I have been an RN in the same department for over 20 years. This department recently wanted to integrate NPs.
During the transition, the salary quotes as NP nurses were losing 3-5 dollars because of lack of NP experience. With the recent market adjustments and RN salary increases, the RN that transitioned to NPs are making less than RN with lesser RN experience and those who transitioned.
From what I am reading, most posts say RN experience should not count when you transition into the same department (most of us have been in the department for over 15 years, and some now are making 6-7 difference as NPs. If they were to transition back to RN, the pay would increase by 7 dollars (I am curious about those who say RN experience should not count. Would you transition to an NP role knowing your salary would be less (just because of lack of NP experience)...Once you transition, responsibilities increase, and now I am a provider and not RN.
I can not help to believe that if you put two resumes side by side (no disciplinary issues both high performers the only difference is RN experience.. no bad habits. The one with higher RN experience oriented the lesser RN experience to the department. If the person who would be hired is the one who has more experience, you would have more inferior orientation and could expedite the experience RN to the NP role.
I have been an RN in the same department for over 20 years. This department recently wanted to integrate NPs.
During the transition, the salary quotes as NP nurses were losing 3-5 dollars because of lack of NP experience. With the recent market adjustments and RN salary increases, the RN that transitioned to NPs are making less than RN with lesser RN experience and those who transitioned.
From what I am reading, most posts say RN experience should not count when you transition into the same department (most of us have been in the department for over 15 years, and some now are making 6-7 difference as NPs. If they were to transition back to RN, the pay would increase by 7 dollars (I am curious about those who say RN experience should not count. Would you transition to an NP role knowing your salary would be less (just because of lack of NP experience)...Once you transition, responsibilities increase, and now I am a provider and not RN.
I can not help to believe that if you put two resumes side by side (no disciplinary issues both high performers the only difference is RN experience.. no bad habits. The one with higher RN experience oriented the lesser RN experience to the department. If the person who would be hired is the one who has more experience, you would have more inferior orientation and could expedite the experience RN to the NP role.
No, the issue is that NP pay is inadequate at baseline. With the recent rise in RN salaries post-COVID, even my six-figure income is about the same as most nurses who put in a little OT. NPs need a salary buff but the problem is excess supply and not enough demand (unlike RNs).
I tell every RN wanting to be a NP this but no one listens. Oh well.
Once again I don't know how many times I can say RN experience is largely pointless in the NP world. Being a RN does not translate over to being a provider at all for the reasons I have already stated. I have precepted dozens of NP students at this point and IMO slightly older students with some sort of science/engineering background were by FAR the best.
Other than pattern recognition, what about RN experience or training benefits the provider role? (To the degree where extra pay is warranted).
Physical examination and assessment? Time management? Pattern recognition (which shouldn’t be downplayed). People who minimize RN experience and the importance it has on advance practice nursing fail to grasp the whole point the profession. Capitalize on nursing experience to provide advance care to improve patient access. Suggesting this isn’t necessary only promotes diploma mills and reinforces MD belief NPs aren’t as capable.
One thing that set me up to easily negotiate my initial pay was extensive background in pain management as an RN. At the height of the opiate crisis, I was able to sell this background to the hiring clinic as I was actively motivated in managing pain from a broad holistic approach that minimized use of opiates.
Physical examination and assessment? Time management? Pattern recognition (which shouldn’t be downplayed). People who minimize RN experience and the importance it has on advance practice nursing fail to grasp the whole point the profession. Capitalize on nursing experience to provide advance care to improve patient access. Suggesting this isn’t necessary only promotes diploma mills and reinforces MD belief NPs aren’t as capable.
One thing that set me up to easily negotiate my initial pay was extensive background in pain management as an RN. At the height of the opiate crisis, I was able to sell this background to the hiring clinic as I was actively motivated in managing pain from a broad holistic approach that minimized use of opiates.
I think having pattern recognition and physical assessment skills help somewhat, at least initially, but I think its importance is actually overplayed in the nursing world not downplayed.
I don't think it really has any impact on how physicians look at APNs; all the physicians I've every worked with have cared about competency or making money (or maybe both). I can honestly say I've never had a physician colleague ask how long I worked as a nurse for. Maybe it could be an interview question but I haven't been interviewed in a long time, I was recruited into my last job change.
This notion is an antiquated (and harmful) belief in my opinion that is pervasive in the nursing culture that practice is linear: novice nurse -> competent nurse -> expert nurse -> novice APN -> competent APN -> expert APN. The two roles diverge. You can be an expert RN and a incompetent APN and you can be an expert APN and a incompetent RN. Expert RNs should be paid for their expertise. Expert NPs should be paid for their expertise. I can promise you that I am a pretty good APN but you would not want me taking care of you as an RN at the bedside!
I am currently working on an offer that does give me credit for previous nursing and my hourly rate / salary will also be above average. I am a brand new NP starting a Critical Care Neuro position. My experience is ICU and Rapid Response Team. I understand I will be in a completely different role. That isn't even taking into account the learning curve with Neuro alone. Now I won't be performing procedures and will be basically doing the "admin" side of medicine to take pressure off the docs, but I'll still be rounding in the ICU. I have worked in healthcare my entire life. I have worked in several different positions and on the business side. It ALL counts. To have a complete understanding of how the entire system works, the challenges in it as it has changed over the years, I have experience that you can't get in a classroom and the team I am joining very much appreciates what I bring to the table. If you are joining a team that can't appreciate what you have done and what you are bringing in, you are joining the wrong team. Always negotiate. A bedside nurse of 2 years in a critical care environment and no other experience in healthcare is just beginning to see the tip of an iceberg. Anyone who thinks a 9 year nurse (with all other things equal) is just as valuable as a 2 year nurse doesn't know what they are talking about. You aren't even understanding the complexities of ethics and end of life discussion in 2 years - you are just getting your feet wet, just my opinion.
I agree that all experience makes a difference be it RN experience or business or case management or restaurant or retail or admin it all makes us who we are and adds and contributes to the team in different ways.
I always find it interesting that there are nurses so passionate in commenting about how vitally important RN experience is when they have not ever worked as an APN. I hear it all the time around the wards and the internet. It's hard to say how important experience is to a role you have no experience with.
Physical examination and assessment? Time management? Pattern recognition (which shouldn’t be downplayed). People who minimize RN experience and the importance it has on advance practice nursing fail to grasp the whole point the profession. Capitalize on nursing experience to provide advance care to improve patient access. Suggesting this isn’t necessary only promotes diploma mills and reinforces MD belief NPs aren’t as capable.
One thing that set me up to easily negotiate my initial pay was extensive background in pain management as an RN. At the height of the opiate crisis, I was able to sell this background to the hiring clinic as I was actively motivated in managing pain from a broad holistic approach that minimized use of opiates.
No, RN experience is a hack lobbying point to further perpetuate low clinical hour thresholds required for graduation.
Again, no. Diploma mills NP programs exist for many reasons. Having RN experience is the most minor countering factor with regard to stopping them.
I mean being motivated using buzzwords and throwing out words like "guided-imagery" or whatever to the hiring manager isn't the same as having tangible advantages to a provider.
NP operate in a medical model whether they like it or not. RN experience does not contribute to that.
Physical assessment: Minor. Most RNs do an extremely basic assessment that could be taught to anyone within a week or two and these assessments are never done at a provider level. PA are also not extremely vital for making most provider decisions.
Time management: RN tasks have 0 to do with a provider's tasks. TM can also be learned in any field.
Pattern recognition: I noted as valuable but superficial PR only goes so far with value.
I am currently working on an offer that does give me credit for previous nursing and my hourly rate / salary will also be above average. I am a brand new NP starting a Critical Care Neuro position. My experience is ICU and Rapid Response Team. I understand I will be in a completely different role. That isn't even taking into account the learning curve with Neuro alone. Now I won't be performing procedures and will be basically doing the "admin" side of medicine to take pressure off the docs, but I'll still be rounding in the ICU. I have worked in healthcare my entire life. I have worked in several different positions and on the business side. It ALL counts. To have a complete understanding of how the entire system works, the challenges in it as it has changed over the years, I have experience that you can't get in a classroom and the team I am joining very much appreciates what I bring to the table. If you are joining a team that can't appreciate what you have done and what you are bringing in, you are joining the wrong team. Always negotiate. A bedside nurse of 2 years in a critical care environment and no other experience in healthcare is just beginning to see the tip of an iceberg. Anyone who thinks a 9 year nurse (with all other things equal) is just as valuable as a 2 year nurse doesn't know what they are talking about. You aren't even understanding the complexities of ethics and end of life discussion in 2 years - you are just getting your feet wet, just my opinion.
Where are RNs at any level doing end-of-life discussions in a role more than just adjunct/supportive? Like hey you have 6 months to live and no I don't recommend moving forward with chemo etc etc.....those are very different conversations. Hospice doesn't count since the decision has been made. This is another example of the RN vs provider difference.
I will stand by my assertion that experienced RN students usually performed the poorest during rounds/presentations and plans of care. They also overestimated their knowledge base frequently. This is after seeing dozens of NP students...
When I look at hiring I absolutely do not look at RN experience. Brand new NP with a fellowship vs a 10 year RN experience NP. Easy decision.
Where are RNs at any level doing end-of-life discussions in a role more than just adjunct/supportive? Like hey you have 6 months to live and no I don't recommend moving forward with chemo etc etc.....those are very different conversations. Hospice doesn't count since the decision has been made. This is another example of the RN vs provider difference.
I will stand by my assertion that experienced RN students usually performed the poorest during rounds/presentations and plans of care. They also overestimated their knowledge base frequently. This is after seeing dozens of NP students...
When I look at hiring I absolutely do not look at RN experience. Brand new NP with a fellowship vs a 10 year RN experience NP. Easy decision.
First, I don't know if you intended the tone here to be condescending, but it is. Second, I made it clear my experience is in the ICU. Of course you never asked what kind but after the past 2 years alone I was definitely part of the conversation. I often facilitate and advocate for families that are afraid of stating how they feel. I don't know what kind of nurses you work with or what your experience is, but it sounds limited and horrible.
Depending on RN experience and location, it often is just as good, if not better than most residencies. If you want someone who just jumped into a NP position and tried to avoid the bedside because it is hard as hell, I don't even know what to say to that. The ED I work in depends on the experienced RNs to enhance the experience of Residents and we are absolutely engaged in their training.
Also, I made it clear my experience expands well beyond. I know all about billing, coding, politics, how the pharmacy runs and the difficulties several different departments face when trying to accomplish their jobs because I have previously worked with them. If you can't understand the position your team member plays and the limitations involved, you can't be a good team member yourself. RNs are a HUGE part of the team. If you are implying that RNs have a difficult time mastering a condescending, holier than thou attitude....I think you have nailed it. It is damn near impossible to be at the bedside for 5+ years and dream that you are above anyone. If you are having a hard time understanding where someone is coming from and how to transition their thinking, that says more about you than about them.
HemOnc, MSN, RN, APN
40 Posts
I definitely see your point, but CNAs are not required to maintain their CNA licenses after they become RNs.
NPs are Advanced Practice Registered Nurses, still need that RN license to be an NP