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).
1 hour ago, ThePTNurseGuy said:
You’re a good person FullGlass. You truly are helping people out on this forum, and I’m sure many people appreciate it. You looking to stay in California or are you willing to go wherever?
Ive always been told that obtaining 2 out of these 3 variables is reasonably obtainable: (1) compensation/benefits, (2) specialty preference, and (3) location. Obtaining all 3 can be especially difficult, particularly depending on your experience and where you live. It’s possible, but the main takeaway is that you usually have to give up something, no matter where you are. There are dream jobs out there that have all 3, but sometimes that isn’t realistic for NPs (or any profession for that matter).
Thank you for your kind words. I agree with you on getting 2 out of 3 on most matters.
Personally, I am getting fed up with California. My goal now is to get a job in an affordable area. When I get closer to retirement, I will be moving to another state with lower taxes, lower cost of living, and a state government that is not a bunch of looney tunes. I'm seriously looking at Washington State, Southern Oregon, Nevada, New Mexico.
Here in California, there are some very nice affordable cities like Bakersfield, Fresno, Redding, etc. They also generally pay MORE than SF, LA, or San Diego, because they have a hard time attracting providers.
I just got a job offer for $150K per year for an interventional pain mgt group, going to $160K per year in year 2, in Bakersfield. Bakersfield is growing like crazy and the metro area now has 849K people. You can buy a nice house for $200K to $300K and it is only 1.5 hours to Los Angeles! Unfortunately, I had to turn it down because it did not meet the public service requirement of my Nurse Corps Scholarship.
In the Central Valley of CA, primary care NPs can make $120 to $150k per year. Remember, this is a very affordable area. Specialty and acute care NPs make more than that, with PMHNPs easily making $180K+ per year with a few years of experience.
3 hours ago, momofm1998 said:
All I can say is what I have experienced as an NP with tons of RN experience and I do know how to do a pap smear. the salaries offered to NPs new or experienced in middle TN are 20% less than being offered in some other states. Job openings are rare to non existent, My current salary as an NP is the same as I made as a travel RN in 2003. "Fullglass BSN, MSN" is obviously in a prime state for midlevels. Please share that location, I will move tomorrow!! I see ads here everyday and have actually received offers( same as I made as an ICU RN in 2000) for positions that make me just regret ever going through the pain and expense of going back for my NP. I was much more marketable as an RN. I will never pay my student loan off and it has hampered any hope of mortgage approval. For what?? A salary I could make as a manufacturing plant worker with a high school diploma??? Yes, I love my work, but I have to feed my family also. And yes, our schools have betrayed us with their greed by diluting the market. "Here $25K tuition, ok here is your NP certificate". When do we stop them and how???
Unfortunately, it appears TN really does pay NPs poorly.
I just got a job offer for $150K per year for an interventional pain mgt group, going to $160K per year in year 2, in Bakersfield. Bakersfield is growing like crazy and the metro area now has 849K people. You can buy a nice house for $200K to $300K and it is only 1.5 hours to Los Angeles! Unfortunately, I had to turn it down because it did not meet the public service requirement of my Nurse Corps Scholarship.
In the Central Valley of CA, primary care NPs can make $120 to $150k per year. Remember, this is a very affordable area. Specialty and acute care NPs make more than that, with PMHNPs easily making $180K+ per year with a few years of experience.
Specializes in tele- 7 yrs, Pyxis- 3 yrs, med/surg 4.
As programs shift to DNP this high bar will hopefully stem the tide of grad mills. I am a bit worried....I am in a fnp program and the thoughts of finding a preceptor much less a job have given me much reconsideration.....I am thinking of attempting to switch to mental health as the actual program has not started. I completed adv patho and pharm. I am in the last msn program at my university...USM....and going forward all np programs are dnp.
Specializes in DPT, DNP. Ortho, Family Practice, Psych..
9 hours ago, phil1968 said:
As programs shift to DNP this high bar will hopefully stem the tide of grad mills. I am a bit worried....I am in a fnp program and the thoughts of finding a preceptor much less a job have given me much reconsideration.....I am thinking of attempting to switch to mental health as the actual program has not started. I completed adv patho and pharm. I am in the last msn program at my university...USM....and going forward all np programs are dnp.
What program are you in and where are you located? And when you say mental health, do you mean PMHNP or something else?
What “headaches” are you saying that the CRNA profession is having?
When I was a periop RN, there were many complaints of their own saturation. Certainly not on the scale NPs face, but their we’re at the time starting to show it. Also as they typically fall under anesthesia services, they were finding less groups willing to to pay previous salaries. We had an MD from one group a couple years back splinter off, undercut the previous group While hiring new CRNAs and the hospital switched. Many saw it coming and some switched at a pay cut while others protested. In a single day almost an entire CRNA team switched. That is a frightening prospect to me for one of the most advanced degrees You can get as an RN.
That is why one of the obvious answers to the "oversupply" question is to move to an independent practice state (there are over 20 now) and compete directly with physicians where we can (PMHNP's, FNP's primary care, nurse midwives, and even anesthesia (even if the hospital requires an MD the CRNA owned group can hire them). One of the awesome things that I am finding as a PMHNP in looking for a job in the Western states is that the best groups to work for seem to be owned by counselors (not NP's or MD's). They seem to be nicer, offer better pay (perhaps because most of their income is generated by being counselors and I am just an "added service" for their patients). Let physicians be the ones to start squirming for a change.
When I was a periop RN, there were many complaints of their own saturation. Certainly not on the scale NPs face, but their we’re at the time starting to show it. Also as they typically fall under anesthesia services, they were finding less groups willing to to pay previous salaries. We had an MD from one group a couple years back splinter off, undercut the previous group While hiring new CRNAs and the hospital switched. Many saw it coming and some switched at a pay cut while others protested. In a single day almost an entire CRNA team switched. That is a frightening prospect to me for one of the most advanced degrees You can get as an RN.
Corporate anesthesia groups are constantly being taken over by other groups (sometimes hostile). The newer group never gives you MORE:)
My old group had a difficult time recruiting both MDA's and CRNA's but now has somehow snagged 6 residents to solve staffing issues. This won't help CRNA salaries which are stagnant. My program now cranks out almost 5 times the grads it did in the 80's. And some of them come to an old employer of mine for clinicals. I think they should have paid the students to come there instead of the students paying exorbitant ivy league tuition. The quality and passion of the attendings was poor to negligent. Nothing like the days when faculty was looking over your shoulder.
The state our teaching programs has deteriorated to the detriment out ability to practice independently. Too many students without instruction...I couldn't agree more about this. IMHO, the schools are becoming derelict and complicit in making their missions a series of business decisions.
There was a time when becoming an NP was a big deal. It meant interviews, GRE, making top grades in your BSN and hoping to get in. Then you worked your butt off with top notch preceptors and hands on labs. In the end you were in high demand with a specialized skill set.
Then the for profit schools caught wind of it. They started marketing "NP degrees in 18 months online, no interview and no GRE!" to everyone they could. These schools now regularly graduate literally THOUSANDS of NPs a year with almost no instruction - no hands on labs, no standardized preceptors, almost no oversight at all. These poorly prepared graduates oversupply the market and bring down everyone's wages while serving as an example of what's wrong with the "mid-level provider" profession for physician lobbying groups.
Advice to potential NPs: don't do it. Until the certification bodies decide raising our standards is worth more than the money they get from all these graduates taking exams, our profession is heading downward.
That really sucks and I hate to hear that. Unfortunately your story is becoming the norm and not the exception. Some on here will tell you go west and work in a rural clinic. Most new NPs can't just pick up and move to the middle of nowhere to start a new job. Those that can have already started to do so and this just pushes wages down as the flood of new grads accept any job at any wage to just get experience. As a whole, the leaders of NP schools have destroyed us by flooding the market with an overabundance of new NP graduates. I expect NP wages to equal or be below RN wages within 3 to 5 years across the country with the continuing mass production of NPs. It's simple oversupply vs demand.
I know this is an older thread. However, it is likely still relevant.
The original reason for creating NP's was to make care more available in areas where medical care was limited or non-existent - rural areas, for example.
But it didn't quite work out that way. NP's became abundant in cities instead of moving to the underserved locations.
For example, if you want to see Ortho, you must instead see the PA or NP, who will determine if you get to see the MD. I think the mid-levels do a good job, it's just a hard concept for me to be told I can't see an MD unless I first see the mid-level.
I think it is unrealistic to expect schools to lose their income in order for NP's to maintain their own income.
Med schools intentionally have limited the number of students they take. Now they are somewhat undermined by mid-levels, depending on the biz model of the practice.
Doctors are pretty much employed by big health care systems rather than being business owners. The system requires that they limit the time they can spend with each patient and dictates various other rules doctors practice. Insurance companies tell them what tests they can order, Congress tells them what they can prescribe (pain meds).
No I don't feel sorry for doctors. They still can make tons of money and they still get close-in parking. They still garner the most respect and get the credit for success that is often more the result of other people's work than their own.
I guess the cure is for those who aspire to advanced practice to have a course in business/economics in addition to actual AP courses.
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FullGlass, BSN, MSN, NP
2 Articles; 1,968 Posts
Thank you for your kind words. I agree with you on getting 2 out of 3 on most matters.
Personally, I am getting fed up with California. My goal now is to get a job in an affordable area. When I get closer to retirement, I will be moving to another state with lower taxes, lower cost of living, and a state government that is not a bunch of looney tunes. I'm seriously looking at Washington State, Southern Oregon, Nevada, New Mexico.
Here in California, there are some very nice affordable cities like Bakersfield, Fresno, Redding, etc. They also generally pay MORE than SF, LA, or San Diego, because they have a hard time attracting providers.
I just got a job offer for $150K per year for an interventional pain mgt group, going to $160K per year in year 2, in Bakersfield. Bakersfield is growing like crazy and the metro area now has 849K people. You can buy a nice house for $200K to $300K and it is only 1.5 hours to Los Angeles! Unfortunately, I had to turn it down because it did not meet the public service requirement of my Nurse Corps Scholarship.
In the Central Valley of CA, primary care NPs can make $120 to $150k per year. Remember, this is a very affordable area. Specialty and acute care NPs make more than that, with PMHNPs easily making $180K+ per year with a few years of experience.
Unfortunately, it appears TN really does pay NPs poorly.
I just got a job offer for $150K per year for an interventional pain mgt group, going to $160K per year in year 2, in Bakersfield. Bakersfield is growing like crazy and the metro area now has 849K people. You can buy a nice house for $200K to $300K and it is only 1.5 hours to Los Angeles! Unfortunately, I had to turn it down because it did not meet the public service requirement of my Nurse Corps Scholarship.
In the Central Valley of CA, primary care NPs can make $120 to $150k per year. Remember, this is a very affordable area. Specialty and acute care NPs make more than that, with PMHNPs easily making $180K+ per year with a few years of experience.