Is this fair? PAs Receive Wage Increase But Not NPs

[Nurse Beth, MSN]

Dear NP,

The consideration of prior RN experience when determining compensation for Advanced Practice Providers (APPs) like Nurse Practitioners (NPs) can vary from one healthcare organization to another.

Whether or not this is common depends on the policies and practices of the specific healthcare system and how they structure their compensation models.

Here are some factors to consider:

Organizational Policies. Some healthcare systems compensate NPs based on their RN experience, recognizing additional expertise.

However, not all organizations have this policy. Some see the NP role and RN role as different skill sets. 

Market Competition. A lot comes down to market competition in your area. Local market conditions and competition among healthcare employers can influence compensation practices. In regions with high demand for NPs, healthcare systems may be more likely to offer competitive compensation packages, including recognition of prior RN experience.

Negotiation. In some cases, compensation packages for NPs, including recognition of prior RN experience, can be negotiated during the hiring process or contract renewals. Experienced NPs with solid negotiation skills may have more success in securing favorable compensation terms.

Legal and Regulatory Considerations. Legal and regulatory factors may also influence compensation practices. Some jurisdictions or professional organizations may have guidelines or requirements regarding the compensation of healthcare providers.

Employer Philosophy. The compensation philosophy of the healthcare system or hospital can vary. Some organizations may prioritize factors such as years of experience, while others may focus on other criteria, such as clinical outcomes, education level, or specific certifications.

If you and your NP colleagues believe that recognition of prior RN experience should be considered in your compensation, it may be worthwhile to engage in discussions with your employer's HR.

You can present a case for why this consideration is important, citing the valuable skills and expertise experienced NPs with nursing backgrounds bring to patient care. You can also explore whether the organization's compensation structure is flexible for individualized negotiations.

Contact professional organizations or associations for NPs in your area is also a good idea. They may provide guidance, resources, or advocacy support related to compensation issues for NPs in your region.

Whether or not recognition of prior RN experience becomes common practice at your organization may depend on internal policies, negotiation efforts, and industry trends in your area.

Best wishes,

Nurse Beth

[JKL33]

It is unlikely that the PAs are being compensated based on non-provider healthcare experience.

There are different trains of thought about the ways RN experience is directly applicable to the provider role. I was a very experienced RN when I became a provider (well over 10 yrs exp, and my area of RN expertise directly involved the same populations I treat as a provider) and I would still say that entering the provider role put me squarely back to novice status again. Yes, in my opinion significant RN experience is very helpful in a general sort of way (knowing basic terminology, knowing basic disease processes, knowing how to interact with patients, etc., etc), but nearly everything specific to the provider role is novice territory. For example: knowing what often gets ordered by other members of the healthcare team for different problems (e.g UTI = antibiotic) is not truly experience that helps make a correct diagnosis and choose a specific treatment.

I personally don't think the RN experience arguments hold up very well generally speaking, but that is strictly my opinion and obviously can be argued.

Either way, if you choose to enter discussions about this I would not take the tack of "what they got vs what we got." Just discuss the merits of RN experience as you see them.