Jules A

So sad I just found this and mine are gone. Most of you probably don't remember Joyce but I had some from her Daytonite.

It probably isn't about how the OP is presenting and maybe its different for CRNAs? NPs can call themselves whatever they want including "doctor" if the facility allows but it will not put them on par with a physician. The hospital where I work calls us something else which I can't even remember what but it groups NPs and PAs together under physicians. I really don't care what they call me because I have no delusions that my education or knowledge is anywhere near the level of a physician.

and no RN experience with meds or presentations.

These aren't great, imo, unless you are doing a very high volume. My RVU pay is in the $29 and change. It averages out to a minimum of $90 an hour but my volume is heavy. Like OMH said you will have to crunch the actual numbers and see what will be the best for your style and financial goals.

It seems they also don't cover BPD vs Bipolar, Delirium vs Schizophrenia, Malingering or drug seeking at all....but lots of polypharmacy and erroneous diagnoses.

For me although I am efficient I have no interest to do 10 minute appointments on an OP basis. My focus has always been the bottom line so I would need to know the actual numbers for #1 and #2 to estimate my possible income. Is health insurance factored into either of those options also? Everything has a dollar sign you can assign to it so that is what I would do and then look at the likely gross. I'm attracted to #2 as much for the name as anything and also because I work well with an incentive. I work this type scenario inpatient which I like because there are follow-ups and uncomplicated consults I can blow through quickly and the times I get slowed down by a particularly complicated case or getting collateral doesn't throw off my overall numbers.

Physicians are more valuable and higher on the food chain than we are simple as that. If you also work for RVUs you might consider changing jobs as this seems to be the writing on the wall. If in fact she has difficulty keeping patients I would wonder if she will ever fill up or you will be stuck with her sloppy seconds indefinitely?

It is a reality in psychiatry and now the psychiatrists who used to be NP friendly are not so much both due to the tightening up of opportunities and the low quality of the new graduates. Why would a clinic hire a psychiatrist for 2xs the money if they can use NPs?

I'm guess this was said tongue in cheek? Because I can tell you exactly how it will go. Why would anyone pay you $200,000 a year when a bright, shiny new DNP, who hasn't worked on day as a nurse or actually anything else, is willing to do it for $100,000. And as you know employers could are less if the person is competent as long as they have the credentials.

I agree and there are times when I feel my foul language is getting excessive but as you point out I usually decide I'm fine with it and carry on status quo. I probably won't change my ways but it does give me pause when I realize there are those who are truly offended by it because that is never my intent.

Pay attention to this folks it is the truth. The last experienced NP hired in my department is making $40,000 a year less than myself and a colleague who started when I did and $10,000 a year less than the last new grad hired. Sorry I don't have their pay stub to compare to mine so no actual proof. Although I can't think of a reason I'd be motivated to lie about it. Make it your business to find out what other NPs are making and don't put yourself in a position where you are desperate for work. This is the truth and its simple math not even the complicated stuff.

It is one of my all time favorite words. I use it often although not directed at others or knowingly in ear shot of a patient. Cursing is like scrubs one of the few perks of being a nurse.

Best wishes. Please let us know how things work out.

$53 an hour is a terrible rate in my opinion even for a FNP. I would be more proactive than just telling them you were offered $95 an hour as 1099 and also include the rate it would take to hire me. Note to others: Don't back yourself in a corner and wait until your job is unbearable before starting to explore other options. Coming into negotiations from a position of desperation is never a good starting point.

Excellent points and unfortunate although I tend to avoid the whole discrimination thing. It is business and their job is to get someone for the lowest rate and there are factors that go into who is more desirable regardless of actual legalities. I also suspect right from the start OP presents as one who will take whatever they offer since it has happened previously. They mentioned multiple reasons why they won't try to find another job or insist on a rate matching their peers so in this case it sounds like both parties are getting their needs met. It is unfortunate but if someone is willing to work for low rates the employers are happy to oblige. If they aren't willing to walk away from a job or refuse one with a terrible offer there's that.

If you are the first NP that might work to your benefit. Jeez so non psych NPs are practicing and PAs are also working in psych in your state? Thats unfortunate. We rarely see that here which also adds to our value. Collect rate information for NP jobs in your area to add to your current pay documents and present it. You will probably have to be patient as they work things out but if they need you they will pay. Doubtful it will be as nice as you are picturing it but will at least reduce your commute which is money too. Good luck.

I wouldn't approach it as letting them know they lowballed you, because there are clueless NPs out there willing to work for embarrassingly low wages so who knows how they came up with that figure. More along the lines of "$130 an hour is my current rate from XYZ and therefore I would need $ABC to consider making this move". Its always helpful if you know other NPs in the area and what they are making to add strength to your negotiation and so you aren't going into an area blind. I think the loan repayment is something that varies from year to year but I haven't heard of anyone who took a job with that intent and didn't receive the payment. I work in a DC suburb. Feel free to PM me but I think this is a good topic to keep online for the sake of others who might benefit. There are so many new grads and all the low earning post masters FNPs jumping on the psych bandwagon that it is ruining the earning power of this specialty.

Trust the $130 an hour isn't causing me any confusion. That would be my established rate. It is unfortunate you are willing to give up on that opportunity as it relates to your next job. In my area a new grad PMHNP should start at a minimum of $150,000 a year regardless of tuition reimbursement.

Add the numbers. I would imagine the extra $158,400 per year might make up for the lack of benefits.

First and most importantly why on earth would you even consider working for $53 an hour when you are making $130 an hour? Good benefits will never make up for such a terrible annual rate. Keep in mind the clinics that offer tuition repayment are not in any way contributing to the payment so it should not be considered part of their reimbursement. And while YMMV the clinics I know who have this designation are not the most organized and the locale is undesirable. I'd need an extra $40k tax free on top of my current salary to even consider working at the two I'm familiar with because I know the prescribing that has been passed along from one awful prescriber to the next and I'm not interested in the benzo and stimulant roulette game. It is my understanding that if you don't fulfill your obligation the penalty is extremely stiff, not just a matter of paying back the bonus you have received but there are fines in addition?

I know this sounds snarky but from where I sit this latest, greatest dual whatever is yet another cash grab for the universities. That our fellow nurses, the nurse educators, are participating in the reaming of our own is inexcusable, imvho.

I work both inpatient and at a local clinic. My rates are consistent, the job with benefits pays $30 an hour less than the job without benefits. I'm decent at what I do and well known but only a rock star in my mind, lol. I share and inquire about compensation with peers and could care less if they think I'm crass. My rates are in line with the NPs I know in a four state area who are into networking and are aware of how much they can command. Doubtful you are a schmuck, it is more likely either uninformed about what you should be making and or a geographical difference.

In the hospital where I work the ACNPs are competing with PAs who for multiple reasons are more highly regarded in this particular system. My guess is regardless of the culture PA vs NP as more and more of both graduate the market will continue to tighten. I have heard PA programs are ramping up like is happening with NPs? As for ED FNP and PAs are competing for positions there also so the same as above.

Lol I initially read this as the universities will seemingly let any applicant into their NP programs to simply bolster their numbers but either way is accurate.

Sorry but unless this was in Florida or as an employee and included a sweet benefits package yeah you failed your negotiations miserably. I might be mistaken but I thought Locums companies kept whatever surplus the employer is paying so they try to low ball? And if 1099 they should be offering premium wages in imo.