How Much Do Nurses Make Per Hour — 2026 RN Hourly Pay

Registered nurses in the United States earn an average of $42.88 per hour in 2026 — but that number obscures a range from $31/hr in the lowest-paying states to $75+/hr for experienced California ICU nurses on union contracts. Where you work, what specialty you're in, and whether you work nights all have more impact on your hourly rate than your raw years of experience.

RN Hourly Pay by State

State is the single biggest driver of hourly nurse pay. The gap between top and bottom states exceeds $28/hr — more than the total hourly rate in some low-paying states.

Use the nurse salary calculator to estimate hourly pay for your specific state, specialty, and experience level. For detailed state breakdowns: California RN salary, Texas RN salary, New York RN salary.

Hourly Pay by Specialty

Specialty choice adds $5–$70/hr above the basic RN rate depending on role and required credentials:

• CRNA: $102.88/hr national average; California CRNAs earn $120–$135/hr
• Nurse Practitioner: $60.58/hr national average
• ICU / Critical Care RN: $45.67/hr national average
• ER RN: $43.75/hr national average
• OR RN: $42.79/hr national average
• Med-Surg RN: $34.62/hr national average — the entry baseline

How Shift Differentials Add to Your Hourly Rate

Base hourly rate is only part of what nurses actually earn per hour worked. Shift differentials, overtime premiums, and specialty stipends can add $4–$12/hr to effective hourly earnings:

• Night shift differential: Adds 10–25% to base hourly — approximately $4–$15/hr depending on your base rate and employer
• Weekend differential: Adds 8–15% above base — $3–$9/hr for weekend shifts
• Overtime (1.5x): Adds 50% above base rate for qualifying overtime hours; California daily overtime kicks in after hour 8 in a single shift
• On-call / call-back pay: Typically $5–$10/hr for on-call time plus 1.5x for actual call-back hours worked

A Texas ICU nurse earning $43/hr base who works nights and picks up overtime can earn $58–$65/hr effective rate during those shifts — well above the state average and comparable to lower-pay California markets.

Converting Hourly Rate to Annual Salary

The standard nurse work year calculation: hourly rate × 2,080 hours (52 weeks × 40 hours). Most staff nurses work 36 hours/week on three 12-hour shifts — so the exact annual formula is hourly rate × 1,872 hours for base pay, then add differential and overtime separately.

A nurse earning $42/hr on a three-day 12-hour shift schedule earns $78,624 in base pay annually, before any differentials or overtime. With 15% night differential on all shifts, that becomes approximately $90,418. Add one extra overtime shift per week on average and total annual compensation approaches $100,000+ — significantly above what the headline $42/hr rate implies.