General pay/scheduling questions re: NP

  1. I had wanted to become an NP for quite some time, unfortunately life circumstances have prevented this. I might actually be able to do this at some point, and have a few questions regarding compensation and scheduling.

    I saw a posting in which it was stated that it's very rare for an NP to work hourly, and that NPs almost exclusively work as salaried employees. Is this true? If so, are schedules often abused? I.e., If an NP is contracted to work "x" hours per week, are they often made to work more without compensation? It is my understanding that it is possible/common to work for twenty hours per week. In such scenarios, is this scheduling abused? Also, are such NPs offered benefits if considered salaried?

    If NPs can work hourly, is overtime usually offered? For example, if I wanted to work sixty hours per week, would this be possible? Would I have to work forty hours per week at one institution, and twenty at another (assuming anyone would hire me hourly)?

    Is there any additional info related to this that you think that I might need to know? For what it's worth, I'm located in the suburbs of NYC.

    Thanks.
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  2. 12 Comments

  3. by   djmatte
    It's been my experience that many NPs who work full time are typically salaried while those who are part-time or contingent tend to work hourly. How long you work over/under tends to be dependent on the individual and their own work ethic. Not to mention all of the ancillary things that cause late starts on seeing patients that contribute to the clinics falling behind. I have seen clinicians stay late (sometimes for hours) finishing charting or catching up on messages because they either fell behind through the day or were just overloaded. This could be interpreted as the company taking advantage by overloading the clinician or simply a busy day. I tend to think it's the latter, but if it is something that happens all the time perhaps the facility is to blame or perhaps the clinician needs to do some soul searching about their abilities.

    Most of what you are asking needs to be addressed with individual employers and by each contract. What are the hourly expectations...what is expected should you go over...etc. Also what are you willing to tolerate for the occasional lapses. At the end of the day though, you are being trusted to manage the health of your patients. So much of it comes down to what you are comfortable with waiting until the next day (when who knows what new setbacks may or may not present) or just getting done and moving on.
  4. by   Allis A. Clamp
    Thanks, I appreciate the reply.
  5. by   FullGlass
    Djmatte provided a good response. Many NPs do work 2 jobs to make extra money - a full time job and a part time job like home health assessments. Depending on the practice, there may be opportunities to make extra money by working evenings and/or weekends.

    Some experienced NPs choose to work locum tenens ("temp") positions. They can get a very high hourly rate, but no benefits. Here in California, a primary care locums NP can make $200K per year. That can be much higher for other specialties like psych.

    As far as not adhering to scheduled hours, that depends on the individual practice and also, the specialty. There are plenty of jobs where little to no OT is required or expected - SNFs, schools, sleep medicine, etc. However, if you are working in a very busy urgent care practice, you probably will work OT. This is something you can find out up front when interviewing for a job.
  6. by   Allis A. Clamp
    I'd assume the overtime in a "very busy urgent care practice" would likely be unpaid, as the NP would be on salary, right? Please don't misunderstand what I'm asking. I'm trying to get a feel for things, not looking at this from the perspective of short-changing patients and getting out the door.
  7. by   djmatte
    Quote from Allis A. Clamp
    I'd assume the overtime in a "very busy urgent care practice" would likely be unpaid, as the NP would be on salary, right? Please don't misunderstand what I'm asking. I'm trying to get a feel for things, not looking at this from the perspective of short-changing patients and getting out the door.
    Not necessarily. Some salaried positions provide additional pay for hours worked over 40 (sometimes if over a regular 8hr day) and it's typically a pre-agreed upon number. One place I recently applied to suggested this in their contract.
  8. by   juan de la cruz
    I am considered full time with 0.9 FTE working 6 12-hr shifts per 2-week pay period. We're all part of a group of ACNP's working with intensivists in adult critical care. We are employed by the medical center and have employee benefits through the medical center including hourly pay, overtime pay for hours worked above 40 per week, holiday and weekend pay, shift differentials, etc. I would say that in our role, it's in our best interest to have this kind of benefit structure. We don't typically stay over longer than the 12 hours or so to finish our work.
  9. by   Allis A. Clamp
    Thanks for all of the info. You've all thoroughly answered my questions.

    Out of curiosity: FullGlass on what kind of hours would $200K/year be based? (My guess would be over five years of experience, with sixty hours per week.)
  10. by   SpankedInPittsburgh
    Where I work the Docs are salaried and the PAs & NPs are hourly. As a result Docs will often stay hours after their shift to finish charting and seeing patients. PAs and NPs don't unless OT is approved which almost never is so they generally leave on time. Personally, I'm glad to be an hourly employee in a union otherwise I'm sure I'd be working many more hours without compensation.
  11. by   Forest2
    I can only give advice as to salaried positions. I have never worked salary where they did not expect you to work more hours than they were actually paying. The whole idea of paying salary is to negate overtime pay, etc. It is usually beneficial to the company because they know they can meet budget by not having a fluctuating payroll. In addition, they get more work out of the employee.
  12. by   djmatte
    Quote from Forest2
    I can only give advice as to salaried positions. I have never worked salary where they did not expect you to work more hours than they were actually paying. The whole idea of paying salary is to negate overtime pay, etc. It is usually beneficial to the company because they know they can meet budget by not having a fluctuating payroll. In addition, they get more work out of the employee.
    I actually work a salaried but toy are expected to only work the scheduled hours. Any additional need to be approved as either ot or comp time and the pay is broken up based on what the salary would be if hourly. I'm sure there are people who work over and don't bother reporting it, but since the job is federal, they aren't supposed to come down on you for claiming it.
  13. by   FullGlass
    Quote from Allis A. Clamp
    Thanks for all of the info. You've all thoroughly answered my questions.

    Out of curiosity: FullGlass on what kind of hours would $200K/year be based? (My guess would be over five years of experience, with sixty hours per week.)
    That figure was for an experienced NP working locum tenens in California in primary care. To do a quick hourly rate calculation, [hourly rate] x 2,000 billable hours = estimated annual income. The exact number for full-time is 2,030 hours. So, if an NP earned $100 per hour and worked full-time, 100 x 2,000 = 200,000.

    A new grad primary care NP in Calif is going to start around $100 to $120K per year if they are a salaried full time employee.
  14. by   Soxchica
    In our clinic, our NPs are salaried, but then make a certain amount per patient that they see over 10 daily.

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