RN vs LPN Salary in Tennessee: 2026 Comparison

HCA Healthcare is headquartered in Nashville and operates roughly 180 hospitals across 20 states. The company employs more than 90,000 registered nurses across its network. The fact that the corporate headquarters is in Tennessee is not just a curiosity. It shapes the Tennessee nursing labour market in three concrete ways. First, HCA runs a uniquely large clinical and operations corporate function out of Nashville, which creates roles for nurses who want to leave the bedside without leaving healthcare: clinical informatics, quality and patient safety, clinical education, nurse executive, and nurse operations roles, with corporate base pay typically $90,000 to $140,000 for mid-career nurses with the right credentials. Second, HCA runs the Galen College of Nursing system, which operates a substantial nursing-program footprint including LPN-to-RN bridge tracks, with an explicit pipeline into HCA hospitals. Third, HCA's dominant market share in middle Tennessee gives the company outsized wage-setting power, which works to nurses' advantage in tight labour markets and against them in soft ones.

In the Nashville metro specifically, HCA TriStar competes with Vanderbilt University Medical Center, Ascension Saint Thomas, and the smaller Williamson Medical Center for the same nurse pool. That competition keeps Nashville RN pay roughly $6,000 above the statewide average. New graduate RN base in Nashville at the major systems was in the $62,000 to $68,000 range in 2025, with experience curves bringing senior staff RNs to the high $80,000s and specialty-certified nurses well into the $90,000s.

The Vanderbilt Academic Medical Centre Premium

Vanderbilt University Medical Center is the academic medical centre serving middle Tennessee and one of the larger academic systems in the southeast. Vanderbilt RN pay typically runs 8% to 12% above the regional median for equivalent roles, reflecting the system's competition for specialty talent against academic systems in Atlanta, Birmingham, and Charlotte. Vanderbilt offers strong tuition reimbursement (up to roughly $5,250 per year tax-free) for RNs pursuing BSN completion or graduate nursing degrees, and the system runs one of the larger nurse residency programmes in the southeast with a structured 12-month transition for new graduates. For nurses who want academic-medical-centre depth without coastal-state cost of living, Vanderbilt is one of the more competitive options nationally.

The Memphis Picture: St. Jude, Methodist, and the Mid-South Wage Floor

Memphis is a smaller nursing market than Nashville but it has its own distinct dynamics. Methodist Le Bonheur Healthcare is the dominant general-acute employer, Baptist Memorial operates a significant share of the market, and St. Jude Children's Research Hospital sets specialty pediatric oncology nursing pay at a premium that does not exist anywhere else in the region. The Memphis cost of living is meaningfully below the national average (housing roughly 25% below), so Memphis RN pay around $68,000 represents stronger purchasing power than the nominal number suggests. Memphis is also a substantial LPN employer, with Methodist and Baptist both running LPN positions in long-term acute care, transitional care, and outpatient settings. Memphis LPN pay around $47,000 is competitive for the regional cost structure.

The Knoxville and Chattanooga Mid-Tier Markets

Knoxville and Chattanooga are smaller hospital markets dominated by single major employers (Covenant Health and University Health System in Knoxville, Erlanger Health and CHI Memorial in Chattanooga). Wage levels run modestly below Nashville and Memphis, in the $62,000 to $66,000 RN range for new hires at the major systems. Both metros benefit from low cost of living (Chattanooga housing roughly 20% below national average, Knoxville similar) and have been attractive destinations for travel nurses on contract. Johnson City and the Tri-Cities region of upper east Tennessee is closer to the Virginia and North Carolina markets than to middle Tennessee, with Ballad Health (the merger of Mountain States Health Alliance and Wellmont) dominating the regional employer landscape.

LPN Scope and the Rural Healthcare Story

Tennessee's LPN scope is broad. Tennessee LPNs may administer IV fluids and certain IV medications after completing a Board-approved IV therapy course, and the state has explicit regulations that allow LPNs to perform a wider range of procedures in rural hospitals and critical access hospitals than most states allow. This matters because Tennessee has one of the higher concentrations of rural hospitals in the southeast (more than 50 critical access hospitals statewide), and many of those facilities depend on LPN staffing to maintain operations. The state's rural hospital wage premium for LPNs is meaningful: rural-hospital LPN base pay is typically $4,000 to $7,000 above the statewide LPN average, in part because recruitment is harder. The Tennessee Board of Nursing maintains the IV therapy approval list and the rural-practice scope guidance.

Compact Licence Status and the Tri-State Border

Tennessee is a Nurse Licensure Compact state, which is particularly useful for nurses who live in the Memphis metro (where the labour shed crosses into Mississippi and Arkansas, both compact states), the Tri-Cities (Virginia and North Carolina, both compact), or the Chattanooga area (Georgia, also a compact state). A Tennessee compact licence covers practice in 41 states without additional applications, which is a real efficiency for travel nurses, agency staff, and nurses in border metros. The bridge cost framework applies to Tennessee community college bridge programs (Nashville State, Pellissippi State, Roane State, Southwest Tennessee, and Northeast State all run accredited bridge tracks at standard in-state community college tuition).

For neighbour comparisons see Georgia and North Carolina. Salary figures cite the BLS Occupational Employment and Wage Statistics for Tennessee (May 2024 release).