in two positions increased from 15.1% in 2020 to 17.4% in 2022. The percentage of respondents who indicated that they held three or more positions in nursing also increased from 2.5% in 2020 to 3.5% in 2022 (Table 70).
Table 70Number of Positions Currently Held by Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs), 2015–2022
Number of Positions
2015
2017
2020
2022
n
%
n
%
n
%
n
%
LPN/LVN Survey Respondents
N = 23,317.3
N = 27,576.8
N = 31,231.7
N = 45,431.9
1
19,706.5
84.5
22,725.0
82.4
25,738.9
82.4
35,983.4
79.2
2
3,113.0
13.4
4,117.5
14.9
4,705.7
15.1
7,882.7
17.4
≥3
497.8
2.1
734.3
2.7
787.1
2.5
1,565.8
3.5
U.S. LPN/LVN Population
1
592,611
84.5
519,563
82.4
611,554
82.4
598,977
79.2
2
93,613
13.4
94,139
14.9
111,807
15.1
131,214
17.4
≥3
14,970
2.1
16,788
2.7
18,701
2.5
26,064
3.5
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
Number of Hours Worked During a Typical Week in All Nursing Positions
A little more than half (50.8%) of responding LPNs/LVNs reported working 32 to 40hours in a typical week in all positions. This is lower than the results from the 2020 survey (58.6%) and the 2017 survey (59.4%). The second most frequently reported category was 41 to 50hours (20.6%). This represents an increase from 2020 (14.9%) and 2017 (16.0%) (Table 71 and Figure 28).
Table 71Number of Hours Worked by Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs) During a Typical Week in All Nursing Positions, 2015–2022
Hours Worked per Week
2015
2017
2020
2022
n
%
n
%
n
%
n
%
LPN/LVN Survey Respondents
N = 22,450.6
N = 27,505.7
N = 30,985.7
N = 45,095.9
1–15
913.1
4.1
1,132.6
4.1
1,214.4
3.9
1,527.3
3.4
16–23
1,088.9
4.9
1,298.4
4.7
1,323.6
4.3
1,461.9
3.2
24–31
1,866.4
8.3
2,031.1
7.4
2,238.6
7.2
2,622.0
5.8
32 –40
13,562.8
60.4
16,328.2
59.4
18,164.7
58.6
22,901.9
50.8
41–50
3,410.0
15.2
4,412.7
16.0
4,609.1
14.9
9,292.1
20.6
51–60
928.3
4.1
1,391.1
5.1
1,567.2
5.1
3,933.0
8.7
≥61
681.1
3.0
911.5
3.3
1,868.1
6.0
3,357.6
7.5
U.S. LPN/LVN Population
1–15
27,459
4.1
25,896
4.1
28,854
3.9
25,424
3.4
16–23
32,744
4.9
29,686
4.7
31,449
4.3
24,335
3.2
24–31
56,126
8.3
46,437
7.4
53,189
7.2
43,646
5.8
32–40
407,859
60.4
373,314
59.4
431,592
58.6
381,223
50.8
41–50
102,546
15.2
100,888
16.0
109,512
14.9
154,676
20.6
51–60
27,916
4.1
31,805
5.1
37,237
5.1
65,468
8.7
≥61
20,482
3.0
20,841
3.3
44,386
6.0
55,890
7.5
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
Of those LPNs/LVNs who responded to the question, 30.6% indicated that a nursing home/extended care was their primary nursing practice setting. This represents an increase of 3.1% from 2020. Hospital settings were the second most frequently selected setting at 11.7% of LPNs/LVNs, followed by home health at 11.6% and ambulatory care settings at 8.6% (Table 72 and Figure 29).
Table 72Primary Nursing Practice Position Setting of Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs), 2015–2022
Primary Practice Setting
2015
2017
2020
2022
n
%
n
%
n
%
n
%
LPN/LPV Survey Respondents
N = 22,989.1
N = 26,459.8
N = 30,055.4
N = 43,306.2
Hospital
2,478.9
10.8
2,540.3
9.6
3,831.4
12.8
5,084.7
11.7
Nursing home/extended care
6,911.9
30.1
8,385.3
31.7
8,250.3
27.5
13,250.0
30.6
Assisted living facility
1,369.5
6.0
1,484.2
5.6
1,679.5
5.6
2,835.5
6.6
Home health
3,451.0
15.0
3,710.5
14.0
3,733.3
12.4
5,025.9
11.6
Hospice
-
-
426.6
1.6
639.8
2.1
698.7
1.6
Correctional facility
670.2
2.9
738.6
2.8
729.3
2.4
961.6
2.2
School of nursing
142.0
0.6
78.4
0.3
173.7
0.6
141.4
0.3
Public health
399.8
1.7
498.3
1.9
623.1
2.1
972.6
2.3
Dialysis center
-
-
165.8
0.6
266.1
0.9
310.4
0.7
Community health
922.6
4.0
888.1
3.4
1,073.8
3.6
1,487.7
3.4
School health service
683.9
3.0
697.4
2.6
977.2
3.3
1,410.7
3.3
Occupational health
174.9
0.8
166.6
0.6
187.3
0.6
278.4
0.6
Ambulatory care setting
2,061.2
9.0
1,797.3
6.8
2,588.2
8.6
3,702.9
8.6
Insurance claims/benefits
259.7
1.1
241.3
0.9
331.8
1.1
518.5
1.2
Policy/planning/regulatory/ licensing agency
32.3
0.1
24.4
0.1
36.7
0.1
16.0
0.0
Other
3,431.2
14.9
4,616.7
17.4
4,933.9
16.4
6,611.2
15.3
U.S. LPN/LVN Population
Hospital
74,544
10.8
58,079
9.6
91,034
12.8
84,639
11.7
Nursing home/extended care
207,854
30.1
191,715
31.7
196,026
27.5
220,559
30.6
Assisted living facility
41,183
6.0
33,933
5.6
39,905
5.6
47,200
6.6
Home health
103,779
15.0
84,834
14.0
88,703
12.4
83,661
11.6
Hospice
-
-
9,753
1.6
15,202
2.1
11,631
1.6
Correctional facility
20,154
2.9
16,887
2.8
17,328
2.4
16,007
2.2
School of nursing
4,270
0.6
1,792
0.3
4,127
0.6
2,354
0.3
Public health
12,022
1.7
11,394
1.9
14,805
2.1
16,190
2.3
Dialysis center
-
-
3,790
0.6
6,323
0.9
5,167
0.7
Community health
27,745
4.0
20,305
3.4
25,513
3.6
24,764
3.4
School health service
20,565
3.0
15,945
2.6
23,218
3.3
23,482
3.3
Occupational health
5,260
0.8
3,810
0.6
4,450
0.6
4,634
0.6
Ambulatory care setting
61,984
9.0
41,091
6.8
61,495
8.6
61,637
8.6
Insurance claims/benefits
7,810
1.1
5,517
0.9
7,884
1.1
8,632
1.2
Policy/planning/regulatory/ licensing agency
973
0.1
557
0.1
872
0.1
266
0.0
Other
103,182
14.9
105,553
17.4
117,229
16.4
110,049
15.3
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
About two-thirds (66.5%) of LPNs/LVNs reported staff nurse as their nursing position title. This is down from 2020, when 72.8% identified as a staff nurse (Table 73 and Figure 30).
Table 73Primary Nursing Position Title of Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs), 2015–2022
Primary Title
2015
2017
2020
2022
n
%
n
%
n
%
n
%
LPN/LVN Survey Respondents
N = 23,567.8
N = 26,776.9
N = 30,512.5
N = 44,122.7
Consultant
140.6
0.6
152.7
0.6
148.4
0.5
257.4
0.6
Nurse researcher
65.0
0.3
51.2
0.2
66.3
0.2
79.8
0.2
Nurse executive
137.6
0.6
70.9
0.3
120.6
0.4
157.5
0.4
Nurse manager
1,365.4
5.8
1,661.5
6.2
1,680.2
5.5
2,955.9
6.7
Nurse faculty/educator
967.9
4.1
257.5
1.0
310.5
1.0
481.0
1.1
APRN
401.7
1.7
9.0
0.0
149.4
0.5
110.6
0.3
Staff nurse
16,214.1
68.8
19,564.6
73.1
22,209.9
72.8
29,324.4
66.5
Case manager
595.3
2.5
561.4
2.1
842.8
2.8
3,708.4
8.4
Other – health related
3,444.2
14.6
4,275.5
16.0
4,768.8
15.6
6,049.8
13.7
Other – not health related
236.0
1.0
172.7
0.7
215.5
0.7
997.9
2.3
U.S. LPN/LVN Population
Consultant
4,227
0.6
3,490
0.6
3,526
0.5
4,285
0.6
Nurse researcher
1,955
0.3
1,170
0.2
1,575
0.2
1,329
0.2
Nurse executive
4,138
0.6
1,621
0.3
2,865
0.4
2,621
0.4
Nurse manager
41,060
5.8
37,986
6.2
39,921
5.5
49,203
6.7
Nurse faculty/educator
29,107
4.1
5,887
1.0
7,377
1.0
8,007
1.1
APRN
12,079
1.7
206
0.0
3,550
0.5
1,841
0.3
Staff nurse
487,589
68.8
447,308
73.1
527,705
72.8
488,131
66.5
Case manager
17,902
2.5
12,835
2.1
20,025
2.8
61,730
8.4
Other – health related
103,572
14.6
97,751
16.0
113,306
15.6
100,704
13.7
Other – not health related
7,097
1.0
3,949
0.7
5,120
0.7
16,611
2.3
Note. APRN = advanced practice registered nurse. Survey participants were asked to answer this question only if they were actively employed in nursing.
In the 2022 survey, a new question was added: “Are you currently a travel nurse?” The majority (95.4%) of LPNs/LVNs indicated they were not a travel nurse (Table 74).
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
In 2022, 31.3% of LPNs/LVNs reported their primary practice specialty was geriatric/gerontology. This increased from 26.6% reported in 2020. The second most common position specialty in 2022 was home health at 8.4%, which was unchanged from 2020. Pediatrics was the third most often reported practice specialty at 7.4% followed by adult health at 7.0% (Table 75 and Figure 31).
Table 75Primary Nursing Position Specialty of Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs), 2015–2022
Primary Position Specialty
2015
2017
2020
2022
n
%
n
%
n
%
n
%
LPN/LVN Survey Respondents
N = 21,932.4
N = 25,214.9
N = 28,417.9
N = 36,204.7
Acute care/critical care
458.5
2.1
670.0
2.7
1,157.6
4.1
1,227.7
3.4
Adult health
960.6
4.4
1,968.0
7.8
2,354.2
8.3
2,541.7
7.0
Anesthesia
18.0
0.1
17.6
0.1
22.5
0.1
36.9
0.1
Cardiology
-
-
250.4
1.0
312.5
1.1
338.4
0.9
Community
262.6
1.2
216.8
0.9
323.6
1.1
381.0
1.1
Emergency/trauma
157.2
0.7
127.5
0.5
261.6
0.9
531.4
1.5
Family health
-
-
1,712.4
6.8
1,840.3
6.5
1,832.6
5.1
Genetics
182.2
0.8
-
-
-
-
537.7
1.5
Geriatric/gerontology
6,064.1
27.7
7,685.8
30.5
7,545.9
26.6
11,348.1
31.3
Home health
2,109.3
9.6
2,228.2
8.8
2,372.5
8.4
3,055.9
8.4
Informatics
41.4
0.2
-
-
-
-
36.6
0.1
Information technology
-
-
-
-
-
-
28.4
0.1
Maternal-child health/obstetrics
120.5
0.6
225.1
0.9
266.5
0.9
308.1
0.9
Medical-surgical
777.3
3.5
728.6
2.9
1,008.2
3.6
1,412.8
3.9
Neonatal
28.2
0.1
28.8
0.1
40.8
0.1
23.9
0.1
Nephrology
133.7
0.6
201.0
0.8
258.2
0.9
402.2
1.1
Neurology/neurosurgical
90.6
0.4
-
-
-
-
177.1
0.5
Occupational health
154.5
0.7
160.8
0.6
183.4
0.7
242.0
0.7
Oncology
137.1
0.6
152.9
0.6
252.5
0.9
290.0
0.8
Orthopedic
185.5
0.9
-
-
-
-
256.3
0.7
Palliative care/hospice
348.2
1.6
354.7
1.4
490.7
1.7
653.5
1.8
Pediatrics
1,326.0
6.1
1,880.2
7.5
1,819.5
6.4
2,660.3
7.4
Perioperative
93.1
0.4
76.4
0.3
135.3
0.5
189.0
0.5
Primary care
1,695.5
7.7
-
-
-
-
1,725.2
4.8
Public health
173.1
0.8
257.6
1.0
332.4
1.2
456.4
1.3
Psychiatric/mental health/substance abuse
1,084.8
5.0
1,205.0
4.8
1,405.0
4.9
1,064.2
2.9
Radiology
24.2
0.1
-
-
-
-
14.1
0.0
Rehabilitation
847.7
3.9
1,081.5
4.3
990.8
3.5
1,023.1
2.8
School health
612.9
2.8
646.2
2.6
870.1
3.1
660.9
1.8
Urology
102.1
0.5
-
-
-
-
53.8
0.2
Women’s health
342.8
1.6
291.0
1.2
426.2
1.5
240.4
0.7
Other - clinical specialties
-
-
2,724.1
10.8
3,264.9
11.5
1,986.9
5.5
Other - nonclinical specialties
-
-
324.1
1.3
482.9
1.7
468.0
1.3
U.S. LPN/LVN Population
Acute care/critical care
13,787
2.1
15,319
2.7
27,504
4.1
20,437
3.4
Adult health
28,888
4.4
44,995
7.8
55,936
8.3
42,309
7.0
Anesthesia
542
0.1
401
0.1
535
0.1
614
0.1
Cardiology
-
-
5,725
1.0
7,425
1.1
5,633
0.9
Community
7,896
1.2
4,956
0.9
7,689
1.1
6,342
1.1
Emergency/trauma
4,729
0.7
2,915
0.5
6,216
0.9
8,846
1.5
Family health
-
-
39,151
6.8
43,725
6.5
30,505
5.1
Genetics
5,480
0.8
-
-
-
-
8,950
1.5
Geriatric/gerontology
182,359
27.7
175,722
30.5
179,290
26.6
188,899
31.3
Home health
63,430
9.6
50,944
8.8
56,370
8.4
50,869
8.4
Informatics
1,244
0.2
-
-
-
-
610
0.1
Information technology
-
-
-
-
-
-
473
0.1
Maternal-child health/obstetrics
3,623
0.6
5,148
0.9
6,332
0.9
5,128
0.9
Medical-surgical
23,375
3.5
16,659
2.9
23,955
3.6
23,518
3.9
Neonatal
848
0.1
659
0.1
969
0.1
398
0.1
Nephrology
4,022
0.6
4,595
0.8
6,135
0.9
6,696
1.1
Neurology/neurosurgical
2,723
0.4
-
-
-
-
2,948
0.5
Occupational health
4,647
0.7
3,677
0.6
4,358
0.7
4,028
0.7
Oncology
4,124
0.6
3,497
0.6
5,999
0.9
4,828
0.8
Orthopedic
5,577
0.9
-
-
-
-
4,267
0.7
Palliative care/hospice
10,471
1.6
8,109
1.4
11,659
1.7
10,878
1.8
Pediatrics
39,875
6.1
42,988
7.5
43,231
6.4
44,282
7.4
Perioperative
2,798
0.4
1,747
0.3
3,215
0.5
3,147
0.5
Primary care
50,986
7.7
-
-
-
-
28,717
4.8
Public health
5,207
0.8
5,889
1.0
7,898
1.2
7,597
1.3
Psychiatric/mental health/substance abuse
32,622
5.0
27,550
4.8
33,383
4.9
17,714
2.9
Radiology
727
0.1
-
-
-
-
235
0.0
Rehabilitation
25,493
3.9
24,727
4.3
23,541
3.5
17,031
2.8
School health
18,432
2.8
14,774
2.6
20,674
3.1
11,001
1.8
Urology
3,071
0.5
-
-
-
-
896
0.2
Women’s health
10,308
1.6
6,653
1.2
10,126
1.5
4,002
0.7
Other - clinical specialties
-
-
62,282
10.8
77,574
11.5
33,074
5.5
Other - nonclinical specialties
-
-
7,411
1.3
11,474
1.7
7,791
1.3
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
Providing Direct Patient Care—Primary Nursing Position
In 2022, 78.6% of LPNs/LVNs reported providing direct patient care in their primary nursing position. In 2020, the first year this question was asked, 77.8% of LPNs/LVNs said they provided direct patient care in their primary nursing position (Table 76).
Table 76Licensed Practical Nurses/Licensed Vocational Nurses Providing Direct Patient Care Through Primary Nursing Position, 2020–2022
Provide Direct Patient Care
2020 (N = 5,140.8)
2022 (N = 8,035.0)
n
%
n
%
Yes
4,393.8
85.5
6,565.3
81.7
No
747.0
14.5
1,469.7
18.3
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
Of the 20.9% of LPNs/LVNs who have more than one nursing position (Table 70), 29.9% reported practicing in a nursing home/extended care setting, 17.8% in home health, and 11.7% in an assisted living facility (Table 77 and Figure 32).
Table 77Secondary Nursing Position Setting Among Licensed Practical Nurses/Licensed Vocational Nurses, 2015–2022
Secondary Nursing Position
2015 (N = 3,018.7)
2017 (N = 4,376.2)
2020 (N = 5,067.9)
2022 (N = 8,416.1)
n
%
n
%
n
%
n
%
Hospital
180.4
6.0
261.2
6.0
461.1
9.1
756.7
9.0
Nursing home/extended care
813.3
26.9
1,422.0
32.5
1,608.2
31.7
2,516.4
29.9
Assisted living facility
232.5
7.7
332.3
7.6
374.8
7.4
983.4
11.7
Home health
961.3
31.9
1,173.1
26.8
1,189.7
23.5
1,498.7
17.8
Hospice
-
-
115.7
2.6
177.8
3.5
349.7
4.2
Correctional facility
108.7
3.6
136.6
3.1
125.1
2.5
228.6
2.7
School of nursing
32.7
1.1
10.4
0.2
54.8
1.1
97.0
1.2
Public health
30.3
1.0
55.8
1.3
54.1
1.1
179.7
2.1
Dialysis center
-
-
35.0
0.8
30.4
0.6
41.5
0.5
Community health
69.1
2.3
85.2
2.0
108.0
2.1
176.7
2.1
School health service
42.1
1.4
111.9
2.6
109.9
2.2
211.9
2.5
Occupational health
16.9
0.6
31.1
0.7
44.3
0.9
101.9
1.2
Ambulatory care setting
78.4
2.6
121.7
2.8
165.7
3.3
285.7
3.4
Insurance claims/benefits
6.5
0.2
22.8
0.5
25.8
0.5
45.8
0.5
Policy/planning/regulatory/licensing agency
15.9
0.5
16.6
0.4
6.2
0.1
36.5
0.4
Other
430.5
14.3
444.8
10.2
532.0
10.5
905.9
10.8
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
Of those LPNs/LVNs who reported more than one nursing position, 66.4% reported being staff nurses in their secondary position. This represents a decline from 2020, when 77.7% of LPNs/LVNs were staff nurses. About 20% of respondents reported other health-related titles (Table 78 and Figure 33).
Table 78Secondary Nursing Position Title of Licensed Practical Nurses/Licensed Vocational Nurses, 2015–2022
Secondary Nursing Title
2015 (N = 2,980.3)
2017 (N = 4,217.2)
2020 (N = 4,942.1)
2022 (N = 8,533.0)
n
%
n
%
n
%
n
%
Consultant
37.5
1.3
45.2
1.1
47.0
1.0
170.3
2.0
Nurse researcher
7.0
0.2
1.3
0.0
7.3
0.2
18.6
0.2
Nurse executive
10.4
0.4
10.0
0.2
8.6
0.2
45.7
0.5
Nurse manager
59.9
2.0
141.4
3.4
153.2
3.1
350.0
4.1
Nurse faculty/educator
132.0
4.4
58.4
1.4
107.9
2.2
165.4
1.9
APRN
34.1
1.1
2.6
0.1
36.1
0.7
24.7
0.3
Staff nurse
2,167.2
72.7
3,309.2
78.5
3,842.2
77.7
5,666.0
66.4
Case manager
53.8
1.8
66.6
1.6
111.6
2.3
240.4
2.8
Other – health related
440.3
14.8
528.9
12.5
586.2
11.9
1,682.9
19.7
Other – not health related
38.3
1.3
53.5
1.3
42.1
0.9
169.1
2.0
Note. Survey participants were asked to answer this question only if they were actively employed in nursing.
Providing Direct Patient Care—Secondary Nursing Practice Position
In 2022, 81.7% of LPNs/LVNs reported providing direct patient care in their secondary nursing position. In 2020, the first year this question was asked, 85.5% of LPNs/LVNs said they provided direct patient care in their secondary nursing position (Table 79).
Table 79Providing Direct Patient Care—Secondary Nursing Practice Position of Licensed Practical Nurses/Licensed Vocational Nurses, 2020–2022
Provide Direct Care
2020 (N = 5,140.8)
2022 (N = 8,035.0)
n
%
n
%
Yes
4,393.8
85.5
6,565.3
81.7
No
747.0
14.5
1,469.7
18.3
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
2022 Pretax Annual Earnings From Primary Nursing Position
The median pretax annual earnings for LPNs/LVNs grew to $50,000 in 2022. Pretax wages grew by about 14% since 2020, when the median pretax annual wage was $44,000. Compared with 2020, the percentage of LPNs/LVNs earning less than $40,000 annually (24.3%) decreased by 10.2% in 2022, while those earning between $40,000 and $60,000 (42.4%) increased by 1.5% between 2020 and 2022. The percentage of respondents in categories making between $60,000 and $80,000 per year (22.0%) also showed an increase of 6.3% from 2020 to 2022. The proportion of LPNs/LVNs making between $80,00 and $100,000 (6.8%) increased by 2.5%, and those making more than $100,000 per year (4.6%) remained the same as reported in 2020 (Table 80 and Figure 34).
Table 80Annual Earnings of Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs) for Nurses’ Primary Nursing Position, 2015–2022
Annual Earnings
2015
2017
2020
2022
n
%
n
%
n
%
n
%
LPN/LVN Survey Respondents
N = 19,436.4
N = 24,473.1
N = 26,035.6
N = 34,311.9
<$40,000
10,138.3
52.2
11,190.3
45.7
8,988.0
34.5
8,321.6
24.3
$40,000 to <$60,000
7,088.3
36.5
9,819.4
40.1
10,653.6
40.9
14,546.7
42.4
$60,000 to <$80,000
1,418.5
7.3
2,243.9
9.2
4,073.6
15.7
7,559.4
22.0
$80,000 to <$100,000
174.6
0.9
361.1
1.5
1,118.1
4.3
2,318.4
6.8
>$100,000
616.8
3.2
858.4
3.5
1,202.3
4.6
1,565.8
4.6
U.S. LPN/LVN Population
<$40,000
304,877
52.2
255,845
45.7
213,554
34.5
138,521
24.3
$40,000 to <$60,000
213,157
36.5
224,501
40.1
253,129
40.9
242,143
42.4
$60,000 to <$80,000
42,657
7.3
51,303
9.2
96,788
15.7
125,833
22.0
$80,000 to <$100,000
5,250
0.9
8,256
1.5
26,566
4.3
38,592
6.8
>$100,000
18,548
3.2
19,626
3.5
28,567
4.6
26,064
4.6
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Annual earnings include overtime and bonuses but do not include sign-on bonuses.
As was seen in the analysis of RNs, the annual median wage was greater for male LPNs/LVNs across most specialties in 2022. Female LPNs/LVNs reported higher earnings in anesthesia, emergency/trauma care, informatics, information technology, and orthopedics. LPNs/LVNs in informatics, radiology, rehabilitation, and palliative care/hospice reported the highest median wage, while LPNs/LVNs in school health, women’s health, neonatology, and family health reported the lowest median wage (Table 81).
Table 81Median Annual Earnings of Licensed Practical Nurses/Licensed Vocational Nurses for Primary Nursing Position by Nurses’ Gender and Specialty, 2022
Specialty
Male
Female
Nonbinary
Total
n
Mdn
n
Mdn
n
Mdn
n
Mdn
Acute care/critical care
41
$62,000
369
$50,000
4
$53,000
414
$50,000
Adult health
76
$59,000
588
$50,000
2
$30,556
666
$50,000
Anesthesia
1
$52,000
8
$52,900
-
-
9
$52,000
Cardiology
4
$68,100
125
$48,000
-
-
129
$48,000
Community
12
$56,500
134
$50,000
1
$80,000
147
$50,000
Emergency/trauma
21
$42,000
104
$47,500
-
-
125
$46,000
Family health
18
$55,000
758
$42,000
2
$25,000
778
$42,000
Genetics
12
$57,500
210
$51,100
1
$34,000
223
$52,000
Geriatric/gerontology
266
$60,000
3,486
$52,000
10
$47,000
3,762
$52,000
Home health
68
$55,500
816
$48,000
3
$45,000
887
$49,000
Informatics
4
$55,000
22
$66,000
-
-
26
$63,500
Information technology
2
$47,500
16
$56,000
-
-
18
$51,000
Maternal-child health/obstetrics
-
-
111
$45,000
-
-
111
$45,000
Medical-surgical
40
$50,000
403
$45,000
1
$18,000
444
$45,000
Neonatal
1
$48,000
7
$40,000
-
-
8
$41,000
Nephrology
12
$59,000
93
$50,000
-
-
105
$50,000
Neurology/neurosurgical
7
$52,000
50
$44,000
-
-
57
$45,696
Occupational health
13
$60,000
92
$47,132
2
$62,000
105
$49,000
Oncology
6
$48,250
81
$45,000
-
-
87
$45,000
Orthopedic
3
$39,590
109
$45,000
-
-
112
$44,800
Palliative care/hospice
15
$62,000
199
$52,000
2
$22,500
216
$52,932
Pediatrics
25
$50,000
721
$42,000
-
-
746
$43,000
Perioperative
6
$53,650
56
$47,183
-
-
62
$47,333
Primary care
38
$60,000
740
$48,710
1
$120,000
779
$49,483
Public health
4
$61,500
142
$43,750
1
$70,000
147
$45,000
Psychiatric/mental health/substance abuse
40
$56,500
264
$50,000
1
$63,000
305
$50,000
Radiology
1
$69,000
1
$50,000
-
-
2
$59,500
Rehabilitation
30
$55,500
247
$54,616
1
$42,000
278
$54,808
School health
6
$41,850
168
$34,500
-
-
174
$35,000
Urology
3
$50,000
19
$47,000
-
-
22
$47,500
Women’s health
-
-
64
$41,000
-
-
64
$41,000
Other – clinical specialties
3
$90,000
57
$50,000
-
60
$51,325
Other – nonclinical specialties
45
$60,000
589
$50,000
1
$52,000
635
$50,000
Total
823
$58,000
10,849
$49,184
31
$44,000
13,992
$50,000
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Annual earnings include overtime and bonuses but do not include sign-on bonuses.
As was found in previous surveys, LPNs/LVNs holding a baccalaureate degree reported the highest median annual wage ($60,000). LPNs/LVNs with an ADN ($50,000) earned similar wages to those with a vocational/practical certificate ($50,000) and those with a diploma ($48,000) (Table 82).
Table 82Median Annual Earnings of Licensed Practical Nurses/Licensed Vocational Nurses of Primary Nursing Position and by Highest Education, 2017–2022
Highest Education Level
2017
2020
2022
n
Mdn
n
Mdn
n
Mdn
Vocational/practical certificate-nursing
16,750
$42,000
17,947
$43,000
10,238
$50,000
Diploma
3,709
$41,600
3,589
$43,000
2,174
$48,000
Associate degree
2,199
$40,000
3,565
$45,000
2,119
$50,000
Baccalaureate degree
227
$51,619
566
$60,000
262
$60,000
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Annual earnings include overtime and bonuses but do not include sign-on bonuses.
Reported annual median wage rose in most states in 2022. Only five states and territories did not experience annual median wage increases. The highest median earning for LPNs/LVNs were practicing in California ($64,000), Rhode Island ($60,000), Oregon ($60,000), Nevada ($60,000), and New Jersey, Massachusetts, Hawaii, and Connecticut ($58,000 each). The lowest median earnings for LPNs/LVNs were in West Virginia ($40,020), Alabama ($44,000), and Arkansas, Iowa, Kentucky, Louisiana, Minnesota, Mississippi, Nebraska, North Dakota, Oklahoma, and Tennessee ($45,000 each). As stated above, all but five states saw increases in wages between 2020 and 2022, with 35 states seeing median wages increase by more than 10%. Wages rose between 5%–10% in nine states and by 1%–5% in three states. Wages did not change from 2020 in three states/jurisdiction (New Hampshire, New Mexico, and District of Columbia), while median annual earnings declined in two states (New York: -16.7% and Texas: -0.8%) (Table 83).
Table 83Median Annual Earnings in Primary Nursing Position by Jurisdictions Where Licensed Practical Nurses/Licensed Vocational Nurses Are Currently Practicing, 2015–2022
Missouri did not participate in the 2015 and 2017 surveys.
-
-
$40,000
$50,000
Montana
$36,260
$37,440
$43,000
$47,000
Nebraska
$33,000
$38,000
$40,000
$45,000
Nevada
$48,000
$49,000
$55,000
$60,000
New Hampshire
$42,000
$45,500
$50,000
$50,000
New Jersey
$45,000
$48,000
$54,000
$58,000
New Mexico
$45,000
$45,000
$50,000
$50,000
New York
$40,000
$45,000
$60,000
$50,000
North Carolina
$38,000
$41,000
$44,000
$50,000
North Dakota
$35,000
$37,000
$40,000
$45,000
Ohio
$34,000
$36,000
$40,000
$47,000
Oklahoma
$35,000
$37,000
$40,000
$45,000
Oregon
$42,240
$47,000
$53,000
$60,000
Pennsylvania
$39,000
$40,320
$44,000
$50,000
Rhode Island
$45,000
$50,000
$50,000
$60,000
South Carolina
$37,124
$40,000
$42,000
$48,000
South Dakota
$30,000
$34,865
$38,000
$45,500
Tennessee
$34,000
$36,000
$40,000
$45,000
Texas
$40,082
$43,000
$49,383
$49,000
Utah
$36,000
$41,000
$41,000
$47,646
Vermont
$37,128
$42,000
$45,000
$50,381
Virginia
$36,000
$40,000
$44,000
$50,000
Washington
$44,000
$48,000
$54,000
$55,000
West Virginia
$32,000
$35,000
$36,000
$40,020
Wisconsin
$35,000
$38,000
$40,000
$50,000
Wyoming
$40,000
$40,500
$44,000
$50,000
Northern Mariana Islands
$55,000
$28,500
$32,959
$45,000
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Annual earnings include overtime and bonuses but do not include sign-on bonuses.
a Missouri did not participate in the 2015 and 2017 surveys.
As was previously noted with RNs, wages for LPNs/LVNs saw steady increases by years of experience except for LPNs/LVNs with more than 10years of experience, which did not change. LPNs/LVNs reported wage increases across the younger age groups. Earnings in the 30 to 34 age group increased by 14.2% over the 17 to 29 age group, 5.0% in the 35 to 39 age group, and 4.2% in the 40 to 44 age group over their younger age groups. Two age groups (60-64 and ≥65) reported median wage decreases when compared to the next youngest age group (Table 84).
Table 84Median Annual Earnings of Licensed Practical Nurses/Licensed Vocational Nurses for Primary Nursing Position by Nurses’ Years Licensed and Age, 2022
Number of Years Licensed
0–1
2–5
6–10
≥11
Total
Age, y
n
Mdn
n
Mdn
n
Mdn
n
Mdn
n
Mdn
17–29
299
$36,000
615
$42,000
126
$41,375
7
$49,820
1,047
$40,000
30–34
132
$40,000
410
$47,217
461
$46,000
118
$46,000
1,121
$45,696
35–39
97
$40,000
305
$46,630
396
$48,000
542
$49,000
1,340
$48,000
40–44
83
$40,000
273
$50,000
385
$50,000
873
$50,000
1,614
$50,000
45–49
62
$45,000
173
$50,000
291
$52,000
1,075
$51,000
1,601
$50,000
50–54
55
$49,000
138
$53,500
256
$53,000
1,438
$52,000
1,887
$52,000
55–59
20
$53,000
84
$48,250
151
$56,000
1,520
$52,000
1,775
$52,000
60–64
13
$40,000
32
$54,500
108
$50,000
1,771
$50,000
1,924
$50,000
≥65
5
$54,000
38
$43,000
49
$52,000
1,591
$47,000
1,683
$47,000
Total
766
$40,000
2,068
$46,113
2,223
$50,000
8,935
$50,000
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Annual earnings include overtime and bonuses but do not include sign-on bonuses.
Telehealth utilization by LPNs/LVNs remains relatively unchanged from previous years, with a little less than half of LPNs/LVNs (44.5%) not providing services via telehealth. However, slightly more LPNs/LVNs who reported utilizing telehealth all the time rose to 15.2%, an increase of 3.8% from the 2020 survey. About a quarter (23.4%) of LPNs/LVNs spend up to a quarter of their time and 12.5% spend between a quarter and half of their time proving services via telehealth (Table 85 and Figure 35).
Table 85Percentage of Time Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs) Spend Providing Telehealth, 2015–2022
Provide Telehealth
2015
2017
2020
2022
n
%
n
%
n
%
n
%
LPN/LVN Survey Respondent
N = 23,619.9
N = 27,760.6
N = 31,095.7
N = 39,650.3
Never
12,723.1
53.9
12,715.8
45.8
15,504.3
49.9
17,650.4
44.5
1%–25%
5,496.6
23.3
6,436.4
23.2
6,799.8
21.9
9,283.1
23.4
26%–50%
2,207.1
9.3
2,821.3
10.2
2,993.3
9.6
4,965.5
12.5
51%–75%
1,490.6
6.3
2,253.8
8.1
2,240.4
7.2
1,716.6
4.3
76%–100%
1,702.4
7.2
3,533.3
12.7
3,557.9
11.4
6,034.7
15.2
U.S. LPN/LVN Population
Never
382,606
53.9
290,722
45.8
368,381
49.9
293,806
44.5
1%–25%
165,294
23.3
147,157
23.2
161,563
21.9
154,526
23.4
26%–50%
66,373
9.3
64,503
10.2
71,121
9.6
82,656
12.5
51%–75%
44,826
6.3
51,529
8.1
53,232
7.2
28,574
4.3
76%–100%
51,195
7.2
80,781
12.7
84,535
11.4
100,453
15.2
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
About 71% of LPNs/LVNs did not utilize telehealth to provide services to patients across state lines in 2022. Twenty percent of LPNs/LVNs reported spending between 1% and 25% of their time providing services to patients in other states through telehealth. Utilization of services across state borders through telehealth declined in compared to the reported 2020 rates (Table 86 and Figure 36).
Table 86Percentage of Time Licensed Practical Nurses/Licensed Vocational Nurses Spend Providing Telehealth Across State Borders, 2015–2022
Provide Telehealth
2015 (N = 11,421.5)
2017 (N = 12,214.3)
2020 (N = 12,981.4)
2022 (N = 23,516.1)
n
%
n
%
n
%
n
%
Never
7,566.5
66.2
6,849.9
56.1
7,413.4
57.1
16,616.9
70.7
1%–25%
3,140.4
27.5
4,040.1
33.1
4,062.8
31.3
4,721.9
20.1
26%–50%
371.1
3.2
622.9
5.1
692.7
5.3
1,043.3
4.4
51%–75%
180.4
1.6
372.2
3.1
390.8
3.0
288.8
1.2
76%–100%
163.1
1.4
329.3
2.7
421.7
3.3
845.1
3.6
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
A little more than 10% of LPNs/LVNs in the United States provide services via telehealth across international borders. This rate has changed little from previous surveys (Table 87 and Figure 37).
Table 87Percentage of Time Licensed Practical Nurses/Licensed Vocational Nurses Spend Providing Telehealth Across National Borders, 2015–2022
Provide Telehealth
2015 (N = 11,089.2)
2017 (N = 11,117.1)
2020 (N = 12,295.4)
2022 (N = 16,513.5)
n
%
n
%
n
%
n
%
Never
10,201.8
92.0
9,800.3
88.2
11,068.0
90.0
14,768.6
89.4
1%–25%
633.3
5.7
807.0
7.3
814.2
6.6
1,074.2
6.5
26%–50%
129.0
1.2
208.1
1.9
193.3
1.6
313.3
1.9
51%–75%
82.0
0.7
189.0
1.7
115.8
0.9
66.3
0.4
76%–100%
43.1
0.4
112.7
1.0
104.2
0.9
291.2
1.8
Note. Survey participants were asked to answer this question only if they were actively employed in nursing. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
As seen in previous years, the use of the telephone is the most common mode (88.1%) of communication for telehealth provision by LPNs/LVNs. The use of electronic messaging was the second most common mode (35.6%) and has increased markedly in use since 2020. Email was the third most common mode at 32.8% and was relatively unchanged since 2020. The use of video call technology was used in 30.9% of provisions of telehealth service and had increased by 19.6% since 2020 (Table 88 and Figure 38).
Table 88Modes of Communication Used by Licensed Practical Nurses/Licensed Vocational Nurses for Telehealth, 2015–2022
Mode of Telehealth
2015 (N = 8,881.7)
2017 (N = 11,164.0)
2020 (N = 12,154.9)
2022 (N = 16,948.4)
n
%
n
%
n
%
n
%
Electronic messaging
1,947.7
21.9
2,510.8
22.5
3,280.4
27.0
6,036.3
35.6
Virtual ICU
84.9
1.0
125.2
1.1
287.5
2.4
830.2
4.9
Telephone
8,498.5
95.7
10,405.0
93.2
11,274.7
92.8
14,924.3
88.1
Email
2,622.2
29.5
3,226.2
28.9
3,706.7
30.5
5,565.4
32.8
Video call
207.4
2.3
260.7
2.3
1,371.8
11.3
5,236.4
30.9
Other
883.0
9.9
1,027.2
9.2
998.1
8.2
1,631.8
9.6
Note. ICU = intensive care unit. Survey participants were asked to answer this question only if they were actively employed in nursing. Respondents were asked to select all that apply. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
The coronavirus pandemic affected LPN/LVN respondents most through its impact on their workload. More than 60% reported an increase in their workload due to the pandemic. About 11% of LPN/LVN respondents reported a change in their practice setting because of COVID-19 (Table 89).
Table 89Impact of COVID on Employment of Licensed Practical Nurses/Licensed Vocational Nurses, 2022
Impact
%
My workload increased
62.9
I became a travel nurse
3.7
I changed my practice setting
11.4
I started doing telehealth
4.8
I left nursing
4.0
I retired
5.9
No impact
14.4
Other
17.2
Note. Respondents were asked to select all that apply. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
About a quarter of LPNs/LVNs reported they were emotionally drained from work every day and another 25.8% reported they were emotionally drained a few times per week. Thus, about a half of LPNs/LVNs reported that they were emotionally drained from work at least a few times every week. Only 6.9% reported never feeling emotionally drained from work (Table 90).
Table 90Feeling of Being Emotionally Drained From Work of Licensed Practical Nurses/Licensed Vocational Nurses, 2022
Felt emotionally drained
2022 (N = 48,786.9)
n
%
Never
3,385.1
6.9
A few times a year
5,032.3
10.3
Once a month or less
3,535.8
7.3
A few times a month
7,823.6
16.0
Once a week
4,365.8
9.0
A few times a week
12,580.4
25.8
Every day
12,064.0
24.7
Note. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
Over half of LPNs/LVNs reported feeling used up at the end of their workday, with more than half of this group feeling that way every day. Less than 20% reported feeling used up at the end of their workday only a few times per year or never (Table 91).
Table 91Licensed Practical Nurses/Licensed Vocational Nurses Who Reported Feeling Used Up at the End of Their Workday, 2022
Felt Used Up
2022 (N = 48,421.6)
n
%
Never
4,259.8
8.8
A few times a year
3,783.9
7.8
Once a month or less
3,465.1
7.2
A few times a month
5,943.5
12.3
Once a week
4,288.8
8.9
A few times a week
12,397.3
25.6
Every day
14,283.4
29.5
Note. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
Over a quarter of LPNs/LVNs reported feeling fatigued when they get up and have to face another day on the job every day. Another 24.2% reported feeling fatigued when they get up and have to face another day on the job a few times a week. About 10% reported never feeling fatigued when they get up and have to face another day on the job (Table 92).
Table 92Licensed Practical Nurses/Licensed Vocational Nurses Who Reported Feeling Fatigued When They Get Up, 2022
Felt Fatigued
2022 (N = 48,501.1)
n
%
Never
5,104.7
10.5
A few times a year
4,594.4
9.5
Once a month or less
3,855.6
8.0
A few times a month
6,175.4
12.7
Once a week
4,340.0
9.0
A few times a week
11,716.8
24.2
Every day
12,714.2
26.2
Note. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
A quarter of LPNs/LVNs reported feeling burned-out from work every day, and nearly 20% reported feeling burned-out at least once per week. About 13% reported never feeling burned-out from work (Table 93).
Table 93Licensed Practical Nurses/Licensed Vocational Nurses Who Reported Feeling Burned-Out From Work, 2022
Felt Burned-Out
2022 (N = 48,541.6)
n
%
Never
6,211.2
12.8
A few times a year
6,315.6
13.0
Once a month or less
4,158.7
8.6
A few times a month
6,193.9
12.8
Once a week
3,881.5
8.0
A few times a week
9,482.2
19.5
Every day
12,298.6
25.3
Note. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
How Often Did You Feel You Were at the End of Your Rope?
About 30% of LPNs/LVNs reported feeling they were at the end of their rope at least a few times per week, with half of this group feeling like that every day. About a third of LPNs/LVNs never felt like they were at the end of their rope (Table 94).
Table 94Licensed Practical Nurses/Licensed Vocational Nurses Who Reported Feeling at the End of Their Rope, 2022
Felt at the End of Their Rope
2022 (N = 48,323.7)
n
%
Never
15,773.1
32.6
A few times a year
5,867.5
12.1
Once a month or less
3,840.2
8.0
A few times a month
4,924.3
10.2
Once a week
3,789.2
7.8
A few times a week
6,839.5
14.2
Every day
7,289.9
15.1
Note. This question was not administered in the jurisdictions of Missouri, North Carolina, New Mexico, Washington, or Wyoming.
Many older nurses left the workforce between 2020 and 2022. This decline was associated with estimated losses to the workforce of at least 200,000 experienced RNs and 60,000 experienced LPNs/LVNs. The loss of the intellectual capital of older nurses is concerning, but that loss is somewhat offset by the growing number of younger nurses in the profession.
The workforce in 2022 is more demographically diverse and representative of the country’s population than in any year in which this study was previously conducted. The racial composition reflects growth in diversity with increases reflected for Hispanic and multiracial nursing categories. It is unclear whether this increase in diversity will slow. After years of decline, the proportion of RNs and LPNs/LVNs identifying as White/Caucasian in the youngest age ranges has risen back to the level of the overall population mean.
Though women continue to account for the majority of nurses, the proportion of men licensed as RNs or LPNs/LVNs in the country has increased steadily since at least 2015. Additionally, male nurses are more racially diverse than their female counterparts. Although the rate of growth appears to be leveling, this is a positive trend for gender diversity in the profession.
Employment
Nursing employment jumped significantly. About 88% of all licensed nurses who maintain licensure are employed in nursing; among those who are employed in nursing, roughly 71% work full-time, 10% work part-time, and 7% work per diem shifts. While the proportion of nurses working in nursing part-time or per diem has remained steady since 2020, the proportion of nurses working full-time has increased by about 5% during this same time.
Over the past reporting periods, there has been a consistent number of licensed RNs and LPNs/LVNs who report working in fields other than nursing. Using weighted sample values, this translates to approximately 200,000 licensees. Proportionally more LPNs/LVNs than RNs work in a field other than nursing (5.5% vs 3.4%, respectively). Despite recent concerns about nurses leaving the profession, a larger proportion is now practicing in nursing roles than in previous years.
But future employment may still be impacted by the exit of nurses. In the survey, respondents were asked if they plan to retire in the next 5 years, and 28% of all nurses replied positively to the question, an increase from the 21% who responded positively in 2020. These data are consistent with the idea that the long-anticipated “retirement tsunami of nurses” (
For nurses who report being unemployed, about 47% of RNs and roughly 42% of LPNs/LVNs cite taking care of home and family as their reason for not working. The COVID-19 pandemic is another significant reason reported for unemployment among RNs (22.6%) and LPNs/LVNs (20.2%). In past reports, about 11% of RNs and 17% of LPNs/LVNs indicated a disability was the main reason for being unemployed, but this has declined in 2022. About 7% of RNs and 13% of LPNs/LVNs reported a disability as the reason for being unemployed in 2022.
Most nurses (82.4% of RNs and 79.2% of LPNs/LVNs) work in only one position in nursing. However, 17.6% of RNs and 20.9% of LPNs/LVNs reported that they work in two or more nursing positions. Nearly 53% of nurses work 32 to 40hours per week and about a third of nurses work more than 40hours each week.
Hospitals continue to be the primary practice setting for RNs (57.5%), followed by the ambulatory care setting (10.4%), nursing homes (3.9%), and home health (3.4%). The primary practice setting for LPNs/LVNs is nursing homes/extended care settings (30.6%), followed by hospitals (11.7%) and home health (11.6%). In comparison to 2020, increased proportions of RNs and LPNs/LVNs reported providing direct patient care in their jobs.
Education
In the 2022 survey, the educational accomplishment of RNs increased with more than70% of the workforce holding a baccalaureate degree or higher. But the nation continues to fall short of the National Academy of Medicine’s (formerly the Institute of Medicine) goal for 80% of RNs to hold a baccalaureate degree or higher (
The proportion of baccalaureate-prepared and master’s-prepared nurses increased from 2020 to 2022, while the proportion of nurses earning a diploma, associate degree, or vocational/practical certificate decreased from 2020 to 2022.
There is evidence that RNs and LPNs/LVNs are continuing their nursing education after obtaining their initial nursing license. From 2015 through 2022, diplomas in nursing and ADNs decreased from 39.3% to 28.4%, while bachelor’s of science in nursing, master’s of science in nursing, DNPs, and other doctoral degrees increased from 59.9% to 70.8%; however, PhDs remained fixed around 0.9%. No growth or slow growth of PhD-prepared nurses is concerning because this population of nurses has the expertise to conduct research, generate new knowledge, and serve in the role of faculty to prepare the nation’s future nurses.
Younger nurses tended to hold a baccalaureate degree as their highest level of nursing education, while older nurses tended to have a nursing diploma or associate degree as their highest level of nursing education. The highest level of education was very similar for male and female nurses with respect to baccalaureate and associate degrees. However, male RNs tended to hold doctorate degrees at a slightly higher proportion than female RNs (3.1% vs. 2.6%).
Licensure
As in previous years, most RNs (96%) and LPNs/LVNs (99%) obtained their initial nursing license in the United States. However, evidence suggests that these nurses are less experienced now than in previous years. The proportion of RNs licensed for 20 or fewer years was at the highest level in 2022 (62.5%) when compared to the previous three surveys. The same trend was reported in the LPN/LVN workforce; in 2022, 69.4% of the responding LPNs/LVNs were licensed for 20 or fewer years.
By contrast, APRN credentials and multistate licenses are now more prevalent. The proportion of RNs holding an APRN credential recovered from the 5-year low recorded in 2020 (6.6%) and was at its second-highest level (9.8%) in 2022. The reported prevalence of APRN credentials was only 0.2% lower than the highest level of 10% in 2017. Although the proportion of nurses holding a multistate license increased by 6.3% for RNs and 7.5% for LPNs/LVNs in the past 2years, fewer than a third reported actively using it. Of the few who reported using it, most used it for providing telehealth services. travel nursing, and multistate practice.
Annual Earnings
Nursing incomes for both RNs and LPNs/LVNs have increased annually by about 7% from 2020 to 2021. with the median RN income increasing from $70,000 to $80,000 and the median LPN/LVN income increasing from $44,000 to $50,000. RNs’ earnings grew in every state except New Hampshire and Tennessee. Similarly, earnings for LPNs/LVNs grew in every state except for five. Wages did not change in three states (New Hampshire, New Mexico, and the District of Columbia) and declined in two (New York and Texas).
Inflation and increased demand due to the pandemic are likely contributors to the increase in wages, but another possible contributing explanation is that highly paid travel nurses were common during the pandemic. While only 6% of RNs and 5% of LPNs/LVNs are currently travel nurses, the demand for travel nurses was much higher during the first year of the pandemic. In 2020, the number of travel nurses grew by 35% over the previous year and wages grew by 25% (
). As the use of travel nurses decreases, it will be interesting to see how this affects future earnings growth.
Telehealth
While telehealth has become a major focus of pandemic healthcare delivery, it does not seem to have changed how nurses use telehealth overall. However, there is some reason to believe the use of telehealth is increasing for some nurses. Nurses who spend much of their time providing services via telehealth increased since 2020. It is likely that nurses working in areas with high telehealth utilization, such as primary care and ambulatory care settings, are beginning to learn how to best use telehealth to provide nursing services. Both RNs and LPNs/LVNs saw a large increase in the use of video calls to deliver services (24.4% for RNs and 19.6% for LPNs/LVNs) since 2020.
The Impact of COVID-19
The COVID-19 pandemic had a deleterious impact on nurses’ work and emotional well-being. Over 60% of all nurses reported an increase in their workload due to COVID-19, while 16% of RNs and 11% of LPNs/LVNs reported changing their practice settings. Consequently, it was not surprising that the majority of nurses reported feeling emotionally drained from work, used up at the end of their workday, and fatigued when they woke up. A considerable proportion also reported feeling at the end of their rope and burned out from work. The toll of COVID-19 on nurses requires urgent attention.
Conclusion
In the wake of the COVID-19 pandemic, the nursing workforce has undergone a dramatic shift with the loss of hundreds of thousands of experienced RNs and LPNs/LVNs. The nursing workforce has become younger and more diverse, with increases reflected in Hispanic/Latino and multiracial nursing categories, in addition to a steady increase in the proportion of men licensed. An increasing proportion of the RN workforce holds a baccalaureate degree or higher, moving closer to goals established by the National Academy of Medicine (2011). Salaries have notably increased for RNs and LPNs/LVNs, likely due to inflation and increased demand for nursing services. With the majority of nurses reporting feeling emotionally drained from work, used up at the end of their workday, and fatigued when they wake up, and with about a quarter of the population contemplating leaving the profession, the impact of the pandemic may still be felt in the future.
Appendices
Appendix A 2022 National Workforce Study Questionnaire
Appendix B Registered Nurse Nonresponse Analyses and Sample Weighting
Registered Nurse Nonresponse Analyses and Sample Weighting
A formal nonresponse bias analysis was conducted following the close of the survey. Although response rates are a valuable indicator of survey quality, they are not a good measure of response bias. An analysis of basic demographic data (gender and age) for all registered nurse (RN) licensees sampled from the Nursys database was used to compare the survey respondents and nonrespondents to determine the representativeness of the survey participants. The analysis was restricted to the states in the mailout portion of the survey who allowed the data to be shared from the Nursys database.
Variables in the data file came from both the Nursys database (i.e., the frame data) and responses to the survey (i.e., survey data). The variables used in the nonresponse analysis were from the frame and include state, date of birth, gender, and ethnicity. The dependent variable in the analysis was whether or not the sampled RN population completed the questionnaire.
Preliminary Analysis
Of the 150,698 RNs in the sample frame, 26,757 responded for a response rate of 17.8%
(Table B1). Table B2 shows the frequencies for gender. Table B3 shows the descriptive statistics for age. The only demographic information used for the following analyses come from Nursys, not the survey.
Table B4 shows the bivariate relationship between gender from the sample frame and whether or not the respondent completed the survey. There were far fewer men in the database (9,695 men compared to 80,444 women), and they were less likely to complete the survey (12.6% among men compared to 17.0% among women).
Table B4Response Bias of Registered Nurses: Survey Completion Rate by Gender (N = 150,698)
Table B5 displays the mean age of RNs. On average, those who completed the survey were 4.9 years older than the nonrespondents. This relationship was statistically significant.
Table B5Response Bias RNs: Differences in Mean Age by Survey Completion
Complete survey?
n
Age, y, M (SD)
No
69,676
45.5 (13.7)
Yes
14,121
50.4 (14.5)
Total
83,797
46.3 (14.0)
Note. A t test showed that the relationship was significant at p < .001.
In the 2015, 2017, and 2020 National Nursing Workforce Survey reports, nonresponse adjustments were made for gender and age. For the 2022 Survey, nonresponse adjustments were applied for gender and age in the jurisdictions for which data were obtained through the Nursys database. To create the combined age and gender (AgeGender) nonresponse weights (i.e., AgeGenderWgtC), the survey response rates for the age variable were compared at the 5-year age group level and neighboring cells with similar response rates were collapsed. Upon completion of this process, five age groups were created (18 to 34, 35 to 54, 55 to 59, ≥60, and missing). These five age groups were combined with the gender variable response categories (male, female, missing) to produce 15 AgeGender categories. The survey response rate for each AgeGender category (# responding/# in sample frame) was calculated and used to create each category’s weight as follows:
As an example of how this was calculated, there were 1,794 RNs in the sample frame whose gender was identified as male and whose age was missing. Out of these 1,794 RNs, 196 responded. The AgeGender response rate for this category was determined to be 196/1794 = .1093. The overall survey response rate was 26757/129356 = 0.2068. So the AgeGender weight for the age missing-gender male category was 0.2068/0.1093 = 1.8934.
When the AgeGender weights for each respondent are totaled, the sum comes to 26,757 – the same as the total number of respondents. Table B6 displays the weights for the 18 AgeGender categories in jurisdictions for which data were obtained through the Nursys database.
Table B6Response Bias of Registered Nurses: AgeGender Weights
In a similar manner, poststratification weights (i.e., JurisdictionWgtC) were constructed at the state level to adjust for differing sampling rates across states. These adjustments were made by comparing the number of responses to the number of licensees in that state. Analysis of the raw data, without accounting for the sample design, would lead to the overall results being too heavily influenced by states with fewer licensees.
For example, there were 466,414 RNs in California out of which 664 responded. The California response per license rate was 664/466414 = 0.0014. The overall response per license rate was 278631/5239499 = 0.0532. So, the poststratification weight for California was 0.0532/0.0014 = 37.3545.
Overall weights (pct_wgtC), which combined the AgeGender and poststratification weights, were created by multiplying the AgeGender and poststratification weights for each individual to create an initial set of weights, adding the initial weights together and slightly adjusting the weights so that they summed to 278,631—the total number of responses in the mailout, email, and e-Notify portions of the survey.
The overall weights adjust the distribution across states, age, and gender but sum to the actual number of RNs in the subset of completed responses. They can be applied when analyzing relationships between variables without the effect of artificially altering the degrees of freedom and thereby affecting significance tests.
Licensed Practical/Vocational Nurse Nonresponse Analyses and Sample Weighting
As with the RNs, a formal nonresponse bias analysis was conducted on the licensed practical nurse/licensed vocational nurse (LPNs/LVNs) data following the close of the survey. Variables in the data file came from both the Nursys database (i.e., the frame data) and responses to the survey (i.e., survey data). The variables used in the nonresponse analysis were from the frame and included date of birth and gender. The dependent variable in the analysis was whether or not the sampled LPN/LVN population completed the questionnaire. The analysis was restricted to the states in the mailout portion of the survey who allowed the data to be shared from the Nursys database.
Preliminary analysis
Of the 149,169 LPN/VNs in the sample frame, 22,634 responded for a response rate of 15.2% (Table B7). Table B8 shows the frequencies for gender, and Table B9 shows the descriptive statistics for age.
Tables B10 shows the bivariate relationship between gender from the sample frame and whether or not the respondent completed the survey. There were far fewer men in the database (7,526 men compared to 83,338 women), and they were less likely to complete the survey (10.0% among men compared to 14.7% among women).
Table B10Response Bias of Licensed Practical Nurses/Licensed Vocational Nurses: Survey Completion Rate by Gender
Table B11 displays the mean age of LPN/VNs. On average, those who completed the survey were 6 years older than nonrespondents. This relationship was statistically significant.
Table B11Response Bias of Licensed Practical Nurses/Licensed Vocational Nurses: Differences in Mean Age by Survey Completion
Complete survey?
n
Age, y, M (SD)
No
75,842
46.2 (13.2)
Yes
12,688
52.2 (13.7)
Total
88,530
47.1 (13.4)
Note. A t test showed that this relationship was significant at p < .001.
In the 2015, 2017, and 2020 National Nursing Workforce Survey reports, nonresponse adjustments were made for gender and age. For the 2022 Survey, nonresponse adjustments were applied for gender and age in the jurisdictions for which data was obtained through the Nursys database. To create the combined age and gender (AgeGender) nonresponse weights (i.e., AgeGenderWgtC), the survey response rates for the age variable were compared at the 5-year age group level and neighboring cells with similar response rates were collapsed. Upon completion of this process, five age groups were created (18 to 34, 35 to 54, 55 to 59, ≥60, and missing). These five age groups were combined with the gender variable response categories (male, female, missing) to produce 15 AgeGender categories. The survey response rate for each AgeGender category (# responding/# in sample frame) was calculated and used to create each category’s weight as follows:
An example of how this was calculated can be found in the RN nonresponse sample weighting section.
When the AgeGender weights for each respondent are totaled, the sum equals 22,634 – the same as the total number of respondents. Table B12 displays the weights for the 15 AgeGender categories in jurisdictions for which data were obtained through the Nursys database.
In a similar manner, poststratification weights (i.e., JurisdictionWgtC) were constructed at the state level to adjust for differing sampling rates across states. However, these adjustments were made not by comparing the number of responses in a state to its sample frame count, but rather by comparing the number of responses to the number of licensees in that state. An example of how these weights were calculated can be found in the RN nonresponse sample weighting section.
Overall weights (pct_wgtC), which combined the AgeGender and poststratification weights, were created by multiplying the AgeGender and poststratification weights for each individual to create an initial set of weights, adding the initial weights together, and slightly adjusting the weights so that they sum up to 55,503– the total number of responses in the mailout, email, and e-Notify portions of the survey.
The overall weights adjust the distribution across states, age, and gender but sum to the actual number of LPNs/LVNs in the subset of completed responses. They can be applied when analyzing relationships between variables without the effect of artificially altering the degrees of freedom and thereby affecting significance tests.
References
Institute of Medicine
Future of nursing: Leading change, advancing health.
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