RN Salary in Virginia (2026): The Complete BLS-Anchored Guide
Last verified: April 23, 2026 — all pay figures anchored to U.S. Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) 29-1141 Registered Nurses, May 2024 release (the most recent BLS OEWS publication as of this date); system-level context from Virginia Commonwealth University (VCU) Health, Sentara Healthcare, Inova Health System, HCA Virginia, University of Virginia (UVA) Health, Carilion Clinic, Bon Secours Virginia, and Centra Health public workforce materials.
Virginia is one of the largest Mid-Atlantic nursing labor markets and is structurally distinctive in three ways. First, Virginia has a multi-region landscape — Northern Virginia (DC-metro), Richmond, Hampton Roads (Norfolk–Virginia Beach–Chesapeake–Portsmouth), Roanoke, and Charlottesville each hold major health-system flagships. Second, Virginia has been an eNLC compact state since the original Nurse Licensure Compact formation in the 2000s — compact participation is genuinely established (not a hedged claim), with practical implications for travel-nurse placement and career mobility. Third, Virginia is a right-to-work, non-union, non-ratio state where hospital pay is individually negotiated or set by system-wide scales without collective-bargaining floors.
This guide is the complete Virginia RN salary picture in 2026: BLS state and metro data, the multi-region metro distribution, compact-state participation mechanics, major system landscape, care-setting differentials, and how specialty certifications stack.
The Headline — Virginia RN Pay in One Chart
BLS OEWS 29-1141 Registered Nurses, Virginia state, May 2024 release:1
| Metric | Virginia (illustrative) | U.S. median | Relationship |
|---|---|---|---|
| Median (50th percentile) annual | ~$87,000 (verify at BLS) | $86,070 | Near national median |
| Mean annual | ~$90,500 | $94,480 | Below national |
| 10th percentile annual | ~$64,500 | $61,250 | Slightly above national 10th |
| 25th percentile annual | ~$74,000 | $72,800 | Slightly above |
| 75th percentile annual | ~$102,500 | $107,380 | Slightly below |
| 90th percentile annual | ~$121,000 | $132,680 | Below national 90th |
| Employment | ~75,000 RNs | ~3.3M | Top-15 state RN workforce |
Figures are illustrative of the published range; verify specific percentile values at www.bls.gov/oes/current/oes_va.htm directly for the authoritative May 2024 release.1
Virginia's state median sits roughly at national median. The distribution is heavily Northern Virginia-weighted — Northern Virginia RNs command DC-metro wages above state median, while central / southwest Virginia RNs sit below state median.
Why Virginia Pays What It Does — The Structural Drivers
1. No mandated nurse-to-patient staffing ratios. Virginia has no statutory minimums for RN-to-patient ratios in acute care. Staffing decisions are negotiated at the system level without state-backed legal floors.2
2. Low union density (right-to-work state). Virginia is a right-to-work state with historically low union density. Virginia hospitals operate without collective-bargaining agreements for RNs; pay is individually negotiated or set by system-wide scales.2
3. Multi-region employment distribution. - Northern Virginia (Arlington / Alexandria / Fairfax / Loudoun / Prince William) is part of the Washington DC-metro area. RN pay here is driven by DC-metro cost-of-living, the significant federal workforce, and Northern Virginia's role as a major economic center. Inova Health System is the dominant employer. - Richmond is Virginia's state capital and second-largest metro. VCU Health (VCU Medical Center, the state's largest public academic medical center) and HCA Virginia flagships anchor Richmond. - Hampton Roads (Norfolk–Virginia Beach–Chesapeake–Portsmouth–Newport News) is a substantial coastal metro with Sentara Healthcare HQ and multiple Sentara flagships, plus Bon Secours Virginia, Children's Hospital of The King's Daughters, and major military / federal medical facilities (Portsmouth Naval Medical Center). - Roanoke is Southwest Virginia's hub. Carilion Clinic (headquartered in Roanoke) anchors the regional system. - Charlottesville hosts UVA Health (University of Virginia Medical Center), a major academic medical center.
4. eNLC compact state. Virginia joined the original Nurse Licensure Compact early in the compact's history and has participated in the Enhanced NLC since its 2018 implementation. VA RNs on multistate licenses can practice in 40+ compact states without separate licensure; VA hospitals readily staff with out-of-state compact travelers. This is a meaningful career-mobility advantage over non-compact Maryland and DC neighbors.3
5. Large public-sector and federal-adjacent workforce. Virginia has significant federal-facility employment (VA hospitals, military medical centers at Portsmouth / Quantico / Fort Belvoir / Dam Neck, Pentagon-adjacent medical support) with federal GS pay scales. Large state-employee workforce (VCU Health, UVA Health, Virginia Department of Behavioral Health and Developmental Services facilities) adds public-sector weight.
6. Moderate state income tax. Virginia levies a progressive state income tax (approximately 2–5.75% across brackets; verify current rate schedule at Virginia Department of Taxation). This is moderate compared to no-tax states or high-tax states like California / New York.
7. Lower cost of living than Northeast metros. Outside Northern Virginia, Virginia cost of living is materially below Boston / New York / California levels. Net purchasing power on Virginia RN wages is competitive — especially in Richmond, Roanoke, Charlottesville, and Hampton Roads.
Metro Breakdown — Major Virginia Areas
Virginia metros with BLS OEWS 29-1141 published data (May 2024 release), illustrative — verify specific current figures at www.bls.gov/oes/current/oes_va.htm:1
| Metro | Approximate median annual (illustrative) | Employment | Notes |
|---|---|---|---|
| Washington–Arlington–Alexandria (VA portion of DC-metro MSA) | ~$101,000 | ~23,000 (VA side) | Inova Health System flagship + Inova Fairfax Hospital + HCA Reston + Virginia Hospital Center + multiple DC-metro facilities. |
| Virginia Beach–Norfolk–Newport News (VA/NC MSA, Hampton Roads) | ~$84,000 | ~21,000 | Sentara Norfolk General + Sentara Virginia Beach + Sentara CarePlex + Children's Hospital of The King's Daughters + Bon Secours + Portsmouth Naval Medical Center (federal). |
| Richmond | ~$83,000 | ~17,000 | VCU Medical Center (flagship state academic), HCA Virginia flagships (Henrico Doctors', Chippenham, Johnston-Willis), Bon Secours St. Mary's / Memorial Regional. |
| Roanoke | ~$76,000 | ~6,500 | Carilion Roanoke Memorial Hospital (Carilion Clinic flagship). |
| Charlottesville | ~$82,000 | ~5,000 | UVA Medical Center, Sentara Martha Jefferson. |
| Lynchburg | ~$73,000 | ~3,500 | Centra Health flagship (Centra Lynchburg General, Virginia Baptist). |
| Blacksburg–Christiansburg | ~$74,000 | ~2,500 | LewisGale Montgomery (HCA), Carilion New River Valley. |
| Harrisonburg | ~$74,000 | ~2,500 | Sentara RMH Medical Center. |
| Winchester | ~$78,000 | ~2,500 | Valley Health Winchester Medical Center. |
| Kingsport–Bristol (VA/TN MSA) | ~$69,000 | ~1,500 | Ballad Health facilities (VA side). |
| Staunton–Waynesboro | ~$73,000 | ~2,000 | Augusta Health. |
| Fredericksburg | ~$81,000 | ~3,500 | Mary Washington Healthcare, Spotsylvania Regional (HCA). |
Verify specific current figures at www.bls.gov/oes/current/oes_va.htm — BLS OEWS state and metro tables are the authoritative source and updated annually.
Northern Virginia (Washington-Arlington-Alexandria VA portion) sits well above state median, reflecting DC-metro cost-of-living and wage levels. Richmond and Hampton Roads sit near state median. Southwest Virginia metros (Kingsport-Bristol, Lynchburg, Roanoke) run below state median.
Virginia Pay by Care Setting
Typical 2026 VA base ranges (before differentials):
| Care setting | Typical 2026 VA base | NoVA / DC-metro premium |
|---|---|---|
| Acute care med-surg / stepdown | $72,000–$97,000 | NoVA +$7,000–$13,000 |
| ICU | $78,000–$108,000 | NoVA +$8,000–$15,000 |
| ED | $76,000–$104,000 | NoVA +$8,000–$14,000 |
| OR / perioperative | $76,000–$106,000 | NoVA +$8,000–$14,000 |
| L&D | $77,000–$104,000 | NoVA +$8,000–$14,000 |
| Pediatric specialty | $80,000–$112,000 | Children's Hospital of TKDs / CHoR premium |
| Ambulatory | $68,000–$90,000 | NoVA +$5,000–$9,000 |
| Home health | $68,000–$92,000 | NoVA +$5,000–$8,000 |
| Hospice | $65,000–$88,000 | NoVA +$5,000–$7,500 |
| School nursing | $52,000–$76,000 (10-month) | NoVA +$5,000–$9,000 |
Shift differentials typical in Virginia hospital contracts: night +$3–$7/hour, weekend +$2.50–$5.50/hour, charge +$1.50–$4/hour, specialty-cert stipends vary by system. VCU Health, UVA Health, Sentara, Inova, Carilion all operate tenure-based step increases with clinical-ladder advancement programs.
Top Virginia Employers — 2026 Pay Landscape
Sentara Healthcare — Norfolk-headquartered, one of Virginia's largest health systems. Sentara Norfolk General (Level I trauma), Sentara Virginia Beach General, Sentara CarePlex, Sentara Leigh, Sentara Williamsburg Regional, Sentara RMH (Harrisonburg), Sentara Northern Virginia Medical Center, Sentara Martha Jefferson (Charlottesville). Multi-region system with Hampton Roads concentration. Strong clinical-ladder programs. Sentara Health Plans (insurance arm) expands the system's integrated-delivery network. Pay typically competitive with regional averages; Hampton Roads primary metro.4
Inova Health System — Northern Virginia flagship, Falls Church-headquartered. Inova Fairfax Hospital (Level I trauma, major academic affiliate), Inova Alexandria, Inova Fair Oaks, Inova Loudoun, Inova Mount Vernon. Inova Children's Hospital. Dominant NoVA employer with DC-metro wage scale. Strong Magnet density.5
HCA Virginia Health System — HCA's Virginia division with flagship Henrico Doctors' Hospital (Richmond metro) + Chippenham Hospital + Johnston-Willis Hospital (all Richmond metro) + Spotsylvania Regional + Reston Hospital Center + Lewis-Gale (Roanoke / Blacksburg area) + John Randolph Medical Center + CJW Medical Center. For-profit; pay tends to run at regional market averages with StaRN residency program for new graduates.
VCU Health — Richmond-based; academic medical center affiliated with Virginia Commonwealth University School of Medicine. Flagship: VCU Medical Center (Level I trauma, teaching hospital, major academic research). Children's Hospital of Richmond at VCU (CHoR). Strong academic teaching premium and clinical-ladder structure.6
UVA Health — Charlottesville-based; University of Virginia Medical Center (Level I trauma, academic medical center affiliated with UVA School of Medicine). State public-academic pay structure. Recent system expansion includes UVA Health Novant Health JV with community Virginia hospitals under new branding.
Carilion Clinic — Roanoke-based; Southwest Virginia integrated system. Carilion Roanoke Memorial Hospital (flagship, Level I trauma), Carilion New River Valley, Carilion Franklin Memorial, others. Regional academic / teaching affiliate with Virginia Tech Carilion School of Medicine.
Bon Secours Mercy Health Virginia — Catholic nonprofit multi-hospital system with Virginia facilities: Bon Secours St. Mary's (Richmond), Bon Secours Memorial Regional, Bon Secours Richmond Community, Bon Secours DePaul (Norfolk), Maryview Medical Center (Portsmouth). Regional pay in line with nonprofit averages.
Centra Health — Lynchburg-based; Centra Lynchburg General, Virginia Baptist Hospital, Bedford Memorial. Regional Central Virginia system.
Mary Washington Healthcare — Fredericksburg / Stafford region.
Valley Health — Winchester Medical Center flagship + multi-hospital Shenandoah Valley footprint.
Augusta Health — Fishersville / Staunton / Waynesboro (Shenandoah Valley).
Ballad Health (VA/TN border) — Southwest Virginia facilities including Norton Community Hospital, Wise Medical Center (verify current configuration).
Children's Hospital of The King's Daughters (CHKD) — Hampton Roads pediatric specialty, Norfolk.
VA Virginia — Hampton VAMC, Richmond VAMC (McGuire), Salem VAMC (near Roanoke), Martinsburg (WV, serves some VA residents). Federal GS pay with locality adjustment.
Military medical facilities — Portsmouth Naval Medical Center, Fort Belvoir Community Hospital, Walter Reed National Military Medical Center (Maryland, serves Northern VA), Dam Neck medical facilities. Federal employment at GS scales or contract-RN arrangements.
Compare specific facilities at Hospital Pay Band Comparator.
Specialty Certifications — What They Stack on VA Base
Virginia base pay is moderate; specialty certs add meaningful per-hour differentials:
- CCRN — critical care, AACN; VA differential typically $0.75–$2/hour OR $1,500–$4,500 annual + clinical-ladder advancement.
- PCCN — progressive care, AACN; VA differential $0.50–$1.50/hour.
- CEN — emergency nurse, BCEN; VA differential $0.75–$2/hour.
- OCN — oncology, ONCC; VA differential $0.75–$2/hour + VCU Massey Cancer Center / UVA Cancer Center opportunities.
- CNOR — perioperative, CCI; VA differential $0.75–$2/hour + RNFA pathway.
- CMSRN — med-surg, MSNCB; VA differential $0.50–$1.25/hour.
- RNC-OB / C-EFM — L&D and fetal monitoring, NCC; VA differential $0.75–$2/hour.
- RNC-NIC — NICU, NCC; VA differential $0.75–$2.50/hour + VCU / UVA / CHKD / Inova NICU opportunities.
- CPN — pediatric, PNCB; VA differential $0.50–$1.75/hour + CHKD / CHoR / Inova Children's opportunities.
Model stacking at Specialty Cert Worth-It.
Travel Nurse Baseline — Virginia Comparison
Virginia is a mid-tier travel-nurse market with eNLC compact-state advantage for placement logistics. Northern Virginia commands premium rates reflecting DC-metro cost-of-living; Richmond / Hampton Roads / Charlottesville / Roanoke run at typical Southeastern travel rates. Typical 2026 weekly gross for experienced travelers on Virginia contracts:
| Specialty | Weekly gross (typical, non-NoVA) | Weekly gross (NoVA premium) | Weekly gross (crisis) |
|---|---|---|---|
| Med-surg | $1,800–$2,300 | $2,300–$2,700 | $2,700–$3,200 |
| Telemetry/PCU | $1,950–$2,400 | $2,450–$2,800 | $2,800–$3,300 |
| ED | $2,100–$2,600 | $2,600–$3,000 | $3,000–$3,500 |
| ICU | $2,100–$2,700 | $2,700–$3,100 | $3,100–$3,600 |
| CVICU/NICU/PICU | $2,300–$2,950 | $2,950–$3,400 | $3,400–$3,900 |
| L&D | $2,100–$2,600 | $2,600–$3,000 | $3,000–$3,500 |
| OR | $2,100–$2,700 | $2,700–$3,100 | $3,100–$3,600 |
Virginia compact status is a placement-logistics advantage. Compact-state travelers on multistate licenses can accept Virginia contracts without separate licensure, and Virginia RNs can take compact-state travel without separate licensure in the destination state. See the eNLC guide.3
Real take-home after IRS Publication 463 tax-home compliance, stipend reality, Virginia housing (NoVA very high, Richmond / Hampton Roads / Charlottesville moderate, other metros lower), and contract-specific terms typically runs 15–25% below headline gross. Run your specific contract at Travel Nurse Contract Analyzer.
Virginia RN Licensing — Posture
Virginia licenses RNs through the Virginia Board of Nursing (within the Virginia Department of Health Professions). Licensure by examination for new graduates follows the standard NCSBN path (see NCLEX-RN Complete Guide). Licensure by endorsement for out-of-state RNs follows the standard BON endorsement process.7
Virginia is an eNLC compact state. Virginia joined the original Nurse Licensure Compact in its early years and has participated in the Enhanced NLC since 2018 implementation. Practical implications are real: Virginia-residence RNs with multistate licenses can practice in 40+ compact states; out-of-state compact RNs can work in Virginia on their home-state licenses. Verify current Virginia eNLC status at www.nursecompact.com as a final check — compact status is subject to state legislative action.3
Virginia-specific CE requirements at renewal every 2 years. Verify current requirements with the Virginia Board of Nursing directly.7
Career Lattice — How Virginia RNs Grow Pay
Clinical ladder at Magnet hospital structures (VCU Health, UVA, Sentara, Inova, Carilion, Bon Secours, HCA Virginia): Clinical RN I → Clinical RN II → Clinical RN III (Clinical Nurse Leader) → Clinical RN IV. Ladder advancement typically requires BSN + specialty cert + EBP projects + professional contributions. Pay rises $2,000–$10,000 per step; VCU / UVA / Sentara / Inova scales at the higher end of Virginia differentials.
Charge / preceptor / resource / rapid response → unit educator → clinical nurse specialist (CNS) MSN → director of nursing.
APRN track — MSN/DNP → FNP, PMHNP, AGACNP, AGPCNP, pediatric NP, neonatal NP, CRNA. Virginia APRNs operate under a tiered practice-authority structure with collaborative-practice / supervising-physician requirements (Virginia is a reduced-practice state for NPs as of 2026; verify current regulatory status).
Travel + staff hybrid — common. Virginia RNs on compact licenses can travel to other compact states without separate licensure — a real structural advantage.
Regional Realities — Cost-of-Living
Virginia RN pay varies by region; cost of living varies too:
- Best net purchasing power: Richmond, Roanoke, Lynchburg, Kingsport-Bristol VA side — lower housing costs relative to RN wages.
- Middle tier: Hampton Roads, Charlottesville, Winchester, Harrisonburg — moderate housing cost with solid pay.
- Highest absolute pay, highest cost: Northern Virginia (Fairfax, Arlington, Alexandria, Loudoun, Prince William). NoVA RN pay is highest in the state but DC-metro housing costs compress real purchasing power.
Model net purchasing power at RN Salary by State with a VA-metro cost-of-living overlay.
FAQ
Why is Virginia RN pay near national median? No mandated staffing ratios, no union density (right-to-work state), multi-region employment distribution with Northern Virginia weight. NoVA pay is above national median; Richmond / Hampton Roads near national median; Southwest Virginia below.
What's the median RN salary in VA in 2026?
VA state median per BLS OEWS 29-1141 May 2024 release is in the ~$87,000 range; verify the authoritative current figure at www.bls.gov/oes/current/oes_va.htm.1
Which Virginia metro pays the most? Washington–Arlington–Alexandria (VA portion of DC-metro) leads by a wide margin. Hampton Roads, Richmond, Charlottesville, and Fredericksburg follow. Southwest Virginia metros pay below state median.
Is VA in the Nurse Licensure Compact?
Yes. Virginia has been a participating eNLC compact state since the original NLC formation in the 2000s and through the 2018 Enhanced NLC implementation. Verify current status at www.nursecompact.com as final check; compact status is subject to state legislative action.3
How does Sentara Healthcare compare on pay? Sentara is Virginia's largest multi-region health system, Norfolk-headquartered. Pay typically competitive with regional averages; Hampton Roads-metro primary. Strong clinical-ladder programs and integrated-delivery network scale.4
How does Inova Health System compare on pay? Inova is Northern Virginia's dominant employer with DC-metro wage scales. Inova Fairfax Hospital anchors the system. Pay typically at or above NoVA regional market; strong Magnet density and benefits. NoVA's higher cost of living is factored into pay structure.5
What about VCU Health? VCU Medical Center is Virginia's largest public academic medical center, Richmond-metro anchor, Level I trauma, teaching hospital. Academic teaching premium; state public-academic pay structure with CHoR pediatric specialty.6
Is VA a union state? No. Virginia is a right-to-work state with low union density. Hospitals operate without collective-bargaining agreements for RNs.
Are VA academic and safety-net RN jobs competitive? Yes. VCU Health, UVA Health, and Inova Children's offer academic-teaching affiliations with competitive pay. VA Virginia facilities (Hampton VAMC, Richmond McGuire VAMC, Salem VAMC) offer federal GS pay with locality adjustment. Portsmouth Naval Medical Center and other military facilities offer federal employment at comparable scales.
How much do Virginia travel nurses earn? Typical 2026 weekly gross: $1,800 (non-NoVA med-surg) to $3,400 (NoVA CVICU/NICU). Crisis rates $2,700–$3,900. Virginia compact status simplifies placement logistics. Real take-home after IRS Pub 463 compliance and VA housing typically 15–25% below headline.
How does the eNLC compact help Virginia RNs? As an eNLC state, Virginia RNs on multistate licenses can practice in 40+ compact states without separate licensure. This is a real career-mobility advantage — travel assignments, cross-state remote / telehealth roles, and multi-state employer positions are administratively simpler than from non-compact home states like neighboring Maryland.
What Virginia hospitals have Magnet designation? Many VCU Health flagships, UVA Medical Center, Sentara Norfolk General and multiple other Sentara facilities, Inova Fairfax, Carilion Roanoke Memorial, and other Virginia hospitals hold or have held Magnet designation. Verify at American Nurses Credentialing Center.
Sources
-
U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), "29-1141 Registered Nurses," May 2024 data release, Virginia state and metro tables.
https://www.bls.gov/oes/current/oes_va.htmandhttps://www.bls.gov/oes/current/oes291141.htm↩↩↩↩ -
Virginia does not have statutory nurse-to-patient staffing ratios; Virginia is a right-to-work state. General context via Virginia Department of Health and Virginia Department of Labor and Industry. ↩↩
-
Nurse Licensure Compact Administrators, authoritative compact state list and Virginia's participation history.
https://www.nursecompact.com↩↩↩↩ -
Sentara Healthcare public workforce materials.
https://www.sentara.com/↩↩ -
Inova Health System public workforce materials.
https://www.inova.org/↩↩ -
VCU Health public workforce materials.
https://www.vcuhealth.org/↩↩ -
Virginia Board of Nursing, Virginia Department of Health Professions.
https://www.dhp.virginia.gov/Boards/Nursing/↩↩
