LOCUM Nurse Practitioner Pay

NedRN · Dec 9, 2016

You are correct. Unless you are a midwife, or possibly an experienced open heart first assist (able to harvest vein), your pay is at best only few dollars more than normal specialty pay. And that is only in an acute care hospital. Hopefully you became an NP because you like primary care. If your dream was to travel, it would have been better to do that for a couple years before continuing your education post BSN. If you have specialty experience and don't mind traveling in that specialty, you can do that. Healthcare's future under Trump is uncertain, however if the ACA is left relatively intact, it won't be that difficult to return to a career as an NP after a couple years of travel. As you know, primary care needs more practitioners now and in the foreseeable future if the ACA is left alone. You would probably know better than me, but I think you can do better than the average traveler in regular career as an NP. And even more if you run a specialty clinic such as tattoo or hair removal (what you can do without direct supervision will vary by state). But the really good paying things you could end up doing seem far removed from primary care which presumably was your goal.

There is a loan forgiveness deal. I forget the details (posted elsewhere on Allnurses, and in a fairly recent thread in this forum), but something to do with working a government job for 10 or 15 years. A job with the VA and a transfer once a year may meet your travel itch. Or the armed services. Picture a year in Germany and a year in Italy!

It might also be possible to work for IHS and move around several reservations but that is limited location options and you would have to love the working environment.

guest769224 · Dec 9, 2016

Check out travelingnp dot com. There are lots of tips on there on how to get started, and how to make high dollar as a locum tenens provider. Chat with the blog owner, she's very nice and helpful.

NedRN · Dec 9, 2016

Check out travelingnp dot com. There are lots of tips on there on how to get started, and how to make high dollar as a locum tenens provider. Chat with the blog owner, she's very nice and helpful.

Thanks for that site recommendation. It is an unorganized blog which makes finding specific information on compensation difficult (still a great site as I don't know of others). With the help of Google, I finally tracked down one quote on comparative pay:

"When I began working locum tenens, I started off immediately making $10/hour more than I did at my perm job."

Unfortunately without more context, this means almost nothing. Most regular nurse travelers can say (and believe) the same thing, but considering staff benefits, some actually are making less than they did as staff.

I'm certainly willing to adjust my perceptions about travel NP pay as most of what I know comes from rate sheets at acute care hospitals. There is a much bigger world out there for NPs than acute care, and demand is rising. I couldn't find much of use about compensation on her blog. Of course, the issue is exactly the same as for regular nurse travelers, you travel for the lifestyle first, and worry about maximizing your income secondarily.

I was interested to read about her experience working in California. She say the pay is not better than other states and the working conditions notably worse - apparently due to increased demand (and thus workload) from California's very successful implementation of the ACA increasing healthcare utilization.

Another interesting story is warning that obtaining a California license will slow licensure in certain other states. The same is true for RNs as well. California still requires a paper form to verify licenses versus Nursys. Most states may only require the original and/or a current license to be verified, but some states require all licenses ever held to be verified. California BON doesn't appear to prioritize verifications so it can take months while you are waiting to start your assignment in another state. Huge pain!

I also found a list of agencies she has used that I'm not familiar with for locums. I think the very large "regular" nurse travel companies such as American Mobile or Cross Country can be used by NPs successfully. They all have divisions just for locums. But to aid any NP traveler that wanders into this thread, I'm repeating her list. I suspect there are professional journals that make finding such agencies easy anyway but here goes:

â€“Staff Care

â€“Barton Associates

â€“Comp Health

â€“All Medical

â€“Delta Locums

â€“VISTA Staffing

â€“Medical Doctor Associates

Nurse_Lightning · Dec 9, 2016

Thank you so much for taking the time to give me all of this information!

NedRN · Dec 9, 2016

You are welcome. I like learning about different parts of the travel business. What do you think your first move will be?

Nurse_Lightning · Dec 9, 2016

Well, I only have an IN license right now, so just to get started, I'll probably try to get something in IN as I work on getting licenses for CA, AZ, and/or TX.

NedRN · Dec 12, 2016

No doubt pay potential for NPs in primary care is well known to anyone pursuing that degree program. But not to me! I was at a party with my GP last night and discussed NP pay. He started his practice less than two years ago and within three months had to start turning down new patients - which is like a year ahead of schedule for most GPs starting a new practice. I remember discussing the MD versus NP issue for growing the practice when he started up and he preferred adding an MD over NP. I can't remember exactly why now, and it seemed to me to make more financial sense to add NPs.

However, he has failed at finding MDs for his practice and a few months ago added an NP fresh out of school. He is not paying her as well as an experience NP, less than 6 figures base and productivity, and while she could practice relatively independently, he is signing off on all the charts and plan of care until both have high confidence in her judgement without close oversight.

To get to the fun part, he told me that the absolute max for an NP in office practice is 150K, and even a really efficient NP will be very busy to make 125K. So it appears, that in the Midwest anyway, an NP with a life will make 100 to 115K.

That seems like decent pay to me especially in the Midwest, and 30% or more of what a staff nurse usually makes here. Enough to incentivize the cost and work of NP school for those with the ability and aptitude and to enough to pay off those costs.

I'd have to be a lot younger to find that career pathway enticing. It might be interesting to some readers that my income potential is actually quite a bit higher than the numbers above right now as an operating room nurse traveler with an ADN (gratis California, no debt). This is possible for many other travelers too, in fact I have a 1099 employee for whom I figured out his potential annual earnings to encourage him to take an assignment I offered him. It was 201K, a good bit of which is tax-free. However he doesn't work all year and took 7 months off this year.

So just like it was possible for me at 18 to do blue collar work and out earn my college professor dad, higher education doesn't always result in higher pay for some. Statistically, more education is highly correlated with higher lifetime earnings, so my anecdotes should not deter anyone from going for it - my examples are not representative of most travelers. That said, most travelers working full-time do make around 100K to 140K per year in total compensation - which may not be comparable to a benefited NP salary and their total compensation will be higher than just salary.

guest769224 · Dec 12, 2016

It might be interesting to some readers that my income potential is actually quite a bit higher than the numbers above right now as an operating room nurse traveler with an ADN (gratis California, no debt). This is possible for many other travelers too, in fact I have a 1099 employee for whom I figured out his potential annual earnings to encourage him to take an assignment I offered him. It was 201K, a good bit of which is tax-free.

Very intriguing. Curious on how I could replicate such earnings for myself. Maybe will have to ask you for some additional details. You consider it possible to earn in excess of 200K per year as a traveler in CA? I wish I had the knowledge you possess in this area.

most travelers working full-time do make around 100K to 140K per year in total compensation -

This is specialty dependent, right? Does one have to be in a hot specialty to make that on average? I'm in ICU.

NedRN · Dec 12, 2016

Not sure if you are talking advanced practice with that question. I have zero doubt that if you become a CRNA that that is a winner.

For travel, remember I do direct contracts and work in a hot specialty. My ED friend could make that much (and a bit more) if he also did direct contracts (but this was unusually high paying for ED). As it is, he makes that much because I am so low overhead and have fun placing an occasional traveler (plus a potential benefit if I am ever audited).

guest769224 · Dec 13, 2016

For travel, remember I do direct contracts and work in a hot specialty. My ED friend could make that much (and a bit more) if he also did direct contracts (but this was unusually high paying for ED). As it is, he makes that much because I am so low overhead and have fun placing an occasional traveler (plus a potential benefit if I am ever audited).

I have quite a few more questions but I'm not sure if I should PM you or create a separate thread about it, as I don't want to derail this thread.

NedRN · Dec 13, 2016

To gain direct contracts, you operate as your own agency. Basically, you want to be indistinguishable from any other agency. As such, this is a business topic and most appropriately discussed on the Entrepreneurs forum. Alternatively, send me a PM and I'll send you a link to my startup blog.