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.
I could not agree more. There is a glut and those that disagree are in my mind naïve. Those of us in the trenches see it. Just because you got one great job in the middle of nowhere USA doesn't mean jobs are plentiful and salaries are rising. In fact based on simply anecdotal evidence from over a dozen of my NP friends wages are decreasing and jobs are becoming more difficult to find for even the very experienced NPs. If I was considering being a NP for a career at this point I would seriously have second and third thoughts. It's just not a good time to be a NP if you are in it for $$$
There are much better careers than nurse practitionering out there. I got in while it was good and left to go back to med school. Almost done and would never go back. the same places where NPs are fighting for jobs, the hospitals are fighting for doctors, of all specialties. Literally if I applied for a job here as an NP id be fighting tooth and nail for a spot, yet, here not even done with med school we get shimmied into recruitment dinners and tons of stuff like that.
of course if i was starting out again id do computer software engineering and development lol
The job out look, as of now, for physicians in rural and non coastal areas is great. The residency cap helps docs out by limiting supply to a point. Some say it may be greedy but increasing supply of any job well over demand only helps the businesses employing them, and with medicine being so regulated, it never fares well for the employee
There are much better careers than nurse practitionering out there. I got in while it was good and left to go back to med school. Almost done and would never go back. the same places where NPs are fighting for jobs, the hospitals are fighting for doctors, of all specialties. Literally if I applied for a job here as an NP id be fighting tooth and nail for a spot, yet, here not even done with med school we get shimmied into recruitment dinners and tons of stuff like that.
of course if I was starting out again id do computer software engineering and development LOL
The job out look, as of now, for physicians in rural and non coastal areas is great. The residency cap helps docs out by limiting supply to a point. Some say it may be greedy but increasing supply of any job well over demand only helps the businesses employing them, and with medicine being so regulated, it never fares well for the employee
Alot of people seem to be going back for the STEM careers that relate to technology. I know I am ?
As my fluffy childhood friend would thoughtfully say removing a grape sucker from his mouth, "Welp, I dohno."
Well, I don't know. It's a multifactorial probelm shared by lawyers and pharmacists.
Too many schools many if which have questionable standards
And the glut still not wanting to work with the underserved when the ivory tower nursing leaders profess NPs to be there for those neglected by "rich doctors."
Heck, job or no job, I'm not living out in the wild yonder much less the inner city.
The CRNAs had their metaphorical stuff together long ago. They do hard things academically and embrace that. They have standards. Even in my state, at a real university, as a RN student, I was told, at this point if you want to get into the NP program and can pay you'll get in." And it's affiliated (on the campus of) with a top university medical center. There were perfunctory admissions requirements, but the only gal I ever met who had her heart set on being a NP only to get rejected sbowed me a letter that the school was terminating its gynecology NP program. She re-applied to family and got in.
agree with the above, there will always be jobs in computers. Especially for the best programmers and firewall builders. Doing that stuff probably has a higher skill cap than most of whats done in nursing or medicine.
I can only imagine what the best firewall builders make. prob upwards of a mil a year since we seem to value money more than human like nowadays lol
Part of the problem too is that people aren't happy being BSN nurses, so they're going the NP route in hopes that it will be better and that they can salvage their career. Some people legit want to be NP's, and that's fine, but many are simply unhappy as RN's and see NP as an oasis, still within the nursing realm. Yet most of the one's I've seen graduate are no happier as NP's than they were as BSN nurses. The entire profession wholly has a problem with burnout and unhappiness, particularly in the hospital setting. I think that if this were not first the issue, we wouldn't see so many flocking to NP programs.
Finally. I have been reading through this whole Negative Nellie thread, and not one person mentioned the obvious---DIRECT CARE MODEL.
A friend is a direct care MD in Post Falls, ID--and she loves it. Former Navy MD and she wouldn't go back to any service to anyone other than her patients, ever.
Direct care is big in Oregon, where NPs can work without MD oversight---and you can practice in many other states the same way. Relocate if the laws of your state don't align with your personal goals. I don't understand people, I really don't. We can prioritize our patients lickity split, but we can't make sacrifices to prioritize our lives and professional course?
My plan is to do direct care. My pal's patients love her. She gets to spend an hour with each one. She charges $80-100/mo and has about 1500 pts. She still does appointments only, so no walk-ins unless they are emergent--but in that case, if it's that bad, they're going to the local ED anyway. The patients feel cared-for, as she answers her phone and is available, with no MAs or insurance clerks or hassles with coverage and billing slowing her down.
I may not strike it rich doing it this way, but I've watched my friend do this successfully for 18 years and she has constant offers of buying her out, or some type of corporate schtick mumbo-jumbo accountant propeller head trying to get her to "up her income" by selling out.
I want to take care of my patients, not work for a corporation. If that means I get to pay for malpractice insurance, but I get to go home at 4p after my last patient, I will do it. I don't need to make $1m a year. I was married to that and it's not pretty how that obsession with money crushes your love of life.
There was a direct care set up in Portland/Seattle not long ago--they were doing well---and then sold out to some scheme that would "increase their profits"...I believe it was accepting medicaid or medicare...and it all went to crap.
It's very small minded of some here that the only way you can succeed is by being exploited by someone else.
My plan is to do direct care. My pal's patients love her. She gets to spend an hour with each one. She charges $80-100/mo and has about 1500 pts. She still does appointments only, so no walk-ins unless they are emergent--but in that case, if it's that bad, they're going to the local ED anyway. The patients feel cared-for, as she answers her phone and is available, with no MAs or insurance clerks or hassles with coverage and billing slowing her down.
I love thinking outside the box but if you are referring to a cash practice keep in mind that unless you want to waste valuable time doing MA tasks yourself ancilary staff is a necessary and an intelligent business decision. Why would you spend your time answering phones and chasing down labs when you could pay administrative staff $20 an hour to do it? Something else to consider is that many cash practice patients have insurance and will be submitting in which cases you will still have insurance invoices and prior authorizations to be completed. I know some wealthy people who go to boutique practices but none of them are paying out of pocet for medications.
I can understand where you're coming from; all I can say is that if I had to be paid the same to be an RN or an NP I'd choose NP a thousand times over! Not saying you should settle for less money, because NP's bring in revenue which we should be appropriately compensated for but please don't think you made the wrong decision unless it was solely money based... I love being an NP, I hope you will too. Oh and another thing, the preceptor shortage is a problem everywhere but doesn't reflect on the overpopulation of NPs it's just that most providers don't precept and new grads obviously cannot precept. It took me 3 months after I graduated to find a job ( I was very picky and only wanted private practice). Good luck :)
I love thinking outside the box but if you are referring to a cash practice keep in mind that unless you want to waste valuable time doing MA tasks yourself ancilary staff is a necessary and an intelligent business decision. Why would you spend your time answering phones and chasing down labs when you could pay administrative staff $20 an hour to do it? Something else to consider is that many cash practice patients have insurance and will be submitting in which cases you will still have insurance invoices and prior authorizations to be completed. I know some wealthy people who go to boutique practices but none of them are paying out of pocet for medications.
Yeah one also has to assume people are willing to pay 100 to see a NP instead of a doctor. a lot of docs set up those practices since they are one of the only fm or im docs around without a 5 month new patient waiting period. "Three months wait for doc 1 week for NP"
Not bashing NPs but anecdotally this is usually how it is
nor sure how it is in psych but I know psychiatrists ain't cheap LOL
Yeah one also has to assume people are willing to pay 100 to see a NP instead of a doctor. a lot of docs set up those practices since they are one of the only fm or im docs around without a 5 month new patient waiting period. "Three months wait for doc 1 week for NP"
Not bashing NPs but anecdotally this is usually how it is
nor sure how it is in psych but I know psychiatrists ain't cheap LOL
Not to mention the aca requirement of insurance put the pay as you go idea into questionable territory. I know the requirement is slowly going away, but it's still a concern. My other concern with cash models is it opens you up to further scrutiny as feds vie it as a method to circumvent methods they use to evaluate care. We've had a few passion clinics and pcps in our area shut down when they used cash models to avoid scrutiny. Thankfully DEA catches up with them eventually. But still gives a bad rap for cash model businesses.
wayemika
332 Posts
This really is good and insightful advice