The hourly rate on your offer letter looks like a fact, but someone already made a call about your experience to get there. Your nurse starting step is that call. At Stanford, one step too low costs $7,993 in the first year. I read the placement rules at four hospitals and wrote out what I would ask HR before signing.
Staff RN · Map My Pay Co-Founder · November 14, 2026
Most nurses I talk to assume the pay scale protects them. Every nurse on a step does earn the same rate, so it feels settled. The part that is still open is which step you land on when you are hired.
That one decision sets your nurse starting step, and it usually happens before you meet your manager. So I priced it. I took four hospitals nurses recognize, placed a nurse on the right step, and then moved that nurse down one step and two steps.
| Hospital | How outside experience is placed | One step low, first year |
|---|---|---|
| Stanford, Stanford, CA | The hospital's assessment | $7,993 |
| UC San Francisco, San Francisco, CA | The location's hiring grid or hiring plan | $7,020 |
| Brigham & Women's (BSN), Boston, MA | I could not find a public contract, so ask | $4,811 |
| Kaiser Oakland, Oakland, CA | A formula: one year of credit for every two years | $4,755 |
| NewYork-Presbyterian Hospital, New York, NY | Three or more verified years, as an administrator decides | $1,441 |
Base pay before taxes and shift differentials, at three 12-hour shifts a week, or 1,872 hours a year. Rates are 2026 rates. Each hospital's example is in the next section.
Before you sign, get the step in writing and ask how it was counted. This is for experienced nurses at hospitals with a pay scale. A new grad usually starts on the one new grad step. Per diem nurses can have their own rule, as Stanford's relief nurses do. At a hospital with no published scale, the posted range and a written rate from the recruiter are what you have.
What a low nurse starting step costs
The math is the hourly rate times 1,872 hours, which is three 12-hour shifts a week for 52 weeks. I picked one spot on each scale for the example: the rate at about five years, or Step 5 at Stanford. Then I read the rates one and two rows down.
| Hospital | Right rate | One step low | First-year loss | Two steps low | First-year loss |
|---|---|---|---|---|---|
| Stanford, CA | $108.59 | $104.32 | $7,993 | $100.32 | $15,481 |
| UC San Francisco, CA | $107.68 | $103.93 | $7,020 | $100.33 | $13,759 |
| Brigham & Women's (BSN), Boston, MA | $53.40 | $50.83 | $4,811 | $48.51 | $9,154 |
| Kaiser Oakland, CA | $105.04 | $102.50 | $4,755 | $98.95 | $11,400 |
| NewYork-Presbyterian Hospital, New York, NY | $70.02 | $69.25 | $1,441 | $68.48 | $2,883 |
Day shift base rate, before taxes and differentials. Rates from the Map My Pay hospital table, checked against each contract where I could open one. UC rates are calculated from the January 2025 tables times the 5% raise in Article 40.D, because UC has not posted its 2026 table. Many New York nurses work more than 36 hours, so a New York check would run a bit higher. I held every hospital at 1,872 hours to keep them comparable.
You would expect a new step to be worth about the same everywhere, and it is not. A step at Stanford is worth $4.27 an hour here, or more than five times the $0.77 at NewYork-Presbyterian. The scale you are walking onto decides how much this question is worth.
At Stanford, the right step pays $203,280 a year at $108.59 an hour. One step lower gives up $7,993 of that in the first year, and two steps lower gives up $15,481. Both figures are before taxes.
Why five years is not five times one year
I did not multiply by five, because that would be wrong. Both nurses keep moving up, so the gap changes each year. I walked each nurse up the scale on the hospital's own step schedule and added up the difference. Every rate stays at its 2026 level, so future raises are left out.
| Hospital | One step low, five years | Two steps low, five years |
|---|---|---|
| Stanford, CA | $24,636 | $56,759 |
| Brigham & Women's (BSN), Boston, MA | $26,376 | $51,330 |
| Kaiser Oakland, CA | $4,755 | $16,155 |
| NewYork-Presbyterian Hospital, New York, NY | $6,065 | $12,617 |
Before taxes and differentials, at 1,872 hours a year, with satisfactory performance assumed. NewYork-Presbyterian years 6 to 9 are not in the table, so I calculated them from the contract's experience pay. UC San Francisco is left out here. Its contract adds a within-range step each July, and I could not match that to the experience bands with confidence.
Stanford shows why the walk is worth doing. Multiplying by five would say $39,967 for one step, and the walk says $24,636. Stanford's Step 6 lasts two years, so the lower nurse catches up for a year, falls behind, and catches up again.
Brigham goes the other way. Its scale has 5% steps a year for 20 steps, so the lower nurse never catches up in this window, and the gap grows from $2.57 to $3.08 an hour. Brigham nurses rejected the hospital's final offer in October, so check the scale again before you rely on it.
Kaiser Oakland is the surprise. Its scale goes flat at the Year 5 rate of $105.04, and the next step takes seven years of Kaiser service. A nurse placed one step low reaches that rate a year later, so the total loss is $4,755 and it stops there. That is still worth a phone call, but I would not tell you it costs that much every year.
Put the hourly rate from your offer into the calculator and see the year before and after taxes.
Open the salary calculator →What the contracts say about your nurse starting step
I opened the contract for each hospital where one is public. The rules below are my plain reading, with the section so you can check it. They run from a strict formula to a judgment call, and that changes what you ask for.
Stanford: the hospital's judgment
Section 6.1.3 of the Stanford and CRONA contract says a new hire with more than six months of experience starts as a Clinical Nurse II, on a step set by the hospital's assessment, "at its sole discretion." It adds two conditions. The experience must be within the past two years, and it must apply to the unit, as the Patient Care Manager decides.
I cannot tell you how HR uses that room day to day. I can tell you there is no formula in that section to point to. So I would ask how the step was reached, and I would bring every reason my experience fits that unit.
Kaiser Northern California: a formula that cuts your years in half
Paragraph 2318 of the Kaiser and CNA contract gives one year of credit for every two years of RN experience in the last ten years. Part-time work at 20 or more hours a week counts as full time. Paragraph 2319 makes the credit automatic, but only for experience Kaiser can verify.
So a nurse with 10 years elsewhere lands on the Year 5 rate, not the Year 10 rate. If two of those years cannot be verified, the nurse gets 4 years of credit, and that is the one-step miss in the tables above. The fight at Kaiser is over your paperwork, and paragraph 2321 lets the union raise experience that does not fit the definition. That contract's term ended August 31, 2026, and bargaining is still going, so these rules and rates could change.
UC San Francisco: the hiring grid
Article 40.A.3.a of the UC and CNA contract says nurses are placed by each location's hiring grid or hiring plan. Credit for relevant experience is measured up to May 1 before your hire date, or July 1 at UC Irvine and UC Berkeley. The grid itself is not in the contract I read, so the first thing to ask for is the grid.
NewYork-Presbyterian: experience pay with a three-year line
At NewYork-Presbyterian, the extra pay for experience is a yearly dollar amount on top of the job rate. Section 10.04 of the NYSNA contract counts outside experience when you have three or more verifiable years in the prior ten, comparable to the job, as the appropriate administrator determines. Full credit goes up to ten outside years, and the hospital may ask for proof. As I read it, a nurse with two outside years should ask directly whether those years count at all.
Other hospitals I have read
Kaiser Northwest gives a year for a year at 20 or more hours a week, and the credit starts on the date you hand over proof. Five years of credit there is worth $19,151 a year over Step 1 on the same 1,872 hours. Kaiser Hawaii counts only the last five years at 20 or more hours a week. At Kaleida Health in Buffalo, NY, the contract lets the hospital start an experienced nurse from Step 1 to Step 6. Those are three different answers from three contracts, which is why I would not guess at yours.
Seven things to ask HR before you sign
These are my own suggested wording. No hospital or union wrote them, and you should change them to sound like you. I wrote them as requests on purpose, so the reply has to be a fact you can check. Send them by email so the answers are in writing.
Number 6 is the one I would never skip. Your next step date shows how they counted your months, even when the rest of the letter does not. Then ask for the step, the rate and that date to go in the offer letter itself.
Bring a list of every job with its dates, unit and average weekly hours. Add a letter from each employer if you can get one, and paystubs for any part-time stretch. A lot of nurses tell me HR will surely look this up. I would not count on it, because at Kaiser Northern California the experience that cannot be verified does not count.
If the step looks wrong
Say so before you sign, with your list in hand, and name the step you expected. The answer depends on the rule. Where there is a formula, the correction is arithmetic, and you are only showing your records. Where the hospital has discretion, you are making a case, so talk about how your experience fits that unit.
Waiting can get expensive. In the Kaiser Hawaii contract, what an arbitrator can award reaches back only 60 days from the date a grievance is filed. Other contracts have their own limits, so check your first paycheck against the offer letter and raise a problem that week.
Some answers will still be no. A union scale will not bend for one hire, and a formula is a formula. Even then, you will know your number before you give notice at your old job, and that is the moment it can still change your decision.
If you are comparing two offers in different cities, run each one against rent and taxes first.
Compare cities in the app →I am a staff RN, and on October 31, 2026 I read the placement sections of these contracts line by line. Every rate comes from the Map My Pay hospital table or a wage appendix, and every yearly figure is that rate times 1,872 hours. Where I calculated a rate, or could not find a contract, the table notes say so. The wording for HR is mine, and it is not legal advice.
The rate on your offer letter came from a count of your years. Before you sign, ask to see the count.
Run your own years, hours and shift at 465+ hospitals in the Map My Pay app before you answer an offer.
Run your rate →Sources: Map My Pay hospital table, read October 31, 2026. Stanford Health Care and CRONA agreement, 2025 to 2028, Sections 6.1.3, 7.1 and 15.3 and Appendix A. Kaiser and CNA agreement, 2022 to 2026, paragraphs 2318 to 2327 and Appendix A, January 2026 rates. University of California and CNA agreement, 2025 to 2030, Article 40. NewYork-Presbyterian and NYSNA agreement, Section 10.04. Kaiser Northwest and OFNHP RN agreement, 2021 to 2025, Article 15. Kaiser Hawaii RN agreement, arbitration remedies section. Brigham and Women's wage proposal page, read October 23, 2026. Massachusetts Nurses Association news page, read October 31, 2026. Kaiser bargaining page, read October 31, 2026.
Yearly figures are base pay at 1,872 hours, before taxes and differentials, with rates held at 2026 levels. UC 2026 rates and NewYork-Presbyterian years 6 to 9 are calculated. Step rules can change with each contract, so confirm your step and rate with the hospital in writing. This article is general information, not legal, career or financial advice.