What the heck is an NP 1 vs. an NP2, etc.

  1. I've seen this in some recruiting ads. I had always thought that an NP is an NP. Is this yet another scheme to pay less for our services? Why don't they also have MD1 and MD2 for the physicians then? Maybe because the doctors would spit in their faces and move on? When will get the respect that we deserve?
  2. Visit Goldenfox profile page

    About Goldenfox, NP

    Joined: Aug '15; Posts: 286; Likes: 511
    from US
    Specialty: 12 year(s) of experience

    24 Comments

  3. by   traumaRUs
    Hmm..weird I haven't seen anything like this. I have seen experienced NP and NP with 5-10 years experience but not labeled as 1 and 2
  4. by   elkpark
    Maybe this is some sort of clinical ladder, like many hospitals have for the staff nurses (even though they are all RNs).
  5. by   eLeVatioN
    I have seen RN1 and RN2 in job ads which is shorthand for the years of experience. For that employer, RN2s have over 4 years of experience in that specialty.
  6. by   Goldenfox
    Clinical ladder? Interesting. Although, I would more accept that for RNs who have different levels of experience with executing clinical tasks, but not for NPs. Not that I ever really bought into the clinical ladder thing for RNs either, but that's another topic. Its a different thing when it comes to qualifying the competence of people who diagnose and treat disease. If our competence is rated according to where we are on a ladder then what does this say about those of us who are at the bottom rung, or not even on the ladder at all (i.e. just plain ole NPs)? Yet another thing to explain to the patients...? My point is that MDs don't have level 1 and 2, and PAs don't have level 1 and 2 either. Why NPs? What makes this even more interesting is that the positions I've seen advertised with this lingo aren't offering a dime more in pay for an NP2 vs an NP1 or 3..whatever.
    Last edit by Goldenfox on Jul 3, '16
  7. by   Jules A
    Quote from Goldenfox
    Clinical ladder? Interesting. Although, I would more accept that for RNs who have different levels of competence with executing clinical tasks, but not for NPs. Not that I ever really bought into the clinical ladder thing for RNs either, but that's another topic. Its a different thing when it comes to qualifying the competence of people who diagnose and treat disease. My point is that MDs don't have level 1 and 2, and PAs don't have level 1 and 2 either. Why NPs?
    That sounds like the labels given from the large, teaching hospitals who in my experience rarely pay a decent wage. Probably to pigeon hole someone into a lower starting salary.

    The reason this is seen for NPs and not MDs can be asked about a multitude of scenarios and there are a variety of reasons, mostly in my opinion because NPs don't align with medical staff, remain willing to do non-provider tasks and work for peanuts despite similar billing value.

    I recommend actively participating with your state NP organization to ensure our voices are heard and we are able to practice to our full scope. It is also crucial, imo, that we discuss our pay rates with peers for the transparency most employers attempt to avoid. It is insane that I am able to make $80,000 a year more than some of my psych np peers who have the same and often more experience.
  8. by   elkpark
    Quote from Goldenfox
    Clinical ladder? Interesting. Although, I would more accept that for RNs who have different levels of experience with executing clinical tasks, but not for NPs. Not that I ever really bought into the clinical ladder thing for RNs either, but that's another topic. Its a different thing when it comes to qualifying the competence of people who diagnose and treat disease. If our competence is rated according to where we are on a ladder then what does this say about those of us who are at the bottom rung, or not even on the ladder at all (i.e. just plain ole NPs)? Yet another thing to explain to the patients...? My point is that MDs don't have level 1 and 2, and PAs don't have level 1 and 2 either. Why NPs? What makes this even more interesting is that the positions I've seen advertised with this lingo aren't offering a dime more in pay for an NP2 vs an NP1 or 3..whatever.
    Why don't you inquire of the employer and find out from the source what "NP 1" and "NP 2" mean before you leap to a lot of conclusions?
  9. by   juan de la cruz
    I work for a medical center that uses those designations as part of a larger state-funded network of state universities with attached academic hospitals. This in not uncommon in civil service positions and yes it is used in determining salary ranges. In our case, it is also part of a contract between the university and the nursing union that represents NP's in terms of collective bargaining.

    As you may know, in a setting where you have a union, your salary is not negotiated individually but collectively and years of experience is factored in. The NP I designation is a new grad, NP II is an NP with six months experience and above, and NP III is someone who has proven leadership and research activities. NP's in management roles and those who work directly under the medical school do not have these designations as they are not represented by the union.

    I like the designations personally and with my years of NP experience, I'm compensated quite well.
  10. by   Goldenfox
    Quote from elkpark
    Why don't you inquire of the employer and find out from the source what "NP 1" and "NP 2" mean before you leap to a lot of conclusions?
    And there you go...

    I assumed nothing. I stated an observation and asked a question. Please mind yourself. My post was intended to invite commentary, not snark.
  11. by   juan de la cruz
    Quote from Goldenfox
    If our competence is rated according to where we are on a ladder then what does this say about those of us who are at the bottom rung, or not even on the ladder at all (i.e. just plain ole NPs)?
    Not to be defensive of the system in place where I work but I prefer a system where new grads with no experience are started at the bottom pay scale and those who have experience are compensated accordingly. I also prefer the transparency of collective bargaining over an individual new hire's ability to secretly talk their way to a higher salary screwing over those who have been hired before them. Finally, I respect an institution that values and compensates NP's who exemplify leadership and engage in research accordingly.

    Quote from Goldenfox
    Yet another thing to explain to the patients...?
    We don't have to specify whether we're NP I or II or III to patients and nobody ever does. Our badges don't even say anything other than NP.

    Quote from Goldenfox
    My point is that MDs don't have level 1 and 2, and PAs don't have level 1 and 2 either. Why NPs?
    Well our PA's have similar designations. MD's at our system have academic rankings so they don't follow the numbers as we do...they either are Clinical Instructors, Clinical Assistant Professors, Clinical Professors and so forth...

    Quote from Goldenfox
    What makes this even more interesting is that the positions I've seen advertised with this lingo aren't offering a dime more in pay for an NP2 vs an NP1 or 3..whatever.
    Not sure that's true. There is another (non-state funded) system in California that uses this (Kaiser Permanente) and they are known for excellent salaries for NP's based on where you fall in the designation.
  12. by   Jules A
    University of California San Francisco posts their pay grades, not sure if union or not, which look decent and considerably better than the big names in this area, unless it takes a million years experience to get to the higher steps. Does anyone know how the steps work? Years back at VA I would have to practice 25 years before I would have made the highest step and it didn't come close to my civilian rate. Base salary wise according to this model I'm at NP 3 step 10. I definitely like the transparency with this:

    Title: 9148 - NURSE PRACTITIONER 1
    Exempt: Non-exempt
    Bargaining Unit: NX
    SubFOC: BE
    Tier: 1
    On Call Rate 1: 50%
    Shift Differential (EV): 10%
    Shift Differential (NT): 16%
    Shift Differential (WD): 5%
    Effective Date: Jan 1, 2016
    Step Hourly Yearly
    1.0 64.20 134,052
    2.0 66.50 138,852
    3.0 68.92 143,904
    4.0 71.40 149,088
    5.0 73.96 154,428
    6.0 75.44 157,524
    7.0 76.98 160,740
    8.0 78.49 163,884
    9.0 80.08 167,208
    10.0 81.66 170,508
    11.0 83.31 173,952

    Title: 9147 - NURSE PRACTITIONER 2
    Exempt: Non-exempt
    Bargaining Unit: NX
    SubFOC: BE
    Tier: 1
    On Call Rate 1: 50%
    Shift Differential (EV): 10%
    Shift Differential (NT): 16%
    Shift Differential (WD): 5%
    Effective Date: Jan 1, 2016
    Step Hourly Yearly
    1.0 67.38 140,688
    2.0 69.78 145,704
    3.0 72.31 150,984
    4.0 74.89 156,372
    5.0 77.56 161,940
    6.0 79.14 165,240
    7.0 80.75 168,612
    8.0 82.36 171,972
    9.0 84.01 175,416
    10.0 85.66 178,860
    11.0 87.39 182,472


    Title: 9146 - NURSE PRACTITIONER 3
    Exempt: Non-exempt
    Bargaining Unit: NX
    SubFOC: BE
    Tier: 1
    On Call Rate 1: 50%
    Shift Differential (EV): 10%
    Shift Differential (NT): 16%
    Shift Differential (WD): 5%
    Effective Date: Jan 1, 2016
    Step Hourly Yearly
    1.0 70.76 147,744
    2.0 73.28 153,012
    3.0 75.91 158,496
    4.0 78.66 164,244
    5.0 81.47 170,112
    6.0 83.11 173,532
    7.0 84.76 176,976
    8.0 86.49 180,588
    9.0 88.19 184,140
    10.0 89.97 187,860
    11.0 91.74 191,556

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  13. by   juan de la cruz
    The steps correspond to years in nursing (RN + NP). We go up a step every number of years (I'll have to look at the contract to be exact but I think it's 3 years). All UC Hospitals (LA, Irvine, San Diego, Davis, SF) uses this but the actual salary is different for each campus since it's in different job markets. Annual salary increases are determined by contract - current contract calls for 4% raise each year.
  14. by   juan de la cruz
    ...actually the steps are probably every 2 years 'cause I'm close to the top

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