First NP job... Did you negotiate the salary?

[RN/WI, ADN, BSN, MSN, RN, APRN]

As a new graduate NP, you’ve made it through the program and passed the boards, yah! Now it’s time to find the first job. Here are some frequently asked questions of the new grad as the time comes to get that first job. Can some NPs that have been here already share the answers to the below questions... Any input is appreciated.

• As a new graduate NP, how long did it take to land the first job?
• Was your first job in the area of practice/ specialty that you wanted?
• Did you negotiate the wage for the position?

[verene, MSN]

1) I took boards and started interviewing about a month after graduation. Received job offer about 2 months after graduation, and started work about 4 months after I graduated. 

2) Job is pretty much my dream job - I didn't think I'd get it as a new grad, but I am SO GLAD that did. Even after a over a year with the honey-moon varnish worn off and COVID related chaos, I still think this is the best job I could have. 

3) State Employee with set band-ranges for pay so not a lot of room for negotiation there - but  I'd looked up the general contract/band ranges before I applied and felt that they aligned reasonably well with market rates in my area.  I could probably  make a bit more elsewhere, but the wages are reasonably competitive and benefits better than average - and like I wrote above - dream job!  (Salary isn't everything! take a look at the whole picture of schedule, vacation time, ongoing education, research/professional opportunities, supports, organizational culture etc). 

I *did* negotiate schedule, supervision/supports, and a few other things (don't remember details off top of my head). 

[amoLucia]

verene - good advice to comment that Civil Service does offer good career opportunities. Even for general staff nurses. Of course, they usually have a union, but that's usually a plus

It has always been said about civil service that 'it's NOT the pay, it's the benefits'.

New nurse grads would do well to look into Civil Service positions. Civil Service does require a certain type of personality, but it can work.

[MentalKlarity, BSN, NP]

Yes, NPs love to overwork and be underpaid it seems. Remember that you are now a revenue producer - the practice makes money everytime you see a patient. 

Things to keep in mind:

Vacation - You don't want to be burnt out! 4 weeks annually is standard/acceptable. 3 weeks is pushing it, and anything less is unacceptable. Would you really only want to have 2 weeks off or less a year?

Benefits - 401k match, insurance, malpractice, CME. These things add up. If they don't offer it (or you're a 1099 employee) the salary should make up for it.

Hours worked per day - Remember to divide that salary out! 100K annually doesn't sound so good if they explain your work week is 7AM to 6PM Mon through Friday. Figure out the hourly rate it works out to! 

Always negotiate. I don't think NPs, even new NPs should be below 6 figures. Having a slightly reduced salary for 3-4 months or so while you "train" is fine as long as the contract states you will then go up to a full rate. Especially as a new NP the expectation is you might be a bit slower as you learn the ropes so the practice will earn less. 

[RN/WI, ADN, BSN, MSN, RN, APRN]

Great thoughts here!

[verene, MSN]

Oh - also ask about things like call (required/optional/none), coverage (do you find own? Does employer provide?) for absences, panel size. Number of admits per day/week and number of follow ups. Patient/case complexity and resources for management. Are there MAs to help with administrative stuff? (e.g. records requests).  What EHR is used? (seriously it can make a big difference). Pharmacy coordination (onsite/offsite/contracted or retail?) --- any specific certs needed (e.g. Clozapine REMS in psych setting)? Do they pay/provide training for additional certifications?  Is pay salary, hourly? 1099 or w-2? Are you paid for working overtime (particularly if salaried this is a good question to ask) and what is the approval process for working overtime? (And is this anticipated to be common occurrence?) 

Liability/legal - are you covered by their malpractice insurance (still have your own!) Is there legal representation or advice if you need it (I speak with our director of legal affairs ALL THE TIME with weird patient situations and correct legal handling - but I also work forensics so EVERYTHING is somehow tied to legal system).  Is it anticipated you will need to testify as expert witness or otherwise provide testimony in your area of practice? What preparation is provided for this? 

Are there teaching or mentoring duties? Expectations to participate in committees? etc. 

ALWAYS ask about non-compete agreements (and try to avoid signing one) as well as policies on having a second/moonlighting job (many places are okay with it but do have you go through a formal conflict of interest process, some employers prohibit this - if you think you might pick up something part-time or per diem on the this matters). 

[djmatte, ADN, MSN, RN, NP]

I did.  I negotiate every time my contract is up.   Be realistic about you will bring in the first year and what your potential is going forward.  I asked for 10g over the initial offer and the MD said he wasn't gonna lose someone over that.  Felt bad because it basically gave the operations director no room to go when I countered.  LOL

[RN/WI, ADN, BSN, MSN, RN, APRN]

49 minutes ago, djmatte said:

I did.  I negotiate every time my contract is up.   Be realistic about you will bring in the first year and what your potential is going forward.  I asked for 10g over the initial offer and the MD said he wasn't gonna lose someone over that.  Felt bad because it basically gave the operations director no room to go when I countered.  LOL

Do you work for one facility, or as a locum  when you say to negotiate each time a contract is up? Congratulations and good job with negotiations?

[djmatte, ADN, MSN, RN, NP]

9 minutes ago, RN/WI said:

Do you work for one facility, or as a locum  when you say to negotiate each time a contract is up? Congratulations and good job with negotiations?

I work for a family medicine group. We have four clinics in our area but at the moment I am in one location.  Originally I did work 1 day at a different site, but eventually they realized it was a problem for patients who wanted to see me specifically. 

We negotiate contracts.  Typically 1 year at a time.  Most of the time its based on your previous year's work.  My initial year I sat down with the owner and the ops manager who did the hiring.  Owner dropped that bomb during the interview.  Manager offered me 90 afterward, and I countered with 100 and he took it.  

[Guest1168644]

14 hours ago, RN/WI said:

As a new graduate NP , how long did it take to land the first job? Was your first job in the area of practice/ specialty that you wanted? Did you negotiate the wage for the position?

I graduated August 2020. I was offered position at internal medicine office I did my internship at, passed boards in September, licensed and started working in November. Initial offer was 80k, I ended up taking 85k, they pay 100% of my families health insurance, and then typical matching for 401k. So reimbursement is actually >100k. Raises are detailed yearly in the contract for the next 5 years. Also gave me about another month of shadowing which was amazing. CE money is around $1,000 I believe. They gave me UpToDate account as well. Wednesday’s are half days, able to call patients and follow up, catch up on paperwork.

[RN/WI, ADN, BSN, MSN, RN, APRN]

2 hours ago, Shamrock1145 said:

I graduated August 2020. I was offered position at internal medicine office I did my internship at, passed boards in September, licensed and started working in November. Initial offer was 80k, I ended up taking 85k, they pay 100% of my families health insurance, and then typical matching for 401k. So reimbursement is actually >100k. Raises are detailed yearly in the contract for the next 5 years. Also gave me about another month of shadowing which was amazing. CE money is around $1,000 I believe. They gave me UpToDate account as well. Wednesday’s are half days, able to call patients and follow up, catch up on paperwork.

Congratulations ? Can I ask how much raises are annually? Is it a raise increase each year in anticipation that as a new NP more revenue will be generated as one becomes more familiar with the position? Also, how many weeks annually of vacation/ personal time?

[Guest1168644]

10 minutes ago, RN/WI said:

Congratulations ? Can I ask how much raises are annually? Is it a raise increase each year in anticipation that as a new NP more revenue will be generated as one becomes more familiar with the position? Also, how many weeks annually of vacation/ personal time?

This stipulation is literally the only thing that bothered me in the contract. There really was no mention about my increasing role/revenue towards the practice as the years progress. Also concerning in regards to inflation, etc. However, I felt the pay and benefits outweigh this aspect by a lot. The physicians in the practice are all great to work with, when I have questions regarding a case they are easily available, which to me is important as I am brand new (I feel safe and I think that is something you should look at as well). I also did my internship here, so know the staff and workflow well.

The pay will increase by 5k for each individual year. But the medical alone is like an extra 12k to my salary, it is top tier coverage. Two weeks vacation the first year, then 3 weeks following years. I am not sure as to the amount of sick days, I think maybe a week? I never call off anyway as my wife has government job and is able to care for the kids at drop of a hat.

I plan on moving on after couple years of experience, would prefer to work for large hospital system, or get involved with urgent care. One downside, if I did work for local hospital system, they would provide 5k a year in tuition, whereas I get no tuition coverage in this practice.