Healthcare Resource
Step-Down RN Salary 2026: PCU Nurse Pay by State, Setting & Certification
In brief
Step-down RN (PCU nurse) salary in 2026 averages $74K-$90K. Cardiac PCU nurses earn more than general PCU. Night shift and travel step-down contracts push total pay to $2,000-$2,600/week.
In this article
The average step-down RN (progressive care unit / PCU nurse) salary in 2026 is $74,000-$90,000/year for staff positions. Step-down units care for patients who are recovering from surgery, a cardiac event, or critical illness but are stable enough to move out of the ICU. The PCU nurse manages lower nurse-to-patient ratios (typically 3:1 or 4:1 vs. ICU's 1:1 or 2:1) and handles continuous monitoring, drips, and post-procedure care. Cardiac PCU nurses earn at the higher end of the range due to the specialized monitoring requirements.
Step-Down RN vs. Telemetry RN vs. ICU RN: Salary Comparison
| Unit Type | Avg Salary | Patient Ratio | Acuity |
|---|---|---|---|
| Med-Surg RN | $65,000-$78,000 | 5:1 - 6:1 | Lowest; routine post-op, medical management |
| Telemetry / PCU / Step-Down RN | $74,000-$90,000 | 3:1 - 4:1 | Intermediate; continuous monitoring, drips, post-procedure |
| Cardiac Step-Down (CVICU Step-Down) | $85,000-$102,000 | 2:1 - 3:1 | High intermediate; post-cardiac surgery, complex arrhythmias |
| MICU / SICU / CVICU RN | $88,000-$110,000 | 1:1 - 2:1 | Highest; vented patients, vasopressors, complex monitoring |
Step-Down RN Salary by State (2026)
| State | Avg Annual Salary | Notes |
|---|---|---|
| California | $105,000 | 4:1 ratio law for PCU (same as tele); union contracts; highest PCU pay nationally |
| Washington | $97,000 | SEIU contracts; PeaceHealth, Providence, Swedish; strong Seattle area rates |
| Hawaii | $95,000 | Cost of living + shortage premium; Queens, Straub, Castle Medical |
| Massachusetts | $93,000 | Academic medical centers; Boston metro; cardiac step-down commands premium |
| New York | $91,000 | NYC health systems; NYSNA; upstate 30-35% lower |
| Nevada | $88,000 | Shortage market; no income tax; Las Vegas suburban hospital growth |
| Texas | $80,000 | HCA, Baylor, Methodist, UT; no state income tax; cardiac step-down pays $85K-$95K in DFW/Houston |
| Florida | $78,000 | High demand; NCH, AdventHealth, BayCare, HCA Florida; no state income tax; sign-ons $10K-$18K |
| Arizona | $79,000 | Banner rapid growth; Phoenix metro PCU demand high; rural supply-demand gaps |
| Georgia | $73,000 | Emory, WellStar, Piedmont; cardiac PCU premium in Atlanta market |
PCU / Step-Down Nurse Competencies That Justify Higher Pay
- Advanced arrhythmia recognition: Differentiating wide-complex tachycardias, recognizing subtle ST changes on continuous monitoring, understanding AV blocks
- Drip management: Heparin drips, amiodarone, nitroglycerine, dobutamine, lower-dose vasopressors are increasingly managed on progressive care units
- Post-cardiac procedure care: Post-catheterization groin management, post-ablation monitoring, post-cardioversion care, temporary pacemaker management
- Hemodynamic assessment: Arterial line monitoring (some step-down units), CVP interpretation, signs of early cardiogenic shock recognition
- Rapid response escalation: Recognizing when a step-down patient needs urgent ICU transfer, the most critical judgment skill in progressive care
Travel Step-Down / PCU RN Rates (2026)
Travel PCU nurses are among the highest-demand travel specialties alongside ER and ICU. Current 2026 travel market rates:
- Weekly gross pay: $2,000-$2,600 (13-week contracts, 36-40 hr/week)
- Tax-free component: $750-$1,200/week (housing + M&IE stipends for qualifying tax home)
- Top markets for travel PCU: California ($2,400-$2,600/wk), Nevada, Florida, Texas
- Experience required: Most travel agencies require 18-24 months PCU/step-down experience minimum; PCCN preferred but not always required
Data from BLS, AACN PCCN program reports, and Ava Health placement data. Ranges reflect 25th-75th percentile of 2026 job postings for experienced PCU/step-down nurses.
Hiring in this space?
Ava Health places nurses and allied health professionals across Florida
Permanent, travel, contract, and per diem placement. No fees to candidates.
Explore staffing services →Free tool
2026 Healthcare Salary Calculator
Estimate comp by specialty, state, experience, and practice setting. Based on MGMA, AMGA, and BLS benchmarks.
Try the salary calculator →Get Ava Health updates
Healthcare salary data and market updates from Ava Health. Sign up to hear when new resources are ready.
No spam. Unsubscribe anytime. We never share your email.