When Linda Hippolyte first got into nursing, she thought everyone at her hospital was paid based on their experience and education.
But when she got a peek at other nurses' salaries at Parkview Community Hospital in Riverside, she was in for a surprise.
"You could really see the difference," she said, noting that male nurses seemed to be making more. "Why was this person who happens to be male making more than this person who is female, with the same experience?"
For nurses, as for nearly everyone else in the U.S. workforce today, it pays to be a man.
Registered nurses who are male earn nearly $11,000 more per year than RNs who are female, new research shows — and only about half of that difference can be explained by factors such as education, work experience and clinical specialty.
That leaves a $5,148 salary gap that essentially discriminates against women, who make up the vast majority of the nursing workforce, according to a study published Tuesday in the Journal of the American Medical Assn.
Approximately 2.5 million women — and the families they support — are being shortchanged by the gender-based pay difference, said the researchers who conducted the study.
"Nursing is traditionally female-dominated, and it's a large profession," said study leader Ulrike Muench, a nurse practitioner with a doctorate from Yale University who studies nursing, health policy and healthcare economics at UC San Francisco. "A difference would affect a sizable portion of the labor force."
Muench and her colleagues from Yale and Vanderbilt University examined two decades' worth of salary information from the National Sample Survey of Registered Nurses. Before the survey ended in 2008, it collected data once every four years from more than 30,000 RNs across the country. Altogether, the study sample included responses from 87,903 full-time RNs, 93% of whom were women.
In the raw analysis, the average salaries for men were $10,775 higher than for women, the researchers found. That discrepancy can be seen in every survey year going back to 1988. Though the gap appeared to narrow in the middle and late 1990s, it widened again after 2000.
Even after the team accounted for things like location, hours worked per week, years of experience and type of nursing degree, men still earned $5,148 more than women.
With nurses earning an average of $66,973 per year, that amounts to an 8% bump in pay for men.
In some nursing specialties, the gap was even greater. In cardiology, for instance, male RNs earned $6,034 more than their female counterparts. Only one specialty — orthopedics — did not have a pay gap big enough to be considered statistically significant.
Workplace mattered too. Nurses who cared for hospital patients took home $3,873 more per year if they were men, according to the study. In outpatient settings, men earned $7,678 more than women.
To see whether the situation had improved since 2008, the researchers compared the salaries of more than 200,000 RNs who took part in the U.S. Census Bureau's American Community Survey between 2001 and 2013. In this sample, the 10% of nurses who were men averaged $9,562 more per year than the women, based on the unadjusted analysis.
Peter McMenamin, a healthcare economist for the American Nurses Assn. in Silver Spring, Md., said the study was "well done" and called gender wage gap "dismaying."
"Any difference should reflect differences in experience and skill, and maybe cost of living, but not gender," he said.
But McMenamin also suggested that limitations in the data used in the JAMA study might have overrepresented the size of the wage gap — and that nursing, as a field, was more equitable than most.
"This has been going on for a long time, and it's not unique to nurses," he said.
Back in 1963, when President Kennedy signed the Equal Pay Act, women earned only 59.8 cents for each dollar earned by men. Since then, the average pay of women has climbed by about 71%, while for men it has increased 35%, according to the National Equal Pay Task Force.
Overall, women in America now make 78.8% as much as men, according to data released last week by the U.S. Census Bureau.
That makes nurses look good by comparison. For every dollar earned by a male registered nurse in 2013, a female RN earned 91.1 cents, the 2013 census report says. The median income for men in the field was $67,990, compared with $61,946 for women.
"Males always tend to get more money than females," said Deborah Burger, co-president of the California Nurses Assn., a union based in Oakland. "Even in a female field, the men still manage to eke out more money."
The JAMA study results did not ring true to Bob Stewart, a longtime cardiac nurse at San Joaquin Community Hospital in Bakersfield. In his workplace, he said, a nurse's salary is based on two things: the number of years you've worked and the kind of nursing degree you have.
"No one ever thinks about it," said Stewart, who became a registered nurse in 1983. "In regular patient care areas, it's all the same."
Women with long track records in nursing, however, expressed a world-weary lack of surprise.
Erica Beltran, a nurse at USC Verdugo Hills Hospital in Glendale, said she had seen situations in which nurses who had been working the same number of years as her got paid more "just because they're male."
"It's outrageous that today in 2015 we're still having these disparities based on gender," she said.
Burger, who has worked as an RN for 43 years, wondered whether an analysis of salaries for teachers — another field traditionally dominated by women — would reveal a similar disparity.
In fact, the gender pay gap for registered nurses is on par with that of teachers, according to the Census Bureau. Women teaching in elementary and middle schools earned 91.4 cents to every dollar earned by men. In secondary schools, female teachers earned 92.9 cents for every dollar earned by men.
Burger and other nurses who have been involved in labor organizing argued that unionization deterred gender-based wage gaps because it made salary information public and standardized the way wage increases are calculated.
McMenamin, of the nurses association, said he hadn't seen any data proving that was the case.
Muench said union participation and whether female nurses had taken time out of the workforce to have children would be factors her team might study in the future to better understand why men's wages outstripped women's.
In the meantime, she said she hoped the new research would "start a conversation" between nurses and their employers.
Jan Boller, an RN and an associate professor at Western University of Health Sciences in Pomona, said she had not been aware of the gender wage gap in nursing. The issue is likely to spark "very interesting classroom discussions," she said.
At her university, 18% of students in the entry-level nursing master's program are men.