FNP work settings and benefits

Advanced Practice Columnist / Guide · Feb 24, 2008

Are you employed in a non-nursing related capacity? will you pursue your NP via the direct entry program route?

A good way to start gathering info on the NP role is to read the responses in this forum. There is such a diversity in NP employment settings. There are also many different NP tracks or specializations each geared toward a particular population based on age, setting of care, or medical problem. Pros and cons of the different work settings and NP specializations are different for each individual. Every opportunity offers different lifestyles, pay scale, stress levels, work schedules, etc for the nurse practitioner.

Salary aside, many nurses who have been in practice for a while realize that there are specific areas in nursing that they enjoy more than others. Some nurses thrive in the chaos and fast pace of a hospital ER or ICU. Many of the nurses who identify with this preference end up pursuing the ACNP route. Some nurses feel that their niche is with the out-patient population. Although these patients are medically stable, these nurses thrive in the opportunity for health maintenance and teaching roles and establishing a long-standing relationship with patients. FNP, ANP, are examples of NP tracks that train nurses for these roles.

It may be difficult for someone who has not stepped into the world of nursing to make an informed decision regarding these options. However, there are alternatives available for such individuals such as shadowing practicing NP's in different settings and specialization as well as reading about NP's in forums similar to this one.

Finally, you mentioned that you currently earn 85K a year. Some NP's earn around the same as you, some earn less, and yet some earn more. Variations are usually dependent on geopgraphical areas as well as practice settings or specializations, type of practice (private or hospital). I would like to direct you to the latest salary survey published by Advance for Nurse Practitioner in this link: http://nurse-practitioners.advanceweb.com/Editorial/Content/Editorial.aspx?CC=105177&CP=2

Other than the above, I am sure others will be able to give you further advice.

DaisyRN, ACNP · Feb 24, 2008

i was looking into the difference in benefits for a fnp working in/for a hospital vs clinical setting/private practice. i really do not have alot of knowledge in this area. the reason i ask is i am looking for np as a 2nd career, my present job i earn 86k, that includes medical, dental, 401k, and pension plan, knowing i would rather pursue np, can i at least fall into this same salary and benefit package, if not what are the different settings a np can work in and what are the pros and cons to each including benefits such as retirement. i appreciate the responses.

first of all,

i have to share something for you to think about... if you'd like to stay in the hosptial, i would recommend an acnp program instead of an fnp program. more and more regulating boards are looking at the scopes of practice for fnp/acnp and because the hospital setting is acute, they are saying that the fnp is out of scope in the hospital (i am not referring to the er). an acnp is qualified to treat acute illness and complex chronic conditions, but the drawback is that you have to choose adult (ages 12+) or pediatric for the acnp role, whereas an fnp spans the age range, but focuses on primary/outpatient care. there's an article in the journal of the american academy of nurse practitioners that just came out and it helped delineate some of the issues of scope.

as for settings in general... it depends on what you want to do. i want hospital and clinic setting, so i am working for a cardiology group. i see patients in the clinic and will also be rounding on patient's admitted to our services, discharging them, and seeing consults for our group. plus supervising stress tests, nuclear testing.

as for my benefits... my salary is less than yours, but after my first year of practice i will receive productivity bonuses quarterly and annually and expect my salary to increase substantially. at that time, my role will be further defined and i will have had time to "prove" my worth to the group. the other benefits are just simply dependent on where you go to work. you can review a previous board that i started at: https://allnurses.com/forums/f34/1st-job-offer-what-look-262177.html and i received a lot of information of what to consider in a first job, but it may overlap into information that you are looking for.

best wishes!

Dino · Feb 25, 2008

I appreciate the info. and the link to NP websites. My main concern I guess is not so much annual compensation, as is retirement plans, including pensions, are these a rare commodity to receive as a NP in practice? If pension plans do exsist, where would one find them, ie) working for a hospital vs private, and what are they like, generally, not specifically? To be honest, most people do not nearly sock away enough money into a 401k to have a comfortable retirement, mostly because cost of living is so high. That's the only real concern I have in changing careers, where I work I have a pension plan, plus a 401k, and my job is not nearly as important as an NP's. I never hear about pension plans for NP's. Making 75-90k/ year before taxes is great if a pension comes attached, if you have to rely on socking enough money away into a 401k from this amount for retirement, after taxes, mortgage, etc... you'd almost have nothing left over. Maybe someone could shed some light on this topic. I know people say you should go into healthcare for the right reasons, and I am hoping to do just that, but it seems like the nurses and NP's in my area will accept and work for peanuts and not stand up for what they should earn, if one has to think long term about retirement, esp. with the likelyhood of no social security for people under 40, I think one would need to start asking for the benefits they deserve. Any info. in this regards? thanks much!

Advanced Practice Columnist / Guide · Feb 25, 2008

I appreciate the info. and the link to NP websites. My main concern I guess is not so much annual compensation, as is retirement plans, including pensions, are these a rare commodity to receive as a NP in practice? If pension plans do exsist, where would one find them, ie) working for a hospital vs private, and what are they like, generally, not specifically? To be honest, most people do not nearly sock away enough money into a 401k to have a comfortable retirement, mostly because cost of living is so high. That's the only real concern I have in changing careers, where I work I have a pension plan, plus a 401k, and my job is not nearly as important as an NP's. I never hear about pension plans for NP's. Making 75-90k/ year before taxes is great if a pension comes attached, if you have to rely on socking enough money away into a 401k from this amount for retirement, after taxes, mortgage, etc... you'd almost have nothing left over. Maybe someone could shed some light on this topic. I know people say you should go into healthcare for the right reasons, and I am hoping to do just that, but it seems like the nurses and NP's in my area will accept and work for peanuts and not stand up for what they should earn, if one has to think long term about retirement, esp. with the likelyhood of no social security for people under 40, I think one would need to start asking for the benefits they deserve. Any info. in this regards? thanks much!

I agree with most of what you say. I live in the Detroit area where many folks have ties to the auto industry. These guys who work in the auto plants have good retirement packages including paid health insurance once they retire. We nurses make a career out of caring for the sick and we lose our health insurance once we're not working for the hospitals anymore.

I am pretty sure most if not all NP's have some form of retirement benefits. I am employed by the hospital and have the corporate 403B, pension plan, and retirement savings account. I have health, dental, and vision from my employer. My base salary is above yours.

yellow finch, BSN, RN · Feb 26, 2008

first of all,
i have to share something for you to think about... if you'd like to stay in the hosptial, i would recommend an acnp program instead of an fnp program. more and more regulating boards are looking at the scopes of practice for fnp/acnp and because the hospital setting is acute, they are saying that the fnp is out of scope in the hospital (i am not referring to the er). an acnp is qualified to treat acute illness and complex chronic conditions, but the drawback is that you have to choose adult (ages 12+) or pediatric for the acnp role, whereas an fnp spans the age range, but focuses on primary/outpatient care. there's an article in the journal of the american academy of nurse practitioners that just came out and it helped delineate some of the issues of scope.

egads. this was a major concern of mine. i wanted to have broader options with my degree and so chose the fnp route. looks like working on my post-master's acnp certification will be necessary now... my husband is tired of me being the permanent student. but after completing lots of hours in clinicals i can't see myself being happy in a family practice office. :cry:

core0 · Feb 26, 2008

I was looking into the difference in benefits for a FNP working in/for a hospital vs clinical setting/private practice. I really do not have alot of knowledge in this area. The reason I ask is I am looking for NP as a 2nd career, my present job I earn 86k, that includes medical, dental, 401k, and pension plan, knowing I would rather pursue NP, can I at least fall into this same salary and benefit package, if not what are the different settings a NP can work in and what are the pros and cons to each including benefits such as retirement. I appreciate the responses.

I think that the days of pensions are for the most part come and gone. Most companies are doing away with pension plans. Given the state of social security it really is the employees responsibility to plan ahead. The best deal I have seen in private practice (or in academia) is matching for 401k. You have to take advantage of this. What I did was put 10% of my salary in (which works to about 5-6% after taxes) and the company matched 4%. When I got a raise I put that money into the 401k until I maxed it (around $15k per year if I remember). I work to keep it maxed. To put that in perspective with reasonble returns after seven years its about $165k. That money will double roughly every seven years (again with reasonable returns). So that initial money will represent more than $1 million in 25 years or so when I hit retirement age. Plus money that I put away until then. The power of pre-tax saving and compound interest in a 401k is a marvelous thing. My mid point salary is around the same as yours.

David Carpenter, PA-C

Dixiecup · Mar 4, 2008

I think that the days of pensions are for the most part come and gone. Most companies are doing away with pension plans. Given the state of social security it really is the employees responsibility to plan ahead. The best deal I have seen in private practice (or in academia) is matching for 401k. You have to take advantage of this. What I did was put 10% of my salary in (which works to about 5-6% after taxes) and the company matched 4%. When I got a raise I put that money into the 401k until I maxed it (around $15k per year if I remember). I work to keep it maxed. To put that in perspective with reasonble returns after seven years its about $165k. That money will double roughly every seven years (again with reasonable returns). So that initial money will represent more than $1 million in 25 years or so when I hit retirement age. Plus money that I put away until then. The power of pre-tax saving and compound interest in a 401k is a marvelous thing. My mid point salary is around the same as yours.
David Carpenter, PA-C

That's great for you, you're young. I'm already fifty years old and have a year left to get my NP degree. I have no retirement at all right now so it looks like I'll just be stuck working till I die!