NP salary too low?

[abcdefg]

I have recently accepted a NP position in North Carlina for 77K. It is a federal job with 7 weeks leave, comfortable working hours, no call and excellent benefits. Still, I have one year of experience in neurology (the new position is in the same specialty) and three years as a RN. I can't help feeling I am being underpaid. The position is marginally more than I make now.

Thoughts?

[alwayslookingnp]

I have been an NP for 5 years and still make less than many RNs and make about 4 dollars/ hr less than I did as an RN in 2007.

[nomadcrna, DNP, CRNA, NP]

1. Become an NP before giving us your opinion on the differences between physicians and NPs.

2. You are very insulting. Really? I think you are just trolling. That statement is one of the more ignorant things I've seen posted.

MDs are paid for their expertise and skill that they have acquired over many years of academic and practical training.

[traumaRUs, MSN, APRN]

While the salary quoted might be low for an NP, to compare NP to MD is ludicrous.

One thing you will learn as an NP is to have respect for all members of the healthcare team. Get in over your head and with a negative attitude, you will get hung out to dry. However, be respectful to everyone and the MDs will also have your back.

[nomadcrna, DNP, CRNA, NP]

Respect is a two way street. What you say above works both ways.

All members of the team should have respect for one another.

All providers should be careful of getting in over their heads.

All providers should not have a negative attitude.

NPs and PAs should be shown the same respect and we will also have THEIR backs.

to compare NP to MD is ludicrous.

I disagree. After doing anesthesia for over 20 years. The exact same job. No difference in any way in regards to my anesthesia services, procedures or types of patients. Independent practice, I might add.

Doing primary care, pain, ER and inpatient care. Seeing MDs, DOs, NPs and PAs come doing locums to help cover the hospital ER and their clinic. We do the exact same job, no difference at all here in rural America. I've seen good and bad in the groups. I would like to clarify though. The locums MD/DOs have all been family practice and one preventive medicine physician. I'm not trying to compare specialist such as ER physicians and such to my medical practice.

At this hospital we(NPs) are full members of the medical staff. In the next decade, the perceived gap will continue to close between NPs and physicians. I see more NP programs, DNP in particular are changing the curriculum. Less EBM and more meat & Potato.

I see more specialty education offerings.

[TicAL]

1. Become an NP before giving us your opinion on the differences between physicians and NPs.

2. You are very insulting. Really? I think you are just trolling. That statement is one of the more ignorant things I've seen posted.

MDs are paid for their expertise and skill that they have acquired over many years of academic and practical training.

I don't understand what's offensive about "MDs are paid for their expertise and skill that they have acquired over many years of academic and practical training." There's nothing in there to be offended by. MDs go through vigorous training and many years of sacrifice to get their rewards. I understand NPs go through schooling as well, but it just doesn't compare to the complexity and difficulty of attaining an MD. You can argue back and forth with me about this, but the curricula, years of practical experience, and high educational standards for entrance to be an MD, can't be denied.

There's absolutely nothing wrong with wanting to be an NP/CRNA. But if you want to start having the exact same compensation/respect/autonomy as an MD, then maybe that's the route to go. I don't understand what's so controversial about that.

[studentdrtobe]

While the salary quoted might be low for an NP, to compare NP to MD is ludicrous.

One thing you will learn as an NP is to have respect for all members of the healthcare team. Get in over your head and with a negative attitude, you will get hung out to dry. However, be respectful to everyone and the MDs will also have your back.

I don't understand what's offensive about "MDs are paid for their expertise and skill that they have acquired over many years of academic and practical training." There's nothing in there to be offended by. MDs go through vigorous training and many years of sacrifice to get their rewards. I understand NPs go through schooling as well, but it just doesn't compare to the complexity and difficulty of attaining an MD. You can argue back and forth with me about this, but the curricula, years of practical experience, and high educational standards for entrance to be an MD, can't be denied.

There's absolutely nothing wrong with wanting to be an NP/CRNA. But if you want to start having the exact same compensation/respect/autonomy as an MD, then maybe that's the route to go. I don't understand what's so controversial about that.

Well said.

It's exactly the kind of attitude that nomadcrna has that leads to conflicts between physicians and NPs. That's one of the reasons physicians were/are so riled up about the comments that Mary Mundinger makes.

If you know your place in the delivery of care and play your part on the team, no one will have any issue with what you do. It's when egos start coming into play and people overstep their bounds when communication and respect breaks down. I'm glad to be surrounded by great faculty as well as midlevels (both NPs and PAs, both of whom work interchangeable roles in my hospital system) where egos are left at the door and the focus is on patient care.

[nomadcrna, DNP, CRNA, NP]

So lets break down my education.

BSN 4 years

ICU required 1 year

CRNA 3.5 years

FNP 1.5 years

DNP 3 years

oh my, thats 13 years. Of course that does not include the 12 years I spent in ICU/CCU and ER. That experience is worthless, right?

Family Practice physician

4 years pre-med

2 years didactic med school

2 years clinical rotation med school

1 year internship

3 years residency

hmm, that is only 12 years.

And yes, I took organic, biochem and such. And yes, I had both masters level and doctoral level pathophysiology and pharmacotherapetics.

I had double the pharm hours required of medical students.

So where is the huge difference? Where are the sacrifices they made that I did not make?

I'm not special. There are many NPs out there with more education than I. Many on this board with more education.

This is why you need to be a NP first before giving your opinion. It would further help if you actually went to a QUALITY DNP program before comparing the differences in education.

It is very obvious that you are not even an RN. I could be wrong but I'd bet you are a med student and here trolling. I went back and read all your posts. Every one negative towards nurses and nursing in general.

Are med students so insecure that need to come here?

I apologize to the other readers. After reading his posts in other threads, I'm a bit irritated.

[TicAL]

So lets break down my education.

BSN 4 years

ICU required 1 year

CRNA 3.5 years

FNP 1.5 years

DNP 3 years

To all of the NPs that state that no mid-level thinks they are equivalent to a doctor, read some of nomads posts on here. It's attitudes like his that makes physicians a little nuts and wanting to fight the NP movement. Since you decided to take the time to try to state your equivalency to an MD, I'll go ahead and refute it.

BSN: Fine, MDs need a BS degree as well. The only issue is that MDs need to perform exceptionally well in their undergraduate studies to move on to the next step in their training, whereas passing grades are sufficient for advanced nursing studies.

ICU: Not academic. Learning to nurse, not learning medicine.

CRNA/FNP: It took you 5 total years for this? There's no way it would take that long, unless you were going part time...which is what I suspect. The combined education if you went full time would be close to 3 years, nice try at inflating though I suspect a medical student would complete these studies in a year and a half based on vigor of their studies.

DNP: 3 years? Really? Again, this must be part time. Full time it would be two years (maximum, probably closer to 1.5 years). Most of these credits are fluff credits (practice management, ethics, etc) so most of this doesn't really make you a better practitioner anyways. Here's Columbia's curriculum so you can't say that I'm making that up: http://sklad.cumc.columbia.edu/nursing/programs/dnp.php

So correcting for your inflation, you truly have 5 post-undergraduate years of training, some of which is not at all related to actually treating patients. I'm sorry, but that does not earn the right for being equivalent.

Look, I understand you've spent a lot of time in the system and I'm not trying to put you down. Everybody has a different role and different skills they can bring to the table, but trying to claim that your work is equivalent to the sacrifice made by those in medicine is extremely insulting to those who have gone through it themselves.

[nursetim, NP]

TicAL, while I agree about ICU, DNP programs seem to run 3 yrs full time, FNP post grad cert runs 1-2 yrs.

To say med students could complete 5 yrs in 1.5 yrs is antagonistic and a spurious

argument at best.

I also agree there is a ton of fluff in DNP programs that takes up important clinical time, IMHO.

[nomadcrna, DNP, CRNA, NP]

LOL, Tical,

Your trolling is amusing. You must feel really insecure to have to come here with us lowly nurses to debate who is better.

Just a quick refute on the ICU first.

I read EKGs better than any physician I've worked with except for cardiologists. I learned that in CCU. Oh wait, I can't learn anything useful. That is just one example. I could spend all day listing them.

CRNA school was 7 full semesters of 8-12 hour days back then. Count them up. The only reason the FNP program was 1.5 years is because I already had all the basics done in my CRNA program. Otherwise it would have been longer.

But to be fair, even though my ICU directly effects what I do as a CRNA, I'll drop that. I'll also drop the internship year for the dermatologist, radiologist, ortho surgeon etc has that really has no bearing on what they do. I don't know how many times the ortho guys tell me they know nothing about medicine anymore.

Sometimes the truth can be insulting to someone who thinks they own medicine. Keep trying. I understand how truly little med students know and understand. I would try and be kind and teach them how to intubate or place an LMA. It was a rare occurrence when one was successful though. The 3rd and 4th year med. students did not have enough knowledge to discuss the pharmacology and physiology behind anesthestics so I kept it pretty simple. They were fairly decent at anatomy. Some could even describe the axillary bundle when I did an interscalene or axillary block.

This will be my last reply in this thread to you. I learned a long time ago to NOT FEED THE TROLLS.

[Chris Caulfield RN NP-C]

TicAL,

Medical Students need to do "Exceptionally well in their studies to move on to the next step of their training"? Not according to some of the average GPA's for Osteopathic and Caribbean Medical Schools.

The NP schools I am applying to all require a 3.0+, I don't know if that classifies as just passing. There are many students with not so stellar GPA that get into medical school. I am sure you have checked out "mdapplicants.com" some of the admitted student have just passed if we are speaking of a 3.0+ and above.

There are many students with 4.0 and 3.1 undergraduate GPA's in both medicine, and advanced practice nursing.

[RealNurse419]

After all that schooling, there was a resident who came down to pronounce my patient (who was still on the vent) ask "why does this patient still have breath sounds"..just to add some much needed humor to this thread :-D