Members are discussing negotiating salaries as new Nurse Practitioners, the importance of building relationships with physicians, the value of sharing salary information for negotiation, the impact of pursuing a Doctor of Nursing Practice degree on earning potential, and the reputation of certain online schools for nurse practitioner programs. Additionally, members are seeking advice on transitioning to a career as an NP, the differences between working in a community clinic versus a hospital, and the potential for career advancement in the field.
My reasons why I question going for a Nurse Practitioner license.
Working with some seasoned nurses in the ER over the last couple of years, they make more than starting NP's do.
Two doctors and a nurse who did recruit and hiring for a couple of years all stated that it was not worth it.
If I don't jump on the bandwagon right away...the rumors of the dreaded 2015 DNP may come true
The Drawbacks:
Increased liability without enough pay
Overworked and underpaid for their work. In our ER, the PA's do most of the work while the physicians kick back
PA's are preferred in hospital settings (which is my major interest...though I'm sure an office setting will be great later in life)
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 an NP degree.
The Positives:
Increased autonomy
I can do a full time NP program and still work
There are 2 great NP programs near me (TWU and UTA)
I believe I can get in without to much hassle
In state tuition is affordable
Self satisfaction
I understand that financial compensation is not all there is to a job though it is a necessity. Increased autonomy is very important to me and the main reason I would like an advanced practice degree. Med school would be great, but being hundreds of thousands of dollars in debt and taking 4 years off is not appealing to me.
So to the current NP's...
Would you NOT get your degree if you had to do it again?
Was it worth it more than just personal satisfaction?
Specializes in Nursing Education, CVICU, Float Pool.
I've been contemplating this myself. Just adds months ago I was all for being an NP, but the last 2 months I've been wondering whether it's really what I want?
In the back of my mind, I know I would like to and that it would likely be an amazing job, but I stop to think of other things, like the likelihood of having a 3 12 hour shift l schedule. (The saying, "You can't have your cake and eat it too" comes to my mind).
I realize that I probably would not like a job where I was on call for interventions. But maybe most providers don't like that, so that may be a moot point. Maybe with time providers come to find call not so terrifying!
I love only working 3 days a week and not having to take work home. I know that there may be NP jobs that have this schedule or are similar set-up, but there don't appear to be a multitude for someone who was planning on being an FNP, like me.
I've never wanted to work in a hospital setting and don't want to treat only adults. I like the variety that Family Practice provides.
The new unit I work on Fulltime is a unit that cares for people from 5 years old and up. It is combined Chest Pain Center and Clinical Evaluation Unit (Short-Term Stay Unit). I enjoy working with patient's of varying ages. Although I have had a learning curve as my experience has been in adult critical care (CVICU, which I still work PRN). I've enjoyed seeing things outside the cardiac specific world, although cardiac is by far my favorite and I realized I have limited tolerance for post-GI surgical cases, but im getting better with that. Lol.
I also think about the money that would have to be invested into schooling and I really don't like the idea of going into debt, even for such a good investment as a NP education. I certainly don't think it would be a waste to go to NP school.
I feel content, I guess that is the best way to explain it. At least for now.
Several years ago when this thread was started the market for FNPs and NPs in general was good. It isn't so good today, and in some areas it's actually pretty bad. You have to get busy networking and start looking for your first job before you graduate. It is still worth it as long as you don't go to a school that's going to lead to ridiculous student loan debt, if you're prepared to relocate to where job opportunities are, and if you're prepared to accept that what you will be earning as a new grad NP may not be a whole lot more than what you currently earn as an RN. Unless you can meet all three of these then I wouldn't bother with FNP or ACNP. Don't fall for the hype that the college recruiters will spin on you about the awesome opportunities out there and that you will get a high paying job real quick. Unless you are lucky or know people it takes time to find an NP job, and sometimes, quite a while.
I see people posting some high salaries here, but these are exceptions. The average NP pay is somewhere in the low to mid $80s. An issue of NP Perspective that I read last year claimed that NP salaries have gone up and they were pitching the average as being mid $90s, but I have reasons for doubting that. NP pay is trending down, not up. You can get very good pay as an NP if you are experienced and can negotiate a good deal, but it has gotten harder to negotiate pay these days because there aren't as many jobs as there used to be and there are a LOT of new grad NPs out there looking for work. When I started out as an NP I was offered quite a bit over $100k as a new grad. But, depending on where one is, one can make this money even as an RN. Many new grad NPs are not being offered $100k now. Most jobs will pay between $80 and $90. A few will pay more. In one of my recent posts I mentioned an NP job that I saw (just weeks ago) being advertised by the State of Florida that is paying $65k and for that they want somebody with experience, LOL. Ok, I admit that the Florida example is an extreme outlier. I've honestly never seen worse. But just out of curiosity, I called about that Florida job after the position had closed, and I was told that there were many applicants. Now that is what I call sad!
Today, for people who want to do advance practice, CRNA and psych are better options because there are more opportunities in those areas (for now, anyway) and they pay much better.
Specializes in Mental Health; Medical-Surgical/Trauma.
Goldenfox said:
Several years ago when this thread was started the market for FNPs and NPs in general was good. It isn't so good today, and in some areas it's actually pretty bad. You have to get busy networking and start looking for your first job before you graduate. It is still worth it as long as you don't go to a school that's going to lead to ridiculous student loan debt, if you're prepared to relocate to where job opportunities are, and if you're prepared to accept that what you will be earning as a new grad NP may not be a whole lot more than what you currently earn as an RN. Unless you can meet all three of these then I wouldn't bother with FNP or ACNP. Don't fall for the hype that the college recruiters will spin on you about the awesome opportunities out there and that you will get a high paying job real quick. Unless you are lucky or know people it takes time to find an NP job, and sometimes, quite a while.
I see people posting some high salaries here, but these are exceptions. The average NP pay is somewhere in the low to mid $80s. An issue of NP Perspective that I read last year claimed that NP salaries have gone up and they were pitching the average as being mid $90s, but I have reasons for doubting that. NP pay is trending down, not up. You can get very good pay as an NP if you are experienced and can negotiate a good deal, but it has gotten harder to negotiate pay these days because there aren't as many jobs as there used to be and there are a LOT of new grad NPs out there looking for work. When I started out as an NP I was offered quite a bit over $100k as a new grad. But, depending on where one is, one can make this money even as an RN. Many new grad NPs are not being offered $100k now. Most jobs will pay between $80 and $90. A few will pay more. In one of my recent posts I mentioned an NP job that I saw (just weeks ago) being advertised by the State of Florida that is paying $65k and for that they want somebody with experience, LOL. Ok, I admit that the Florida example is an extreme outlier. I've honestly never seen worse. But just out of curiosity, I called about that Florida job after the position had closed, and I was told that there were many applicants. Now that is what I call sad!
Today, for people who want to do advance practice, CRNA and psych are better options because there are more opportunities in those areas (for now, anyway) and they pay much better.
Thank for the information. I think a good amount of aspiring NPs know this if they are actually serious about becoming one or are in an actual program like I am now.
I'm working on networking switched from a smaller hospital to one in the Texas Medical Center 😊. I hope my social aptitude benefits me between now and completing my FNP program.
It will be interesting to see what the 2015 salary survey data shows, as the 2014 data still shows salary growth. I am (for many reasons) worried about the "mill" programs churning out novice NPs that are willing to take jobs at $65k because they have been job-searching for a year or more after graduating from a program that graduates more NPs than the market needs and does nothing to help new grads.
Specializes in Mental Health; Medical-Surgical/Trauma.
I think one should be ashamed of taking a $65K position as any sort of nurse practitioner. It is not congruent with the education and skills a nurse would possess in that role.
I too have seen salary growth, but someone not being able to grab the higher salary in a saturated area is not a surprise for logical reasons.
Malpractice, and travel/education for CEU, pre-tax healthcare and retirement contributions/pension plan in addition to base pay are standard fare when you apply for a job as an NP---unless you're doing contract/locum/1099 work and you negotiate a deal for much higher pay in lieu of benefits. The FDOH family HMO used to be $180, it is now $200---which still seems like a little bit of money, until you consider that its being deducted from a pretax amount of $5000 per month. No state tax in Florida because they pay you with sunshine, but let's look at some conservative numbers...
@ 5 grand a month, and let's create a decent tax situation---say the NP is married and she has two kids and she's taking 3 allowances. Her FICA would be about $410, SS about $300, and Medicare about $70. Depending on her pre-tax deductions (retirement savings, etc. and including the $200 for the insurance) she'd likely be netting netting somewhere between $3500 $3900 a month.
Now, she lives in a decent part of Fort Lauderdale and she has a family so she needs at least a modest 2-bedroom apartment. Knock about $1700 a month off the top for that. So now she's got, at best, $2200 left. A moderate amount of groceries for a small family, about $650 a month. She needs a car, let's put the note at about $275, and the insurance at about $100, and weekly expenditure on gas at $25. Now she's down to about $1000. Oh no! the cable bill is $175, and the light bill is $200, she has some credit cards and her minimum payments on all of them comes up to about $300. Student loan payments $200 a month. Cell phone $60. Her kids aren't old enough to be left alone at home by themselves so she needs to hire a sitter to stay with them after school till she get's home---about $10 an hour x 4 hours per day x 5 days. So that's about another $800 a month. At this point, she's broke and in the red by several hundred dollars a month, and there are other incidental expenses that I haven't included. But, the good thing about it is that our hypothetical NP has a spouse who is also working. Hopefully, after we deduct other incidentals from his pay he will not be broke at the end of the month also.
My point is that south Florida is a much more expensive place to live than many other parts of the country not only because the pay is low but because it is sooo low in comparison to the high cost of everything there. Usually, in areas where pay is lower it is because the cost of living there is also lower. An NP who makes 50k to 60k more in a city like L.A. or NYC can still net more income in those areas than one who is earning $60,000 in south Florida---despite the state taxes. This $60,000 pay is about $25,000 lower than average pay for NPs in that area of Florida and they know it. They are offering that salary because there are NPs who will take it and say that it is a good thing. Sixty thousand a year, anywhere at all, for an NP is not a good thing. In fact, it is a very, very bad thing.
I think the problem is not being able to make the transition from bedside wage to NP wage!!! As a RN on the floor you know you earn every penny stomping that pavement, only to come home tired and wishing for a better night shift. I have been doing nursing for 16 years and I am done! I started my nursing career late and I have no intentions pounding more pavement in my 60s. As I see it you work smarter not harder. I do not live above my means nor am I strapped down with an over the top mortgage. I always felt living is far superior than existing. I think for some it is worth it. You cannot put a price on a piece of mind!
I want to get my MSN-FNP due to many reasons. One of the most important reasons is to have time with my family. I work as a bedside nurse now, and the hours are not great at all. I currently work 0.8 FTE meaning I work a total of 4 shift (8 hour each) a week. The problem is that since I am a recent grad nurse (
As I will begin marriage life soon, I want to be able to be present for my kids and wife. And the schedule of a primary care provider works best for me. It is Mon - Fri from 9 to 5 pm only. No weekend and holidays whatsoever. I may make less or the same with my current salary (I work at Kaiser now), but the quality time with my family, in my own opinion, is priceless.
In addition, I don't have to crush my back with heavy patients, deal with politics, and many other stuffs in a big hospital setting. In contrast, I will enjoy being more autonomous and be able to do more for patients than just taking care of them. That is my opinion.
Dreaming? As a NP in primary care insurance will dictate what tests are or aren't approved. The schedule is tight. That 15 minute slot is for VS, med reconciliation, and your time with patient. Usually less than 5 minutes. Charting most often occurs after everyone else has left. You take work home with you. The learning curve is big. Check out some of the NP sites in Facebook. Read the primary care posts. My PCP tells me he not done till 10-11 pm most nights. These providers hide the stress well. I work in the ED, I miss my 12 hours, shifts over- give report and go home. The pts keep flooding in, charting happens after my shift most often. There is an expectation for the provider to see so many pts a shift,from door to provider in less than 10 minutes, dispo in 2-3 hours, length of stay to be short, Each month I get my statistics- number of EKgs ordered, number of CT's and other testing. It comes out in a group Report so we can call see where we are in comparison. I'm spending 1-2 hours after shift finishing charts. Please check into this and think long and hard. I'm spending more time away from my family now than as a nurse.
you may want to look into nursing home rounding, my friend does this she has a very flexible schedule. She sees the acute Medicare patients, looks at the log book of complaints/ lab/ ua results. Has to keep up with all the primary care meds, but yet give if antibiotics for pneumonia and the like. She really enjoys the challenge. And it's Monday they Friday with minimal call. She hardly ever takes work home, and is out at a decent time.
I work an average of 31 hours per week and make $90K per year. Additionally, I don't have a charge nurse, nurse educator, clinical nurse specialist, nurse management, or physicians telling me what to do or constantly watching over my shoulder. As an RN you put up with a lot of petty BS and it just gets old, no matter how much you're earning as a pool nurse working nights (they make the most as far as floor nursing is concerned). That is for example, management making sure you scan all your medications for interoperability; or fill the right forms out for heparin protocols; or making sure your in your patient's room giving report, not in the hall. The list goes on and that's the kind of BS I started to get sick of. Don't get me wrong, I did my time as an RN and enjoyed most of it. And if you are a new nurse, you should probably stick it out for a few years and rock out floor nursing before becoming an APN. For me, after 8 years collectively of being a nursing assistant (3 years) and floor RN (5 years), there comes a time you get sick of it and will seek some kind of career promotion. For me, that was becoming a family nurse practitioner. So to answer the original question. Hell yea, being an NP is worth it.
All_dogs_eat_kale
19 Posts
Can anyone speak to their experience as a NP that works in a community clinic? How different is this from working in the hospital?
Do NPs work their way up the leadership ladder by advanced education or experience and time at a clinic? Maybe a combination of both?