Job offer-why are they so cheap?

scribblerpnp · May 25, 2008

Right now, I would expect a lot on RN to NP's very well take a cut in pay due to the nursing shortage. It is pretty common where I live. From what you have said about the contract, here is what I see as the major cons:

1. Hospital rounds either before or after your office hours. This can add at least 1 hour and up to 5 hours to your work day. Will you be paid extra for this? Taking a salary pay as an NP with hospital rounds is B-A-D. When I had hospital rounds, I worked a 60 hour work week (on salary). NOT FUN. This also doesn't include the time you may be called in the middle of the night by the hospital and have to go in. Are you taking call as well? If so, ask for call money too.

2. Non compete clause. 30 miles is a large area. This may require you to move if you wished to find another job. Depending on the non compete, it can work TWO ways: if you leave, or if you are fired.

Also, don't get sucked into, "Well, I am paying for your malpractice." NP malpractice is cheap for the employer. I live in a state with terribly high malpractice. Mine is 2,000/year. The doc I work with is 10,000. Neither of us has any litigation history.

I would say 70,000 for a new grad (depending on the loction) is OK, but only under the circumstances of NO non-compete, no hospital responsibilitis, and a 40-45 hour work week.

If the other NP at the office has a limit of 45 hours, you should ask for it too. I work in primary care, and though our office hours are over at 5, does not mean that is when I get to go home. I go when the last pt is seen, and in the winter months, with double booking and sick kids, it isn't suprising that on a bad day I get out 2 hours after I was supposed to be home. And if you think you can just walk out and leave a room full of pts to be seen because you have worked your 40, think again. Not to be mean, but primary care doesn't work that way at all.

The best advice I can give you is to be so thrilled that someone wants you as a new grad, that you are sucked into making a bad job decision because the market is tough. I got screwed on my first NP job, and it was totally my fault. I was so happy to have a job opportunity, I would had worked for the devil (and I found out that I did). The second time around I did much better.

js408 · May 26, 2008

That doesn't make sense. A nursing shortage means nurses get paid more, not less. A nursing surplus would be cause for a pay cut. Supply and demand.

Right now, I would expect a lot on RN to NP's very well take a cut in pay due to the nursing shortage. It is pretty common where I live. From what you have said about the contract, here is what I see as the major cons:

SteveNNP, MSN, NP · May 26, 2008

That doesn't make sense. A nursing shortage means nurses get paid more, not less. A nursing surplus would be cause for a pay cut. Supply and demand.

A nursing shortage boosts the salaries of NURSES, much more than compared to midlevel providers. You have to staff your units, and you have to pay competitively to keep nurses. The demand for midlevels, while high, is nowhere near the scale of the demand for nurses.

scribblerpnp · May 26, 2008

Yes! an RN shortage makes the RN pay higher, but here in my area, there is NO NP shortage. Jobs are competitive, and so NP salaries can be lower and those for an RN. Especially for RN's who have been at the hospital for years and are now starting out as NP's. Almost a certainty you will take a paycut. (Where I live anyway). Nurses are running from the bedside for those advanced degrees, so the market is starting to flood around here. Especially if you are specialized- such as PNP, NNP, etc.

One of my friends was an RN for 6 years and won't work as an NP because as a new NP she would make about 4 dollars less an hour than as an RN (and have more responsibility).

PMHNP10 · May 26, 2008

One of my friends was an RN for 6 years and won't work as an NP because as a new NP she would make about 4 dollars less an hour than as an RN (and have more responsibility).

That's very unfortunate, but the problem there is that the NP working as a floor RN will be held to the NP standard. A bad situation to be sure.

PMHNP10 · May 26, 2008

Ok, I just went on my second interview w/ this dr. the office is a primary care office w/ 1 dr. 1 surgeon(the head of the practice) and one Np . So I meet w/ him and he offers me 65,000 which I told him I could not take and he went up to 70,000 which I said I make more as a RN at the hospital but he stuck w/ 70,000. Here are the details of the job by the way when i was talking to him he wasn't too sure on what he offered his employees which i thought was strange since he has owned the practice for 30 yrs. Health for me not hubby. No dental coverage but I could pay for it if needed. If I dont take the health coverage then i can invest in a 401k(but would rather have the money up front or added on to salary), 2 wks vacation, $1000 cme and 7 education days. Malpractice coverage. Hours are 9-6 mon-fri occ sat 9-12(this is not counting n.h. rounds before and after I see pt's at the clinic). The NP that works there now her contract is for 45 hours per week Why 45? what happened to 40 hour work week. If I am going to stay 45 hours it will be on my own accord. The contract is for 2 yrs and renegotiation after 2 yrs. 3% increase for cost of living each year. Does have a non compete clause w/ in 30 miles. I am really not pleased w/ this deal and want to move on w/ another deal but i am realizing the positions are not that great where I live. So I am stuck. I received a great offer from a local hospital that is contracting to a n.h. (my background) but am scared as a new grad to be by myself in a n.h. w/ no one to go to w/ ?
's. Any advice on what to go back and renegotiate with?

Can you make a counter offer to the dr. office? You refused the first offer and he upped it by $5000 so this tells me he wanted you. If you are going to accept the position, then go ahead, but if you aren't going to accept as long as the offer is below a certain figure, make a counter offer. Normally I'd say to go above what you realistically want/think you should get and work down, but since they already made one 2nd offer, they might not be too willing if you go too high.