Pay depends on where you work. The Southeast and eastern regions are the worst paying in the US. The west coast pays the best, plus a lot of hospitals on the west coast are Union, so there are some benefits to that aspect. I worked in the South in Georgia for 10 years and was only making about $28.00 an hour after all that time. I worked in an ER and at that hospital, there was no extra pay for ER skills. Some hospitals give you extra pay for your certifications, such as ACLS, PALS, etc. Mine didn't. Usually, you will have no problem at all picking up extra shifts. Nurses seem to be a dying breed. Also, be sure to find out if the hospital requires CALL hours in addition to your normal shift; and/or if they have weekend-only option.