$200,000 salary as a RN, it's true

Specialties NP

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I'm a NP who works in the Stockton/Sacramento area. One of my boating buddies is a RN at Kaiser. He has been there 10 years and is a charge nurse on a med/surg floor. I didn't believe it until he showed me but he does make a base of $200k a year. With overtime he clears a little of $350,000. This is due to Kaiser in Northern California being unionized. He lives in Modesto which is a low cost of living area but the contracts for the union are tied in with San Francisco which leads to high hourly wages. At retirement he is guaranteed at least $110k annually for life and lifetime medical benefits with any medical insurer he chooses whether it is Kaiser or not. I read the contract and couldn't believe what I was reading but there it was.

SO as a NP it makes me want to jump to Kaiser but......if I was to start at Kaiser with 10 years of NP experience under my belt I still wouldn't be making as much as my friend.

Disturbing??? Maybe....I'm happy for him. It just lets me know that there really are those rare RNs who make more than NPs....way, way more and more than most primary care MDs working on the floor. It makes you wonder if this model is sustainable.

Making over 200k isn't unheard of for me as I saw Paramedics making 330k in Afghanistan when I went and the starting salary for new paramedics was 150k for Afghanistan even in 2012 so an extremely high salary such as that isn't unusual to me. What is unusual is that it's in CA, so you can kiss most of that money goodbye. 200k for a 'small empty plot of land'? Here in Texas most small parcels of land cost 10-20% of that depending on area and even less outside of cities. There are ads for those KB Homes they put up real fast for 150-250k depending on certain size and area. A 400k house is nearly a mansion in San Antonio...

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I think it comes off as bitter when professionals try to take jabs at one's earnings by stating things like "I'd never want to live in Ca" or other disparaging remarks to mask their own insecurity, unease, or discomfort of their own salary/earning potential...

I think it's rare but quite remarkable that the RN you know is making that salary, and even more remarkable of the benefits and retirement package. For myself, personally, even if I were making that kind of money, I wouldn't be satisfied if I were an RN doing it. I much prefer the leadership role an NP job provides. I also like the respect I get in the role. Money is very important, and surely I wouldn't be an NP if the money wasn't right (it's the truth, not ashamed about it), but my satisfaction is a bit more important than the dollar. I'm okay making less than $200,000 if that means I could derive satisfaction in what I'm doing.

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Besides the salary and the bad talking from other posters here, the main reason to work in Cali are the patient ratios. I worked at UCSF on organ transplant for a few years. 4 patients max and honestly, some of the smartest, most professional nurses I’ve worked with. Also, it’s very collegial and you’re an equal. Something I’m guessing is sorely lacking in a lot of cheaper to live states.

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3 hours ago, ToFNPandBeyond said:

I think it comes off as bitter when professionals try to take jabs at one's earnings by stating things like "I'd never want to live in Ca" or other disparaging remarks to mask their own insecurity, unease, or discomfort of their own salary/earning potential...

I think it's rare but quite remarkable that the RN you know is making that salary, and even more remarkable of the benefits and retirement package. For myself, personally, even if I were making that kind of money, I wouldn't be satisfied if I were an RN doing it. I much prefer the leadership role an NP job provides. I also like the respect I get in the role. Money is very important, and surely I wouldn't be an NP if the money wasn't right (it's the truth, not ashamed about it), but my satisfaction is a bit more important than the dollar. I'm okay making less than $200,000 if that means I could derive satisfaction in what I'm doing.

It's because most of them don't know what they're talking about. Modesto is a relatively low cost of living area, with nice middle-class homes in the 250-350k range.

A simple calculation from a salary website will show that a married guy making 350k is taking home 242k a year after federal and state taxes. State income taxes ding him a whopping total of 7.5% of gross...

Even his base pay nets him 148k.

Good for him.

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I believe the point was not only actual take home salary, but cost of living as well. Cali undoubtedly has a high cost of living over other areas. Although you can find places that are less expensive to live, the cost is still far greater than some other places. In San Antonio for example 242k after taxes means a whole lot more than pretty much anywhere in Cali as the cost of living is significantly lower and your take home pay would also increase due to no state income tax. Location of your primary residence is entirely personal preference and thus is difficult to quantify as I would never go back to Cali as I don't view the high cost of living worth it. Others obviously disagree and would never live anywhere else, it's all perspective and preference, but remember to include cost of living into calculations. 242k take home is quite high and will provide pretty much any lifestyle you choose to have but in some areas of the country it may provide more bang for your buck so to speak. I believe that is the point many posters were getting at.

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Specializes in Surgical Specialty Clinic - Ambulatory Care.
On 7/22/2019 at 10:11 AM, FNP2B1 said:

Disturbing??? Maybe....I'm happy for him. It just lets me know that there really are those rare RNs who make more than NPs....way, way more and more than most primary care MDs working on the floor. It makes you wonder if this model is sustainable.

Interesting. Does kind of let you know what unionization could do for one’s pay.

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It's great that people are making that much. Super scary cost of living in many parts of the country.

I like living in a small city in an undesirable part of the US, haha. My cheap house is paid off. There are some decent restaurants here, and no traffic. I love the four seasons.

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Low cost of living and Modesto in same sentence?

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Specializes in Cardiology.

It really isn't that surprising to see a RN make more than a NP. NP's are salary and don't get paid OT for working OT. A RN is still hourly wages and depending on OT could easily make more than a NP. However, over the course of a career I think the NP wins out because working so much OT as a floor nurse is not very sustainable.

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It sounds like your friend might be a fortunate yet rare case. I do know some Kaiser RNs who have worked there forever and are guaranteed lifetime pension, etc., but I was told Kaiser has started to phase that practice out. They are probably realising that that is unsustainable.

I live in California and have lived in other states. I get tired of the "Oh my god, you can't pay me enough to live in California" jargon. I get it--there are parts of California that are expensive, but there are definitely parts that are not. And those people who are leaving and complaining? Well, we'll always have those types. Remember: Many people also stay too.

As an RN/NP, our salaries do make up for it. When I was negotiating my first NP job, I looked online and was prepared to negotiate based on what the average new NP salary was. I was very pleased to be offered something way more than that, which I was told was the average going salary here.

When I was an RN on a high acuity hematology unit, the ratio was 3:1. I was talking to a colleague who worked in Ohio as an RN doing the same work and had five patients. Forget that! I had friends working on the East Coast who had seven patients each. Forget that even more! People keep trying to say that unions and staffing ratios don't make a difference but believe me, they do.

Don't get me wrong--there are things here that drive me nuts (like the Board of Registered Nursing!) but overall, I enjoy and appreciate the quality of life, as well as the weather, the food, the progressive thinking, to name a few. Thanks for listening.

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Specializes in Cardiology.
4 minutes ago, db2xs said:

It sounds like your friend might be a fortunate yet rare case. I do know some Kaiser RNs who have worked there forever and are guaranteed lifetime pension, etc., but I was told Kaiser has started to phase that practice out. They are probably realising that that is unsustainable.

I live in California and have lived in other states. I get tired of the "Oh my god, you can't pay me enough to live in California" jargon. I get it--there are parts of California that are expensive, but there are definitely parts that are not. And those people who are leaving and complaining? Well, we'll always have those types. Remember: Many people also stay too.

As an RN/NP, our salaries do make up for it. When I was negotiating my first NP job, I looked online and was prepared to negotiate based on what the average new NP salary was. I was very pleased to be offered something way more than that, which I was told was the average going salary here.

When I was an RN on a high acuity hematology unit, the ratio was 3:1. I was talking to a colleague who worked in Ohio as an RN doing the same work and had five patients. Forget that! I had friends working on the East Coast who had seven patients each. Forget that even more! People keep trying to say that unions and staffing ratios don't make a difference but believe me, they do.

Don't get me wrong--there are things here that drive me nuts (like the Board of Registered Nursing!) but overall, I enjoy and appreciate the quality of life, as well as the weather, the food, the progressive thinking, to name a few. Thanks for listening.

I work as a RN in Ohio. I would love to have the 3:1 ratio for stepdowns/PCUs but its a pipedream. This state is going backwards in terms of political thinking. I also knew a girl who worked as a RN on heme/onc unit at a well known hospital and she could have as much as 6 pts on nights.

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6 minutes ago, OUxPhys said:

I work as a RN in Ohio. I would love to have the 3:1 ratio for stepdowns/PCUs but its a pipedream. This state is going backwards in terms of political thinking. I also knew a girl who worked as a RN on heme/onc unit at a well known hospital and she could have as much as 6 pts on nights.

Because a lot of people have moved out of Ohio or burned out because of people moving out and working short. There are tons of travel assignments at Cleveland Clinic. It's nothing like it used to be. They're constantly building and expanding while paying nurses less and working folks ragged.

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