Is Becoming A NP Worth It?

[puttinontheritz]

I don't know any NPs making less than RNs around here. I'm not working as a NP right now (I'm waiting for a job 10 minutes from home) but the jobs are out there, if you look on careerbuilder or monster you can find them. I also hear a lot of places are open to adding on a NP they just haven't advertised it.

Becoming a NP is one of the most difficult things you'll ever do. There are times I wanted to quit, times I thought I wasn't going to make it, finances are tight when you have to work at clinicals instead of a job where you get paid, but it's worth it (to me.)

My degree is adult/geron NP, btw.

Also, a lot of schools are phasing out their MSN programs. Next year is the last year USA will offer the MSN. Then, they are going to DNP.

[07302003, ASN, RN]

I'm worried too. Accepted into ANP program, have completed 25% of courses, but worried about:

1) Pay only being $5K more than what I earn now, for > 36 hours.

2) Due to changes in residency rules for doctors, many hospitals are creating NP / PA shift jobs with midnight / weekend hours. No thank you. (Glad to do clinic on Saturdays, but no 12 hour midnights every other weekend, please!)

I'm not seeing any primary care jobs advertised for NP's. Wondering if it's worth it (the debt, long hours, etc.). As much as I hear about the need for NP's in primary care, I'm NOT seeing the jobs (at local hospital system websites or my state NP association website).

[carachel2]

1. Working with some seasoned nurses in the ER over the last couple years, they make more than starting NP's do.

You can't compare a 20 year career veterans salary to a starting salary in most fields. Additionally, who wants to be a 55 year old wiping butts and taking crap in the ER working 12 hour shifts and then coming home and icing your knees while praying your back doesn't give out because the 300 lb guy in bed # 4 needed lift assist to stand at the bed to pee ? Finally, no one in my class started at nursing wages. No one. I started at LEAST $12.00 more an hour than my highest ever PRN/float pool rate and that did not include the raise I got a few months later, etc.

2. Two doctors and a nurse who did recruiting and hiring for a couple years all stated that it was not worth it...their reasons were:

A. Increased liability without enough pay

I work in a family practice office and all of our providers work together as a team. We take on the liability together.

B. Overworked and underpaid for their work. In our ER, the PA's do most of the work while the physicians kick back.

That's sad. I don't work in the ER so I have no idea if that happens or not.

C. PA's are preferred in hospital settings (which is my major interest...though Im sure an office setting will be great later in life)

Yes, I have heard this is true in regards to hospital settings.D. Again...financial. They did not agree that 2.5 years of schooling was worth a mediocre increase in salary (even long term). They collectively felt that working a 4th 12hr shift each week was better than spending another 2.5 years an lots of money for a NP degree.

My FNP degree cost

The positives:

1. Increased autonomy- DEFINITELY!

2. I can do a full time NP program and still work

Eh, up until a point. It will be more challenging that you think. When the heavier clinical hours come on you will have to do some juggling. Also, UTA is heavy on the Saturday classes in the later clinical classes so be aware.

3. There are 2 great NP programs near me (TWU and UTA). UTA is a great program. As with any of them, they are heavy on the fluff (theory, etc.) in the beginning. Just hang in there and play the game.

4. I believe I can get in without to much hassle.

Entry has become much more competitive but yes, you probably can if your undergrad grades were decent.

5. In state tuition is affordable. YES!

6. Self satisfaction

Finally, don't let the staff naysayers get you down. Some people will do and say anything to keep you from moving on and expanding your career. They feel threatened when one of their own seems discontent because it brings out all sorts of insecurity in them. If your hospital only pays NPs a bit more than RNs then that sucks and in the DFW area it does not hold true for all hospitals. It definitely is not true in private practice. I was never remotely near $100K working as an RN unless I busted butt working extra and overtime.

[guest416560]

Don't believe what everybody tells you about low wages for NPs. It isn't true. I will graduate from my FNP program in two weeks and have accepted an independent contractor NP job where my first year gross earnings will be between $200k and $275k. No sicktime, no paid vacation, nothing in the way of benefits but with that type of cash I can buy my own benefits.

If you look hard you can find a job that will pay you well. I'm not going to divulge the name of the company I'm with because I feel very lucky to have this job. What I'm doing is taking physicals for Medicare patients in their homes. I take a blood/urine sample, give a pneumonia shot and take a spirometry reading.

I also have another part time job working for a dermatologist paying a little over 100k per year.

Was my NP degree worth it. You bet it was financially.

[zenman]

As a PMHNP I sit on my butt in a nice office and talk to people. I go to lunch for an hour and I leave at 5 pm. I make well into 6 figures and have free housing (right now a 3 BR house way to big for me) and car allowance. There are a total of 2 RN's and 3 other staff that make sure my day is running smoothly. Right now I'm considering whether to wash my new pickup truck today and what new pistol to buy. I'd love to be back running around on the floor....right....

[carachel2]

traumaRUs said:

Hey, where in the heck are these 200k jobs??

Lol - not in the midwest I'll bet.

I dont know anyone in the North Texas area who is making 200K. 90-120K, yes, but not 200. I have seen ads for pain management clinics that look pretty high, but I don't know of anyone who is taking those jobs (thank goodness!).

[Corey Narry, MSN, RN, NP]

8mpg said:

1. Working with some seasoned nurses in the ER over the last couple years, they make more than starting NP's do.

That's probably true if you look at it from the perspective of a nurse with many years of experience and is already receiving top pay compared to a nurse with just a couple years of experience who becomes a nurse practitioner. The latter has a lower point of reference in terms of salary range than the nurse with years of experience.

8mpg said:

2. Two doctors and a nurse who did recruiting and hiring for a couple years all stated that it was not worth it...their reasons were:

A. Increased liability without enough pay

That's a subjective statement. I would want to know why these individuals felt that they are not well compensated for their increased liability. I personally feel well-compensated for the kind of work I do. I'm not getting paid any close to what our collaborating physicians who are intensivists get but with the kind of schedule they have to work, the length of training they had to undergo, and the amount of responsibility they have to assume, I am convinced I'm doing quite well.

8mpg said:

B. Overworked and underpaid for their work. In our ER, the PA's do most of the work while the physicians kick back

I haven't seen this at all. ER's are busy places and work is typically divided in a manner that maintains fairness for every provider working in the setting and promotes efficiency in making sure patients are seen in a timely fashion. You'll have to give me specific scenarios that support that claim.

8mpg said:

C. PA's are preferred in hospital settings (which is my major interest...though Im sure an office setting will be great later in life)

If that's what you are seeing where you work, then that's probably true. It's a matter of preference and there is so much variation on this depending on where you are. There's very few things that a PA can do that an NP can't. But NP's do tend to be restricted by our training when it comes to our scope (primary vs acute care, adult vs peds) while PA's are covered by whatever scope their supervising physician allows them to have.

As an ACNP, I've only worked in hospital settings and throughout my career so far, I've seen a presence of both NP's and PA's in the settings I've worked in. In my current job as a provider within a critical care NP group, our team is composed exclusively of NP's. Other services within the hospital we work for have only PA's on their team or have a combination of NP's and PA's.

8mpg said:

D. Again...financial. They did not agree that 2.5 years of schooling was worth a mediocre increase in salary (even long term). They collectively felt that working a 4th 12hr shift each week was better than spending another 2.5 years an lots of money for a NP degree.

I think 2.5 years of schooling is not very long at all. I finished my master's degree in exactly 2 years while going full time and didn't incur any debt. The total cost of my training was probably less than 20K in a state university that I didn't need to move away from home for. I am not advocating for choosing the cheapest program out there. I researched a few potential programs to pick and found that the specific program I attended, though cheap, is respected in the community and that there is a large presence of alumni in clinical practice in my area to network with.

As I said, I am hospital based as an NP, employed by the hospital in my current job and in the previous jobs I've held. My salary progression from bedside RN to NP was not mediocre because the hospital salary ranges for its employees reflect the fact I am at a different salary level than a bedside RN. I do work shifts as an NP and if I was to work an extra 4th 12-hour shift, I can guarantee you that my overtime pay (time and a half of hourly) is more than what the bedside RN gets.

8mpg said:

3. If I dont jump on the bandwagon right away...the rumors of the dreaded 2015 DNP may come true

We'll have to wait and see how this pans out. Many in nursing are convinced that 2015 will not be as earth-shaking for NP's as many in the academia are hyping it out to be.

8mpg said:

The positives:

1. Increased autonomy

very true

8mpg said:

2. I can do a full time NP program and still work

easier said than done, I worked part-time for my second year of graduate school.

8mpg said:

3. There are 2 great NP programs near me (TWU and UTA)

8mpg said:

4. I believe I can get in without to much hassle

just as a friendly caution, don't be quick to assume that.

8mpg said:

5. In state tuition is affordable

yes, that was true in my case

8mpg said:

6. Self satisfaction

very true

[eagle78]

I am glad this thread was started. Personally I don't feel that salary is that big of an issue. Not saying I don't need money, I pay bills to. Just that I feel doing something you really love has it's own compensation, some people never get that oppurtunity... Coming from a job where I made 80-90K everyone thought I was crazy to take a surplus and go to nursing school rather than follow the job from Michigan to Texas and continue up the corporate ladder.

Although I have not gotten to the MSN level yet, I am looking forward to pursuing the advanced practice wether it is MSN or DNP. My only caveat is I hope that I can be a critical care CNS in a hospital setting... That could probably start a new thread. It is still my dream, I don't care what anyone says...

[CCRNDiva, BSN, RN]

I will start an ACNP program in the fall and I most certainly feel that it will be worth it. While it will cost $40,000+, I will be able to greatly increase my salary and autonomy after graduation. Nursing wages have been relatively flat for the past 3yrs in my area. RNs here with 30+ yrs of experience are maxed out on the payscale at around $35/hr. The payscale, however, was changed about 10yrs ago (clinical ladders were eliminated) so a RN with less than 20yrs experience (ie, me) will never get to that level of pay here. I'm no where close to making that amount now.

Second, (and I may be tarred and feathered for saying this ,) but the ability to continue caring for patients without damaging my back turning 250+lb patients q2hrs, working mandatory extra shifts while being shortstaffed, working with inadequate supplies, etc (the list goes on, lol) will be priceless for me.

[Corey Narry, MSN, RN, NP]

CCRNDiva said:

Second, (and I may be tarred and feathered for saying this ,) but the ability to continue caring for patients without damaging my back turning 250+lb patients q2hrs, working mandatory extra shifts while being shortstaffed, working with inadequate supplies, etc (the list goes on, lol) will be priceless for me.

That is a legitimate reason. A few of my ICU NP colleagues suffer from back pain and have spent a lot of time and money on Physical Therapy, acupuncture, etc. from working as an ICU nurse prior to becoming an NP...and these are young individuals (ages are between early 30's to early 40's). Many of them are thankful that we don't have to do bedside care of patients in our role as NP's.

[linearthinker, DNP, RN]

I won't T&F you either. I think the ergonomics and physical mechanics of any career are a legitimate issue to consider. The reasons you describe are not reasons that I began my NP education, but they certainly occurred to me more than once as I was working through it! And I sat up a little straighter when I wrote that.

[ChristineN, BSN, RN]

CCRNDiva said:

Second, (and I may be tarred and feathered for saying this ,) but the ability to continue caring for patients without damaging my back turning 250+lb patients q2hrs, working mandatory extra shifts while being shortstaffed, working with inadequate supplies, etc (the list goes on, lol) will be priceless for me.

I doubt there is anyone who is considering being an NP that hasn't thought of those benefits. I had multiple shoulder injuries early on in my nursing career, and the thought of lifting/turning/moving people heavier than me for another 20 years does not excite me. I honestly feel if I were to work as a floor nurse for another 10-15 years, I would end up with a shoulder replacement eventually.

I also want to be a mom and have a family someday. My partner works M-F 9-5 and I want to be home with our future family with him. I don't want to be the mom that is working nights, weekends, and spending Christmas morning at the hospital.