I've been an NP for a while, and I am happy and proud to be one. I am well aware of both our shortcomings and our successes. I think we fill a need in the world of healthcare, and "going to see my NP" has become a normal phrase in American households.
For all of our successes, we seem to have a problem with consistently selling ourselves short when it comes to compensation. I have been reaching out to colleagues and previous students, and I have also been serving as a mentor for some new NP graduates looking for advice. As they navigate positions, one common theme is they do not know how much they are worth, and do not understand that as a provider they are revenue producers! We should be paid as such!
Case in point: last week I had a new graduate FNP telling me about a job in a specialty office she intended to accept. She told me she was satisfied with the salary and benefits and shared them with me. It turned out to be a salaried position at $96K annually working 8 AM to 5 PM five days a week. Vacation was 2 weeks paid going up to 3 weeks after FIVE years. It included all the usual benefits but there was no 401K match and no CME.
Sometimes I feel like nurse practitioners are not being taught about healthcare economics at all. Maybe instead of 4-5 classes on research and "NP roles" we should be teaching a dedicated course on billing and reimbursement? I see NP after NP working for peanuts while the practice that employs them is making hundreds of dollars per hour off of their work. The long-term effect, of course, is that all NP salaries will start to flatten out. Those that do the research and demand a salary that reflects what they bring to the practice will be laughed out the door while those who do not know their worth will end up taking their place.
Does anyone else notice this in the NP world? What can we do to bring awareness to it? Let's Discuss! ?
You seem to say one thing and then change it up. Either it’s “basic economics (supply and demand)” or it’s not. If it is that simple, then even knowing your worth or value won’t get you that job.
Do I really need to explain this? You literally made my point about the business component of your worth.... so, basic economics, saturation can be balanced by the supply regulating its/their interactions with demand.
Do I really need to explain this? You literally made my point about the business component of your worth.... so, basic economics, saturation can be balanced by the supply regulating its/their interactions with demand.
Except the supply doesn’t have the opportunity to do this. Only one third of states have true independent practice for nurse practitioners. The rest are a hodge podge of restriction or collaboration that limit the capacity to actually limit our interactions. Most of us need to work for someone or pay someone to act as a collaborator. Factor in inroads the physician community is making to allow unmatched doctors to work while applying to residency, some doctors will have even less incentive to bother with a nurse practitioner.
Except the supply doesn’t have the opportunity to do this. Only one third of states have true independent practice for nurse practitioners. The rest are a hodge podge of restriction or collaboration that limit the capacity to actually limit our interactions. Most of us need to work for someone or pay someone to act as a collaborator. Factor In inroads the physician community is making to allow unmatched doctors to work while applying to residency, some doctors will have even less incentive to bother with a nurse practitioner.
Definitely challenging times in this profession. But every NP or “supply” can say no to any given offer, subsequently controlling their market. The biggest factor relating to why this does not happen is movement...as seen in other posts.
Very few MDs will be stationary post med school as they will relocate to a more favorable market and gain experience for the next move. Many nurse practitioners go to school with no intention of movement, therefore pigeonholing themselves to work within the the constraints of the market other NPs who did not say no or leave created.
I have friends who are extremely successful NPs and PAs, they have a very similar movement pattern. And are doing quite well because they created their own path to a lucrative career. Interestingly enough, we are all veterans and have no issue with relocating with our household (usually on the hiring organizations dime) for a better return on our educational investments to secure financial security, and live well.
The schools, yes nursing schools, should stop lowering their admission standards into NP programs. Sometime before, it was a strict requirement having prior clinical nursing experience to apply for a NP Program and be admitted, now (no offense) recent RN and not RN graduates can apply and be admitted following some accelerated programs or whatever they call it. They will be excellent students and not doubt, excellent nurse practitioners but with time and experience. Most organizations know that and they take advantage of it. Would you blame them? of course not, the same NP knows and is aware that her or his experience is minimal as such internally understand that cannot get paid as a seasoned nurse. Once I said to myself that the time will come when nurse practitioners will be at the bedside. When you have too much of something, what happen? You get bored, you take it for granted, you don't appreciate it.
I'm curious, how do we fix those things? I have actually written letters in the past to the credentialing boards asking why they continue to certify low performing programs that graduate thousands of NPs annually with almost no oversight. I explain how it hurts the profession both by causing a massive oversupply and by graduating subpar NPs that perform poorly and hurts the reputation of nurse practitioners for colleagues and patients. I have never even received a reply.
I do agree with you though. Part of the problem is that nurse practitioners who find themselves unable to find a job become desperate and accept jobs that are insulting. 1-2 weeks of vacation, pay that works out to 5-10% of what they bring in to the practice, etc.
This is the ongoing conversation my colleague and I have had on numerous occasions.
Specializes in Psychiatric and Mental Health NP (PMHNP).
8 hours ago, cwgirl197 said:
Not everyone can pick up and move to an area with a market that isn’t saturated.
It is the responsiblity of potential NPs to research the job market in their area. As I stated, many healthcare providers will work 4-5 days where their job is, then go home on weekends.
Where I worked, one of the MDs worked 4 ten hour shifts, then drove to SF every weekend and he has been doing this for over 5 years. Prior to becoming an NP, I was a business executive and for many periods, I would do the same, but between LA and SF.
As a new grad NP, you have to flexible. That is true in any career.
Specializes in Psychiatric and Mental Health NP (PMHNP).
5 hours ago, djmatte said:
Except the supply doesn’t have the opportunity to do this. Only one third of states have true independent practice for nurse practitioners. The rest are a hodge podge of restriction or collaboration that limit the capacity to actually limit our interactions. Most of us need to work for someone or pay someone to act as a collaborator. Factor in inroads the physician community is making to allow unmatched doctors to work while applying to residency, some doctors will have even less incentive to bother with a nurse practitioner.
What is all this belly-aching about pay? My goodness, a potential NP should know their earning potential in their desired area.
My first NP job as new grad in rural CA - $125K first year in a VERY low cost of living area (rented a 2BR house for $750 a month!). Second NP job 18 months later - $150K+ per year in a major metro area. Oh, and I didn't have the RN experience some of you mistakenly think is required for a primary care NP. Yes, I took a first job in an area many would consider undesireable, but the experience was incredible.
There are many rural areas in this country desperate for providers, and many of them are within a 1 hour drive of a city! My goodness, if you want this career bad enough, a long commute for 1-2 years is hardly unreasonable, especially in the West.
People, grow up and put on your big boy or girl pants!
I have NO sympathy for NP new grads who whine they can't get a great-paying job in exactly the right location. Too bad.
That sounds about right; the average nurse practitioner salary is $93,000 to $130,000 depending on specialty and zip code. So, if you a new RN grad that completed just enough hours to qualify to sit for the NP licensing and start at $96,000 that's not bad at all.
Conversely, if you are an experienced ER or floor nurse (1 to 3 years) and decide to go NP, then presumably, you are somewhere between 32.00 and 37.00 an hour so you would still see a decent increase going to NP plus no more 12 hour shifts and scrubs (unless you do something other than FNP).
That sounds about right; the average nurse practitioner salary is $93,000 to $130,000 depending on specialty and zip code. So, if you a new RN grad that completed just enough hours to qualify to sit for the NP licensing and start at $96,000 that's not bad at all.
Conversely, if you are an experienced ER or floor nurse (1 to 3 years) and decide to go NP, then presumably, you are somewhere between 32.00 and 37.00 an hour so you would still see a decent increase going to NP plus no more 12 hour shifts and scrubs (unless you do something other than FNP).
With the abundance of schools that accept students with no prerequisites, board exams that are pretty simple, no wonder MD's and PA's look down on the role. Obviously, those NP's who think being a provider is nursing 2.0 are in for a rude awakening.This eventually will lead to a decline in pay, and more of a preference for PA's.
I wish that was the case? In all of my travels, I have never come across any nursing program that did not require prerequisites. If you have some examples, I would love to see them. Now regarding NP's, I have heard the opposite; since they were nurses prior, they have a solid background of clinical experience and more familiarity with acute care, direct patient care, etc., whereas PA's don't have that foundation. So, I suppose one could be successful either way since I have not seen a shortage of PA's.. . .
This! When we become revenue producers we are a net profit! Most of us bring in 300K+ annually to our practice so don't settle for working for a fraction of that! Ask to see your collections after 6-12 months and make sure you're getting a decent percentage of it.
The victim mentality ("I'm just happy to have a job!") should stop.
It is not a victim mentality; it is reality.
I think what you and some others on this thread are not realizing is that NPs have a short shelf-life post-grad until they become "stale"...usually about one year. After that, they might as well not have become an NP in the first place as their chances of getting a job are slim.
Also, not everyone has the luxury of moving or holding out for high paying jobs, some of us are stuck in saturated markets. And just because someone's first job is lower paid doesn't mean subsequent jobs can't be high(er)-paying. That is why I am an advocate of job-hopping to increase one's pay.
What is all this belly-aching about pay? My goodness, a potential NP should know their earning potential in their desired area.
My first NP job as new grad in rural CA - $125K first year in a VERY low cost of living area (rented a 2BR house for $750 a month!). Second NP job 18 months later - $150K+ per year in a major metro area. Oh, and I didn't have the RN experience some of you mistakenly think is required for a primary care NP. Yes, I took a first job in an area many would consider undesireable, but the experience was incredible.
There are many rural areas in this country desperate for providers, and many of them are within a 1 hour drive of a city! My goodness, if you want this career bad enough, a long commute for 1-2 years is hardly unreasonable, especially in the West.
People, grow up and put on your big boy or girl pants!
I have NO sympathy for NP new grads who whine they can't get a great-paying job in exactly the right location. Too bad.
Exactly. You didn't stick around in your first job for years and years...you got your golden year and then left for a more desirable, higher-paying job. I'm not sure why some of these posters don't seem to understand something so simple.
Secretperson
83 Posts
Do I really need to explain this? You literally made my point about the business component of your worth.... so, basic economics, saturation can be balanced by the supply regulating its/their interactions with demand.