As a PMHNP who is also helping recruit NPs for our practice, I am running across new grads who have no idea what a realistic salary range is. Especially for new grads, I strongly urge you to look at job boards and postings to get an idea for the salary range in your desired specialty and location. This will allow you to make a realistic compensation request from future employers. Asking for too much does not make a good impression on a prospective employer. Hint: If a pay range is given, as a new grad, do not ask for the high end of the range! You are competing against NPs who may have 10 years or more experience in that specialty. Those are the NPs that are going to get the highest pay.
Your NP Program should also give you some realistic pay ranges for a new grad of that program. That's what my program did. If they haven't done so, ask your advisor and professors for this info.
For example, I had a NEW GRAD PMHNP based in the southeastern US, with NO psych experience, tell me they expected $100 per hour as a permanent employee with benefits. That is $208K per year. Uh, no, that isn't going to happen. They would be lucky to get 50% of that where they live. Given that I am in California, our practice would consider $80 to $85 per hour, with a good raise in 6 to 9 months, based on performance.
A suggested approach for discussing compensation during interviews:
1. Look at the job boards for jobs in the area where you live or where the job is located (if you are willing to relocate or possibly for telehealth roles). I have also posted compensation reports recently in a separate post. Many jobs provide a compensation range. For example, if you review job postings, the general pay range for a PMHNP in California (for employees, not 1099) appears to be in the $160 to $180K a year range, with some employers offering up to $200K to $220K per year, that gives you a pretty good idea of what you can reasonably ask for. So, a new grad PMHNP could ask for $160K to $175K per year. If that new PMHNP had prior psych experience, like they did a lot of psych as an FNP, then they could ask for more. Don't ask for the middle or top of the range! That just makes you look clueless.
2. As a negotiating tactic, consider asking for a 6 month performance review with (you name your desired raise) at that time for good performance
3. As another negotiating tactic, you might ask for a signing bonus.
4. Or, instead of $, you might ask for something else. For example, if you really want more PTO, ask for a little more of that instead of $.
5. If you an experienced NP that has just changed specialties, then you are a new grad NP. Sorry. For example, you are an FNP that just earned their PMHNP. If your FNP experience obviously includes little to no psych experience, don't expect top dollar! (Yes, some FNPs do a lot of psych in primary care, but that is not true of all FNPs). A new employer in psych would likely give you some credit for general NP experience, but you are not going to command top dollar because you just don't have relevant experience.
6. If you are an experienced NP that has just changed specialties, and you also have work experience in the new specialty, make sure your resume and cover letter highlight that. Be prepared to discuss this during the interview. For example, a new PMHNP with 5 years FNP experience that treated a lot of psych conditions in primary care, and can back that up, can definitely expect credit for that relevant experience. Even so, do not expect to get top dollar! You could reasonably ask for comp in the middle of the stated range.
7. Be aware that there are now some telehealth platforms that will advertise NP pay of up to $350K per year. However, those are 1099 positions. That's fine for experienced NPs who want to maximize earnings, and don't need benefits, but are not a good bet for new grads, as there won't be much, or any, coaching. Those places are not also going to hand you 40 hours worth of appointments right away.
In addition to compensation, do the research on how most specialties operate, such as number of patients seen per day, etc. This information shouldn't be hard to find - research via articles, blogs, ask professors/advisors, and contact alumni if you can. For example, in California, it is pretty standard for both primary care and psych to have 20 minute follow up appointments and 40-50 minute intake appointments (most are 40 min). I wish we had more time, but that is the current standard. Many psych practices have 15 minute follow ups. Normally, there is a ramp up period, so a new employee would not be expected to do this right off the bat (make sure that is the case). So don't go into an interview requesting a 90 minute intake and 30 to 45 minute follow ups on an ongoing basis! If this is a practice, then you will have to adhere to the practice standards. Unrealistic expectations are going to make it very hard to find that first job. I have seen some psych jobs where you can set your own schedule and if you want to have a 2 hour intake, fine, but those jobs are not common.
As a new grad NP, your goal is to get that first job and it should be a job that provides the best learning opportunity with reasonable pay. If all you can get is crappy pay, then so be it. After 1 year, you can go get a better job.
Note: a decent practice will have a reasonable onboarding system and ramp up period. Normally, it take 4 to 6 weeks for a provider to get fully up to speed and able to serve a full schedule. Even an experienced provider has to learn the EMR and all the administrative aspects of their new practice. Avoid any practice that does not have a reasonable system to get new hires up to speed.
Tip #1 for new grads: If you want to maximize your earnings, do the research where there are shortages of providers in your specialty. Those areas are going to pay more and you will be in a strong negotiating position. Many such positions also offer loan repayment, sign on bonuses, relocation assistance, performance bonuses, and even mortgage subsidies. You may have to relocate, but again, it is not necessarily forever. Many NPs will commute to a job in such an area, rent a room there during the week, and then go home on weekends. Some states, such as California, have overall shortages of RNs and NPs. And within a state there are areas with shortages, most likely rural areas and smaller towns and cities. The plus of that is that those areas typically have a lower cost of living. And you may discover you really like it there! I used to work in the North State of California (north of SF and Sacramento). A lot of doctors and NPs work in a rural area during the week, then commute back home on weekends to Redding, Sacramento, or San Francisco Bay Area. Also, some "rural" areas are only 30 to 60 minutes from a decent size town/city. This is also a great way to find organizations that will fulfill public service requirements for HRSA scholarships or that are eligible for state/federal loan repayment programs. I never thought I would want to live outside of L.A. or San Diego, but once I did, I realized I was sick of the traffic, crowds, and super high prices.
I also want to make a pitch for rural areas. Because my first job was in a very rural FQHC, we had to do a bit of everything. That meant an incredible learning experience. We just did not have the option of sending anything out of the ordinary to Urgent Care or the ER. One of the clinics was literally next door to the small rural hospital, and it was an opportunity to develop close working relationships with the ER and even spend time there when it wasn't busy - another excellent learning opportunity. In such a small community, providers get to know their patients very well and can truly practice holistic care by addressing socioeconomic aspects of health. You will also truly be giving back.
The providers in such areas tend to be very dedicated and many have incredibly prestigious backgrounds. They are generally motivated to be excellent mentors because they want their community to have enough good providers.
Another miscellaneous tip: There are positions where the provider has to build up a panel of patients. That means 40 hours can't be guaranteed right off the bat. Do not panic! Frankly, especially for a new grad, that can be better by providing a ramp up period. Find out how long it would take to build up a full patient panel. If the answer is 1 to 2 months, then consider it may well be worth it, especially if the pay is good. There are lot of ways NPs can have side gigs to get more hours temporarily or even permanently, such as a PT job or doing 1099 work such as veteran disability exams. Let's say an FNP has just earned their PMHNP. Their current employer might be happy to have that FNP continue working part time for awhile. An NP currently making $45 per hour ($1,800 per week or $ 93,600 per year) working FT in a state with crappy pay would be better off making $75 per hour at 24 hours a week to start, with the ability to go up to 40 hours per week in 2 to 3 months. ($75 per hour x 24 hours = $93,600 per year, at 32 hours = $124,800 year, at 40 hours = $156,000 per year). In other words, do some basic math.
You may find that being able to work fewer hours for the same or greater annual pay is better for you. This can be a big benefit for someone continuing their education, who wants to spend more time with their family, is in danger of burning out, or just wants more personal time. It can also be an opportunity to have a lucrative side gig or build up one's own private practice while continuing to have decent income. Let's say you are an PMHNP who wants to set up her own practice. You could work PT for a practice, then start building your own practice on the side. A lot of psychiatrists do this - they have a PT job, then also a PT private practice.
Also, a practice with flexibility on hours, that does not require providers to work 40 hours per week, is a benefit. Are you planning to go back to school? Planning to start a family? Planning to slow down gradually before retiring? Feeling burned out? Have family members that require care, such as an aging parent? Knowing that if you have to change your schedule, you can keep your job, can be a big plus.
Personally, when I started my current job, I was scheduled 2 days per week. I did veteran disability exams on the side. (That was good gig, as I could set my own hours - if I wanted to work on weekends, I could, and got paid on 1099). I was going to be starting my PMHNP program soon, so I did not want to work more than 3 days per week. As soon as I completed my PMHNP and was ready for more hours, I got them immediately. Even working only 3 days per week, I was making more than I had been working FT in primary care.
There are plenty of posts here on how NPs can maximize their earnings, so it is not my intention to start another debate on that. I am posting this for people who just need a regular job. Best wishes to all.
