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 Peds Med/Surg; Peds Skilled Nursing.
I graduate this winter from my NP program and i think it is worth it. The pay increase will be nice but my reason for going back to school was to get away from staff nursing. I work in peds and sometimes i take of 300lbs plus adolescents and young adults in diapers and also bigger kids that pee and poop in their beds because they don't feel like getting up to use the bathroom when they are more than capable...i have been a nurse for 7 years and i knew 2 years in that i didn't want to do that forever, not to mention the short staffing, ignorant and irate parents that think they have no parenteral responsibilities once their infant is admitted to the hospital and rather play video games/watch a game at the bedside than pick up there screaming infant who needs to be changed and/or fed; night shifts, holidays, mandatory overtime, nursing management, etc
Specializes in Mental Health; Medical-Surgical/Trauma.
BlueDevil,DNP said:
Interesting thread. Short answer, yes, it is absolutely worth it. I have an independent practice with complete autonomy. I work 3/4 time and earn in the neighborhood of $140K. I make my own hours, come and go as I please.
I personally hate my psych patients, lol. I groan when I see chief complain "depression" or anxiety." I can not stand needy whiners. I'd rather do a DRE any day! Let's get it over with, you go on your way and we do not ever speak of it again, right? I do not want to have to see you and hear about your sucky life and stupid imaginary problems every month for the next year. (Google the Bob Newhart youtube video "Stop It") In that sense, psych NP would be highly preferable to FNP because I suspect most of Zen's patients have genuine behavioral health problems vs. just a failure to cope with normal life challenges, which is mostly what I see labeled as "anxiety" and "depression." Suck it up Buttercup. Get some exercise, get some perspective. A prescription is not going to fix what ails you.
I do get yelled at occasionally, but here is the thing: I am there to treat a medical condition, no to pander to them or enable them. When people are inappropriate, I get up and walk out. The visit is over and I won't see them again.
I do see a variety of fascinating things and meet a lot of very interesting people, most of whom are very pleasant. I really love seeing patients that do what they are supposed to do and whom make good progress toward goals. I don't like seeing people that don't follow directions/advice, make no lifestyle changes. I usually cut them loose after a year of no progress. They need to find someone that inspires them to make healthy life change, if I can't I'm not the right provider for them. I 'm not going to just keep writing scripts for the same conditions if they won't even try to do anything for themselves. Besides, they get tired of hearing me harp on the same things and are ready to be done with me too, lol.
29/30 days work pass by pleasantly and without unexpected complications. Most of my grief comes from insurance companies. The words "prior authorization" sometimes make my blood boil, lol. My least favorite part of the job is paperwork. I can't stand filling out FMLA paperwork and endless forms for nursing homes, home health, physical therapists, etc, but at least I can bill for it. I take a half day a week to do nothing else and I don't enjoy that day very much, but it must be done. I usually treat myself to a nice lunch to give myself something to look forward to that day.
I like 75% of my patients, my career trajectory, , my day to day office life, my colleagues and my salary. I'd do it all again.
Psych NP does not sound too bad provided one does not have to deal with too much hassle from insurance providers. I say this as a new RN starting out in psych.
Also, I think it's admirable that you don't keep patients who just aren't willing to make the necessary changes in order to improve their health. I'm sure there are many other providers who would gladly hold on to those patients, and just keep prescribing them medications.
I myself is caught in the rut in trying to make the biggest decision of my life. I recently got in UIC's BSN-DNP AGNP program and was planning to turn it down. There was a big pit in stomach when I found out my education would cost $100k and I still have loans of 60k from my BSN degree. So does anyone still think it would be worth it? If I was going to pay 160k to be a NP with a DNP...it makes me feel stupid for not going to med school in the first place with that kind of debt. I chose nursing so I can live life and not have spent all my years in my 20s at school especially with all that debt. I want to make sure I able to afford a family and a house one day instead of struggling. But like everyone, I want autonomy and be able to independently plan their care. I don't know if I should pass this up or just go to a school that's more affordable. Then what are my chances again in getting in a NP school? I just don't want to regret my decision in passing this up. Any suggestions??? is it worth that debt to chose over than life(I.e.wedding, future family, house)? In addition, I also just recently got my CA license so my decision was to just transfer over there and then go to school there but I feel like Id be spending the same for just masters and I feel like I keep delaying my education. I just want to be an NP before 30. Any good advice???
I am glad that you posted this 8mpg. I myself is caught in the rut in trying to make the biggest decision of my life. I recently got in UIC's BSN-DNP AGNP program and was planning to turn it down. There was a big pit in stomach when I found out my education would cost $100k and I still have loans of 60k from my bsn degree. So does anyone still think it would be worth it? If I was going to pay 160k to be a np with a dnp...it makes me feel stupid for not going to med school in the first place with that kind of debt. I chose nursing so I can live life and not have spent all my years in my 20s at school especially with all that debt. I want to make sure I able to afford a family and a house one day instead of struggling. But like everyone, I want autonomy and be able to independently plan their care. I don't know if I should pass this up or just go to a school that's more affordable. Then what are my chances again in getting in a np school? I just don't want to regret my decision in passing this up. Any suggestions??? is it worth that debt to chose over than life(I.e.wedding, future family, house)? In addition, I also just recently got my CA license so my decision was to just transfer over there and then go to school there but I feel like Id be spending the same for just masters and I feel like I keep delaying my education. I just want to be an NP before 30. Any good advice???
Good lord! $100k? I can't ever imagine coughing out that kind of money to be an NP. While i think the DNP is nice, is it really worth all the extra money when it doesn't entitle you to any additional scope of practice? I'll be graduating in December with my MSN-FNP, with the total cost for my degree running $18k, and I have worked throughout the process, meaning I haven't taken out a single loan. $100k sounds silly.
Wow so many different salaries and opinions about the field... Currently I am a nursing student just starting out, and my ultimate goal is to be a nurse practitioner and I am confused on what is the difference in pay and difference in education, ARNP, FNP, NP, DNP,
Also I read on here too that people are making 100-150k how is that possible??? Will a practice pay that much? Currently I work for a Rheumatolgoist (Which I love) and I work directly with the Doctor and I love listening to him diagnose patients and helping him ready up injections which is why I want to be a NP one day to do stuff like this, but in the end it is all about money ill be the main bread maker between me and my fiance, so money is a factor because I want to be able to provide for her and my future child/children, so what is the total story? I am currently in Florida, I would love to learn how to make more than 100k a year with being a NP.
NP's make that much because they generate more than that. For example, in a given day I see between 15-20 patients in my primary care office where I work with a physician and another NP. I learned a lot in school about insurance/medicare/medicaid reimbursement, and know what each visit pays (plus our office manager gives us monthly reports on what we generate). Say I see the minimum 15 patients in a day, and plus copay, each patient I see reimburses me $80 (I know it's more but I'm being conservative). At that amount in a single day, I generate $1200 for my practice. In a 5 day work week, that's $6000 of revenue, and in a year that's over $300k. (remember these are conservative estimates and I know exactly what I generate).
This doesn't include the money I generate rounding on 20+ patients at an ortho rehab facility for a couple hours in the evening, where the reimbursement isn't as much, but still scratches close to $1000 a day in revenue. This year for my practice I will generate more than $500k for our practice, and with my profit sharing bonus added to my base pay will likely come in at over $130k in salary. Not bad for me, and not bad for my boss that still will see over $370K gross from my work. If an NP is smart and savvy, and knows how much money they are bringing into a practice, they should and can command the salaries people here are talking about. It's important to know how much money you potentially bring to the table as a provider so when it comes time to talk turkey, you're not left with an $80k a year offer when you're generating 4 or 5 times that much for your practice.
Haha I see, well, as a first "job" NP do you think its a good idea just to accept what comes up until more experience rolls in? or shoot high? haha, I work in a retirement community in Florida I believe this biggest and most popular one in Florida so there is tons of jobs relating to healthcare, I just want to be prepared because I am planning on continuing school as soon as I get my RN and ill be working will getting my BSN as I am working and so on, so I want to be prepared... do you think actually talking to a Doctor/practice owner about it would provide more information? Working with the Doctor I have been open to much more personal relationships with Doctors due to dinners together etc.
If you aren't a nurse yet I'd hold off on wasting too much of anyone's time because opportunities will change although when you start working as a nurse it is a great time to start building relationships with physicians and NPs. In my experience NPs who are willing to share their salaries will be the best source for negotiating in a specific area.
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.
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 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 do not want to have to see you and hear about your sucky life and stupid imaginary problems every month for the next year. (Google the Bob Newhart youtube video "Stop It") In that sense, psych NP would be highly preferable to FNP because I suspect most of Zen's patients have genuine behavioral health problems vs. just a failure to cope with normal life challenges, which is mostly what I see labeled as "anxiety" and "depression." Suck it up Buttercup. Get some exercise, get some perspective. A prescription is not going to fix what ails you.
phillycpnp-pc, MSN, RN, NP
286 Posts
I graduate this winter from my NP program and i think it is worth it. The pay increase will be nice but my reason for going back to school was to get away from staff nursing. I work in peds and sometimes i take of 300lbs plus adolescents and young adults in diapers and also bigger kids that pee and poop in their beds because they don't feel like getting up to use the bathroom when they are more than capable...i have been a nurse for 7 years and i knew 2 years in that i didn't want to do that forever, not to mention the short staffing, ignorant and irate parents that think they have no parenteral responsibilities once their infant is admitted to the hospital and rather play video games/watch a game at the bedside than pick up there screaming infant who needs to be changed and/or fed; night shifts, holidays, mandatory overtime, nursing management, etc