Need advice on this offer..New Grad

NP13 · Jan 27, 2012

Also thought I would add there is No Call, and this is a family practice.

pedspnp · Jan 27, 2012

Hi,I am a new grad with 4 years of RN experience. I have been interviewing with a local clinic. They have made me an offer, and I must say that not only am I disappointed, but I have also been unimpressed with the professionalism of this whole process (as far as HR). The clinic(s) are affiliated with a hospital. HR called me in today and acted as if I had already accepted the job. She basically had a sheet to sign saying I accept the job. I proceeded to tell her that I can't just sign a paper, I don't know how much I will make, bonus, schedule, etc. She says oh, and proceeds to tell me may pay will be $30.52 an hour. I asked if this is negotiable and she said "Not really, we try to be fair and start everyone off based on experience." I also asked about the bonus (more on this later). I asked about insurance, etc, she says it is all online for me to read. I kept asking questions, and she just seemed to get more annoyed and acted like anyone else would have just signed the paper!! I left without signing anything, and proceeded to call the directors of the clinics. The job is a full time job (part time at one clinic, and part time at another). The directors agreed with me that they would not have accepted like that either. We finalized my schedule, and they forwarded that to HR so I had it in writing.Basically the offer is currently this:Pay: $30.52 an hour (80 hours every 2 weeks)Bonus: is quarterly, and based off of quarterly visits:625 patients: $1000725 patients: $1500825 patients: $2000925 patients: $2500Time off: 8 paid holidays, 120 hours paid off a yearHealth Insurance: I do not have all of the details () but I am getting them. Basically what I am reading online is that it is not paid in full. Will have to ask.Dental Insurance: Same as above, Will have to ask.403b: There is a match here, but again, I do not have the details as their site does not say!!!!Will have to ask.CME: $1500 a yearMalpractice: ???? Have to ask.My first question is, I am a new grad so maybe I had higher expectations of the interview/negotiation process, but is the experience I described above normal? Why on earth would they just assume I accepted the job when I never gave any indication of this? Expecting me to sign that I accept without knowing anything about benefits??My second question, this offer seems really low to me. I am located in MO, and I know they do not pay the best, but this is really low, even lower than the minimum respondent on the salary survey that was linked from this site for my area. Also, the bonus seems like it would be impossible to ever get the full bonus!!I plan on telling them that I would like $32 an hour, but I expect them to say no. Maybe I had too high of expectations as a new grad?

I'm a PNP in rural Illinois my base is 37.00 plus 10.00 for every pt I see over 16 a day. Iget 3 weeks vacation a year plus 5 days and 1250 for cme and 10 holidays a year plus 2 personal days yes that seems low. I have a friend who just contracted with a private agency to work for the army she told me she is going to make 130,000 a year, since the agency she was with paid 80,000 to work at the same place. How realistic this is I don't know. I take after hours call but don't get reimbursed for that. I would show them the salary data also. I do get Nhsc loan repayment

TerryBSN · Jan 27, 2012

Hi,
I am a new grad with 4 years of RN experience. I have been interviewing with a local clinic. They have made me an offer, and I must say that not only am I disappointed, but I have also been unimpressed with the professionalism of this whole process (as far as HR). The clinic(s) are affiliated with a hospital. HR called me in today and acted as if I had already accepted the job. She basically had a sheet to sign saying I accept the job. I proceeded to tell her that I can't just sign a paper, I don't know how much I will make, bonus, schedule, etc. She says oh, and proceeds to tell me may pay will be $30.52 an hour. I asked if this is negotiable and she said "Not really, we try to be fair and start everyone off based on experience." I also asked about the bonus (more on this later). I asked about insurance, etc, she says it is all online for me to read. I kept asking questions, and she just seemed to get more annoyed and acted like anyone else would have just signed the paper!! I left without signing anything, and proceeded to call the directors of the clinics. The job is a full time job (part time at one clinic, and part time at another). The directors agreed with me that they would not have accepted like that either. We finalized my schedule, and they forwarded that to HR so I had it in writing.
Basically the offer is currently this:
Pay: $30.52 an hour (80 hours every 2 weeks)
Bonus: is quarterly, and based off of quarterly visits:
625 patients: $1000
725 patients: $1500
825 patients: $2000
925 patients: $2500
Time off: 8 paid holidays, 120 hours paid off a year
Health Insurance: I do not have all of the details () but I am getting them. Basically what I am reading online is that it is not paid in full. Will have to ask.
Dental Insurance: Same as above, Will have to ask.
403b: There is a match here, but again, I do not have the details as their site does not say!!!!Will have to ask.
CME: $1500 a year
Malpractice: ???? Have to ask.
My first question is, I am a new grad so maybe I had higher expectations of the interview/negotiation process, but is the experience I described above normal? Why on earth would they just assume I accepted the job when I never gave any indication of this? Expecting me to sign that I accept without knowing anything about benefits??
My second question, this offer seems really low to me. I am located in MO, and I know they do not pay the best, but this is really low, even lower than the minimum respondent on the salary survey that was linked from this site for my area. Also, the bonus seems like it would be impossible to ever get the full bonus!!
I plan on telling them that I would like $32 an hour, but I expect them to say no. Maybe I had too high of expectations as a new grad?

That does seem a little low to me as well, I went today for an interview they advertised as needing a NP full time and then proceeded to say after 2 months of full time the hours would go down to 16 hours per week at 36 hour with no bonus, no insurance, no anything. I live in TN and have noticed over the last year rates for NP's have been on steady decline.

Trauma Columnist · Jan 27, 2012

Just read an article in Advance for NPs/PAs that mid-level salaries are stagnant and actually have dropped over the past year. I know that we (our practice) took a pay cut last year (little one). This year we got a 3% raise.

I live in central IL and think the salary is kinda low.

zoidberg, BSN, RN · Jan 27, 2012

im hoping that health care salaries across the board will be on the rise once the economy begins to recover. Hopefully once that happens nurses and aprn's can start getting more appropriate salaries. NP's and PA's salaries have been incredibly low as of late for the work they do.

Trauma Columnist · Jan 28, 2012

While it would be nice to have higher salaries, I don't see that happening anytime soon. The economy and especially healthcare is on the decline overall as far as quality and cost is on the rise.

BlueDevil,DNP, DNP, RN · Jan 28, 2012

The salary is low, but that bonus structure is a piece of cake and should easily add 10K a year to your salary based on average productivity, bringing it to a more respectable 73K. I easily see 1200 patients a quarter and I'm neither the fastest nor the busiest provider in my clinic. I have a colleague who probably sees close to 1800 a quarter in family practice. I have a friend whom is a cardiologist and sees 45 patients a day in clinic, minimum, lol. The bar is set for you at an average of 16 a day. Easy peasy. You should be able to hit 925 by your second quarter (allowing yourself an orientation period and learning curve) without breaking a sweat. Seeing a patient every 30 minutes *and* taking a week off every quarter will still get you well past that goal.

However, 73K is still not great, but I don't know what the mean is where you live, nor do I know what the demand for NPs is there. Echoing what Trauma has said, the research out there by Advance and AANP anticipates average NP salaries to drop for new entry NPs and stagnate for experienced NPs, and no one thinks they will increase. The CME is the minimum I have seen, and while not generous, is probably enough. Keep in mind that anything you pay for out of pocket is tax deductible. You need more information about the 403b. It would have to be pretty damn good to impress me, as I don't care for 403bs in the first place. I have a 401K with a generous match. Health insurance is important, but frankly just about everyone's plans are expensive and offer constantly shrinking benefits these days, so I wouldn't turn down a job hoping for better health insurance. Malpractice minimums have been discussed here in detail in past threads and covered so well by others you are better off searching for them than by my trying to rehash it.

When accepting that first job, this is what I would ask myself: do I feel comfortable around my colleagues and the support staff? Being a new grad NP is humbling IME, lol. I needed to be in a place where it was 110% A-OK to say, "I have no idea." "I am over my head here, I need help." And I don't just mean the physicians and other NPs either. I was not embarrassed to tell the clinic nurses or MAs that I didn't know something. I came from critical care, and I never remembered the brand names for childhood vaccines! They had to tell me all the time, lol. I didn't (and still do not) feel like I have to pretend to be the all knowing NP, and if I felt that way I'd have been miserable!

If you are intimidated and don't feel supported to learn and grow, you will be stressed, unhappy and not making the most of the critical first 3-5 years. Frankly, that is the only question I cared about when I took my first job. I left 30K on the table across town to take a lower paying job in a more supportive environment and I have never regretted it for a moment. I love my clinic and my colleagues. I am supported and mentored. Each and every one of them goes out of their way to help me, and the practice manager bends over backwards to make every aspect of my life easier and happier. They are all about what they can do to make my day better and to help me grow as a NP. If I say I don't want to see a certain patient or a certain type of patient, voila, they disappear off my schedule. I have to leave early some days and arrive late others due to my kids' schedules, and they accommodate me to the nth degree. My medical director sits down with me to discuss any and everything on my mind, from cases to IT to systems issues to my continuing ed to the weather any time I ask, and has never once made me feel small for asking a question or not knowing something. That is worth one meeeelllllion dollars to me. What would it be worth to you?

Forget the money, listen to your gut. :) Good luck!

Sanuk · Jan 28, 2012

Threads like this are depressing to me :) When I tell people that I am going to school to be an FNP, they all respond that I must be excited about making more money. I have to tell them that in all likelihood I will make less than I currently do (38/hr plus 0.60 per certification plus 5/hr night diff and 9/hr weekend diff). Very sad.

allnurses Guide · Jan 29, 2012

I am in Pittsburgh and have an offer for $40.50/hr, mostly nights in a critical care unit. That is plus malpractice, 401k/match, CME $1500/yr, tuition assistance $3500/yr, partially subsidized health benefits. It's not much more than I make as an experienced RN, but it's pretty good for this area. This is their first offer so I'll try to push it up, but I know they offered some of my friends with less RN experience down to $37-38/hr for the same job.

I do have some other offers which may be more money but this position is the dream in terms of collaborating doc, environment, training/support program.. so I will probably take it even if it's less than the other one. We'll see.. they are trying pressure tactics re signing but I am not in any hurry.

CCRNDiva, BSN, RN · Jan 29, 2012

I'm starting to get kind of nervous about starting pay too. I will be in a lot of debt when I complete my ACNP program as my program will cost around $45,000. I did not choose to become an ACNP because of the $$;I wanted to increase my level of autonomy, but I will need to make a decent wage in order to pay the back the loans. This is making my head hurt, lol!

MagouRN · Jan 29, 2012

Nervous! my base is $43and change as a experienced bedside nurse in a trauma hospsital in Miami, Fl. The idea of making less as an ACNP with tons of student loan is scary.