I'm gathering that this is a theme in our field, unfortunately...
So after graduating and spending nearly a year of applying for positions as an APRN, I finally scored several interviews and a couple of offers. I'm particularly interested in one of the positions, which offers amazing health insurance benefits for my family (employer pays 80% of premium) but the salary that they offered me is embarrassing. Let's just say it's less than $70,000, but more than $60,000. Large University (i.e. state) position in a city w/population of approximately 100,000 people.
There are other APRNs in this same practice, currently with 10 years experience, who are making $79,000 - $83,000.
- No CME
- No productivity bonus
- 33 days of PTO, including vacation, sick, and personal days
- very good health insurance plans w/employer paying 80+% of premium
- malpractice covered
- excellent potential for career advancement (I plan to advance my APRN education)
My instincts tell me this particular position is The One; this is the position I'm going to love, love what I do, love where I am, and love my coworkers. The health insurance is extremely appealing and I'm assuming that is a big reason why they offer such low salaries. The other position I've been offered is $10,000/year more, but employer only pays 20% of health insurance premium, so I have to automatically deduct $16,000/year from my salary just for that.
I plan to make a counter offer but that is where I'm struggling. I'm truly dismayed at the low salary but I also feel very strongly this particular position is my calling. I need to be able to justify why I'm asking for more $$, considering I'm a new NP. Aside from figuring in CME and license/certification costs, what other suggestions should I make?
Specializes in Obstetrics & Gynecology,Medical/Surgical.
PsychGuy - I've noticed that psych NPs definitely make more than other APRN fields. I frequently see ads in my area, or on recruiting sites. Kudos to you for being a PNP; mental health is definitely not my forte! Definitely could not pay me enough to deal with the complexity of mental health issues.
I've also observed that FNPs, ANPs in the fields of Neurology, Acute Care, etc. tend to make more money in my area. My field - obgyn, women's health, even midwifery - seems to be the red-headed step child in the area.
This job I'm negotiating with...there are 13,000 full time employees with this institution. The associated hospital with the clinic has 160 beds. Someone previously mentioned a salary matrix and I'm sure this is exactly what they use to determine salaries. We're talking about an institution in which the athletic coaches make nearly $1 million but the health care providers (physicians included) make well below national average. I don't know if it is also because it is a teaching hospital, as well. At any rate, I don't think an institution this size is a beast I can fight, and frankly, I need to get in the door NOW as I am already one year out from graduation and that is only hurting me (I was already asked in other interviews why I haven't been practicing all this time).
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
the salary that they offered me is embarrassing. Let's just say it's less than $70,000, but more than $60,000.
Oh dear...I'm a BSN-educated nurse who works from home in a state with a low cost of living. I earn significantly more than the salary you were offered, yet I have minimal stress and no liability.
I'd accept $60k as an APRN only to avert immediate homelessness. Otherwise, I would not seriously consider such an insulting offer.
I've also observed that FNPs, ANPs in the fields of Neurology, Acute Care, etc. tend to make more money in my area. My field - obgyn, women's health, even midwifery - seems to be the red-headed step child in the area.
I live in a high cost of living area. Dual certified as WHNP and ANP. My first job as a new grad in a non-women's health field paid $85,000 in a somewhat lower income part of the state. I interviewed for a WHNP position closer to home in a much higher income part of the state (New England states are small, cost of living varies dramatically in a small radius!) and was told they NEVER pay NPs more than $75,000. For whatever reason, women's health jobs do pay less.
(Didn't take the job, currently making well over 6 figures but not in a women's health position.)
(Didn't take the job, currently making well over 6 figures but not in a women's health position.)
Good for you. I applaud you for not accepting that BS and instead pursuing what I can only imagine wasn't your first choice for appropriate compensation. I have also had a hospital admin say "we aren't going to pay a nurse that" when told them what my rate is, LOL, guess what? they did and I'm still employed there. I'd rather be respected and make an appropriate income than be a martyr, doing my dream job and making diddly. I am fortunate in that I didn't have to make that choice but in any event I would have and will if it ever comes to that again.
Good for you. I applaud you for not accepting that BS and instead pursuing what I can only imagine wasn't your first choice for appropriate compensation. I have also had a hospital admin say "we aren't going to pay a nurse that" when told them what my rate is, LOL, guess what? they did and I'm still employed there. I'd rather be respected and make an appropriate income than be a martyr, doing my dream job and making diddly. I am fortunate in that I didn't have to make that choice but in any event I would have and will if it ever comes to that again.
What did you tell them to get them to agree? I better save it word for word for when I graduate:yes:
What did you tell them to get them to agree? I better save it word for word for when I graduate:yes:
Well to back track a bit I had plenty of work so wasn't in need of this job, a well documented history of this pay range, was brought in by the medical director who had worked with me in a different facility and was pressuring them to make it happen which allowed me to be a bit smug.
So in response to "we aren't going to pay that for a nurse" I attempted to appear low key and light hearted as I said "I see, well you will if you want this nurse". They came back at me several more times with offers and I wouldn't budge until they met my rate. If I hadn't had the inside contact I would have been less smug, thanked them for their time and said if something changes please give me a call because I would welcome the opportunity to join their team. I have gotten most of the jobs I have applied for and haven't ever lowered my required rate.
Specializes in Obstetrics & Gynecology,Medical/Surgical.
Thank you all for your responses, especially the compassionate ones. I am indeed desperate for a position as this point, as every month I play the game of, "Which bill can I put off paying this time?" This is no joke; therefore I cannot put it off any longer. Some of you can clearly afford to turn down positions until you are offered the $$ what you want, but unfortunately I cannot do the same as I am now beyond one year out from graduation and finances have officially dwindled. I'm more convinced than ever that positions in Women's Health just don't pay the same as other fields (as also experienced by Dembitz, so clearly it's not just my area!) - and I have no interest in obtaining certification in any other field.
That all being said, I'm updating at this point for any future new NPs that might come across this thread and feel they are in the same position.
I negotiated a higher salary w/the job I previously mentioned, and got HR to increase it by $3,000/year, once again keeping in mind that I will pay almost nothing to provide my family health's insurance (less than $200/month) compared to other positions I interviewed. Health insurance to some people is probably not an issue, but I have young children and an active family, which translates to a lot of potential for injuries! Health insurance is a must for us. Furthermore, I will have the patient base, work schedule and hospital privileges that I requested, unlike other positions with which I interviewed and was basically told I'd see the same visit type all day every day with the exception of when a doctor steps out (this would be a huge waste of my skills!).
So, I accepted this position. Do I wish the salary was higher? Of course! But, I have to start somewhere and shake off this "new NP/no experience" attached to me.
I plan to renegotiate when I have my first review and have a better idea of how much revenue I am generating for the practice and have some solid data with which to make my argument - if needed. Obtaining input from you all has been very useful in what I will need to know and do!
What I love is negotiating a good salary and benefits. : )
I don't know what your particular circumstances are--but I'm actually relocating for a position. The pay is not high enough here, although we have a low cost of living, people will settle for a ridiculous salary to stay here. Therefore, the going rate for the area isn't exactly being propelled upward.
I recommend negotiating for a higher rate along with asking for some actual CME reimbursement, productivity, and a signing. It doesn't hurt to ask.
What do you lose from asking? Nothing.
Sure, the insurance is good, great. But they're cheap enough to pay you the rate of what you can make as a RN? They aren't giving you a chance for productivity? They aren't even giving you CME money? This doesn't sound like somewhere I'd want to dedicate my skills to..I'd keep looking. However, if you're set on it, negotiate on the higher side.
And why aren't they giving CME? I mean, don't they want their NP's to stay up to date with the latest info? That's embarrassing.
Be gracious about it, of course, they offered you a job. But don't be afraid to tell them, "Thank you for the offer, I really appreciate it...however, I thought about it and know I will provide great patient care and be a high performer--in order to do this job...I need A., B., and C..."
A large university hospital I went through a recruiter for apparently told him that they were paying 34.00 an hour to 55.00 an hour for INPATIENT ONCOLOGY. I told him, I definitely needed the higher end of that. I mean, we aren't volunteering. I can do that in my own time.
I get a bad vibe from the ones that lowball you for sure...I feel like they don't respect the profession.
A large university hospital I went through a recruiter for apparently told him that they were paying 34.00 an hour to 55.00 an hour for INPATIENT ONCOLOGY. .
I'm not sure I could have been gracious about that offer. I have a friend who is lovely, sweet and soft spoken she said with the most ladylike southern drawl "why then you will most certainly be getting what you pay for, but thank you kindly for your time". I ask her to tell me that story at every happy hour we attend together, its gold.
Specializes in ICU, Telemetry, Cardiac/Renal, Ortho,FNP.
Wow. That's RN money, not NP. I balked at $95K to start at a hospital. They thought the offer was fair (okay, newby salary is okay) but it had no other benefits (I don't need healthcare...got my wife's insurance and I can do my own annual physical...can't we all?). Very next offer topped it by $10K, other bene's, lower stress, 5 minute commute, etc. I just wouldn't sign any contracts to stay for that kind of money. Yes, take what you can get to have that magical DEA number and first year under your belt but for all our sake don't keep a underpaying (that isn't even low...it's underpaid) gig.
RNpandoraRN
98 Posts
PsychGuy - I've noticed that psych NPs definitely make more than other APRN fields. I frequently see ads in my area, or on recruiting sites. Kudos to you for being a PNP; mental health is definitely not my forte! Definitely could not pay me enough to deal with the complexity of mental health issues.
I've also observed that FNPs, ANPs in the fields of Neurology, Acute Care, etc. tend to make more money in my area. My field - obgyn, women's health, even midwifery - seems to be the red-headed step child in the area.
This job I'm negotiating with...there are 13,000 full time employees with this institution. The associated hospital with the clinic has 160 beds. Someone previously mentioned a salary matrix and I'm sure this is exactly what they use to determine salaries. We're talking about an institution in which the athletic coaches make nearly $1 million but the health care providers (physicians included) make well below national average. I don't know if it is also because it is a teaching hospital, as well. At any rate, I don't think an institution this size is a beast I can fight, and frankly, I need to get in the door NOW as I am already one year out from graduation and that is only hurting me (I was already asked in other interviews why I haven't been practicing all this time).