NP pay mid-career

Jules A, MSN · Feb 18, 2018

It varies widely among NPs of all experience levels. As of right now I am making $80,000 a year more than someone from my graduating class. In my opinion although there are geographic location and specialty implications the biggest variables are whether the person is business minded, willing to negotiate and or walk if employers don't value their worth.

Oldmahubbard · Feb 19, 2018

I agree with Jules. It depends on so many factors.

I know people who graduated the year I did, and have creditors calling, no money whatsoever in the bank, and drive a 2003 vehicle that they pray over daily.

I also know NP couples who are part of the 1% of their local area.

ToBeMSNNP · Feb 21, 2018

What is approximate raise per year usually?

Jules A, MSN · Feb 21, 2018

What is approximate raise per year usually?

In my experience minimal, whatever the 2-3% COL the general hospital employees get unless you negotiate for a larger raise. It is difficult to get more after the fact unless you have another offer for leverage or are valued and willing to walk. This is why it is important to have you act together out of the gate. For the most relevant information you really need to ask your local NP peers.

ToBeMSNNP · Feb 21, 2018

oh.It is miniscule raise.So it is rare to get more in the same facility

Oldmahubbard · Feb 21, 2018

Physicians see huge dollar signs when we walk in the door.

"Here is someone I can work like a dog, and they'll generate 300 or 400k in billing, but not mind working for 100k".

I actually got a big pay cut after working for a psychiatrist for several years.

It was going fairly well, we were starting to get relatively busy.

Even though she knew that our "show rate" for appointments was about 70%, pretty average in the field, I was told that I could not book more than 2 patients an hour.

Many of them had a therapist, and some only wanted to stop by to pick up their scripts.

So over night, I went from seeing about 3 patients an hour, to seeing about 1.5. And I was paid by the patient, on the basis of the reimbursement, and not by the hour.

A 50% pay cut, and I immediately resigned.

Anyway, it is unlikely that you will start a job, any job, not just NP, at a given pay rate, and ever get much more than a cost of living raise unless you get a large promotion.

There are a few exceptions.

On average, employers tend to offer the minimum amount needed to keep you.

That being said, I do see NP salaries rising in some areas.

Possibly because folks did the math, and realized that it wasn't worth it to go from RN to NP with a 600 dollar loan payment and a raise of maybe 10k.

djmatte, ADN, MSN, RN, NP · Feb 21, 2018

Physicians see huge dollar signs when we walk in the door.
"Here is someone I can work like a dog, and they'll generate 300 or 400k in billing, but not mind working for 100k".
I actually got a big pay cut after working for a psychiatrist for several years.
It was going fairly well, we were starting to get relatively busy.
Even though she knew that our "show rate" for appointments was about 70%, pretty average in the field, I was told that I could not book more than 2 patients an hour.
Many of them had a therapist, and some only wanted to stop by to pick up their scripts.
So over night, I went from seeing about 3 patients an hour, to seeing about 1.5. And I was paid by the patient, on the basis of the reimbursement, and not by the hour.
A 50% pay cut, and I immediately resigned.
Anyway, it is unlikely that you will start a job, any job, not just NP, at a given pay rate, and ever get much more than a cost of living raise unless you get a large promotion.
There are a few exceptions.
On average, employers tend to offer the minimum amount needed to keep you.
That being said, I do see NP salaries rising in some areas.
Possibly because folks did the math, and realized that it wasn't worth it to go from RN to NP with a 600 dollar loan payment and a raise of maybe 10k.

To be fair though, 100k is a substantial pay bump for someone who's been an RN for years. As you stated they will pay just enough to get you or keep you, but until you have a few years under your belt the bargaining power is limited in many markets. Hospitals make millions off of surgeons they pay a fraction of reimbursement costs. That surgeon can all day set up their own surgery center and bank off they play their cards right, but that's not something everyone is in a position or had the capacity to undertake. Obviously we should push our boundaries, but don't want to push so hard we aren't the cost savings they or the general public was hoping for.

Oldmahubbard · Feb 21, 2018

I am told, have heard from many reliable sources, that so many RNs are now making 90k with their ADN and a little overtime, that they laugh about becoming an NP.

Keep in mind, the NP almost never works the night shift, weekends or holidays, and is not even eligible for overtime. This is how most RNs are making their money.

It is an improvement in the quality of life, ie the better schedule.

This is nothing new. There was zero money when I went into it 20 years ago.

It is all about the market. This is why we have threads about NPs who regret it.

Even for a 20k raise, after taxes, it's 1000 dollars a month take home, and then subtract the loan payment.

NPs have resulted in little to no cost savings overall in the health care system.

For multiple complex reasons.

djmatte, ADN, MSN, RN, NP · Feb 21, 2018

Obviously location is highly impacting on this, but the only RN I've ever met making near 90k is my wife who has a ADN at 103 (plus travel). But that's after working years at management level of a national senior living company. An RN making 90k is busting serious overtime or had the luxury of a non benefited pool position, or is a traveler. Which by far isn't the norm. 7 years of experience and my actual take home was 72k and most hospitals around urban Michigan stress topped out at 40/hr. Now in Hawaii we had an uber driver who was an RN and it the gate bye made 40/hr and he said that wasn't even enough to live on. So sometimes money is relative.

Oldmahubbard · Feb 21, 2018

I have known many RNs at this income level. Some become Nurse Admins with NY state and work the night shift. Easily 90k, and in a low cost area.

I know people who work for the for-profit LTC industry. They travel the state and work long hours, but 110 plus is not unheard of.

My sister retired from a company out West that paid her 100k, but it was a high cost of living area.

The market.

I would say, do not do an NP mostly for the money, you will probably be disappointed. On average.

djmatte, ADN, MSN, RN, NP · Feb 21, 2018

I have known many RNs at this income level. Some become Nurse Admins with NY state and work the night shift. Easily 90k, and in a low cost area.
I know people who work for the for-profit LTC industry. They travel the state and work long hours, but 110 plus is not unheard of.
My sister retired from a company out West that paid her 100k, but it was a high cost of living area.
The market.
I would say, do not do an NP mostly for the money, you will probably be disappointed. On average.

Ltc it certainly is norm. My wife for instance is always involved in her job. Consistently managing her nurses as those facilities are 24/7. The trade off is the pay, travel money, and flexibility to work from home s she deems. But there's few rns that aren't putting in a ton of hours or sacrifices to hit those high numbers. Through generally I agree that np certainly isn't for the money. It certainly is asking the fastest way to 100k in nursing without really over working yourself.