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?
Please don't blame them. It is not always worth it. Much.. much more liability and less then 1/2 pay of MD b/c of saturated market. That's the excuse I got from most of my ex-classmate and ex-coworker who did not go back. I don't know about you. But I feel like I always have to keep going with the time-limit with NP jobs and there is no down time. You are given certain time slots to see patient. However, you can relax and enjoy down-time in the ward on RN jobs.
Oh I dont blame my friends for not going back to school. They got married and had kids. Career was not top priority for them. I just feel bad when we get together and they share the same complaints from 6yrs ago. I dont have the time crunch as much as others so maybe thats why I get to enjoy my role as Psych NP. I understand FNPs have 15min to see clients. Thats a whole other ball of wax.
In lurking, I've seen a lot of people worried about what they'll make as a NP. It's all perception, I suppose. I have been in a profession in which I outranked people, but some of those I outranked made a bit more due to years in service. I make nearly 20k more than I did in my previous line of work, which I did full-time will working on my RN/BSN, and the cost of the program happens to be equivalent to the increase in salary I now have.
For my area and my chosen NP focus I'll come very close to doubling what I make now. So to summarize from 32k to 53k to c. 100k. I'm tickled pink over it, lol.
. I dont have the time crunch as much as others so maybe thats why I get to enjoy my role as Psych NP. I understand FNPs have 15min to see clients. Thats a whole other ball of wax.
What do you get 1 hr per 1 patient? That's not fair comparison. We do not have easier job at all. FNPs do not deal with lengthy documentation and trying to get patient with poor historian b/c of psychosis/tangential thoughts/ manipulation to give you needed info. They do not get yelled at. They do not have to call family for collateral info or dig into the chart for more information. They do not walk the grey line of suicide assessment. That's what the extra time assessment time is for. Psych is not as great as people think. Glass may seems to be greener on the other side with exaggeration.
FNPs do not deal with lengthy documentation and trying to get patient with poor historian b/c of psychosis/tangential thoughts/ manipulation to give you needed info. They do not get yelled at. They do not have to call family for collateral info or dig into the chart for more information. They do not walk the grey line of suicide assessment. That's what the extra time assessment time is for.
Sadly we often do deal with this on a regular basis, and I get yelled at pretty much daily.
Managing chronically ill patients with multiple comorbidities often complicated by dementia isn't super easy or quick either. I had a new patient today with 24 items on the problem list.
We have a psych shortage here and I end up managing a number of psych meds I would rather not manage. That requires a lot of phone calls.
What do you get 1 hr per 1 patient? That's not fair comparison. We do not have easier job at all. FNPs do not deal with lengthy documentation and trying to get patient with poor historian b/c of psychosis/tangential thoughts/ manipulation to give you needed info. They do not get yelled at. They do not have to call family for collateral info or dig into the chart for more information. They do not walk the grey line of suicide assessment. That's what the extra time assessment time is for. Psych is not as great as people think. Glass (you mean grass don't you?) may seems to be greener on the other side with exaggeration.
That's what we want you to think. Actually primary care sees more psych patients and prescribes more psych meds. They are also more likely to hear of SI. Even at my location most suicidal patients present to the ED so the ED doc gets them first. I get 30 minutes for rechecks and 1 hour for initial assessment. This is ample time to get a great history and really find out about the patient. Any psychosis/tangential thoughts/manipulation is considered by us to be much less distasteful than treating snotty nose kids or sticking our finger up someones butt. It's what we do so we can handle it. We can bill and get paid for review of records so that's no problem. I dictate so my documentation is not an issue. I'm never behind with it. Life is so sweet...and my salary is so big.
Hahaha. Any time someone posts on here that psych is a good specialty I know a post from harmonizer insisting that psych sucks will soon follow. I think it really depends on your location. Where I am (west coast), psych looks pretty great in terms of job opportunities and pay, even for new grads. After talking to professors, employers, current psych NPs (including new grads), and students from my institution and in my area, it sounds like psych is a great career move. :)
Also, people I know in primary care get yelled at all the time, deal with drug seekers, feel the pinch of a 15 minute visit, deal with SI, charting nightmares, etc. I'm not sure any specialty area is immune from these scenarios.
What do you get 1 hr per 1 patient? That's not fair comparison. We do not have easier job at all. FNPs do not deal with lengthy documentation and trying to get patient with poor historian b/c of psychosis/tangential thoughts/ manipulation to give you needed info. They do not get yelled at. They do not have to call family for collateral info or dig into the chart for more information. They do not walk the grey line of suicide assessment. That's what the extra time assessment time is for. Psych is not as great as people think. Glass may seems to be greener on the other side with exaggeration.
Huh? Digging for collateral, gathering information and synthesizing into a plan to help a client is what I actually enjoy about my job. Now getting yelled at, cursed at.... not the happiest moments. Then again I was a psych RN and am used to it. I have much respect for the FNP's out there. They are busting their butts daily and providing great care. I prefer FNP (ANP) over an MD as my own PCP any day of the week!
That's what we want you to think. Actually primary care sees more psych patients and prescribes more psych meds. They are also more likely to hear of SI. Even at my location most suicidal patients present to the ED so the ED doc gets them first. I get 30 minutes for rechecks and 1 hour for initial assessment. This is ample time to get a great history and really find out about the patient. Any psychosis/tangential thoughts/manipulation is considered by us to be much less distasteful than treating snotty nose kids or sticking our finger up someones butt. It's what we do so we can handle it. We can bill and get paid for review of records so that's no problem. I dictate so my documentation is not an issue. I'm never behind with it. Life is so sweet...and my salary is so big.
Amen brother! Preach on!
(not sure about billing for review of records at least where I've worked but I agree with everything else)
And I spent 20 mins on the phone with an insurance company yesterday who was refusing to pay for a standard of care, while three people waited in rooms.
That is precisely why I only do them one day a week Boston. I can't keep people waiting for that sort of thing, it isn't fair to them or me. I do paperwork on Thursdays only. I have actually had patients drop things off and ask for it the next day . They actually think I'm going to take it home with me and do it that night. As if. A two week turn around is promised and delivered, every time. Life threatening emergencies and telephone calls from other providers (professional courtesy) are the only reason I deviate from the schedule. I don't even take calls from my own kids, lol! If that means someone has to wait longer for their million dollar med or their "free" power chair from the dog blazed Scooter Store (those people all ought to be in jail for fraud IMO), so be it. The upside is, no one waits for their appointments, because I stay on time! I had one patient "fire" me because I couldn't promise to complete her workman's comp paperwork in less than a week. You can guess how heartbroken I was about that.
NPAlby
231 Posts
Oh I dont blame my friends for not going back to school. They got married and had kids. Career was not top priority for them. I just feel bad when we get together and they share the same complaints from 6yrs ago. I dont have the time crunch as much as others so maybe thats why I get to enjoy my role as Psych NP. I understand FNPs have 15min to see clients. Thats a whole other ball of wax.