Decent new grad pay

Jules A, MSN · Dec 10, 2014

I don't know anyone that would work for "significantly less money" either. Similar to slightly less? Sure.
Realize that even though the billing is the same, your productivity is leaps and bounds different compared to an experienced NP. Just how an experienced RN is (usually) much more productive and knowledgable than a brand new RN. We also know that billing and reimbursement doesn't really mean a whole lot in relation to pay for nurses in general, unless you're an NP paid based on productivity. A new nurse in California makes 2 times much as a nurse in Alabama, yet the reimbursement by medicare and insurance companies is identical.

Similar to slightly less money makes sense. :) You make excellent points about productivity but even on my first shift my appointments were scheduled with exact same frequency as seasoned providers. On my inpatient job I split the patient load with the psychiatrists, again right from the beginning. Maybe psych is different.

It frustrates me to learn of NPs making less than RNs and I have to wonder if our willingness to work for less than we are worth has something to do with the fact that we are mostly women.

The truth is if there weren't NPs who were willing to work for RN wages the employers would pay more. I always disclose my rate of pay to other NPs because I don't want a new grad coming in undercutting my pay. We need to stick together, discuss our rates of pay, and approach our careers as if they are a business, which they are. :)

Riburn3, BSN, MSN, APRN, NP · Dec 10, 2014

Excellent point Jules A. I think it's important to remember however that NP's nationwide on average earn quite a bit more than regular RN's. Stories here of RN's taking a pay cut are those RN's that are in the top 10% of nationwide pay scales (about $94k). Depending on your source, $95k is the average salary for a Nurse Practitioner. Compare NP's in the top 10% of pay to the RN's here in the top 10% of pay and it's not even close. It's also important to ask what the RN that is making that kind of money is doing to earn it.

I count myself lucky to be in the top 10% of RN's, but I have a national certification, am a charge nurse in a high acuity unit, and work nights (with at least 4 weekend days a month), plus an overtime shift each week to get it. With my upcoming NP job, I will work 4 days a week 9-5 (plus I'm sure some more for charting, especially early on), a half day Friday, and will be expected to see 15 patients per day in an Internal Medicine office. No weekends, no overtime, no call. My pay will be virtually identical, plus a similar medical benefits package, CME reimbursement, 1 month PTO per year, and license reimbursement. It might be the same amount of money, but the hours put in will be less, no more nights, no more weekends, and I will finally have a normal life after 8 years being a night shift zombie. With a baby on the way, totally worth it for my wife and I. In the end it's important to look at the bigger picture and not just the bottom line.

ThePrincessBride, MSN, RN, NP · Dec 10, 2014

You can't compare a seasoned nurse's salary with a new grad NP. And if you want, let's look at my institution:

New grad NPs are salaried and they start off at 80k/yr and top off at around 115k/yr.

Veteran nurses are hourly and they top out at about 45/hr.

New grad NPs where I work typically only do day shifts with no nights or weekends or holidays.

Veteran nurses are typically stuck with weekends and nights (forever) and many still rotate into night shift.

Both get the same benefits (health insurance, pensions, etc).

NPs are not mandated, but the nurses are.

Aussierules1985 · Dec 18, 2014

....
It frustrates me to learn of NPs making less than RNs and I have to wonder if our willingness to work for less than we are worth has something to do with the fact that we are mostly women.
The truth is if there weren't NPs who were willing to work for RN wages the employers would pay more. I always disclose my rate of pay to other NPs because I don't want a new grad coming in undercutting my pay. We need to stick together, discuss our rates of pay, and approach our careers as if they are a business, which they are. :)

I can guarantee its not just women... I was just young, inexperienced, and in a very poor area. I did what I had to. I needed the experience. When my wife moved to a real market; the wage went way up.

Agree with the discussing pay etc. I do too.

ashonman · Dec 18, 2014

I guess as a new grad you take what you can get until you get you feet wet. There are other variables we will have to consider. I will probably take a 90k with good benefits over 110k with crappie benefits.

MikeFNPC, MSN · Dec 19, 2014

Don't forget that "good benefits" can include bonuses, some significant. I'm fresh out of school, and have had 3 job offers. All are M-F no weekends or call. The first is 100k with 10k/yr productivity bonus. Second is 90K with anticipated 30K/yr bonus. Third is 150k no benefits, 1099 contract.

My goal with the first year out is to find a place that can mentor me. School was great but real-life, I'm sure, will be a different animal.

Jules A, MSN · Dec 19, 2014

Don't forget that "good benefits" can include bonuses, some significant. I'm fresh out of school, and have had 3 job offers. All are M-F no weekends or call. The first is 100k with 10k/yr productivity bonus. Second is 90K with anticipated 30K/yr bonus. Third is 150k no benefits, 1099 contract.
My goal with the first year out is to find a place that can mentor me. School was great but real-life, I'm sure, will be a different animal.

So without talking to peers to verify the figures I'd be careful about counting on productivity models especially if the word "anticipated" is involved. Not that you can't do well with these because I have one gig that is quite profitable but I also have friends who have been sucked in with numbers that never materialized.

Also keep in mind with a 1099 arrangement you are paying the full boat on FICA and with no PTO or health benefits which add significant value.

Riburn3, BSN, MSN, APRN, NP · Dec 19, 2014

I agree with Jules A. The job I took offers a 15% profit share bonus annually, and I was given some ballpark estimates on how much that would actually be. When I asked if they could be more specific, I was given several spread sheets of their actual profit margins in the previous fiscal year. I like concrete data to go off of, and not what someone is trying to pitch to me. When most places want you to sign multiple year commitments, it's important to be as prudent as possible.

You're also on the money about wanting a place to mentor you Mike. I turned down some more lucrative offers just because of the Master/Apprentice relationship I would be getting with the job I accepted. I know there are going to be a lot of deer in the headlight moments in the coming months (or longer), and it's important to be able to have someone to turn to that has an active interest in my growth and development in a judgement free zone.

ashonman · Dec 19, 2014

Riburn3 you are absolutely rightmentoring is important to a new grad's growth in this profession. If you are not careful you will get caught up in trying to make a quick buck which will end up costing you in the long run.

AtomicWoman · Jan 2, 2015

My first NP job only paid a few dollars more per hour than the RN job I had. But the RN job required me to work nights and weekends. And autonomy? I can't describe how important that is to me. I had very little autonomy as an RN. Now, as a primary care NP, I have a lot of autonomy.