The dreadful money question

TX_ICU_RN · May 19, 2008

It all depends on the position you are taking. Here are a few tips my husband and I have learned along the way:

1) Productivity bonus - This should be based on any money you bring in after you have "made" your salary for the year. For example:

Base Salary = $75000/hr

Your Income for the Practice = $150000/year

Amount made over your Base Salary = $75000/year

Your Productivity Bonus = $7500-$15000/year (based on a 10%-20% after salary scale)

2) Your RN experience before becoming a NP. If you have worked ER, sometimes you can negotiate a slightly higher salary

3) The need for NPs in your area

Good Luck!!!

johnson0424 · May 19, 2008

thanks for your reply and i love your quote on your profile it is so true too! I am realizing that this nursing is not only something i love but also a business

DaisyRN, ACNP · May 20, 2008

i encountered this very same dilemma when i went on my interview... when they asked me what i was thinking about salary, i said, "well... make me an offer *big grin*"... but then i said, "i'm open to negotiation, but it is important to remember that as an rn, i can make $60k without much overtime, and i would hope that as an np, i would be competitively compensated." or... something like that.

as for productivity... i am a new grad (as of december) and signed a contract that went into effect april 1, 2008. after 6 months, we will discuss the productivity structure and add it to my contract. so, i would ask to be strictly salary based for the first 6months, with "productivity/incentives to be negotiated after 6 months employment." make sure that if you do that, that it says they will add productivity to your contract in 6 months. i do know how my productivity bonus will work though...

(this is in another one of my posts, somewhere...)

but let's say i make $75,000 per year... divide that by 4... which would be 18750 per quarter. then what my company does for all of its midlevels, is monitor amount billed for over a quarter, subtract my salary for that time, subtract any office overhead, and then me and my supervising doc(s) will split that money 70/30. then, the longer i am with the company, the less my supervising doc(s) will get... and the bigger my percentage will be. the ceo has said that within a year, my salary will become "insignificant." to give you an idea... because i have started roughly tracking my charges... i billed for $15,000 just in april and i work for a cardiology clinic, so this includes office visits, ekgs, echos, stress tests, holter monitors. this does not include anything that i could get in terms of productivity from rounding on patients in the hospital.

best of luck!

core0 · May 20, 2008

I am going on my 2nd interview for a FNP job on wed. I am a new grad and am terrified of the dreadful "what were you thinking in terms of salary" I am scared to give them a number because they might laugh at me or really deny me. What do you do in this situation. I have done some research on what other NP's make in the area and expect this to be comparable to my experience.
Also, how do you negotiate a productivity bonus? what is a good percentage? Will I be that productive in my 1st year-prob. not but do you sign a new contract every year? any help would be appreciated. :)

There is a thread on this here:

https://allnurses.com/forums/f34/np-salary-negotiations-276817.html

Two suggestions.

1. Go the bookstore and get; Negotiating Your Salary: How to Make $1000 a Minute

Read the book and apply it. This will help you more than any single source that I have seen.

2. I continue to think that productivity bonuses are a bad idea generally for a new grad. You want to concentrate on working and getting better, not on productivity. As a new grad you will not be as productive as someone that has experience. This goes double if you are the first NPP in a practice and they do not have experience billing for NPPs.

Look at the bottom of my second post on the linky. There are so many ways to screw someone with a productivity bonus its unreal. You want to negotiate a productivity bonus when you have determined how much you can trust the practice. You also want to know that the practice knows how to bill for you and you can trust them with what they say they are collecting. After a year you will not only be more productive but will know how well the practice works.

If they want to offer a productivity bonus fine. However, make sure that you are happy (can live with) the base salary as if you are not getting a bonus.

David Carpenter, PA-C

DaisyRN, ACNP · May 20, 2008

yes... david brings up a good point. after i met with the ceo and found out how focused he was on my being productive (and now i just realize he was trying to make a point), i kinda freaked out thinking "omg! i gotta see x amount of patients in x amount of time... " but then i realized that i cannot become a good practitioner if i let only efficiency be my focus. it also helped that the medical director talked with a fellow md who employed a new grad and he agreed that productivity should not even be considered until after 6 months, at least. and now that i have kinda relaxed about "being productive," i have become more productive... and gained confidence in seeing my patients. i realized that it will come with time... i just have to be patient with myself. :)

zenman · May 20, 2008

Two suggestions.
1. Go the bookstore and get; Negotiating Your Salary: How to Make $1000 a Minute
Read the book and apply it. This will help you more than any single source that I have seen.

David Carpenter, PA-C

But how hard will I have to work in that minute??

core0 · May 20, 2008

But how hard will I have to work in that minute??

Not very hard. Basically the book tells you to never commit until they show their hand. Ie how much are they willing to pay you. A very short read but a fascinating book. There is another book called Cool Careers for Dummies that has an alternative strategy that works pretty well.

David Carpenter, PA-C

TX_ICU_RN · May 24, 2008

thanks for your reply and i love your quote on your profile it is so true too! I am realizing that this nursing is not only something i love but also a business

I learned this the REALLY HARD WAY!!! I just went back to work two months ago after taking 4 years off to stay at home with my kids and also to recharge myself. I got Rheumatic Fever in Dec 2003 that resulted in multiple hospitalizations and then ended up with a massive ankle fracture 6 months later (due to not listening to my body) that led to RSD/CRPS. Thanks to great nurses, NP's and docs...I am back to work. However, I will never push myself the way I did before. It is not worth it.

When you are a NP, the business side really comes to light. I am rebuilding my career and part of this is trying to get the most money I can for doing what I love. Money is not the reason I do what I do...but it is very important to earn enough to not have to work 80 hours a week. Having been a NP before, approaching this is much easier this time around. The first time, I was scared as hell to negotiate anything. This time, I will fight for everything I need.

scribblerpnp · May 25, 2008

As previous people mentioned, depending on the the area where you work, productivity may not be very beneficial especially if you are going to depend on it. If you are working somewhere where you can't do a lot of procedures, and you are mainly billing office visits, your amounts will be low.

For example, I work in primary care. 60% of our population is low-income (medicaid). Medicaid pays for **** with common "procedures" I can do. Also, because of the low-income area, some pts no show to appointments (which is an instant loss of 85.00 each time.) So it is common that in a work day where I COULD have seen 25 pts, 18 actually came.

In my situation, hourly pay and a yearly bonus (based on productivity) was the most beneficial.