Are Nurses Middle Class?

As AI and automation increasingly threaten jobs, we wanted to see if nurses could still be considered middle class and how their earnings compare to other professions.

To undertake our study, we adapted the Pew Foundation’s definition of middle-income earners. Pew defines the middle-class income bracket as being between two-thirds and two times the annual median household income; we adapted this definition to apply to individual jobs rather than households.

The findings are clear: compared to other occupations, nurses are doing well. This study provides an overview of just how 'middle class' nurses are across the United States, highlighting the financial stability and significant upward mobility that a career in nursing can offer, even in the face of today's economic uncertainties.

Findings

• Nurses can considered middle class at the national level, earning near the top of the middle-income range. With a median salary of $86,070, registered nurses earn 79% more than average, which places them close to the upper boundary of the middle class.
• In several states, registered nurses not only achieve but surpass middle-income earnings, placing them in the upper-income bracket. Specifically, registered nurses' salaries are in the upper-income band in Hawaii, California, Oregon, and Nevada. 
• All types of nurses—LVNs, LPNs, RNs, and NPs—earn middle-income or above, with median salaries ranging from $59,730 to $126,260, ensuring a solid path to financial stability and upward mobility.

Where do nurse salaries exceed middle-income salaries? 

There are a few states where nurses earn above the middle-income band. In Hawaii, California, Oregon and Nevada, nurses earn more than twice the median income for all workers. Experts often cite higher living costs and a nursing shortage as the main culprits for high nurse salaries. However, further investigation shows that other factors make nursing a well-paying job, namely strong unions and nurse-friendly regulations.

Hawaii

In Hawaii, registered nurses earn a median salary of $129,210, 27% above the middle-class range for the state, spanning from $33,673 to $101,020. One factor causing Hawaii's registered nurse salaries to be so high is the increased demand and limited supply, as the state experiences a nursing shortage. Although the number of licensed RNs has increased, the share of resident nurses has decreased from 67% in 2013 to 56% in 2023.

California

Registered nurses in California enjoy a median salary of $133,990, about 24% higher than the upper limit of the middle-class bracket, with the middle-class range for Californians being between $36,020 and $108,060. California nurses benefit from a confluence of factors: a nursing shortage, solid unions and nurse-friendly regulations. 

In 1999, California passed a law establishing minimum nurse-to-patient ratios in hospitals, driving up demand for registered nurses. In a 2009 study, Spetz and colleagues found that from 2000 to 2006, registered nurses in California’s urban centers saw their wages rise by as much as 12 percent more than RNs in other states.

Oregon

In Oregon, the median salary for registered nurses is $110,940. Oregon's middle-class income range is from $33,340 to $100,020. The median nurse salary surpasses the middle-class threshold by approximately 10.9%, highlighting the relatively high earning potential for registered nurses in Oregon.

Similar to California, Oregon nurses also have solid unions and regulations. Last year, the Oregon Nurses Association (ONA) union significantly contributed to successfully negotiating a new contract for nurses at Oregon Health & Science University (OHSU), avoiding a potential strike. After ten months of negotiations, the new three-year contract includes an average base wage increase of 37%.

On the policy front, Oregon also regulates staffing ratios. A lower patient-to-nurse ratio can increase the demand for nurses and, as a result, increase nurse pay. 

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Nevada

Nevada's registered nurses earn a median salary of $96,210, 11% higher than the middle-class range of $29,873 to $89,620.

Where Do Practical and Advanced Practice Nursing Incomes Sit on the Middle-Class Spectrum?‍

Whether you're a Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Registered Nurse (RN), or Nurse Practitioner (NP), you'll find yourself comfortably within the middle-class income range. LVNs and LPNs earn about $59,730 annually, RNs bring in $86,070, and NPs make a notable $126,260. According to the Pew Research Center, the middle-class income bracket ranges from $32,040 to $96,120, and all these nursing roles fit neatly within or above this range.

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Nursing offers a progressive path depending on your career and educational goals. For LVNs and LPNs, a diploma or certificate from an accredited nursing program, usually about a year in length, is required. RNs need an Associate’s or Bachelor’s degree, which can take two to four years. If you're aiming higher, Nurse Practitioners require a Master’s or Doctoral degree in Nursing, opening doors to advanced clinical roles and higher salaries. This structured career progression offers not just job stability, but also exciting opportunities for career advancement and increased earning potential as you gain more education and experience.

‍Bottom Line

Nurses are firmly within the middle class, according to our definition. However, salaries vary significantly across the U.S., with some states offering much higher wages due to factors like nurse shortages, state regulations, and strong union presence. It's important to note that for the sake of simplicity, we’ve ignored other elements of class for this study, such as education and social status. 

Becoming a nurse, whether it's a practical nurse, RN or NP requires school and continuing education. The challenges are considerable, with nurses often facing long hours, high-stress situations, and physical demands.  However, it offers a pathway to a relatively high-paying, stable career. According to the Bureau of Labor Statistics, the nursing field is projected to grow faster than average at a rate of 6%, driven by an aging population, increasing healthcare needs, and advancements in medical technology. Ultimately, nursing is not only a solid middle-class career but also a crucial component of the healthcare system, ensuring the well-being of communities nationwide.

Methodology

To create this list, HealthJob pulled wage national and state-level wage data for the Bureau of Labor Statistics's Occupational Employment and Wage Statistics (OEWS) wage data. We then adapted Pew's definition of the middle class—where the lower bound is two-thirds the annual salary and the upper bound is twice the annual salary—to determine whether nurses earned middle class salaries.

All States