NP Salary/Pay Let's Be Transparent

Specialties NP Nursing Q/A

Transparency is important so we can negotiate. As a new grad nurse practitioner I accepted a ridiculously low paying position and I assumed that was the pay in the new city I move to. I have grown over the past couple years and I understand I was taken advantage of. I hope that this doesn't happen to others. Therefore, I believe it is critical we know what other nurse practitioners are being compensated so we are able to negotiate our salary and benefits packages.

I'm an FNP-C in Houston area working in Surgery (first assist, preop, and follow up post op care) Salary is 110k (negotiating to 115k), 3 weeks pto, 9 paid holidays, 1500 CME/yr, paid DEA, malpractice, 401k without match, 4 day work week (40-50hrs), on-call practically all the time (but only get calls on surgery days 2-3days/week). Overall I'm happy with the work I do.

What is your compensation package look like?

Specializes in Cardiac.
myoglobin said:

PMHNP graduated Oct 2019 working in the Seattle area on pace to earn around 250K three days per week seeing patients. No benefits 1099. Also I work from home and see clients only through telemedicine. My SO has been a PMHNP since 2016 and sees Medicaid patients (mostly few Medicare and private pay) in Arizona and earns $85.00/hr no benefits 1099 also working from home.

Do FP NP make less than PMHNP's?  On the whole I mean?

 

Specializes in Post Acute, Home, Inpatient, Hospice/Pall Care.
jnb1740 said:

Do FP NP make less than PMHNP's?  On the whole I mean?

Yes, they 100% do! At least here in the NE they certainly do.  One of my first jobs I did telehealth mental health, it was 1099 (you get KILLED in taxes UGH) and I worked from home. I opted to only see patients with anxiety, depression, ADHD, some SUD, basic things that I have knowledge of. I let the PMHNPs and MDs handle the bipolar I & II, the schizophrenia, schizoeffective, personality d/o, all the heavy stuff because that is their specialty.  They are paid a lot more because they are in a specialty that can be really heavy. I'm sure there are jobs like I had with the basics but if I did all that school I'd want to practice at the top of my license. FNPs are going to become the backbone of primary care and other areas, the physician shortage is only going to increase and we will be the ones people turn to. Totally off topic, but this is why I feel RN's should have to work at least a few years before starting an NP Program, we build off our practice, if you haven't practiced and are jumping into the NP role, that can be dangerous. 

jnb1740 said:

 

 

Specializes in Cardiac.
RN_SummerSeas said:

Yes, they 100% do! At least here in the NE they certainly do.  One of my first jobs I did telehealth mental health, it was 1099 (you get KILLED in taxes UGH) and I worked from home. I opted to only see patients with anxiety, depression, ADHD, some SUD, basic things that I have knowledge of. I let the PMHNPs and MDs handle the bipolar I & II, the schizophrenia, schizoeffective, personality d/o, all the heavy stuff because that is their specialty.  They are paid a lot more because they are in a specialty that can be really heavy. I'm sure there are jobs like I had with the basics but if I did all that school I'd want to practice at the top of my license. FNPs are going to become the backbone of primary care and other areas, the physician shortage is only going to increase and we will be the ones people turn to. Totally off topic, but this is why I feel RN's should have to work at least a few years before starting an NP Program, we build off our practice, if you haven't practiced and are jumping into the NP role, that can be dangerous. 

 

So if a FP NP makes LESS than a PMHNP, why would someone choose the FP NP route?  I'm an RN for 30 yrs myself, but thinking (I know late) of getting an NP and wondering what kind to get.

jnb1740 said:

So if a FP NP makes LESS than a PMHNP, why would someone choose the FP NP route?  I'm an RN for 30 yrs myself, but thinking (I know late) of getting an NP and wondering what kind to get.

Some of that comes down to what you want and what you believe you can be best prepared for. When I got my FNP, I wanted to with in preventative medicine. I never worked with mental health before and couldn't see myself working in that environment. The money is better in a lot of specialized nursing fields. CRNA to name one. But I didn't have the background or really the interest to pursue those areas. 

Specializes in ICU/Med-Surg.
ZyzzFan said:

Psych NP, private practice owner

Did 510k this year, finally broke the 500k mark after a few years.  Enforcing no show fees has been a game changer for me.  Granted I work M-F 10 hour days and didn't miss a single day of work this year with no vacation.  

The money is out there

510k in Texas..!? OMG.. do you think it is possible to get that as FNP? do you recommend going into Psyc? I was literally considering jumping into CRNA or something else due to salary, but your comment just caught my eye. Were there any changes at all after covid?

Specializes in Physical Medicine & Rehabilitation.

About to approach my first year as a "working NP." Started my first job earlier in 2023 doing contract work doing annual wellness visits, in home ($125) and tele ($90). I was too excited at first, but after a few weeks starting, I realized my covering area had little patients under the insurances we were with. Stuck it out (didn't really make much money since patient census was ungodly low) until my contracting company received a contract with the VA to do medical exams for their disabilities benefits program. It was was $100 per hour (2 patients at most per hour) and this became my full time gig until, well, there was some sort of nationwide system error in August/September that messed up their whole system and nearly wiped out scheduling and appointments. Basically held on the last few months holding out primarily on the VA gig to go back to a normal full time scheduling. After waiting until mid December, I realized that I can't just sit around forever.

I was just recently was offered and accepted a position as an Physical Medicine & Rehabilitation (PM&R) provider for a sizeable, MD owned PM&R company to see patients at one to two SNFs. They offered $128k/year, full benefits, and $1500 per year for CME. Since I was considered a new grad, I did not mind at all as I literally had no experience except doing physical exams for the VA and the annual wellness visits. Included was a paid 4-8 week training (shorter or longer depending on my needs) which including precepting/shadowing different physicians and providers including the CEO in addition to learning from videos/lectures and reading material.

While this process was going on, the VA gig started to pick up so I had started to schedule myself for Saturdays (and hopefully Fridays too in the future) for 7 hours every week which on paper ends up being an addition 33k/year.

Specializes in PMHNP.

PMHNP, Psych Nurse for 12 yearsish.

First "job" was a VA Residency for 1 year.  80k for 1 year.  Lots of experience, PGY-1 Certificate.  Full federal benefits.

Second job was an MAT clinic.  123k a year + incentives and bonuses.  Averaged out to around 140kish.  Full hospital benefits.  (P Northwest USA)

Third/current job is psychiatry outpatient for a privately owned business.  Full benefits.  170k + bonus structure on productivity. (P Northwest USA)

Specializes in Psychiatric and Mental Health NP (PMHNP).
jnb1740 said:

So if a FP NP makes LESS than a PMHNP, why would someone choose the FP NP route?  I'm an RN for 30 yrs myself, but thinking (I know late) of getting an NP and wondering what kind to get.

People pick the specialty they are interested in and want to work in.  FNP pay is really going up, at least on the West Coast, and is approaching PMHNP pay.  Mental health is a difficult specialty - it can be very emotionally draining.  A lot of people just do not want to deal with the mentally ill nonstop 8 hours a day, 5 days a week.  So please do not pick a specialty just based on pay.  Pick what you have a passion for and enjoy.  That will help you be a good provider.

Specializes in PMHNP.
FullGlass said:

People pick the specialty they are interested in and want to work in.  FNP pay is really going up, at least on the West Coast, and is approaching PMHNP pay.  Mental health is a difficult specialty - it can be very emotionally draining.  A lot of people just do not want to deal with the mentally ill nonstop 8 hours a day, 5 days a week.  So please do not pick a specialty just based on pay.  Pick what you have a passion for and enjoy.  That will help you be a good provider.

100% this.  Please do not go into psych just because the pay is better.  Even if you end up landing a super-easy gig, its still a lot more patient interaction than medical visits.

There are also lots of no-shows, medication non-compliance, crisis intervention, etc.  I hear often that other NPs are jealous that we get longer appointment times, but honestly sometimes 30 minutes is not even enough when someone is off their meds, using substances, suicidal, doesn't have money for medications, and wants to talk about their relationship issues.

Specializes in Post Acute, Home, Inpatient, Hospice/Pall Care.
jnb1740 said:

So if a FP NP makes LESS than a PMHNP, why would someone choose the FP NP route?  I'm an RN for 30 yrs myself, but thinking (I know late) of getting an NP and wondering what kind to get.

I have zero desire to be a psych NP, some metal health issues are so complex and you have to want to treat those conditions.  I do some psych for my primary care patients, but only basics like anxiety, depression, ADHD.  I worked as a telehealth mental health NP in my first year of practice so I am comfortable with those Dx and RX.  I want to treat patients medical/physical health problems and their basic MH if needed.  I don't make as much as the PMHNPs around here but it is what it is, they chose their path and I chose mine. I think overall NP's are undervalued.  It's never too late to do something you want to do. I was no Spring chicken when I got my ASN, then BSN and finally MSN. Do what makes you happy! I love this role and am happy I took this path ?

Specializes in Physical Medicine & Rehabilitation.
FullGlass said:

People pick the specialty they are interested in and want to work in.  FNP pay is really going up, at least on the West Coast, and is approaching PMHNP pay.  Mental health is a difficult specialty - it can be very emotionally draining.  A lot of people just do not want to deal with the mentally ill nonstop 8 hours a day, 5 days a week.  So please do not pick a specialty just based on pay.  Pick what you have a passion for and enjoy.  That will help you be a good provider.

^ The exact truth. @jnb1740

I went into FNP knowing that I did not want to do FP/ at all but it was the baseline to get in order to get into other specialties. There are definitely well compensated jobs outside of FP, it just may take some time and also just depends on what you want to do do. From my experience and hearing from fellow PA's and FNPs, decently compensated gigs outside of FP are wound care, annual wellness visits, and mobile primary care gigs. And more recently, VA medical examiner is definitely something worth looking into for a well compensated job that requires no experience.

But as always, go for something you are interested in, but sometimes you won't know until you try it out!

Specializes in PICU/ NICU/ ECMO.

Just sharing my insight, I think Nurse Practitioners (NPs) don't even make enough compared to nurses, but I guess it's because they have less bedside load. I have been working as a Pediatric Intensive Care Unit (PICU) nurse for 20 years and I am now a new PNP with experience in both acute and primary care. As a PICU nurse (MD) in a big hospital, my base pay is $49 per hour plus a 10% night differential, a $4 location benefit, and a 15% weekend differential. I also get 40 hours of vacation time and 5 days of sick leave. If I do overtime, I get paid 1.5 times my regular rate and I may also receive a bonus for the shift, like $200.

Now, as an NP, I have given three interviews and have received nearly the same offer from each.

1. If I work in the same hospital's outpatient department, my pay will be $52 per hour, with no differential or location allowance. I will receive $1000 for Continuing Medical Education (CME), one-time DEA and CDS. Other benefits will be the same as every staff member in the organization, such as discounted medical insurance and vacation and sick leave. I will work for 30 hours.

2. Another hospital ,If I work as a Peds Inpatient ICU NP, I will earn a flat rate of $62 per hour with no benefits. I will only work for 12-hour shifts but only one shift at a time. I guess this may be a start, but I was hoping for better, as being an NP would be a serious hit in pay.

Please don't keep your hopes high, as the pay for new NP in MD is around $50-60 per hour.

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