Only about a third of long-term care nurses are receiving a bonus, merit-based raise or cost-of living increase annually, according to a new survey.

Elite Learning’s 2018 nationwide nursing salary survey included more than 22,000 responses from nurses in a variety of care settings. It was conducted by Elite parent company ADVANCE Healthcare Network.

Responses from long-term care nurses indicated that “the biggest thing is that they are underpaid,” said Maria P. Senior, Director of Operations, Advance Healthcare Division, Elite Continuing Education.

That means long-term care faces a serious problem in attracting new talent.

“Coming out of nursing school, why would I go make $65,000 in long-term care if I can make significantly more than that in critical care? For the work they have to do in these facilities, they should be making more,” she said.

More than half of nurses in various settings are working overtime voluntarily, which Senior believes may be directly tied into needing more money. Almost always more education is the ticket to better pay, figures indicate. Within the top 20 specialties, the average salary is 23% higher for nurses who obtain specialized education, Senior said.

Long-term care needs to “encourage nurses at every level to focus on education,” she said. When a certified nursing assistant becomes a licensed practical nurse, the jump in pay is almost double, she said. LPNs who become a registered nurse can expect to see their pay increase by a third.

Still, for those who are currently CNAs, the industry has to better recognize their contributions, Senior emphasized.

“CNAs are doing a lot of nurse-level work for absolutely no money,” she said. “Nursing assistants are three-and-a-half more times likely to be injured on the job. If I can make the same basic flat rate and work overtime and get benefits — and a lot of CNAs don’t get benefits — why would you put yourself through that?”

While many nurses or nurse assistants feel “called” to geriatrics, they should be encouraged to work their way up, Senior said.

“They need to see the benefit and the earnings potential increase,” she said.

No matter what the position, many providers are stuck with minimal raise increases, given their reimbursement challenges. But Senior said in those cases, there are other options that can make a facility appealing. In addition to tuition reimbursement and installing mentors for newer nurses, long-term care facilities can look at flex-time and shifts that allow home-life balance. New technology also can help let nurses get back to what they want: bedside care.

“Decreasing paperwork and making it easier to do your job: There’s stuff [facilities] could do or implement to make people happy,” she said. At the very least, embrace being a facility that is a “caring and supportive environment,” she added. “They need to feel like they are on a team or part of a family.”

Elite’s 2018 Nursing Salary Guide can be downloaded here.