<prompt> Human: She is an RN in the largest NICU in San Antonio 100 beds. Based on her performance reviews and the cases she is assigned most critical babies, she is an above-average performer in her role. But her annual raises have been pathetically small IMO - average of 1.25 per year over the 5 years she has been there.Is it true that in a hospital environment, a nurse cannot negotiate her pay? Is it common to have all nurses on a structured pay scale - seemingly regardless of the fact that one performs better than another? Or has her management possibly just led her to incorrectly believe that she has no negotiating power?For reference, she is a very non-confrontational person, and I think she might feel uncomfortable with the idea of approaching her manager and presenting a case for why she feels she deserves a raise.I work in a corporate environment where negotiating compensation salary, vacation, etc. is expected. So when she says the culture or her boss, or the company structure doesnt allow her to negotiate her hourly wage, that is difficult for me to comprehend.edit: she is not Union, since a couple people already asked about that.  <response>: I work at a hospital thats part of a large huge, actually corporation. Nurse pay is typically tied to the market, with very little wiggle room. So if there are a large pool of nurses to pull from, youll see wages and raises like your wifes. Since you are in a relatively large market, there may be an abundance of nurses and so wages will remain relatively flat. The corporate environment here would not be open to negotiation. I have seen my company let not only nurses, but doctors with long-standing community ties, walk away because they were unwilling to budge on requests for even small raises 5.This is in spite of the fact that, in the area Im in, there is a huge demand for nurses. So much so that my company pays employees a bounty of about 750 for each nurse that you can refer to work here. A few years ago, a competing hospital threw a huge wrench into the financials of all hospitals in this region by giving every single one of their nurses a 15 raise across the board. Every hospital in about 200 miles had to increase nurse pay accordingly or risk having a shortage. 