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.
Specializes in Psychiatric and Mental Health NP (PMHNP).
2 minutes ago, irvine123 said:
Which is why if your going the NP route to get paid more dont do it becaude regular nurses working 4 days a week with much less responsibility get better wages and go home to sleep. Not the case for the NP.
What are you talking about? A primary care NP works 8 to 5 M-F, and many can work 4 10-hour shifts, with no on-call and no weekends.
While some RNs can make a lot of money, that is generally from working extra shifts or night shifts.
On average, NPs make more than RNs, and with better work hours. In addition, NPs do not have physically strenuous jobs like RNs do. I've seen too many RNs or former RNs with back problems.
While providers have more responsibilty than RNs, RN is plenty stressful, depending on the specific job. As a primary care NP, I seldom have to deal with life or death situations and do not find my work stressful, now that I have finished my first year.
I heard this alot when going to nursing school. "Dont do it for the money" If none of us cared about the money, we would all work for free. I want to be able to provide for my family and not incur unneccessary debt that would not yield any profits in the long run. I also want to have more autonomy and do more for my patients. Clinic hours also seem more appealing to me.
It's a mixed bag. In some aspects, we may be looking at wage reductions if saturation hits numbers that are projected in the next 5 years. Even in areas I feel NEED providers as of last year (note middle of nowhere US), they were talking about 80-90k/year with monetary incentives for meeting goals potentially adding more money. Some said 95 for a new NP with a reduction in pay after 1 year to account for what should be an increased patient load plus patient visit bonuses. That was less than I made in Michigan starting out and we aren't exactly a high need state. Many places are testing the waters of lower wages because they are seeing multiple applicants, many of whom are brand new desperate for a job.
What are you talking about? A primary care NP works 8 to 5 M-F, and many can work 4 10-hour shifts, with no on-call and no weekends.
While some RNs can make a lot of money, that is generally from working extra shifts or night shifts.
On average, NPs make more than RNs, and with better work hours. In addition, NPs do not have physically strenuous jobs like RNs do. I've seen too many RNs or former RNs with back problems.
While providers have more responsibilty than RNs, RN is plenty stressful, depending on the specific job. As a primary care NP, I seldom have to deal with life or death situations and do not find my work stressful, now that I have finished my first year.
You make some points that are often ignored. Most nurses have to work overtime to earn what most NPs earn. Most people also do not talk about the wear and tear on the body that comes with bedside nursing.
Specializes in DPT, DNP. Ortho, Family Practice, Psych..
57 minutes ago, Mimibsnrn said:
I read this thread from beginning to the end and I have got to say I am terrified of going on to NP. I am already enrolled and set up to start an FNP program in September, but this thread scares me. I dont want to spend more money on the degree and end up not finding a job. Most of the people I talk to keep saying that I should go the PMHNP route. One FNP I talked to said he was going back to get his Psych NP to increase his earnings. I guess I will keep doing my research and hold off on school in the mean time.
What side of the country are you located? @djmatte already brought up some good points. It's already been discussed ad nauseam as to why there is a surplus of NPs (surplus of awful programs, low threshold for school acceptance, etc.). If you download AANPs fact sheets for NPs, it should scare you. At the end of the day, you'll have to leverage every experience you can to separate yourself from the competition. For me, being a physical therapist has been invaluable. If you're a nurse, I really think being an ER nurse is your best bet to getting your foot in the door. It is a specialty that is applicable to every field, particularly being a primary care NP. If it's some random specialty that doesn't correlate well with being an NP, you can forget it. You'll need an "in" or it just won't happen. Job recruiters will look at your resume and many of them won't think you can bring anything to the table.
What side of the country are you located? @djmatte already brought up some good points. It's already been discussed ad nauseam as to why there is a surplus of NPs (surplus of awful programs, low threshold for school acceptance, etc.). If you download AANPs fact sheets for NPs, it should scare you. At the end of the day, you'll have to leverage every experience you can to separate yourself from the competition. For me, being a physical therapist has been invaluable. If you're a nurse, I really think being an ER nurse is your best bet to getting your foot in the door. It is a specialty that is applicable to every field, particularly being a primary care NP. If it's some random specialty that doesn't correlate well with being an NP, you can forget it. You'll need an "in" or it just won't happen. Job recruiters will look at your resume and many of them won't think you can bring anything to the table.
Serious truth on your ability to differentiate yourself. I spent the majority of my RN career in Periop services working PACU/PreOp. That background was awesome if I wanted to just stay there for my whole life, but did little for me as an FNP beside the capacity to recognize many end results of life-times of poor management of a range of situations. If it wasn't for my last two years working in acute/chronic pain and setting up my own inpatient pain service, I wouldn't have had as much of an in or negotiating range had I stayed in PACU. It helped me set a solid interview recognizing the new changes in the pain management landscape and also helped my clinic transform from being a huge opiate space to something more palatable by federal/state and primary care standards.
NP pay is going to be based on market factors, end of story. Still it rankles me that when the NP is paid 40% of the MD rate for similar work in primary care, that margin is siphoned off into somebody's pocket. Usually the MD who "supervises", or "collaborates". The low pay or savings, depending on how you look at it, are not passed on to the public or the health care system at large. Not at all. Not even a little.
I just reviewed my latest Medicare EOB and saw that the NP who saw me in the ER recently charged $921 for the encounter, which was nothing more than a focused assessment, and Medicare paid only $100.29 and nothing for the BP reading which was also mentioned. Notwithstanding that I don't know the intricacies of insurance billing, I could not help but be initially jealous of the charged amount. Imagine me charging that for one hour billable of my patient "encounter", including measuring a BP. Even at paying $100, somebody is getting over on John Q. Public. People don't realize that basic nursing care, focused assessment and measuring a BP, is a bargain.
Socializing medicine would save a whole lotta money but then all the salaries would go down and big pharma/insurance would lose out on a lot of dough which is why it wont happen because its all about "me" in the US of A.
Not everyone can pack up and relocate, and not everyone is up for working in middle of nowhere. So seriously think about your situation and local demands, and position yourself in the most competitive ways. In my high-COL area, new grad FNPs and AGNPs start around $80k *IF* they can find a job. Even the Psych NP market is saturated in my city and many jobs now require 2+ years of PMHNP experience. (My state has an oversupply of both psychiatrists and psych NPs, but local distribution issues do exist.)
There are a lot of FNP/AGNP going into psych, even if they had little interest prior. Nobody can stop others from doing that and I don't really have an issue with it. However, PMHNP programs provide the bare minimum even at top programs. Without the strong interest in this specialty it's hard to remain motivated to learn much on one's own and the result is likely borderline competence in treating this challenging population.
In a lot of ways graduating with a NP is like graduating with a Bachelor's in Business Administration. You can get either degree in a lot of different places, completely online, cheap, or you can spend a ton of money getting the degree at Yale. There are tons of people that have the degree and no job, while there are some with "just a bachelor's degree" running very successful businesses. What separates them? This is what you must ask yourself. The market may be oversaturated with NPs, but what kind of NPs? What kind do you want to be? I am not just asking about what specialty...what are YOU bringing to a very messy table in which the patients and professionals sitting at it need help. There are markets oversaturated with nurses as well, because there are all kinds of associate and bachelor degree prepared programs. This problem is not unique. I am not saying it doesn't concern me, it does. It is scary and stressful...but it should be. The amount of responsibility it daunting and it is good that our Healthcare system is capable of being picky and choosey about who gets a job with such fly by night programs existing, simply in the interest of public safety. An obtained degree should not equal an automatic 6 figure job. Ever. For any profession. We all know people in our lives that can probably be fantastic in a position like a NP without all of the formal education just because of who they are, how they learn and how they apply knowledge where they are. We also know people who could graduate a program like Duke and be a problem. Ideally our market would never be so desperate. This makes life a little tricky and competitive....but it should be. Just my thoughts.
I read this thread from beginning to the end and I have got to say I am terrified of going on to NP. I am already enrolled and set up to start an FNP program in September, but this thread scares me. I dont want to spend more money on the degree and end up not finding a job. Most of the people I talk to keep saying that I should go the PMHNP route. One FNP I talked to said he was going back to get his Psych NP to increase his earnings. I guess I will keep doing my research and hold off on school in the mean time.
I am currently working night shift RN on a heavy med-surg/geri unit just to get health insurance and to have stable hours. Once a week I round for 4 hours for an Internal Medicine MD and I have talked to 7 new grad NP's all working as RN's looking, applying for a NP job. All of them ask me for my thoughts and opinion. Mind you, that this hospital has 1000 beds, teaching magnet hospital.
Schools want money- everything is a business. Private doctors are unpredictable if they are paying hourly, and if they pay salary they take advantage and overwork you.
Great posts from everybody, thank you for sharing your thoughts.
Programs should require at least 2 years of experience prior to starting a NP program as well as limiting the acceptance rate and preventing accelerated programs from opening up. That would help the kmage of the NP profession and future NPs
Teaching was never anything that great, but it was a steady job with benefits, and the credentials were easy to get. You had summers off.
Fast forward 15 or 20 years, and there were 100 teaching applicants for every job.
Law used to be very decent, but the number of lawyers needed was overestimated.
Also greatly overestimated was the pay, considering the investment.
The US is replete with adjunct professors, who now supply more than half of our college education. Many of them have truly pathetic lives, poverty wages and no benefits, along with their PhD. If you don't know about their plight, you should google it.
The NP profession is headed this way, in my opinion. How could it not?
FullGlass, BSN, MSN, NP
2 Articles; 1,964 Posts
What are you talking about? A primary care NP works 8 to 5 M-F, and many can work 4 10-hour shifts, with no on-call and no weekends.
While some RNs can make a lot of money, that is generally from working extra shifts or night shifts.
On average, NPs make more than RNs, and with better work hours. In addition, NPs do not have physically strenuous jobs like RNs do. I've seen too many RNs or former RNs with back problems.
While providers have more responsibilty than RNs, RN is plenty stressful, depending on the specific job. As a primary care NP, I seldom have to deal with life or death situations and do not find my work stressful, now that I have finished my first year.