I recently received a published form from the State of Florida showing that ARNPs increased 22% over the past two years. RNs only increased by 7.4% If you are a new grad wondering why you can't find a position here is your answer. Our NP mills have pumped out too many graduates for the demand of society. I don't have the data to back it up but if this is happening in Florida I would assume it is happening around the nation.
I'm licensed in Florida but moved to California years ago because I could see the tsunami of new graduates slowly starting to erode the wages of established NPs. It's now happening here in California and I have been directly affected. I can count at least another dozen of my NP colleagues around the nation who are complaining of wage deflation happening because new grads will accept a position at almost any wage. Starting wages are below those for RNs in some cases.
For those of you thinking of becoming a NP think and long and hard before you commit your money and your time. The job is enjoyable but the return on investment is declining year after the year with the flooding of the markets. Maybe one day the leaders of our nursing schools will open a book on economics and understand the relationship between supply and demand rather than stuff another useless nursing theory down our throats.
Really? My situation...Only 2 classes from going into P.A school, only 2 classes from Pharmacy school, and only 2 classes away from Direct entry into Occupational Therapy, My undergrad is like a pre-everything. However, I went nursing because I only need 8 classes to get R.N and then hop into N.P school. However, I do not want to do family practice ( I know this coming in ). I opted NOT to go into OT because their tuition is around 75k for just 2-3 years of grad school. Plus everyone wants to become OT. I think there was only 10,000 OTs National wide, now 30,000. In my nursing program an OTA( occupational therapy assitant ) is in the class. I asked why....why not go OTA to an OT bridge program? Like how RNs to N.P? She replied with the same thing I didn't go direct entry into grad school with OT, the cost. Ots make about $35 an hr where I live, which where I live it is 10% below the national average in income ( not for OT but just in general ). So OTs do well for the cost of living. However, if you add undergrad and grad debt to be an OT, it would be around 130k to make $35 an hr. So, I said, welp.....Nursing then N.P it is. I got accepted into every nursing program I applied ( should have applied to more ). However, my whole focus is N.P. Nursing is eh....we spend 15 minutes on a wash cloth fold and 1 minute on shock. Is this normal? I mean for infection control.......I studied the labs, Basophils, Moncytes etc for infection...if they elevate or drop etc. I also thought there would be scenerio based questions on this with these labs and science? You know what we were tested on....Bed linens..on infection control? I was pizzed. I studied the book, the study guide, the power points in red and all what I studied was not on test, but bed linens....The prof I guess uses not her power points, the assigned book and the assigned study guide, but outside sources. Anyone have this?
Anyway to the point, if N.P is going to be Like O.T.....then man. My Profs already know I am not in it for nursing itself. I actually was breaking down chemistry with one of the profs who has it for grad school for Doctorate Degree they are taking. I took Pharm and took that with an M.D and also my Patho was taught by an M.D, along with my AP2 class. So, I learned how the drugs work at the chemical level. I didn't use a drug handbook in Pharm because I just memorized generics and knew how each class worked. If you know how they work, then you can kind of predict why they would take how long and possible sides and tie that into patho and abnormal psychology( which I took as well ). Although trade names, I am screwed lol. However, this thinking does not seem to be any relevance for nursing, but who knows my first semester.
Did you research what nursing was prior to going into it? Having that "i know more sciency stuff" than you attitude to your professors will help you make friends quickly lol
I am on my psych rotation now (in med school) and we had a couple nursing students with us today. They ALL want to be nurse practitioners. Some have some interest in nursing but a few are literally like "wow omg nursing sux just wanna be NP"
I turned to my classmate on the rotation with me and said "this is why I stopped working as an NP and went to med school, EVERYBODY wants/is in NP school and our salaries are gonna tank!. They don't have the residency bottleneck like we do.
I know it sounds anecdotal but back when I was in the hospital working as an NP half the floor was in NP school, 3-4 years later it still holds true. For those stating we do not or will not have a saturation in NP land you are either a recruiter lying or just delusional. There are a few final bastions of the US where jobs are plentiful but the orcs will come for you sooner than later to cut your salaries since they will work for much less.
On the bright side maybe bedside nursing salaries will go up?
Honestly people need to just get off this obsession with healthcare that colleges have fed us. Unless one is in medicine and in a non coastal city, literally there is no true shortage of MOST healthcare jobs in MOST areas. Its just BS that colleges feed us to get our dollars.
Literally take a look at the government predictions on physicians/PA/NP/RN/LPN (not on BLS.GOV but the actual department of health and human services website).
Projected SURPLUS of MOST THINGS (NP/PA/RN) and deficiency of (MD/DO/LPN) in most areas. While its difficult to predict the future, its def a better analysis than Fullglass's "i got a good job why cannot everyone else"? mantra.
Go into computers if you want the good jobs otherwise dodge the healthcare bullet.
Specializes in Neurology, Psychology, Family medicine.
Did you research what nursing was prior to going into it? Having that "i know more sciency stuff" than you attitude to your professors will help you make friends quickly lol
I am on my psych rotation now (in med school) and we had a couple nursing students with us today. They ALL want to be nurse practitioners. Some have some interest in nursing but a few are literally like "wow omg nursing sux just wanna be NP"
I turned to my classmate on the rotation with me and said "this is why I stopped working as an NP and went to med school, EVERYBODY wants/is in NP school and our salaries are gonna tank!. They don't have the residency bottleneck like we do.
I know it sounds anecdotal but back when I was in the hospital working as an NP half the floor was in NP school, 3-4 years later it still holds true. For those stating we do not or will not have a saturation in NP land you are either a recruiter lying or just delusional. There are a few final bastions of the US where jobs are plentiful but the orcs will come for you sooner than later to cut your salaries since they will work for much less.
On the bright side maybe bedside nursing salaries will go up?
Honestly people need to just get off this obsession with healthcare that colleges have fed us. Unless one is in medicine and in a non coastal city, literally there is no true shortage of MOST healthcare jobs in MOST areas. Its just BS that colleges feed us to get our dollars.
Literally take a look at the government predictions on physicians/PA/NP/RN/LPN (not on BLS.GOV but the actual department of health and human services website).
Projected SURPLUS of MOST THINGS (NP/PA/RN) and deficiency of (MD/DO/LPN) in most areas. While its difficult to predict the future, its def a better analysis than Fullglass's "i got a good job why cannot everyone else"? mantra.
Go into computers if you want the good jobs otherwise dodge the healthcare bullet.
Exactly, I've said it before and I stand by it now and will say it again. If you are not a strong asset to your company with good experience, your job and your salary are in trouble as an NP. I also project from all the research I've done, looking at projections, and using anecdotal evidence from others looking at their hiring difficulties, that if you do not have experience as an NP in the next 5 years you will be un-hirable. There is going to be so many excess NP's well over demand that a new graduate will have extreme difficulty. The last projections predicted well over 40k surplus of NP vs projected demands with no state being having a deficit by 2025. This by no means surprises me. I would also venture to say that this projection actually under projects the surplus from their inclusion that only a net growth of 53k primary NP's will be produced in over ten years. Last I looked AANP had 26,000 new NP's graduate this last year. At 60% being primary that equates around 15k new NP's. We obviously are going to continue to produce a net much larger than 53k in which the survey originally predicted. Yikes, the future looks fun.
303 dnp programs are currently enrolling students at schools of nursing nationwide, and an additional 124 new DNP programs are in the planning stages (58 post-baccalaureate and 66 post-master's programs).
DNP programs are now available in all 50 states plus the District of Columbia. States with the most programs (10 or more programs) include California, Florida, Illinois, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, and Texas.
From 2015 to 2016, the number of students enrolled in DNP programs increased from 21,995 to 25,289. During that same period, the number of DNP graduates increased from 4,100 to 4,855.
Specializes in Psychiatric and Mental Health NP (PMHNP).
Re-read your post and make a note of how many times you used the words "I", "me", and "my". Your view of the situation is myopic. You see everything only from the point of view that fits your individual situation. Consider for a moment that not everyone who is or who will become a nurse practitioner is like you or has circumstances exactly like yours. For example, not everyone can just move. And moving is not always a solution either. Everyone's life, finances, and family situation is unique to them.
What is "lovely?" What is "affordable?" What is "good?" What is "bad?" Do you not see that experience is subjective, and that most of these descriptors are frequently nothing more than a point of view? What you have written is YOUR point of view and a description of your own situation. Many other NPs have had very different experiences. When others tell about their experiences and observations its not just a matter of 'negativity' as you choose to view it, its another perspective of reality. And when the majority of these perspectives tell a very different story than yours then maybe that is of significance?
Circumstances can change. Not every new grad NP stays in the big coastal cities. Some ARE relocating for job opportunities. I am happy for you that you are successful but you need to understand that your utopia can change too. Others have posted here about how that happened to them.
You make a very good point. ALL of us can change and control our perceptions and expectations. That means broadening horizons and being more open-minded. Interestingly, openness is one of the traits on the MMPI (Minnesota Multiphasic Personality Inventory) and I scored the highest score possible on that.
As for moving, just stop it. What do you think military families do? They move - a lot. It is not the end of the world to move. I'm an Army brat and went to 12 schools by the time I graduated from high school and then went on to Yale. As a business professional, I moved multiple times - San Diego, Washington DC metro, Silicon Valley, Los Angeles - before becoming an NP.
So, an NP who refuses to move is going to have fewer opportunities. End of story.
There are plenty of good NP jobs out there begging for applicants.
Specializes in Psychiatric and Mental Health NP (PMHNP).
Projected SURPLUS of MOST THINGS (NP/PA/RN) and deficiency of (MD/DO/LPN) in most areas. While its difficult to predict the future, its def a better analysis than Fullglass's "i got a good job why cannot everyone else"? mantra.
Go into computers if you want the good jobs otherwise dodge the healthcare bullet.
I agree with most of your post, but here is where we disagree:
1) Projections CHANGE because circumstances change. We have a shortage of MDs, especially primary care MDs who are willing to work outside of the big coastal cities. Current projections of an impending NP/PA surplus do NOT account for that. Given that MDs make 2-3 times as much as an NP/PA in primary care, and the MDs won't even go to areas that are desperate for primary care providers, what do you think is going to happen? This is basic supply and demand. When the supply goes down and demand remains constant or increases, prices for the good or service in question go UP. That is why NP salaries are INCREASING in REGIONS WITH SHORTAGES. And the lack of primary care MDs will only increase the number of states with full practice authority for NPs.
2) I previously posted on why high tech is not the silver bullet you think it is, which appears to be your "mantra." You did not respond to my post on this. In addition, studies have indicated a large number of American STEM graduates are not able to secure employment in high tech. Don't forget that Americans in high tech are competing with low-cost H1B1 tech workers and also with outsourced tech jobs in India, Eastern Europe, etc. Think experienced NPs can't compete with new grads in terms of salary? How about a programmer in Silicon Valley making $200K a year competing with the same making $25K a year in India once the technology becomes commoditized, which happens very rapidly? And the vast majority of high tech work can be done virtually. That is definitely not true for healthcare. High tech can be a very rewarding career, but it is not for everyone.
I agree with most of your post, but here is where we disagree:
1) Projections CHANGE because circumstances change. We have a shortage of MDs, especially primary care MDs who are willing to work outside of the big coastal cities. Current projections of an impending NP/PA surplus do NOT account for that. Given that MDs make 2-3 times as much as an NP/PA in primary care, and the MDs won't even go to areas that are desperate for primary care providers, what do you think is going to happen? This is basic supply and demand. When the supply goes down and demand remains constant or increases, prices for the good or service in question go UP. That is why NP salaries are INCREASING in REGIONS WITH SHORTAGES. And the lack of primary care MDs will only increase the number of states with full practice authority for NPs.
2) I previously posted on why high tech is not the silver bullet you think it is, which appears to be your "mantra." You did not respond to my post on this. In addition, studies have indicated a large number of American STEM graduates are not able to secure employment in high tech. Don't forget that Americans in high tech are competing with low-cost H1B1 tech workers and also with outsourced tech jobs in India, Eastern Europe, etc. Think experienced NPs can't compete with new grads in terms of salary? How about a programmer in Silicon Valley making $200K a year competing with the same making $25K a year in India once the technology becomes commoditized, which happens very rapidly? And the vast majority of high tech work can be done virtually. That is definitely not true for healthcare. High tech can be a very rewarding career, but it is not for everyone.
I just responded to this in the other AMA post. It seems tech is pretty broad as is healthcare but do you think there are any tech jobs where one is pretty safe from all of the above if they are exceedingly dedicated to their work? It seems tech has a higher ceiling than medical stuff does and I was wondering if one who was "one of the best" in his or her field would be relatively safe from all of the above.
Are there certain aspects of tech where american graduates get jobs? I know software engineering is a total different league than general computer science and am wondering if you have grouped the general CS majors, and other lower end tech fields into the american STEM category? On the last note, do you think it is those who are not good/bottom of class that do not get hired from the american STEM group? I am assuming its not like med school where the worst in the class will still get residency and a job usually. thanks for the answers in advance!
If NPs could carve out a "mid-level" provider niche - we would do well. In some states - such as my state of Hawaii - there is a provider shortage - meaning MDs. If more mid-level family providers provided regular chronic care and straight-forward urgent care and MDs were reserved for more complex cases then it could lower the overall cost of healthcare and use providers more efficiently. I personally believe NPs can proficiently manage chronic care and urgent care with better methods of patient education than some higher level providers do. Since the pay is less than an MD we should be able to spend a little more time with each patient and combine prescribing meds with patient education and goal-setting for patient. I started as an NP 5 years ago in community health for a wage slightly lower than I made as a RN. However, within 3 years I was able to move into a position - 135-155K annual salary. We have 1 NP in our practice in the role I mentioned above (its not me - I am same role as MD). Maybe the answer would be to offer more education specific to chronic disease management and urgent care in our dnp programs with specific certifications to make us more marketable to practices in increasing efficiency and patient outcomes - not a more academic training but rather a more practical one. We need to demonstrate the value of our outcomes if we want to advance the profession.
You make a very good point. ALL of us can change and control our perceptions and expectations. That means broadening horizons and being more open-minded. Interestingly, openness is one of the traits on the MMPI (Minnesota Multiphasic Personality Inventory) and I scored the highest score possible on that.
As for moving, just stop it. What do you think military families do? They move - a lot. It is not the end of the world to move. I'm an Army brat and went to 12 schools by the time I graduated from high school and then went on to Yale. As a business professional, I moved multiple times - San Diego, Washington DC metro, Silicon Valley, Los Angeles - before becoming an NP.
So, an NP who refuses to move is going to have fewer opportunities. End of story.
There are plenty of good NP jobs out there begging for applicants.
Extremely tedious, and bereft of objectivity of thought... You haven't internalized even an iota of what was written in my previous post. You continue to make this only about YOU and YOUR life experience. Re-read all of your posts--- 'me, my, I...' Remember though that there is a world of reality that others live in that is a whole lot bigger than your own.
"There are plenty of good NP jobs out there begging for applicants" is an opinion. Stop trying to present it as a fact. You are not doing new grads who are out there looking any favors by posting things that aren't true.
Specializes in Psychiatric and Mental Health NP (PMHNP).
I just responded to this in the other AMA post. It seems tech is pretty broad as is healthcare but do you think there are any tech jobs where one is pretty safe from all of the above if they are exceedingly dedicated to their work? It seems tech has a higher ceiling than medical stuff does and I was wondering if one who was "one of the best" in his or her field would be relatively safe from all of the above.
Are there certain aspects of tech where american graduates get jobs? I know software engineering is a total different league than general computer science and am wondering if you have grouped the general CS majors, and other lower end tech fields into the american STEM category? On the last note, do you think it is those who are not good/bottom of class that do not get hired from the american STEM group? I am assuming its not like med school where the worst in the class will still get residency and a job usually. thanks for the answers in advance!
Thank you for your response. The way for an American in high tech to stay employed is to be at the top of their game and to always learn the latest and greatest. We used to say you had to be at the "bleeding edge." Think of tech like surfing. You want to be just ahead of the wave breaking. This means being aware of the trends and the new upcoming technologies at all times and making sure you keep learning and training. Once a technology becomes well-established, and a lot of people are knowledgeable, then it is like to be outsourced, especially overseas. This is commoditization. So, someone who does maintenance low level programming is vulnerable and also not going to command top dollar. Individuals who are hot shot programmers in a language where there are not a lot of experts are gold. Good programmers can advance to technical architects and good ones make excellent money. For example, there was a time when the Java programming language was new and up and coming, so good Java programmers made excellent money and had lots of opportunities. Now they are a dime a dozen. Same with technologies like content management and so forth. If you want to be an employee, look for companies that are on the leading edge and/or invest in training for their staff, also look for the good consulting firms like Accenture, etc. Once a person has a "hot" skill they can make a boatload as an independent contractor, but only for as long as the skill is "hot." Good luck!
Specializes in Psychiatric and Mental Health NP (PMHNP).
Extremely tedious, and bereft of objectivity of thought... You haven't internalized even an iota of what was written in my previous post. You continue to make this only about YOU and YOUR life experience. Re-read all of your posts--- 'me, my, I...' Remember though that there is a world of reality that others live in that is a whole lot bigger than your own.
"There are plenty of good NP jobs out there begging for applicants" is an opinion. Stop trying to present it as a fact. You are not doing new grads who are out there looking any favors by posting things that aren't true.
My final words to you: good luck!
Thank you for your good wishes. I have consistently provided evidence. Supply and demand for NPs is regional. You are the one who provides no evidence. As for whether a location is "good" or "bad," of course that is subjective. However, many people simply rule out a location like Fresno without even taking the time to go visit the area and see whether or not it is good or bad. My point, consistently, is to maintain an open mind. NP is consistently rated in the top 10 careers for pay and opportunity on a national level. It is up to individuals to take advantage of the opportunities available and research before starting an expensive education program on job opportunities and pay in their desired location(s). It is not the responsibility of schools/government/anyone to guarantee every NP a great job making top $ in the location of their choice. And a hard truth is that people who are flexible and willing to make sacrifices like moving are the ones most likely to enjoy significant career progression. Individuals who cannot relocate must determine the best career options based on their constraints.
Important to know your source. The job websites are notoriously low as compared to what I have made even as a new grad. I get emails all the time from recruiting companies with salaries that mean nothing until you actually find out the back story. I have pursued opportunities that were offering far less than they advertised and gotten jobs making far more than was listed. If I were looking for a reliable feel for the opportunities and salary quote it would be from my fellow NPs, in my specialty, in my area.
Spadeforce
191 Posts
Did you research what nursing was prior to going into it? Having that "i know more sciency stuff" than you attitude to your professors will help you make friends quickly lol
I am on my psych rotation now (in med school) and we had a couple nursing students with us today. They ALL want to be nurse practitioners. Some have some interest in nursing but a few are literally like "wow omg nursing sux just wanna be NP"
I turned to my classmate on the rotation with me and said "this is why I stopped working as an NP and went to med school, EVERYBODY wants/is in NP school and our salaries are gonna tank!. They don't have the residency bottleneck like we do.
I know it sounds anecdotal but back when I was in the hospital working as an NP half the floor was in NP school, 3-4 years later it still holds true. For those stating we do not or will not have a saturation in NP land you are either a recruiter lying or just delusional. There are a few final bastions of the US where jobs are plentiful but the orcs will come for you sooner than later to cut your salaries since they will work for much less.
On the bright side maybe bedside nursing salaries will go up?
Honestly people need to just get off this obsession with healthcare that colleges have fed us. Unless one is in medicine and in a non coastal city, literally there is no true shortage of MOST healthcare jobs in MOST areas. Its just BS that colleges feed us to get our dollars.
Literally take a look at the government predictions on physicians/PA/NP/RN/LPN (not on BLS.GOV but the actual department of health and human services website).
Projected SURPLUS of MOST THINGS (NP/PA/RN) and deficiency of (MD/DO/LPN) in most areas. While its difficult to predict the future, its def a better analysis than Fullglass's "i got a good job why cannot everyone else"? mantra.
Go into computers if you want the good jobs otherwise dodge the healthcare bullet.