ACNP Compensation

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Specializes in Critical Care, Cardiothoracic/Cardiology.

Hey Everyone,

I hope this finds everyone well!!

I have some questions with regards to NP compensation. I have applied to a couple of positions as an ACNP. I have many certifications such as my CCRN, CFRN, RNFA, TNCC, and all the AHA stuff! I have been a nurse for 15 years and have done everything a RN could do in the critical care realm.

I was offered a position outside a major metropolitan area with the specialty I am interested in with a compensation package that is quite reasonable. The metropolitan group sent me an offer $40/K less than the more rural area. How can there be this big of a discrepancy? The group in the metropolitan area offered me an amount that I can make as a RN, not to mention that I will be required to take call 1-2 weeks per month and that is part of my salary. Does any other ACNP's get compensated for call? What if we get called into surgery? Is there incentive for that?

Now here is the kicker. I am continuing my education to obtain my DNP and Post-Masters in Pediatric Acute Care. The group that came in less is close in proximity and affiliated with the children's hospital where I will be doing clinical, so there is that advantage and perk.

I guess here is the other dilemma. In the state where I will be practicing, NP's can practice independently and can bill for the 85% with CMS. How is it that a physician hospitalist's average salary is approximately $250/K, yet a NP Hospitalist is $95/K? Are NP's just taking what they can get?

Dr. Barkley made an excellent point during his review; Nursing and math don't mix. Honestly as a profession, we should really do our homework and not accept the first offer and know our worth. I'm not expecting big compensation as a new NP, but they should also realize that I bring extensive clinical experience and expertise to the table as well. Not to mention I have student loans to repay as well. I didn't do an additional three years of graduate school to make the same amount as a ADN (no offense....I started as an ADN)

Thoughts????

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Specializes in Internal Medicine.

That's a rough offer. I've said this in other threads but it's important to know the volume they expect you to see, the services/skills you will be doing, and what the reimbursement rates are in your area for the coding you'll be doing. You can get a rough estimate of the amount you'll be generating.

In my area (West Texas) all the local hospitals use contract agencies like TeamHealth or SoundPhysicians for their hospitalists, and the NP's start at a minimum of $120k with TeamHealth and $135k with Sound, with other bonuses and incentives depending on shift demand. $95k a year for hospitalist work is terrible.

I will say the local pulmonary intensivist group in my area is notorious for lowballing new NP's with offer's like $70k-80k a year and the requirements to take call and work nights, so I'm not surprised there's other groups across the nation trying to lowball new NP's.

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Tell the low ball offer about the higher offer. Say you'd like to accept their offer but the difference is just too much. That's the truth. You'll have nothing to loose as long as you are comfortable walking away or taking the pay cut. It's worth a try. But also, if the rural group is the kind of work you want to do, I think the benefits of going there outweigh the benefit of working at a place where your clinicals will be.

side note - I'm currently in the middle of getting my ACNP. I work in the OR right now and really want to continue my career in the OR. I'm doubting that I chose the right speciality. Lots of people are telling me I should get my FNP. Do you think it matters? If you dont mind me asking, what type of position is the metropolitan hospital that you're able to assist in surgery?

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Specializes in Critical Care and ED.

I'm curious to know how it works when negotiating with a hospital as a new grad AGACNP. Do the hospitals have a scale above which they will not go? I know it's possible to negotiate with independent practices but I'm assuming it's not really that easy to negotiate with a large facility with a set pay scale and a formidable HR department. Am I right?

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I'm still in school, but from what I've heard its difficult to negotiate with a large facility. I work at a level 1 trauma center, teaching hospital, the whole nine yards. Its basically pre-set what everyone makes starting out as a new grad, so its kinda of like you take it or leave it.

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Specializes in Registered Nurse.
I'm still in school, but from what I've heard its difficult to negotiate with a large facility. I work at a level 1 trauma center, teaching hospital, the whole nine yards. Its basically pre-set what everyone makes starting out as a new grad, so its kinda of like you take it or leave it.

I work in the same type of facility. They do have those pre-set rates based on experience, job type, etc. I did negotiate successfully however. It only ended up being maybe like 5 grand more than original offer but it made me more comfortable based on other offers I had. I actually just got a promotion and was prepared to negotiate for 10% increase-offer ended up being 35% more so I kept my mouth shut on that one. But usually I always negotiate. Know thy worth!

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