Is this true? Salary Question

PG2018 · Nov 1, 2015

I see a lot of high horse RNs and a lot of disgruntled, improperly utilized NPs complaining about that on here. I can attest, there is no way in heck I would or could ever have made what I made as a RN what I make as a NP. Compound that by the fact that I don't really do anything other than meet with patients and sign the occasional form and I'm making light years more than I did. I kid you not I make at least four times what I made as a RN not counting what I can make in productivity bonus and moonlighting opportunity. Accounting for that and it's six times what I made as a RN. The hardest thing I do now is type. As a RN, geez, walking around all the time serving juice, wiping butts, dealing with unruly coworkers, smelling dirty crotch, doing that paltry IV mess, setting up suture trays ad nauseum (then cleaning it up), making beds... Now, I talk, type, sign, and repeat.

Jules A, MSN · Nov 1, 2015

IMO if a NP isn't making considerably more than they made as a RN there is something wrong with their negotiating skills or the dipshit NPs in their area who have allowed this foolishness to continue.

I have always made what I considered good money for my field, as an ADN I made over $80,000 a year and as a NP my base salary before weekends, holidays and OT is more than twice that amount. Please note, like PsychGuy, I also do not do the hybrid nurse thing. I'm a provider and as I have said many times before I won't do anything the Doctors don't do.

guest538567 · Nov 1, 2015

I think the answer to this question is somewhat complicated and varies based on the region you practice. Look at some data from the BLS on this subject. According to federal data, the CA region is the highest paid nationally for both RN and NPs. To try to compare apples to apples - for the Vallejo-Fairfield, CA area, for NPs, the mean hourly wage is $61.47 and Mean annual salary is $127,860. For the same region, the RN mean hourly salary is $54.95 and the mean annual salary is $114,290

However, if you compare other parts of the country, like the south or midwest, you will see significant differences in the mean wages of RNs when compared to NPs. You also must take into account that many RNs are hourly employees and can therefore earn extra pay with extra hours. Many NPs are salaried.

You must also consider that many who argue they would take a pay cut as an NP have been in nursing many years and may be at the higher end of the pay scale. Generally, they may start lower as an NP but have a much higher pay scale as they gain experience.

Anecdotally, in my area, NPs earn significantly more than RNs. As a NP, I now earn twice as much as my highest RN salary and this should only continue to rise with job changes, negotiation, and experience.

Nurse Practitioners

Registered Nurses

Dumplins, MSN, RN, APN · Nov 1, 2015

There are many factors that can contribute to this. Overall...on average, an NP will make more than an RN. The examples that you are probably hearing about are the RN's that have been a nurse for 10 years in the ICU and get night shift differential. They've obviously accumulated a fairly large wage. Then after acquiring their NP degree, they're instantly a "new grad" and may make less than what they were making as an RN. If you're an RN making $80k+, then it's possible you're making more than some NPs.

Depending on the area, an FNP can make $70-100k as a new grad.

PMHNP-1 · Nov 1, 2015

I do know quite a few NPs who went BACK to work as RNs. I'm pretty sure it is this state - it is notorious for being a very bad practice environment for NPs, there are NO unions for nurses and so wages for them are pretty bad, there is also no patient safety act so everyone gets the shaft: RNs, NPs, and of course the patients. The hospitals here hire NPs as "contingents", that is, they don't want to pay benefits. You CANNOT negotiate. They TELL you: THIS is what it pays, there IS no negotiating, take it or leave it. Many left it: contingent NP pay here in this state averages maybe a dollar - yes ONE DOLLAR more than contingent RN makes. Hours are fewer because of that one dollar. The physicians hate the NPs and treat them worse than dirt. Some of the RNs don't want to work with NPs because as soon as the physician comes in, s/he changes the NP's prescribing orders for the patient: constant adjustment of meds. Not because the NP was wrong, but because the physician MUST feel in charge. Then, of course, the hospital pays the med. insurance for the physicians, and pays for their continuing ed credits, but NPs must pay their OWN insurance, and pay for their own CEUs, PLUS do them on their OWN TIME.

I do wish I had never gone into this field. It is the worst decision I ever made in my life. The university lied about everything - and never no where on the internet did anyone ever tell me these truths. I quit 2 jobs that were too horrendous already. Friends are working as pharma reps, teachers, temps, RNs, and some - in demeaning bad doc-handmaid jobs that don't pay that much more than if they were working as RN (and again, when you have high insurance costs and no benefits, you WIN as an RN and lose as an NP). No one is happy in any NP job they have. And BTW, no, we CANNOT open private practices here: NPs are not allowed, by law, to own ANY business at all in this state. RNs can. and PAs can . NP is the ONLY health care profession that cannot own a private practice.

PMHNP-1 · Nov 1, 2015

The salary surveys, provided annually in NP/PA magazine typically show that PAs, who must work with a physician (while NPs don't have to except in Mississippi and Michigan) under supervision, get more by far than NPs. Their salary has been going up, while NP wages have been stagnating. that's because the medical staff at the hospitals go to bat for the PAs, and also because women in the U.S. are discriminated against. There is a higher percentage of male PAs than male NPs, therefore, employers PAY them more, and they bring the averages up.

guest538567 · Nov 1, 2015

I do know quite a few NPs who went BACK to work as RNs. I'm pretty sure it is this state - it is notorious for being a very bad practice environment for NPs, there are NO unions for nurses and so wages for them are pretty bad, there is also no patient safety act so everyone gets the shaft: RNs, NPs, and of course the patients. The hospitals here hire NPs as "contingents", that is, they don't want to pay benefits. You CANNOT negotiate. They TELL you: THIS is what it pays, there IS no negotiating, take it or leave it. Many left it: contingent NP pay here in this state averages maybe a dollar - yes ONE DOLLAR more than contingent RN makes. Hours are fewer because of that one dollar. The physicians hate the NPs and treat them worse than dirt. Some of the RNs don't want to work with NPs because as soon as the physician comes in, s/he changes the NP's prescribing orders for the patient: constant adjustment of meds. Not because the NP was wrong, but because the physician MUST feel in charge. Then, of course, the hospital pays the med. insurance for the physicians, and pays for their continuing ed credits, but NPs must pay their OWN insurance, and pay for their own CEUs, PLUS do them on their OWN TIME.
I do wish I had never gone into this field. It is the worst decision I ever made in my life. The university lied about everything - and never no where on the internet did anyone ever tell me these truths. I quit 2 jobs that were too horrendous already. Friends are working as pharma reps, teachers, temps, RNs, and some - in demeaning bad doc-handmaid jobs that don't pay that much more than if they were working as RN (and again, when you have high insurance costs and no benefits, you WIN as an RN and lose as an NP). No one is happy in any NP job they have. And BTW, no, we CANNOT open private practices here: NPs are not allowed, by law, to own ANY business at all in this state. RNs can. and PAs can . NP is the ONLY health care profession that cannot own a private practice.

Wow, what state are you describing? It sounds like a horrible practice environment.

guest538567 · Nov 1, 2015

The salary surveys, provided annually in NP/PA magazine typically show that PAs, who must work with a physician (while NPs don't have to except in Mississippi and Michigan) under supervision, get more by far than NPs. Their salary has been going up, while NP wages have been stagnating. that's because the medical staff at the hospitals go to bat for the PAs, and also because women in the U.S. are discriminated against. There is a higher percentage of male PAs than male NPs, therefore, employers PAY them more, and they bring the averages up.

Surveys I have seen are relatively similar if you compare specialties. Primary care NPs tend to make a similar pay as primary care NPs. I think the reason that PAs tend to have a higher mean salary is that they tend to work in specialty areas that pay higher (ie. surgery), whereas many NPs work in primary care.

I recognize that female employees can have lower wages than their male counterparts. However, I have always wondered if this is due to a traditional lack of negotiating when they are hired. Anecdotally, I have known plenty of female colleagues that will NOT negotiate and just accept whatever salary they are offered. They just do not seem comfortable with this skill. My male colleagues on the other hand always seem to negotiate a higher starting wage. Again, this is anecdotal, but negotiating can have a big impact on your salary trajectory after you are hired and even with later jobs.

Jules A, MSN · Nov 1, 2015

Surveys I have seen are relatively similar if you compare specialties. Primary care NPs tend to make a similar pay as primary care NPs. I think the reason that PAs tend to have a higher mean salary is that they tend to work in specialty areas that pay higher (ie. surgery), whereas many NPs work in primary care.
I recognize that female employees can have lower wages than their male counterparts. However, I have always wondered if this is due to a traditional lack of negotiating when they are hired. Anecdotally, I have known plenty of female colleagues that will NOT negotiate and just accept whatever salary they are offered. They just do not seem comfortable with this skill. My male colleagues on the other hand always seem to negotiate a higher starting wage. Again, this is anecdotal, but negotiating can have a big impact on your salary trajectory after you are hired and even with later jobs.

It is so frustrating to hear stories like PMHNP-1's however like you point out I think some of the ownership is absolutely the NPs. What the heck is their state NP organization doing? That people are willing to work for subpar wages and be treated "like dirt" is discouraging to me. I would guarantee if all the NPs in that state suddenly said "hell no" and refused to work under those conditions things would change, no union needed. What are the NPs doing to better their situation? I can tell you in my state we meet, spend money on lobbyists and fight for our rights to practice independently. As for the Doc NP relationships again some of that is the treatment NPs are willing to accept. Its annoying that Doctors would make unnecessary changes to meds that were acceptable but so what? Is it really that big of a deal? I have yet to meet a physician who continued to treat me like a dolt after spending any time with me and seeing my skill set. In general I have not found physicians to be as petty or concerned with how others are practicing as compared to nursing. It has to start somewhere so unless NPs in your state are willing to accept status quo its time they do something.

There also seem to be many students going into this field with no clue what to expect. Look at how many posts are on here asking for a NP to interview or for preceptors. It puzzles me that so many RNs don't know any NPs before going into this field. Who spends years and thousands of dollars on a career without doing indepth investigation into what it entails?

MexicanFNP · Nov 1, 2015

So in a general sense PAs have it better in terms of salary and opportunities as opposed to NPs? Speaking as a California resident..

Dranger · Nov 1, 2015

So in a general sense PAs have it better in terms of salary and opportunities as opposed to NPs? Speaking as a California resident..

I think nationally PAs are slightly higher, for California I don't know.

However, if I read correctly from your other thread you need to work full time and health have insurance right?

For PA schools many will tell you straight up that you can NOT work. It just isn't possible unlike NP education. So if you are trying to compare PA vs NP look at your life situation first before thinking about salaries.