FNPs don't let me down!!! Where's the Money?

aprnKate · Feb 15, 2017

What the heck are FNPs doing? We are filling a primary care shortage. that's what we are doing which is a VERY IMPORTANT JOB. I personally don't think that everything is about money. I have worked at a job where I made 170k, rural, not happy. I now have a job that is 70k less than that job and its rural and I am quite content and happy with it because of the working environment. I work with people who went to prestigious /ivy league schools who could've gone to any working place that pays a heck of a lot more and pay their loans as well but they choose to work in rural under-served areas.

Jules A, MSN · Feb 15, 2017

Appropriate compensation, a pleasant work place and providing much needed care to an underserved population are not mutually exclusive. Its discouraging that NPs continue to cite these reasons as justification for poor salaries. That I make over $100,000 a year more than a peer is mind blowing to me.

Unfortunately with the current trend that everyone and their poodle is enrolled in NP school in addition to the overwhelming number of poor or non-negotiators there is now a legit supply vs demand issue. Its concerning to me because I have no intention of taking on the responsibility of diagnosing and prescribing for wages in line with what I can make as a RN. A high end specialty or private practice are probably the best avenues for FNPs to make an exceptional salary at this time although I'm not sure what the future will bring. If I were a FNP I'd probably look into the heavy hitting MD specialties such as derm and ortho. Find Rock Star Doc, slightly narcissistic definite type A, as they are the ones I have seen who are usually willing to appropriately compensate a highly competent NP.

Trauma Columnist · Feb 15, 2017

BTW - poodles are very smart Jules A.

However, I digress - nephrology isn't bad but I had a friend recently who told me I work too hard - lol. At the moment I am putting in 55hrs/week as we have one NP out on ext maternity leave and another NP just left the practice suddenly.

And...I have two interviews coming up soon for new candidates.

Specialty practices are the way to go....ortho in my area is the coveted PA only position.

JellyDonut · Feb 15, 2017

Amen! Specialty practice is da bomb! where else can could I work m-f with holidays and weekends off and never on-call. Yes, I have mommie hours and I do not apologize for it. I spent years working rotating shifts, missing holidays and weekends and being on call and I do not think i could ever go back to that ever again. You could throw triple my salary at me and I would not budge. The only way i am leaving is if I drop dead on rounds! Money is wonderful, but I like a little life outside of my work. Stella like to get her groove back every now and again and she cannot do that if she gotta worry about being on call. For those of you chasing that paper i hope you get every cent you deserve, but this one may not make 200k, but I am happy right where I am.

Jules A, MSN · Feb 15, 2017

Amen! Specialty practice is da bomb! where else can could I work m-f with holidays and weekends off and never on-call. Yes, I have mommie hours and I do not apologize for it. I spent years working rotating shifts, missing holidays and weekends and being on call and I do not think i could ever go back to that ever again. You could throw triple my salary at me and I would not budge. The only way i am leaving is if I drop dead on rounds! Money is wonderful, but I like a little life outside of my work. Stella like to get her groove back every now and again and she cannot do that if she gotta worry about being on call. For those of you chasing that paper i hope you get every cent you deserve, but this one may not make 200k, but I am happy right where I am.

Legit LOL. It sounds like you have the total package, money and a schedule you love. Me too and I don't think we could hope for more than that.

NurseLauraM · Feb 15, 2017

Primary care has always paid the least. Average general practitioner salary for both NPs and MDs is less than in specialties. That doesn't mean an FNP salary needs to be excessively low (someone recently posted saying they are an NP making 60,000 a year... yikes.) However, in general, primary care will always pay less than specialty.

I'm a relatively new FNP and, while I could have worked in a specialty setting and made more, I prefer the primary care setting. I have so much variety in my work day. In one day I might put in an IUD, do a pediatric physical, do a home visit to a geriatric patient, and treat someone with bipolar (we take on a lot of psych because the wait list is over a year to see a psychiatrist here). I see the appeal of specialty care as well, and the extra money would be welcome, but I don't like any one particular area of medicine so much that I want to do it exclusively. I guess I'm the "jack of all trades, master of none" type

allnurses Guide · Feb 15, 2017

I agree with JellyDonut. I love specialty practice. I work 4-9 hour days, no major holidays, no nights, no weekends. I make well over $100K and I don't feel stressed or overworked. I know I really help my patients, and I like having the in depth knowledge of the conditions I treat. I worked for 3 years in Primary Care and I'm glad I had that experience. I work 2-3 shifts a month in Urgent Care, which helps keep my skills current and helps pay for college for my youngest. I'll probably quit that job when she graduates in 2018 and just enjoy my awesome schedule, which gives me every Friday off.

Riburn3, BSN, MSN, APRN, NP · Feb 15, 2017

I've read the salary posts, almost to my dismay.
Most of the rock stars are Psyc NPs (cough Jules A cough) followed by distant ACNPs.
My question is...WHAT THE HECK ARE THE FNPs DOING?!
I've seen a couple of them that do well, but, seriously!
Are there any FNPs out there that make >$150k?
Business owners, 1099 folks, specialty peeps, anyone?!

I posted in the newest salary thread and I am an FNP. Between my fulltime and part-time job, I'm knocking on close to $200k a year.

You're also just basically asking why primary care makes less than the other APRN specialties, when its essentially the same issue for physicians. 85%+ of FNP's work in primary care.

The critical care intensivist doing procedures and rounding daily on a 20 bed ICU is going to pull in more money than a family practice doc seeing the same number of outpatients. If you're seeing people in primary care making a mint, it's because they're knocking out huge volume.

By the same logic, the AGACNP working in an ICU dropping lines and intubated while rounding on 20 people a day is also going to make more than the FNP seeing 20 outpatients in the primary care clinic.

If you see FNP's really doing well, it's because they're seeing a very high volume, they're part of a practice that shares revenue, they're independent, or they're working hospital (myself), ER, or urgent care.

Palliative Care, DNP · Feb 18, 2017

Definitely need to go into a specialty as an FNP to make money. My specialty isn't for everyone but I enjoy it. I feel like I'm filling a much needed role and assisting both patients and families. I do take call but its only every 5th week. I have work/life balance and leave the office by 5 p.m. at the latest daily.

DragonflyLady17 · Feb 21, 2017

I agree with JellyDonut. I love specialty practice. I work 4-9 hour days, no major holidays, no nights, no weekends. I make well over $100K and I don't feel stressed or overworked. I know I really help my patients, and I like having the in depth knowledge of the conditions I treat. I worked for 3 years in Primary Care and I'm glad I had that experience. I work 2-3 shifts a month in Urgent Care, which helps keep my skills current and helps pay for college for my youngest. I'll probably quit that job when she graduates in 2018 and just enjoy my awesome schedule, which gives me every Friday off.

Curious as to where you work ? How did you get the position. I want a flexible job that allows me to spend quality time with family and travel too.

Thanks.

allnurses Guide · Feb 21, 2017

I've read the salary posts, almost to my dismay.
Most of the rock stars are Psyc NPs (cough Jules A cough) followed by distant ACNPs.
My question is...WHAT THE HECK ARE THE FNPs DOING?!
I've seen a couple of them that do well, but, seriously!
Are there any FNPs out there that make >$150k?
Business owners, 1099 folks, specialty peeps, anyone?!

I am a partner in a practice. I do very well financially. More importantly, I enjoy my job/life and I have a great work-life balance.

Remember that while having a competitive salary and knowing your worth is very important, when you are thinking about your first job, find a practice with good support where you won't be taking home work every day. Burnout, especially in primary care, is very real.