RNpandoraRN

WKShadowRN - thanks for the link to that article. Very interesting. And for anyone who is actually paying attention to when I've updated -- in the above article on MedScape, on slide 11, "APRN Annual Earnings by Geographic Region," I'm in a yellow state; which, according to that pictograph, are states on the lowest end of the payscale. It's very easy to tell someone they should keep looking, refuse to accept a job like that, "it's a disgrace," that NPs like us are to blame for the low salaries, etc. etc. But when you live in a region where this is the norm, and you've got bills to pay and mouths to feed, you do what you have to do.

Thank you all for your responses, especially the compassionate ones. I am indeed desperate for a position as this point, as every month I play the game of, "Which bill can I put off paying this time?" This is no joke; therefore I cannot put it off any longer. Some of you can clearly afford to turn down positions until you are offered the $$ what you want, but unfortunately I cannot do the same as I am now beyond one year out from graduation and finances have officially dwindled. I'm more convinced than ever that positions in Women's Health just don't pay the same as other fields (as also experienced by Dembitz, so clearly it's not just my area!) - and I have no interest in obtaining certification in any other field. That all being said, I'm updating at this point for any future new NPs that might come across this thread and feel they are in the same position. I negotiated a higher salary w/the job I previously mentioned, and got HR to increase it by $3,000/year, once again keeping in mind that I will pay almost nothing to provide my family health's insurance (less than $200/month) compared to other positions I interviewed. Health insurance to some people is probably not an issue, but I have young children and an active family, which translates to a lot of potential for injuries! Health insurance is a must for us. Furthermore, I will have the patient base, work schedule and hospital privileges that I requested, unlike other positions with which I interviewed and was basically told I'd see the same visit type all day every day with the exception of when a doctor steps out (this would be a huge waste of my skills!). So, I accepted this position. Do I wish the salary was higher? Of course! But, I have to start somewhere and shake off this "new NP/no experience" attached to me. I plan to renegotiate when I have my first review and have a better idea of how much revenue I am generating for the practice and have some solid data with which to make my argument - if needed. Obtaining input from you all has been very useful in what I will need to know and do! Cheers!

PsychGuy - I've noticed that psych NPs definitely make more than other APRN fields. I frequently see ads in my area, or on recruiting sites. Kudos to you for being a PNP; mental health is definitely not my forte! Definitely could not pay me enough to deal with the complexity of mental health issues. I've also observed that FNPs, ANPs in the fields of Neurology, Acute Care, etc. tend to make more money in my area. My field - obgyn, women's health, even midwifery - seems to be the red-headed step child in the area. This job I'm negotiating with...there are 13,000 full time employees with this institution. The associated hospital with the clinic has 160 beds. Someone previously mentioned a salary matrix and I'm sure this is exactly what they use to determine salaries. We're talking about an institution in which the athletic coaches make nearly $1 million but the health care providers (physicians included) make well below national average. I don't know if it is also because it is a teaching hospital, as well. At any rate, I don't think an institution this size is a beast I can fight, and frankly, I need to get in the door NOW as I am already one year out from graduation and that is only hurting me (I was already asked in other interviews why I haven't been practicing all this time).

What would you all do for a position in which the current APRNs on staff, with 10+ years of experience, are being paid $77,000-84,000? (to be fair, this may just be their base salary and does not include bonuses or other incentives). It would definitely be arrogant for a new grad to come in demanding $100k base. I would be laughed out the door. Salary information of every single employee is made public since it is a public institution. Also noted - physician residents in this system make between $53,000-56,000.

Hi LucyLou - I have made a counter offer. Awaiting a response.

Thank you everyone, for your responses thus far! I have counter-offered with Job B, due to CME, costs of maintaining licensing/certifications, and professional memberships, and am currently awaiting a response. At Job B, the employer pays 83% of the health insurance premium (they are paying $1100-1300/month depending on the plan chosen). This is a difference between my paying $16,000 per year with a very large deductible for insurance to cover my family (I have young children, and we MUST have health insurance) or $3,400 a year with $0 deductible. Huge difference in take home pay!! So I take the salary they offered and add $16,000 to the salary, and that actually significantly raises it to the $80,000/year range. If I accept the other position (which the salary offer in the mid-70s but I would pay $16,000/year for health insurance), then I will still TAKE HOME LESS each year than I would with Job A. Additionally, there is tuition reimbursement and retirement (401a or 403b). 6 month probationary period and then there will be a review. I am told that new NPs are typically not profitable for the first 6 months, anyway...and I fully expect I, too, will be slow to start! I am extremely hesitant to turn down offers at this point, as I have been job searching for a year as it is, and though I'm working as an RN in my field, my family is struggling financially and my student loans are looming... I actually disagree with PsychGuy. It is very possible to love your job. I LOVE the field I have chosen. All of your responses are very helpful and I have pored over this site on this very topic. I, too, worry that accepting lower salaries only continues to hurt our profession but when you already feel you've few or no choices, it sure puts us in a bad place.

I'm gathering that this is a theme in our field, unfortunately... So after graduating and spending nearly a year of applying for positions as an APRN, I finally scored several interviews and a couple of offers. I'm particularly interested in one of the positions, which offers amazing health insurance benefits for my family (employer pays 80% of premium) but the salary that they offered me is embarrassing. Let's just say it's less than $70,000, but more than $60,000. Large University (i.e. state) position in a city w/population of approximately 100,000 people. There are other APRNs in this same practice, currently with 10 years experience, who are making $79,000 - $83,000. - No CME - No productivity bonus - 33 days of PTO, including vacation, sick, and personal days - very good health insurance plans w/employer paying 80+% of premium - malpractice covered - excellent potential for career advancement (I plan to advance my APRN education) My instincts tell me this particular position is The One; this is the position I'm going to love, love what I do, love where I am, and love my coworkers. The health insurance is extremely appealing and I'm assuming that is a big reason why they offer such low salaries. The other position I've been offered is $10,000/year more, but employer only pays 20% of health insurance premium, so I have to automatically deduct $16,000/year from my salary just for that. I plan to make a counter offer but that is where I'm struggling. I'm truly dismayed at the low salary but I also feel very strongly this particular position is my calling. I need to be able to justify why I'm asking for more $$, considering I'm a new NP. Aside from figuring in CME and license/certification costs, what other suggestions should I make?

Thank you all for your responses thus far! Yes, the WHNP curriculum was specifically women. No males and no pediatrics (other than newborn care for the first two weeks following birth). My Med/Surg background was hospital, right out of nursing school for a couple of years. I am not at all interested in caring for males or pediatrics (or taking on more educational debt!), so a post-Master's FNP is not on the table. I realize an FNP is more marketable, but my passion lies in women's health. Fulleffect1 - I do have an account on LinkedIn, but not Premium - had done so in the past and it was not worth the money. Do you suggest sending requests to local providers?

Yes, I'm a member of NPWH and Sigma Theta Tau (STTI). I have several staffing agencies with my information, as well as email/text alerts through Indeed, Glassdoor, LinkedIn, etc. I'm not really in a position for relocation due to family and finances, though I'd love to!

I am in desperate need for guidance. I graduated summer 2015 and have yet to find a job in my field (women's health, ob/gyn). I have reached out to staffing agencies as well, and did have a well-known urban women's clinic interested, but they did not want to pay what the recruiter quoted them ($45/hr in a city of over 2 million, midwest region). The clinic would not state what they were willing to pay, so then I was rejected. I am not certain how accurate sites like salary.com are for giving an idea of what the starting pay should be for a new NP. There are plenty of FNP positions advertised in my area, but I am a WHNP. I have sent out a few resumes unsolicited, but mostly apply to those that are advertised. Then, I never hear anything from them and my calls to follow up are never returned. I've tapped out the few connections I have, with no success. I'm at a loss as to how to proceed. I had no idea that finding a job would take this long or be this difficult, and I'm at a point where my finances are in dire straits and wondering how much longer I can keep deferring student loans. I do work full time as an RN - my family has to eat! - so time for "pounding the pavement" is a luxury. Any tips or advice would be very much appreciated! THANK YOU!

The tuition is very steep - about $70K when it's all said and done. That's not including travel costs for required trips to campus (airfare, hotel, meals, etc) and you have to attend an annual conference of the American College of Nurse Midwives, which is a few days, so there is registration fee for that, plus more hotel/travel.... The price tag is daunting but I'm pushing forward. I'm not and never have been an L&D nurse but my experience is a few years of Med/Surg and a few years of OB/GYN in the clinic setting. I quit working altogether in order to attend the program full-time (working, doing the program, and having a family all at once is impossible for me)

madalena - did you start the program?

Unfortunately I ended up not being able to start in March as planned. A very unsupportive employer wouldn't allow me a couple of hours off a week to attend class, so I ended up deferring my enrollment to the June 2012 cohort, which is the full time program. I am really anxious to begin! That price tag sure is daunting, though...

I, too, am Georgetown bound, but I am starting in just a couple of weeks (March 19th!)

I can't even get into PP (mother/baby in my area). Even with two years nursing experience, I still applied for the graduate nurse position one hospital had listed for mother/baby...I expect they will have to treat me like a graduate nurse and I am 100% ok with that, even the salary, if it means I finally get in. But no luck with that, either. *sigh* Do you ladies think it's worth calling the Nurse Recruiter at this particular hospital and ask why I wouldn't be considered even for a graduate nurse position (the position was just recently removed from their website but I don't know if that means it has been filled)? And/or ask her what I should do to make my application more appealing? Thank you so much for all your replies!!

Forgive me if this is a dumb question, but where is the cost for the training? I don't know how other units proceed, but in my med/surg unit, preceptors are not paid extra to orient a new nurse. I think many of them enjoy it because it gives them a "break," so to speak, while others do it in order to promote from RNI to RNII, etc. Does the bulk of the cost of training come from the mandatory hospital and unit orientation classes? Or simply due to the hospital having to pay two nurses for one position until he/she is fully trained? One of the things that irritates me is that several hospitals that had openings months ago, I applied for and was rejected (based on no current experience), and yet those openings are still listed today. I just think, gee...if they had hired me then, I would be fully trained and running by now and they still wouldn't have the need!!!

I have applied at 6 of the hospitals in my city ; there are 3 teaching hospitals (one of them having the nurse entry position I applied for) but I've had no luck at any of those. The hospitals range from 200-1000 beds overall; not sure how many beds for those particular units but the teaching hospitals are quite large overall. I know that the smaller hospitals are less likely to hire in OB without experience, but once in a while they do. I got NRP a year ago. I've considering looking into becoming a doula as well, but don't know how much that will help since it is not really hands-on with the medical aspect of L&D. I've even contacted a couple of local birthing centers to inquire about volunteering but they don't even have those. I'm so discouraged!!

Hello everyone, I'm sure this is a tired topic and I did a bit of searching but didn't find much. So here's my story. I now have 2 years of medical/surgical experience with some PCU. My interest has always been with OB, but I listened to my nursing school instructors and pursued med/surg after nursing school (I was told to get that background first and then I'd easily get in to OB anywhere). The latter could not be more false! I am and have been continuously rejected from any OB-related jobs for the past year - mother/baby, NICU, and L&D. The reason is always that they want current experience. I don't know how much of this may be due to the poor economy, but I am so frustrated! How am I supposed to get experience if no one will give me a chance? I have even applied for nurse entry positions (i.e. graduate nurse) for mother/baby, but have not heard from that position and I expect I will be rejected for that, too. It seems all I can get is med/surg positions, and to be honest, I was horribly miserable for two years doing that. Does anyone have any advice as to what more I could do to try to get my foot in the door?? TIA!!

Oh my, be thankful that you are even getting a raise this year! I've been a nurse for approximately 18 months and no one at my hospital is getting raises. Yep, that means I'm still making what I started out as a Graduate Nurse 18 months ago. I have already wondered if the new GN's that started last month are making more than me. Sure hope not, or there is going to be one angry nurse here....

that is not true. fafsa gets you subsidized or unsubsidized loans.

People reacted the same way with the "bird flu" a few years back (or was that more recent?). I, too, get tired of hearing the media blow everything out of proportion. It should be taken seriously, but so far is it any more dangerous than the 'regular" flu, i.e. affecting the elderly and the very young (already immunocomprised)...

oh my goodness! thank you all! reading your responses has helped lift my spirits. it hadn't occurred to me that the lengthy 20-question-type interview that i had for my first (and current) nursing job was....well....because i was a new grad and it was my first nursing job! in answer to a couple posters' question - i don't think the director is new in her position or in interviewing; i got the impression she's an "old hand" at it. i should know by tuesday (5/5). i sure hope the majority of you will be correct! :)

i've been a nurse now for 16 months and finally got an interview for my "dream" unit; however, the interview was odd. it was with the director of the unit (not hr) and while she did a fantastic job of explaining/describing the unit (which automatically answered any questions i had prepared), she never really asked me any questions! i was prepared to answer why i am interested in that field, why i'd be a good addition to her team, describe a situation in which i excelled, etc etc. she never asked a single one! then we toured the unit and it was over. i think the whole interview took maybe 30-40 minutes. maybe she has already chosen someone but had to do my interview because it was already scheduled? i'm feeling pretty bummed because it's taken me months to even get the opportunity to interview for my ideal position, and i feel like i didn't get an opportunity to promote myself and probably was already not considered before i even walked in the door. i can't think of any other reasons she would not have asked the customary interview questions... has anyone ever had an interview like this? was the outcome in your favor?

I work a Med/Surg unit. We are medical and surgical combined. I would assume if it's written as "med/surg" on a job listing, then it is a combined unit as well.

Ya never know. I've lost 15 pounds in the past 9 months. I work nights, and work long halls. I'm often moving very quickly up and down those halls nonstop for my 12-hour shifts. We do have poor eating habits, but mine is not because I eat junk food but because often I eat before work (around 5:00pm), usually a pretty healthy meal around midnight (or when time allows), and then usually I go straight to bed in the morning and don't eat again until I wake up...or 5:00pm.