Tips from a Nurse Coach: A Guide To Negotiation (With Examples)

Updated June 9, 2023

The thought of initiating a discussion about salary can feel uncomfortable, but having them periodically in your career can set you up for financial success in your current position as well as in future roles. Whether you are a newly graduated nurse seeking your first position or are transferring to a new employer, knowing how and when to articulate your value to employers can make discussions around salary and professional advancement easier.

In this article, we sat with Keith Carlson, BSN, RN and Board-Certified Nurse Coach (NC-BC), to discuss tips for articulating your individual value and how to advocate for yourself during salary discussions throughout your career.

How much can I negotiate in nursing?

To evaluate the quality of a job offer, start by reviewing the full compensation package—not just the annual base salary. This can be especially important if you have multiple job offers and will give you a better understanding of which elements are negotiable based on the value and experience that you offer the employer.

The opportunity for negotiation will vary greatly depending on the employer and the level of experience you bring as a nurse. For example, there can be little wiggle room for new graduates, but Carlson suggests trying, “...especially if [you] have some previous experience that makes [you] even more compelling. If part of the job you’re getting hired for involves research and you were a research assistant with a master's degree in biology and before becoming a nurse you worked at the National Institute of Health, you can definitely bring that up in the negotiation.”

Some examples of negotiable items within a benefits package include:

Shift schedule
Continuing education reimbursement
Paid time off
Salary
Flexible schedule
Sign-on bonus
Scrubs or other nursing equipment

Tips for becoming a self-advocate

As a nurse, it might feel strange to think about your impact as an individual. Carlson describes how “age-old tropes about nurses like we’re ‘angels of mercy’ or ‘heroes in scrubs,’ make us seem like stereotypes and not real people.” The ability to speak up for yourself and what’s important to you, also known as self-advocacy, is a critical skill that will help you articulate your individual contributions to an organization with confidence. If it’s a skill you are still developing or strengthening, here are some tips to help that can help you advocate for yourself:

1. Keep a list of personal accomplishments

There will be many situations throughout your career that require you to share your individual accomplishments—performance evaluations, updating your resume or preparing for discussions around salary to name a few. One way to ensure you can provide a holistic record of your individual contributions is to keep a running list of your accomplishments, accolades and achievements throughout the year.

At the end of the year or review period, review and internalize your contributions. For example, you might calculate the number of total blood transfusions you were able to successfully provide or how many doses of a chemotherapeutic agent you delivered. Weave those numbers into a basic elevator pitch to use at networking events, on your cover letter or resume.

2. Request professional development conversations

If you are currently employed, establishing a line of communication with your manager about your professional development goals can set the expectation that career growth is important to you. Some employers are better than others about having regular and continuous conversations around growth, so be your own agent and ask for feedback and development as needed.

Let your manager know continuous development is important to you by saying something like, “My last review was six months ago, but since then I feel like there are some areas I've been outperforming and others where I could improve. Can we meet for 30 minutes to talk about my development? I’d like to check in on how I’m doing.”

Carlson adds, “Having the humility to admit where you feel like you need to grow and the sense of self to delineate where you feel like you're doing a really good job shows an incredible amount of assertiveness.”

3. Acknowledge that you’re more than “just” a nurse

Carlson recalls hearing a common phrase when working with nursing clients: “I’m just a nurse.” Many of the nurses he works with can speak to the importance of nurses as a collective but have difficulty speaking about their personal value:

“I've always said ‘just’ is a four-letter word when you're talking about yourself as a nurse because it's diminishing. It makes you smaller and it can make it seem like maybe you don't even value who you are and what you've done.

Don't even say you're ‘‘just a CNA (Certified Nursing Assistant)’ because the CNA does really important things. They take care of the skin and the personal care of the elderly and people with disabilities. CNAs are the backbone of health care. So you'd never say ‘I'm just a CNA’ because what you do is important.”

When to negotiate

There are various opportunities throughout your nursing career to discuss salary and benefits. Here are a few examples:

At the job offer stage

Negotiating your salary and benefits package during the offer stage of the hiring process can feel uncomfortable, but doing so may significantly increase your lifelong earning potential if done correctly and consistently. For instance, the average U.S. annual salary increase is 3%, so if you accept a starting salary that is 10% below your expectations, it could take over two years just to regain those earnings.

At your one-year performance review

Carlson says, “An annual review is a natural place to review your salary. One would expect that if you get a really good review that here's going to be some kind of financial or another type of acknowledgment that you have improved, met or exceeded your benchmarks.”

After continuous education

To increase earning potential, it’s common to seek additional certifications, advanced degrees and specializations in a particular area of nursing. As part of your professional development, some organizations may even offer financial support for completing specialized certification exams and training.

Depending on the specialization you’re seeking, you can be required to achieve different levels of experience or education, like when becoming a certified nurse operating room or a critical care nurse. These specializations can merit an increase in salary at your current place of employment or increase your marketability for future roles.

Considerations before entering a negotiation

Many factors can help you decide when and how to negotiate successfully among them being the following:

Clinical Ladder Programs

Clinical ladder programs are structured systems that provide nurses with career advancement opportunities within their current clinical setting. These programs vary by employer, but they clearly differentiate the levels of nursing care and expertise within the hospital system. While clinical ladder programs can be used to recognize professional development, they can also create limitations for negotiations but a set of criteria that you must meet before leveling up or receiving a pay increase.

“It's a little easier if you're going trying to get a job in a small medical practice or something that's not a really intense acute care system. There's more wiggle room. It's those clinical ladders in acute care facilities that are really tough nuts to crack,” says Carlson.

Be realistic about your requests

One of the keys to a successful negotiation is making realistic requests with evidence to support your merit. Carlson adds, “If what you’re asking for is realistic, what's wrong with showing that you value yourself enough to ask for a little. They might ask you, ‘What would merit us paying you $76,000 instead of $70,000 a year? What do you bring to the table?’ If you're going to ask for more, you'd better have a response to tell them why you deserve it and look them straight in the eye, don't bat an eye and tell them exactly how amazing you are.”

For non-salary benefits, like shift details, you should feel confident making a request as long as it is not clearly defined in the job description. For example, it wouldn’t be reasonable to request a day shift if the posting clearly states they are seeking someone to work overnight.

Here is an example of how to request a preferred shift length:

“I was very excited to see the official offer come through for the RN role at your hospital. Before I can accept, I would like to request to work 12-hour shifts. I didn’t see a shift specification in the job posting or the offer details. My commute to your hospital would be about an hour, so a 12-hour shift would reduce my time on the road. I’ve also found that longer shifts reduce miscommunication between caregivers during handoff, improving the patient’s experience.”

Know your audience

Gaining insight into what type of information is important to the decision-maker can help you adapt your delivery. When speaking to the importance of knowing what information your audience values, Carlson says, “Being able to understand the type of person your manager, supervisor or chief medical officer is and then overcoming your own ways of communicating to match their style can help get a better response.”

For example, if the decision-maker is data-driven, be sure to provide quantifiable evidence for why you deserve an increase. Consider providing examples of situations where you took on additional responsibilities. If you took on the role of training new RNs, mention the number of nurses you trained and the percentage of your goals that you were able to achieve in the process.

While some suggest emotion should be left out of negotiations, one study by The Harvard Business Review highlights how it can be almost impossible to separate emotions from the things that people care about, like salary.

One way to be a successful negotiator is to connect to your own emotions and calmly articulate how a salary increase would positively impact your life in a way that resonates with your manager. For many employers, it is important that their workforce feel happy, supported and satisfied in their jobs—and having an appropriate salary is a big part of that equation.

Tips for having a salary conversation

Whether you are seeking a new job or a salary increase in your current position, the following tips can help you prepare for the salary negotiation to come:

Prepare the decision-maker for the conversation

It’s a good idea to let the decision-maker know in advance that you would like to discuss salary expectations so they have time to prepare for the conversation. A direct conversation is always best and can be initiated differently depending on if you are speaking to a potential or current employer.

Negotiations at the job offer stage

Request to have the conversation over the phone or through a video conference if not possible in person. While it’s appropriate to initiate the conversation through email, it’s best to conduct them in real time. Negotiations are active conversations and the back and forth that occurs through email can slow down the conversation and text may not appropriately convey your gratitude and excitement for the opportunity.

Here is how you might approach the situation if you want to begin the negotiation process via email:

Dear Ms. Jackson,

Thank you for sending over the job offer package for the nursing practitioner opportunity. I want to state again how honored I am to be considered for this exciting position and appreciate you sharing these details.

Before I can accept your offer, I want to address the proposed compensation. As I shared with your recruiting manager, I have more than five years of experience in EMR systems and have worked in ICU for the last three years. In my last role, I mentored 10 new RNs to achieve their goals and provide exceptional care. Given my experience and expertise, I am seeking a salary in the range of $110,000 to $120,000, which is slightly higher than your offer of $107,000.

I know I can bring a great deal of value to your organization and can provide quality and compassionate care to your patients. Please let me know when we can discuss the salary further.

I look forward to hearing from you soon.

Thank you,
Marie Perez

Negotiations when currently employed

Start by requesting to set an appointment on your manager’s calendar. Conversations about salary are personal and sensitive, so try and have the discussion in a private room with the door closed.

If you have a performance review coming up, you may not need to invite your manager to a separate meeting if the review is already scheduled. If you’re asking for a review of your salary outside of a scheduled performance review, request the meeting at least two weeks in advance.

In either case, it’s good to let your manager know that you plan to discuss compensation in this meeting. Here are some suggestions for how you can make your intention to have a salary discussion clear in the meeting description or an email.

“Would it be alright if we spent some time during my performance review discussing my compensation?”
“I’d like to set a short meeting to discuss my compensation. Please let me know if this time works for you.”

Write your talking point out on a notecard

It can be challenging to recall your talking points by memory in high-stress situations like salary negotiations. Since you may not be able to anticipate what effect stress will have on you, consider bringing a list of talking points written on a notecard or in a notebook. Stick to a bulleted shortlist of your key accomplishments that support why you believe you deserve an increase.

If the conversation is during your yearly performance evaluation, Carlson recommends writing down your relevant accomplishments: “Did you heavily contribute to a committee you served on? Did you serve as charge nurse 50% more time than you were supposed to? Were you part of some special initiative? I think any boss doing an annual review can likely expect that the employee is either going to ask for or expect something in return for outstanding work.”

Project confidence

How you deliver your talking points in a negotiation is as important as the words you say. The more confidence you convey, the more confident the employer will be in their consideration of your feedback. The pay your employer offers should account for the value you provide.

Before initiating a negotiation conversation, conduct research to gain a strong understanding of your personal professional value which will be unique to your work experience and location. You should have confidence in your decision to ask for more if you’ve done the research and have personal value data that supports your ask.