MORGANTOWN – Registered nurses in West Virginia rank relatively low for hourly pay compared to those in other states, but fare better when their pay is adjusted for cost of living.

Pay for nurse practitioners ranks even lower, but their adjusted rate places them even higher.

And the pay for physician assistants, when adjusted for cost of living, is among the best in the nation.

The numbers come from three articles in Becker’s Hospital Review. This story looks at the numbers and then focuses on registered nurses and the various factors – not just pay – affecting the nursing shortage statewide and across the nation.

The numbers

West Virginia registered nurses rank 45^th in the nation among the 50 states and Washington, D.C., for mean hourly pay, at $36.53 per hour.

But adjusting for cost of living (COL), their pay amounts to $40.45 per hour, 35^th in the nation.

Becker’s used May 2023 salary data from the U.S. Bureau of Labor Statistics and 2024 COL data from the World Population Review.

World Population Review averages COL across the nation and sets that as the baseline of 100. Individual states are then given a number reflecting costs there compared against the baseline. West Virginia’s index number is 90.3.

Among West Virginia’s neighbors, Maryland is 16^th nationally at $44.27 per hour, but 45^th adjusted for COL, at $37.05. It’s COL index is 119.5.

The other neighbors: Virginia, 23^rd, $42.48; COL adjusted, 31^st, $41.20. Pennsylvania, 25^th, $42.08; COL adjusted, 21^st, $42.51. Ohio, 29^th, $40.59; COL adjusted, 17^th, $43.18. Kentucky, 38^th, $39.31; COL adjusted, 25^th, $41.91.

West Virginia nurse practitioners rank 47^th nationally, at $54.54. They rise to 28^th nationally when adjusted for COL, at $60.40.

Maryland, 20^th, $61.54; COL adjusted, 47^th, $51.50. Pennsylvania, 24^th, $61.27; COL adjusted, 21^st, $61.89. Ohio, 33^rd, $59.07; COL adjusted, 17^th, $62.84. Virginia, 39^th, $58.11; COL adjusted, 39^th, $56.36. Kentucky, 49^th, $53.06; COL adjusted, 37^th, $56.57.

West Virginia’s physician assistants rank higher than all of our neighbors for actual mean hourly wage and adjusted for COL. For actual wage, they rank 37^th, at $58.55. Adjusted for COL, they climb to 13^th, at $64.84.

Virginia, 38^th, $57.70; COL adjusted, 40^th, $55.98. Ohio, 39^th, $57.67; COL adjusted, 25^th, $61.35. Pennsylvania, 40^th, $57.58; COL adjusted, 33^rd, $58.16. Maryland, 42^nd, $56.39; COL adjusted, 47^th, $47.18. Kentucky, 47^th, $47.74; COL adjusted, 45^th, $50.89.

The nurse shortage

Melanie Heuston is chief nursing executive for the entire WVU Health System and is overseeing the creation of the WVU Medicine Center for Nursing Education at the WVU Innovation Corp. building.

“The nursing shortage has been going on for quite some time,” she said – nationally and in West Virginia.

It preceded COVID, though the pandemic exacerbated it and brought more attention to it. Bottom line was not enough nurses were and are being produced to meet the demand, she said. “As a state we’ve continued to not put out enough nurses.”

Pay is one factor among several, she said, and not necessarily the chief factor.

“Pay is always important to people and it always matters,” she said. “Staying competitive to the local market is really important.”

They focus on the local market, she said. For registered nurses, West Virginia can’t compete with California, for instance – first in hourly wage at $66.20 and adjusted for COL at $49.22.

Just as important is how they’re treated and the work environment, Heuston said.

With that in mind, she said, WVUM within the past two years has revised the clinical ladder to increase nurses’ pay while allowing them to keep taking care of patients.

The clinical ladder has six steps of increases built on experience, responsibilities and education. “You don’t want a nurse to feel as though they need to leave bedside care to get an increase in salary.”

Like other systems, WVUM relies on contract nurses to fill the gaps. Part of that is good news – the system is growing and needs more nurses.

Meanwhile, the Center for Nursing Education is one way WVUM is building its own supply. As previously reported, there are people who’ve wanted to be nurses but weren’t able to go to school for various reasons, Heuston said, including money and time. The new school is designed to break down those barriers.

The center will have a tuitionless option. Even with tuition waivers, nursing students still have fees, uniform and book costs. At the center, all of those costs will be covered if the students agree to a three-year work commitment with WVU Medicine.

Another factor in the nurse shortage is a faculty shortage, Heuston said. “I think a lot of that is pay related.” Academia typically doesn’t pay as well as the private sector.

The nurse shortage is chiefly in acute care hospitals – mostly the medical/surgical areas, she said. “Nurses have more options today than they’ve ever had in the 40 years I’ve been a nurse. … The places where nurses are is endless.” They can work remotely, or for an insurance company, or advance to nurse practitioner, or many other options.

After talking about the barrier-breaking of the new school, Heuston talked a bit about other barriers to entering nursing. She cited the work of Peter Buerhaus, a nurse, healthcare economist and author.

One of his points, she said, is that social media, with its penchant for emphasizing the negative side of just about everything, has not been good for nursing. And today’s culture doesn’t provide opportunities for high school students to get an introduction – such as the candy stripers some Baby Boomers and Gen Xers might remember.

“We’ve got to figure out ways to shine a light on how wonderful nursing is so people can go into it,” she said.

One way WVU Medicine is doing that, she said, is through its Aspiring Nurse Program. The program offers financial and human-centered support to nursing students enrolled at select schools in West Virginia and neighboring states. This helps not only WVU, but other nursing schools fill their open seats, and helps the students have access to the education they want and need.

Under the program, the students can receive up to $5,000 per semester, twice a year, for a total $25,000 for the duration of their nursing education, in exchange for a three-year work commitment in the WVU Health System. There are now 200 students in the program, she said.

Mon Health Medical Center did not have anyone available to talk about nursing in time for this report.

Email: dbeard@dominionpost.com