What is your take home pay as Nurse Practitioner?

Hi everyone. I'm curious as to see what an actual paycheck (before taxes) looks like from an NP. I find salary websites to be not very helpful. So...

What type NP are you?

Where (state)(rural/urban) do you practice?

Are you independent or in a group?

How many years experience?

What is your before tax paycheck amount?

Monthly or bi-weekly?

Salary/hourly/other(explain)?

Avg hours on check?

What are the perks of your contract? (ie. PTO/vacation/bonuses)

I know this is very personal, but if you are able to provide input, I would appreciate it! I'm mainly interested also to see after the gov/operational costs etc have taken their share, how much are you left with?

[Jules A, MSN]

Well crud! I also rounded per diem on an IP floor. They told me they were lowering my APRN rate by 1/3. I pushed back. Found out today that they don't need me anymore. Oh well - I'm still glad I pushed back!

I'm considering looking into a p/t telepsych position to cover what I had made. Not to hijack this thread, but anybody do that?

That wasn't even a staff with benefits position? Good riddance. That was awful. I'm not a fan of telepsych so while I've done it reluctantly on occasion in the ED I don't have solid info to offer. Maybe start a new thread?

[Jules A, MSN]

No, the $85 was w/o benefits. I tried to rally my peers; the experienced ones took the "we will quietly stop picking up time" approach. And the brand-new ones accepted it (but really, I cannot blame them and would more than likely do the same). I was the only one with the "we are stronger together and if we make noise, they will listen" idea. Ugh. Somebody said "it will be no use to argue. I talked to the director and the rate was given to them by HR." As if HR is God?! Um, folks, they can easily change the rate too. So, I spoke up and I got punished for it. Like I said - I'd rather this outcome than just rollover and take it!

I have heard the HR excuse, ignored it, and also from peers who believe them when they say they can't pay more. It has rarely been my experience that they won't match my rate if they need a good provider. Unfortunately as more graduate from NP school and are willing to take subpar wages this is where we will end up.

It is a shame really because you know they would be forced to pay a psychiatrist 2xs that if the NPs had a backbone like you did.

[NHGN]

It still doesn't feel very good, and I honestly enjoyed the job and all the education it brought. Genuinely -thanks for your support :)

[DrZaphod, BSN, MSN, DNP, RN, NP]

It still doesn't feel very good, and I honestly enjoyed the job and all the education it brought. Genuinely -thanks for your support :)

That's good work on your part. I bet they didn't cut physician wages. One of the clever things the AMA does is artificially limit the supply of physicians. This leads to shortages and higher wages. That's where NPs got an opening. Unfortunately, as that supply increases to meet demand, wages go down. All the while, the physicians state they are the "experts" and there is still a shortage.

NP wages, overall though, do seem to be rising. I used to get headhunter emails for salaried positions of 95k. Now I'm seeing a lot more $125-$150k positions being offered.

Just remember that billing insurance directly vs. taking any hourly or salaried job will always be beneficial. Even Medicare pays NPs around $50 per patient. 20 patients per day = $1000. With an S-Corp, you declare a "reasonable" salary and pay taxes on that. The excess you just take as a distribution at a much lower percentage rate.

Again, if there were more NPs like you refusing to work for these wages, we would actually gain power and salaries would rise to reasonable amounts.

[Jules A, MSN]

That's good work on your part. I bet they didn't cut physician wages. .

Right? And I would have been forward enough to ask that. If it was a team-wide change that would make a difference although unless I was desperate I'm not suddenly working for less.

One of the clever things the AMA does is artificially limit the supply of physicians. This leads to shortages and higher wages. That's where NPs got an opening. Unfortunately, as that supply increases to meet demand, wages go down. All the while, the physicians state they are the "experts" and there is still a shortage.

But is this a reasonable approach if it keeps the numbers manageable and the product consistent? Nurses are on the other end are so desperate for numbers they are admitting anyone who has a pulse and they are being taught by many with minimal to no actual experience. It will be difficult to keep a handle on quality in my opinion.

Again, if there were more NPs like you refusing to work for these wages, we would actually gain power and salaries would rise to reasonable amounts.

YES!

[NHGN]

It's actually really helpful to hear you guys' positive comments. I had a horrible night's sleep, waking up worried about money - nice to wake up to these posts!

[gusthygirl]

no vacation you tryna kill yourself? no amount of money can make me say no to vacation days in a contract. but hey thats me

[DrZaphod, BSN, MSN, DNP, RN, NP]

But is this a reasonable approach if it keeps the numbers manageable and the product consistent? Nurses are on the other end are so desperate for numbers they are admitting anyone who has a pulse and they are being taught by many with minimal to no actual experience. It will be difficult to keep a handle on quality in my opinion.

I'm not sure which data you are referencing. I've seen no evidence that NPs are being taught by many with minimal to no experience or that anyone can get in. Decades of research continue to show that there is no difference in patient outcomes or satisfaction. I would definitely advocate for one year of residency after school, though. I think a lot of the NP programs like the one at Columbia are starting to make a residency mandatory.

Physicians have also started allowing accelerated 2nd Bachelor's degrees which guarantee admittance to med school - much like the accelerated BSNs which were offered to nurses in early to mid 2000s. So now one can do one accelerated year for a BS and then do a 4 year med school directly after. Several of those schools are also 6 year programs - 4 year med school plus two years residency (I'm looking at psych specialties.)

[Jules A, MSN]

I'm not sure which data you are referencing. I've seen no evidence that NPs are being taught by many with minimal to no experience or that anyone can get in.

Actually not anyone can get in, they have to be able to pony up the tuition so I guess that does narrow it down a bit. You aren't aware of the for profit NP programs with rolling admissions? And or those that require a 3.0 gpa but will admit someone with less than a 3.0 on a provisional basis? They are out there.

My experience with faculty who have minimal if any experience comes from attending a BSN program, two NP programs, teaching at two state universities and having worked with at least two dozen new grad CNLs and NPs over the years who were instructors immediately after graduation.

If there are programs making residency mandatory that would be music to my ears.

[DrZaphod, BSN, MSN, DNP, RN, NP]

I wasn't aware of the for-profit NP schools, but I suppose that's equivalent to all the "physicians" headed to Caribbean schools. I've heard all sorts of terrible things about them - particularly these NP to MD programs - but people are still scoring residencies. My friend actually just saw a physician who went to some unknown Caribbean school and was actually practicing in Beverly Hills. So I suppose the "anyone can get in" is a problem with a lot of greedy schools, NP, MD, or otherwise.

[Jules A, MSN]

What type NP are you?

FNP

Where (state)(rural/urban) do you practice?

Urban

Are you independent or in a group?

Outpatient private practice physician owned

How many years experience?

4

What is your before tax paycheck amount?

base salary is $95k, my W2 was ~$125 in 2017 includes my quarterly bonuses

Monthly or bi-weekly?

bi-weekly base salary + quarterly bonus

Salary/hourly/other(explain)?

salary

Avg hours on check?

well, it's salary but I work ~52 hrs/week

What are the perks of your contract? (ie. PTO/vacation/bonuses):

quarterly bonuses based on RVUs, 5 days & $1000 CME, cost of licensing, malpractice insurance (but I also carry my own), 3 weeks vacation, health insurance for myself with no monthly premium, length of contract is 2 yrs with a $1500 fee if I break early, and a 2 yr 5 mile radius non-compete clause for other family practice settings

My gig is not too bad, probably middle of the road not the best but not the worst.

I'm hoping I read or added wrong because if my math is correct at 52 hours a week you are only making $46 an hour and that includes your bonus.

[GoodNP]

I'm hoping I read or added wrong because if my math is correct at 52 hours a week you are only making $46 an hour and that includes your bonus.

Well, I work 46 weeks per year (3 weeks vacation, 1 week CME, and 10 days federal holidays which I neglected to mention above), so:

52 hrs/week x 46 weeks/yr = 2,392 hrs/yr divided into $125,000 = $52.25/hr.

Too low?

I thought it was pretty middle of the road, but I confess I feel like I work too much.