I was offered a full time job at an IM clinic. I asked for $48 per hour compensation with full benefits because i thought this was reasonable for a new grad in southern CA. The average is $44-46/hr.
On my second day of orientation, my boss told me that she is going to switch my pay to salary. She said she will offer me 75k per year. I was really shocked!
I told her that at the hospital, although without benefits, I get paid $52 per hour. Then she said that i shouldn't expect that much because being a nurse is different from being an NP. She also has to train me and that will take time. Then i countered and said i am willing to meet her at $88k. Then she said she can only offer up to $80k. Then i said i also have to make ends meet at home so I will think about it over the weekend.
Then she said she will call me back this weekend for a final offer.
Any suggestion or tips on how to handle this negotiation when she calls me back? Should i walk away from a low ball offer? Or is it worth it to get that experience for a year then go? This negotiating acitvity is exhausting! ;-)
I want to get an offer of at least 86-88k. I am better off working at the weight loss clinic at $60/hr
You definitely have to do what your gut is telling you and I know others are learning from your journey also but what disturbs me most is the place of insecurity and inferiority she has pushed you into. My guess is that unless you take exactly what she offers there will be no deal and that is rotten. If in fact she actually will give you an orientation that would be worth the reduced rate for a set time frame, say 90 days, after which a previously negotiated increase should take effect. Be very careful with offering an employer a bunch of options. It comes off as unprofessional and confusing imo. It sounds like she is fairly certain you can be pushed around so she will probably not be too happy if you start to attempt to assert some independence in the manner of any counter offer.
I could be mistaken, happens often, but I'm not sure I agree that having experience is so important that it is worth working in a challenging position with a huge responsibility and educational investment for less or even close to what you can make as a RN. In fact you have a NP job at the weight loss clinic so you aren't even a new grad any longer even though you haven't worked in IM yet.
Not just taking whatever crumb is thrown our way is annoying and different than being a RN but as you saw by the numbers it can make a huge difference. Personally I could care less if the weight loss clinic was boring as hell if I was going to make $44,803 a year extra.
My guess is men wouldn't stand for a situation like this and I'm not either. I approach every opportunity, even when I was a new grad, as what they can do for me because I know what I'm bringing to the table. If they didn't like my rate no worries I will find someone who will. I know that sounds rather smug but there is no way I'm going to be intimidated into taking a job under squirrely pretenses.
Thank you, Jules! You have been very helpful. Reading your side of things gave me the mental courage to walk away tomorrow, if I am not happy with her final offer. I should really stop worrying about getting that first year experience. I will find the right job, or if not, the right offer. I will keep the wt loss clinic job for sure. I will probably have to find another job though but i will stop obsessing about getting a full time job at a family practice, at least for now. I wish i was more decisive and direct like you. According to the book i am reading, men usually get a higher negotiated salary than women because they are not afraid to make their worth known to the company, just like you said.
I know my worth but hearing from doctors (over and over again) that new grad NPs must have (and expected to have) a lower pay than RNs (despite the increased responsibilities/liabilities) is really affecting me. It sort of lowered my confidence. However, i feel renewed tonight and ready to face the world again tomorrow ;-)
Let us know how it goes! Negotiate the number of hours per week you will be working into that contract if you read this!
Other things I'm worried about if you decide to take the job and quit later on once you have the experience for a better job:
1) Is there a non-compete? If this employer is changing salary after you've started working, there might be some unruly non-compete. I have heard horror stories of NPs having to commute 60 miles to another job after leaving their previous due to a non-compete.
2) Is there a required length of service? A 1 or 2 year contract with an expensive buyout will make you miserable and could be detrimental to your budget if you decide to break it. (plus add on a non-compete sending you to another county for work, yikes).
3) If the MD is thinking of future call, remember that will increase your number of hours worked. What could really work in your favor is at the 3 month review of salary when he wants you to take call is to negotiate that into your pay. This is your worth, freeing up time for the MD, which is very valuable to him. Make your worth known!
Let us know how it goes! Negotiate the number of hours per week you will be working into that contract if you read this!
Other things I'm worried about if you decide to take the job and quit later on once you have the experience for a better job:
1) Is there a non-compete? If this employer is changing salary after you've started working, there might be some unruly non-compete. I have heard horror stories of NPs having to commute 60 miles to another job after leaving their previous due to a non-compete.
2) Is there a required length of service? A 1 or 2 year contract with an expensive buyout will make you miserable and could be detrimental to your budget if you decide to break it. (plus add on a non-compete sending you to another county for work, yikes).
3) If the MD is thinking of future call, remember that will increase your number of hours worked. What could really work in your favor is at the 3 month review of salary when he wants you to take call is to negotiate that into your pay. This is your worth, freeing up time for the MD, which is very valuable to him. Make your worth known!
Thank you, swimstudent! I wrote all of these. These are good to know and make sure are covered. I couldn't sleep all night due to thinking much about this, lol. Yes, i will let all of you know what happens ;-)
Btw, i called her yesterday but she wants me to talk to the "person that handles it". Well i will, but i won't lift any finger today until i get a signed contract first... I'm supposed to follow her all day again.
Specializes in Med-Surg; Infectious Diseases; Research.
It looks like they are low-balling you in the hopes to pull you back down to what they want to pay. Before a position is posted, the salary range is predetermined - especially in nursing. So they may not have much wiggle room. If the average in your state is $44-46, then as a new grad how did you calculate $48 to be an acceptable request? Understand their perspective, you're asking for above average pay with no NP experience for an NP job?
You shouldn't really compare compensation with benefits to compensation without benefits because that's the equivalent to comparing apples to oranges. Benefits can actually really add up for a company, especially when dependents are added. Keep in mind $86-88k/year with benefits may not leave you with much to take home.
Regardless of what she offers you, I'm most concerned that she changed your salary AFTER orientation. If you already signed a hiring contract. If it were me, I would walk away. If the confusion and ineptitude are already showing themselves on Day 2, then that's not a place that you want to work. I would also contact the California Association for Nurse Practitioners and talk to them about appropriate salary options for new grads.
It makes me so angry that Admins attempt to minimize our NPs value. I don't think it is as prevalent in psych because most of my physician bosses are fairly young. They have come up valuing nurses and NPs. Recently an administrator at a hospital where I work said he hopes a psychiatrist I work with doesn't hear how much I make for my on call shifts and I was like "he's the who told me how much to get".
Definitely get involved with your local nurse practitioner's organization. Although a majority aren't even remotely business minded if you snoop around you will find the few super sharp ones and learn excellent things from them. I have said it a million times but in this profession, probably in all professions, being well connected pays off big time.
This post really highlights problems with nursing wages and negotiation. Salary = work like a dog for less, NO OVERTIME! With the offer they made you I could easily make that with just 12 hours per week overtime and I'm just a floor RN...remember clinics hire NP's so they don't have to pay as much for PA's. Stopped being a punching bag, stand firm or walk away. If you can get one job you can get another. Don't start any job without a firm WRITTEN offer in hand.
SO... I made a deal with an option to re-negiotiate in 90 days, if i am up to speed (seeing 15-20 patients). The biggest hurdle for me is mastering the extensive/complicated EHR and knowing where to send the pt for labs/imaging, etc, d/t insurance issues. MAs seem to be overworked as well.
Even though they did not accept my counter of $88k, I had to negotiate on many other things (i believe this is confidential information, i'm sorry). I did not get the 88k but i feel alot better with the new contract/offer. At least i know i could at least maintain my sanity with the modified hours, knowing that i am getting my experience, and while enjoying "other benefits".
I will be working my butt off in the next 90 days though. I was honest to them and said that my goal is to reach $99k (current RN rate with 9 yrs experience) and be full time someday. I'd like to work for the clinic for a long time, but someday, i will have to move on, if i do not receive the compensation i deserve. But of course, i also need to justify any salary increase.
Thanks everyone for all the advice! I feel so much better, at least for now and in the next 3 months ;-) I will keep everyone posted!
The biggest hurdle for me is mastering the extensive/complicated EHR and knowing where to send the pt for labs/imaging, etc, d/t insurance issues. MAs seem to be overworked as well.
The computer will just take some time to become proficient but I'd personally avoid getting to invested in where the patient needs to go for labs etc. I write the order and ancillary staff can assist them with finding where to get services.
Remember you are the provider not the nurse, secretary or janitor. Setting boundaries from the start is crucial imo. If you devote your time to actual diagnosing and prescribing you will naturally increase your revenue power which is what your employer wants and will pay you in the end.
The computer will just take some time to become proficient but I'd personally avoid getting to invested in where the patient needs to go for labs etc. I write the order and ancillary staff can assist them with finding where to get services.
Remember you are the provider not the nurse, secretary or janitor. Setting boundaries from the start is crucial imo. If you devote your time to actual diagnosing and prescribing you will naturally increase your revenue power which is what your employer wants and will pay you in the end.
Thanks, Jules! I really love your comments.
I will remember these because you are absolutely correct ;-) That means i can't really clean the room after seeing the patient because i'd like to bring in more income by spending my limited time seeing/dx/tx patients. I'm actually very excited to reach my new goal (15 pts)! New beginnings.
Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.
Thanks, Jules! I really love your comments.
I will remember these because you are absolutely correct ;-) That means i can't really clean the room after seeing the patient because i'd like to bring in more income by spending my limited time seeing/dx/tx patients. I'm actually very excited to reach my new goal (15 pts)
Yes. Be efficient. Keep asking questions as you perform the physical exam. Let the MA's tidy up, MA should be able to keep your rooms full and anticipate for example UTI sx, get UA dip and have results ready for you. Remember every minute that you are not doing things the MA or staff can do adds up, every 15-20 min can be another pt that you saw & where the pt goes for labs is for MA or staff to help the pt with (but keep your ears open you may eventually learn that XYZ insurance goes to Blah, Blah lab on main st.
As for the EHR, are there tutorials? Find out who is the "expert" and ask to follow another provider of 1/2 or one day to see how be efficient. Good luck sounds like you are feeling better about this position but keep eyes open for new positions, always. The best time to find a new job is when you are not needing any job. Can you post monthly updates of your journey so we can learn about other issues and for new grads too.
Congrats on making a final decision. So I guess this is for anyone else who stumbles into this thread. I am not an NP yet but I have become an expert on getting paid. My husband jokes that I am the check whisperer. Any half decent recruiter/manager can smell a desperate applicant from the first phone call. I know because when I worked in staff development I could tell how much a potential employee would "settle for" in about three minutes. Everything from the expression on your face, body language, and adjectives used says "pay me what I'm asking" or "make me an offer". I know that its hard when you NEED a job like yesterday but it sucks to "settle" and then find out you are the lowest paid person in the group. Moreover, I have found that the employers who were required to pay over their initial offer valued me the most. It's a very basic principle. People value what they pay for. For reference I made just over 80k as an LPN in 2008 in PA (64 hours/week). Ask for what you want, all they can say is no.
Yes. Be efficient. Keep asking questions as you perform the physical exam. Let the MA's tidy up, MA should be able to keep your rooms full and anticipate for example UTI sx, get UA dip and have results ready for you. Remember every minute that you are not doing things the MA or staff can do adds up, every 15-20 min can be another pt that you saw & where the pt goes for labs is for MA or staff to help the pt with (but keep your ears open you may eventually learn that XYZ insurance goes to Blah, Blah lab on main st.
As for the EHR, are there tutorials? Find out who is the "expert" and ask to follow another provider of 1/2 or one day to see how be efficient. Good luck sounds like you are feeling better about this position but keep eyes open for new positions, always. The best time to find a new job is when you are not needing any job. Can you post monthly updates of your journey so we can learn about other issues and for new grads too.
Thank you, sailornurse!
Good idea about following the expert on EHR. I am following the doctor right now. The 2 NPs are really fast, like they have used this EHR forever. I will definitely request to have a day with them. Actually, i should really follow one of them for a few days!They keep telling me tricks here and there but i never remember them... I should write them all for now. I get so much information everyday that i should bring a binder and write them all out!
And yes, i'm always networking for possible jobs. I will keep everyone posted about my new grad NP journey.
I really love our NP forum, not only because I can help fellow new grad NPs, but i could ask experienced NPs advice for free and without hesitation. Thank you very much, everyone!.
CocoaLoverFNP
238 Posts
Thank you, Jules! You have been very helpful. Reading your side of things gave me the mental courage to walk away tomorrow, if I am not happy with her final offer. I should really stop worrying about getting that first year experience. I will find the right job, or if not, the right offer. I will keep the wt loss clinic job for sure. I will probably have to find another job though but i will stop obsessing about getting a full time job at a family practice, at least for now. I wish i was more decisive and direct like you. According to the book i am reading, men usually get a higher negotiated salary than women because they are not afraid to make their worth known to the company, just like you said.
I know my worth but hearing from doctors (over and over again) that new grad NPs must have (and expected to have) a lower pay than RNs (despite the increased responsibilities/liabilities) is really affecting me. It sort of lowered my confidence. However, i feel renewed tonight and ready to face the world again tomorrow ;-)
Thanks again!