NP Salaries/Location/Specialties

luckylady5 · Jun 28, 2015

Jules A - can you give any more details about your background and current job and experiences? I'm in a Boston suburb and have wanted for years to go back to school for PMHNP. I have a family and a little nervous about the time and financial commitment and that the outlook won't be as great by the time I'm ready for a job. Thank you for any info :)

Jules A, MSN · Jun 28, 2015

Jules A - can you give any more details about your background and current job and experiences? I'm in a Boston suburb and have wanted for years to go back to school for PMHNP. I have a family and a little nervous about the time and financial commitment and that the outlook won't be as great by the time I'm ready for a job. Thank you for any info :)

I started as a LPN and worked as a psych nurse on inpatient units prior to and during NP school which served me well for both experience as well as professional contacts. Most of my best jobs as a RN, instructor and NP came from insider information, someone who knew me and wanted me on their team. As a psych NP I mostly work inpatient but have one outpatient job where I work at a physician's practice who I have known since I was a LPN.

I do think things are as good as they are going to get now that every 19yo in my undergraduate clinical groups have their sights set on being a NP without ever working as a nurse. As the numbers increase the wages and quality of care will likely decrease. Just my opinion and what I have seen in other fields. That doesn't mean that it won't still be a great career just that the opportunities might not be as abundant or lucrative. I'm fortunate that I have a decent foot hold in the local market and also am heading into the last decade of my career so I'm trying to keep a handle on the worry. If you truly love psych and want to do this work I would encourage you to consider it.

"The future workforce is projected to grow to 244,000 in 2025, an increase of 94% from 128,000 in 2008. If NPs are defined more restrictively as those who self-identify their position title as NP,â€ supply is projected to grow from 86,000 to 198,000 (130%) over this period."

Medical Care:

July 2012 - Volume 50 - Issue 7 - p 606â€“610

notnursezelda · Jun 29, 2015

Interesting information. .. are there any other np specialities that are in high demand or are on the higher pay scale?

edmia, BSN, RN · Jun 29, 2015

I didn't say anyone on this thread said NPs are unworthy. I meant the general feeling (by MPs I've known and some people on these forums) is that NPs should not expect to make much more money than their regular nursing salary. I also see that reflected in these threads about salary when people speak of what to expect as an NP.

I just wonder if the culture of nurses being lower on the pay/respect hierarchy that is prevalent in the healthcare system is being carried onto the advanced practice field. I don't think this is good for business or the well-being of the profession. No NP should start below $100,000 in any area of the country in my opinion. That's just my feeling on the issue and I wish more NPs asked for fair pay. That's all.

Sent from my iPhone -- blame all errors on spellcheck

Jules A, MSN · Jun 29, 2015

I didn't say anyone on this thread said NPs are unworthy. I meant the general feeling (by MPs I've known and some people on these forums) is that NPs should not expect to make much more money than their regular nursing salary. I also see that reflected in these threads about salary when people speak of what to expect as an NP.
I just wonder if the culture of nurses being lower on the pay/respect hierarchy that is prevalent in the healthcare system is being carried onto the advanced practice field. I don't think this is good for business or the well-being of the profession. No NP should start below $100,000 in any area of the country in my opinion. That's just my feeling on the issue and I wish more NPs asked for fair pay. That's all.
Sent from my iPhone -- blame all errors on spellcheck

I think it is somewhat due to the nursing culture and also that we are largely a female dominated field. Oddly enough some of the greatest resistance and negative feedback I have received has been from fellow NPs, who aren't making much money btw. Some things I have heard and my thoughts in parenthesis:

-I'm not doing this for the money (really? well I certainly am)

-I'm doing it for the experience (ok maybe I'll buy this but after 6 months I'd be packing my bags)

-But its XYZ Hospital do you know the opportunities I will get? (hopefully some that pay decently)

-There are other benefits to working here than just monetary (I'd like to know just what those benefits include since the person who said this was making $60,000 a year less than I make)

-If I don't do it who will? (one of my least favorite co-dependent nurse phrases ever)

-I won't work somewhere awful just to make money (yeah neither will I and fwiw I have been able to make great money while working at nice places)

-I was hoping they would offer me more (Are you kidding me?)

These low paying jobs would not exist if someone wasn't willing to fill them. I go into job opportunities letting the prospective employer know my salary requirements up front. I do not wait for them to make me an offer and then attempt to barter. The bottom line is the more supportive and transparent we are with each other and the more we think like business people the better our income and credibility will be.

Jules A, MSN · Jun 29, 2015

Interesting information. .. are there any other np specialities that are in high demand or are on the higher pay scale?

To the best of my knowledge in my area Acute care and CRNAs are the other money makers.

Rocknurse, MSN, APRN, NP · Jun 29, 2015

I think it is somewhat due to the nursing culture and also that we are largely a female dominated field. Oddly enough some of the greatest resistance and negative feedback I have received has been from fellow NPs, who aren't making much money btw. Some things I have heard and my thoughts in parenthesis:
-I'm not doing this for the money (really? well I certainly am)
-I'm doing it for the experience (ok maybe I'll buy this but after 6 months I'd be packing my bags)
-But its XYZ Hospital do you know the opportunities I will get? (hopefully some that pay decently)
-There are other benefits to working here than just monetary (I'd like to know just what those benefits include since the person who said this was making $60,000 a year less than I make)
-If I don't do it who will? (one of my least favorite co-dependent nurse phrases ever)
-I won't work somewhere awful just to make money (yeah neither will I and fwiw I have been able to make great money while working at nice places)
-I was hoping they would offer me more (Are you kidding me?)
These low paying jobs would not exist if someone wasn't willing to fill them. I go into job opportunities letting the prospective employer know my salary requirements up front. I do not wait for them to make me an offer and then attempt to barter. The bottom line is the more supportive and transparent we are with each other and the more we think like business people the better our income and credibility will be.

I agree with your attitude and admire it. I would like to ask you though, at which point in the hiring process do you make it clear what your salary range is. At the interview? After you've received an offer? I've always heard it's pretty unacceptable to mention money before an offer has been made. I'm just curious what your practice is as it obviously works!

Jules A, MSN · Jun 29, 2015

I agree with your attitude and admire it. I would like to ask you though, at which point in the hiring process do you make it clear what your salary range is. At the interview? After you've received an offer? I've always heard it's pretty unacceptable to mention money before an offer has been made. I'm just curious what your practice is as it obviously works!

Great question. All but one of my NP jobs have been through contacts that I previously had so they knew me and wanted me which makes things easier. This is also another reason to really nurture your physician contacts while you are working as a nurse.

I don't ever talk to HR first. I negotiate the actual job, duties and hours, with the medical director and usually tell them right up front what my wage requirements are. The good news is since they are physicians they could care less how much I get paid, think I'm asking for peanuts compared to their wages, know I will be worth every penny and expect administrators to just make it happen. Sometimes it takes a few rounds of "this is my rate, do you want my services?" with administrators but I haven't ever taken less than what I initially asked for. Fortunately I have always had more work than I needed so its never a matter of having to compromise because I was in a bind.

Rocknurse, MSN, APRN, NP · Jun 30, 2015

Thank you for that. I plan on fostering that attitude and I realize how important my relationships will be during clinicals. I'm gonna make them want me! :inlove:

I always say that that initial rate will determine what you earn for a very long time because there are only so many percentage points you'll get as a raise each year. Might as well start off high! Thanks again.

Jules A, MSN · Jun 30, 2015

Its always interesting to me that more of the experienced NPs aren't willing to jump in on discussions like this. I have to wonder if it isn't because they didn't negotiate to get a decent wage?

To send our new grads out without a clue on how to negotiate and what to expect for compensation doesn't help anyone, imo. It doesn't cost me anything if they make a good rate and I definitely don't want people willing to work for significantly less.

harmonizer · Jun 30, 2015

That sounds like a horrible life honestly. Have you been in an exam room with a psych patient with multiple issues? Suicidal thoughts, bipolar disorder, etc??? 15 minutes per patient ? 16 hour days? That NP does not make 220K per year. .

Yep. Yep. Yep. It's HELL on earth to have 4 patients per hours. :nailbiting: I see 2 patients per hour and if I work 6 days per week, I would make that much with CONTRACT, not salary. I am already feel overwhelmed with my schedule booked up. Imagine 4 psych patients an hours! 32 patients per 8 hr shift!! When does this NP got to document? Yep. On her weekends or night time or at dinner time!! And remember more documentation for psych than medicals...

Remember that this is probably not a salary. It is probably a contract job per patient paid.

So she needs to take 6.75% out of that salary for self-employment tax, may be $15,000 out for PTO, $6000 per year out for health insurance, and may be $15,000 out for 401k, and may be 1/3 of her salary adjusted for seeing that many patient- normal pace is 2 follow-up per hours. Adjusted salary would be around $140k, which is far less than that!!

Jules A, MSN · Jun 30, 2015

Remember that this is probably not a salary. It is probably a contract job per patient paid.
So she needs to take 6.75% out of that salary for self-employment tax, may be $15,000 out for PTO, $6000 per year out for health insurance, and may be $15,000 out for 401k, and may be 1/3 of her salary adjusted for seeing that many patient- normal pace is 2 follow-up per hours. Adjusted salary would be around $140k, which is far less than that!!

Excellent point although we don't know if she is 1099 or not. This is the first thing people say to me when I tell them my rate and they are incorrect. At this time I am an employee at all my jobs although I only get health benefits from 1 of them. And I think your figures are rather high. I'd love to find an employer contributing $15,000 to my 401k! Personally I'd figure at $220,000 contractural would be more like $185,000 if you are paying your own FICA, insurance and lack of vacation time, which is still a nice income, imo.