Total Number of Nurse Practitioners Hits 325,000

[MentalKlarity]

According to latest AANP survey, the total number of nurse practitioners in the United States is now at 325,000.

Last year it was at 290,000 so it increased by 35,000 or 12% in one year.

There are approx. 9,000 physician assistant graduates per year.

There are approx. 33,000 physician graduates per year.

The number of new NPs annually is not only higher than other fields, but accelerating. In 2010, for example, there were only about 10,000 NP graduates a year.

Are we heading toward massive saturation of our own field?

[NurseBlaq]

1 hour ago, MentalKlarity said:

By not flooding our market with endless new graduates so that the NP supply < NP demand. 

This is really just basic economics.

MDs do manage that. Let me know when an MD is applying to $40-$50 per hour jobs like many NPs are now. They have kept their supply low and thus demand is high and employers have to dangle big incentives. When there are 100,000+ (and growing) more NPs than NP jobs, employers will simply reduce the wages/benefits for every NP. 

 

I will give you a concrete example so you can understand better. About 8 months ago I actually applied for an interesting NP position (psych) that was interested in at a fairly large private practice. The employer informed me they would like to interview me and told the salary range. It was insulting. I did the interview anyway for practice and assuming I could always negotiate. They offered me the job. When I told them they were about 40% below the median PMHNP salary they told me they would not come up and that they had more than enough applicants that they didn't need to increase the pay. Another NP ended up accepting the position at the offered wage, which was in the 70K range for a psych NP full-time.

This is what oversupply does to our market. 

No, that's what oversupply is doing to your area. You're applying your experience to the country when not every market is the same. According to you, people shouldn't want to move up in nursing and stay at the bedside forever and a day so you can make the wage you want. That's selfish!

If the market is oversaturated in your area, why not move to a less saturated area? Year after year there are threads about nursing, NPs, etc are oversaturated when everyone is clearly saying it's area-related. Stop trying to discourage people from wanting to improve their educational/financial/personal situation.

[CommunityRNBSN, BSN, RN]

8 hours ago, MentalKlarity said:

Again, it's not just about "finding a job" it's about ensuring we always have high wages, good benefits, and flexible PTO. An oversupply of providers WILL effect everyone, even those with a ton of experience who went to a great school. It's very difficult to explain to the hospital bean counters why you deserve $100 an hour and 6 weeks PTO if the Walden graduate was happy with $45 and 2 weeks off.

I think the truth is somewhere in between. The doctor that I go to, who is an MD with six years family practice experience, wanted to move his family to California. He told me that he interviewed for a job there at a clinic owned by a prestigious hospital chain and was offered $84,000 a year. There’s clearly not an oversupply of MDs, but there must be an oversupply of family practice MDs in that area who want to work for that hospital chain. I guess my point is, it’s more complicated than just saying “Shut down most of the schools” or “cap the number of graduates.”  There are a lot of factors at play. One of them is oversupply but that’s certainly not the only one. 

But I do agree we need to rein in some of these schools. I have an acquaintance trying to become a pediatric NP (she’s great, with a ton of PICU experience) via a shady online program. She can’t get clinicals and her program has been delayed multiple years because of this and there’s nothing she can do about it. 

[djmatte, ADN, MSN, RN, NP]

5 hours ago, NurseBlaq said:

No, that's what oversupply is doing to your area. You're applying your experience to the country when not every market is the same. According to you, people shouldn't want to move up in nursing and stay at the bedside forever and a day so you can make the wage you want. That's selfish!

If the market is oversaturated in your area, why not move to a less saturated area? Year after year there are threads about nursing, NPs, etc are oversaturated when everyone is clearly saying it's area-related. Stop trying to discourage people from wanting to improve their educational/financial/personal situation.

This isn’t about being selfish or discouraging advancement. As a matter of fact, there are distinct differences in the role of a bedside RN and I wouldn’t even suggest discouraging pursuing an NP is particularly preventing anyone from “moving up”.  But the reality is that beside RN is often viewing this on as one with better opportunities (work life balance, increased pay, personal decision autonomy). But as the market saturates, they could easily waste a lot of money on an education they can’t end up using. Especially when schools like Walden advertise a fast track with easy acceptance and the barrier of enter is the ability to sign a check.

When I started NP school in 2014, there was a significant need in all markets. When I graduated, those gaps were already starting to close in many. I will forever be ahead of the pack given my experience and my work ethic. I came in at the last right time IMO given the market I see.  But newer grads and especially the glut of ones from the Walden’s are going to be in significant debt if states don’t add more autonomy at a faster pace. At the moment, only about 1/3rd of states have real NP autonomy. That has not changed much with only 2-3 added in the last 3 years. 

[NurseBlaq]

30 minutes ago, djmatte said:

This isn’t about being selfish or discouraging advancement. As a matter of fact, there are distinct differences in the role of a bedside RN and I wouldn’t even suggest discouraging pursuing an NP is particularly preventing anyone from “moving up”.  But the reality is that beside RN is often viewing this on as one with better opportunities (work life balance, increased pay, personal decision autonomy). But as the market saturates, they could easily waste a lot of money on an education they can’t end up using. Especially when schools like Walden advertise a fast track with easy acceptance and the barrier of enter is the ability to sign a check.

When I started NP school in 2014, there was a significant need in all markets. When I graduated, those gaps were already starting to close in many. I will forever be ahead of the pack given my experience and my work ethic. I came in at the last right time IMO given the market I see.  But newer grads and especially the glut of ones from the Walden’s are going to be in significant debt if states don’t add more autonomy at a faster pace. At the moment, only about 1/3rd of states have real NP autonomy. That has not changed much with only 2-3 added in the last 3 years. 

Again, saturation is area-related. I don't support diploma mills either but they're starting to have problems even before their students graduate. Diploma mill students are having a hard time finding people to precept them so that problem is fixing itself. In my area, FNPs are having a hard time finding jobs and most of them went to brick and mortar schools, with good reputations, in the state. There are just too many FNPs in my area. However, if they were willing to move just a few hours away, they'd find jobs with ease. If they were willing to drive an hour or so away they'd find jobs. Nope, they all want to work at the same places and that's why they can't find work. However, it's just FNPs having this problem, not specialized NPs. Everyone can't work in a doctor's office or up the street from their home but they don't want to accept that.

[djmatte, ADN, MSN, RN, NP]

58 minutes ago, NurseBlaq said:

Again, saturation is area-related. I don't support diploma mills either but they're starting to have problems even before their students graduate. Diploma mill students are having a hard time finding people to precept them so that problem is fixing itself. In my area, FNPs are having a hard time finding jobs and most of them went to brick and mortar schools, with good reputations, in the state. There are just too many FNPs in my area. However, if they were willing to move just a few hours away, they'd find jobs with ease. If they were willing to drive an hour or so away they'd find jobs. Nope, they all want to work at the same places and that's why they can't find work. However, it's just FNPs having this problem, not specialized NPs. Everyone can't work in a doctor's office or up the street from their home but they don't want to accept that.

I have no doubt that it is about location and there are locations that are persistently in need. But I also believe even in less saturated areas, you are seeing wages change and compensation lower. I had offers from rural areas come in at 85k with rigid pay structures and no negotiation opportunities this was just 4 years ago). I have the wear-withal to not accept that crap, but someone who just wasted years going through a paper writing degree like Walden may not. This person just gave that employer a significant win that will affect later hires and encourage other employers to do the same.

And in the meantime, we get to see the real fallout here as those nurses who went to the Walden’s are failing to secure clinical or jobs.  they come here for help and advice. So when we tail against these schools, it’s because we see regularly how they are failing students and making money hand over just with little professional accountability. 

I’m all about moving to get the job. But it isn’t always that simple. Some places aren’t easy to move to. some states don’t make license transfer smooth or a timely process.  Doctors often expect movement for residency and other training as part of the longer curriculum as it’s part of their game plan from the start where nurses are typically well established in their community before they even consider advance practice. Even places with NP saturation still can tolerate more providers given community needs. But we are typically limited but needs for collaborators or total number of clinics willing to hire anyone. Where a doctor can hang his own shingle, we can’t without ridiculous hurdles. 

[NurseBlaq]

8 minutes ago, djmatte said:

Even places with NP saturation still can tolerate more providers given community needs. But we are typically limited but needs for collaborators or total number of clinics willing to hire anyone. Where a doctor can hang his own shingle, we can’t without ridiculous hurdles. 

I believe independent practice will be here nationwide sooner than later as physicians are opting to retire due to COVID vs staying well past retirement age as they did in the past. The problem with IP is many states have nursing boards under the control of medical boards so it's beneficial to them to get paid as collaborators. Nursing associations should push for IP and better reimbursement for NPs. There is room for improvement on both ends, education and associations/boards of nursing.

[renatanada]

I’m in NP school because RNs are treated like medication administering monkeys. I am actually interested in having more knowledge and having more power to help people. NPs who are in it for the money were RNs who were in it for the money. Not my kind of folk, but whatever floats your boat. Oh and I’ll take an NP job wherever I can find one. Anywhere but the hospital! 

[djmatte, ADN, MSN, RN, NP]

1 minute ago, renatanada said:

I’m in NP school because RNs are treated like medication administering monkeys. I am actually interested in having more knowledge and having more power to help people. NPs who are in it for the money were RNs who were in it for the money. Not my kind of folk, but whatever floats your boat. Oh and I’ll take an NP job wherever I can find one. Anywhere but the hospital! 

It isn’t about being in it for the money. It’s about recognizing the role you operate, the money you make for a clinic, and the value your position is worth. As a nurse practitioner, you are a revenue generator. The patients you see and how you bill can make or break a clinic. So when a NP takes whatever job they can get at whatever rate, they both undervalued what they do and make it harder for others who actually understand the nuts and bolts of this profession to maximize their value. Wages should be based off what we bill for just like most physicians enjoy. But that negotiation is fragile if schools continue at the current pace of pumping out graduates. 

[renatanada]

Um, that’s quite a leap. I only said I’d take whatever job I can get assuming there won’t be much demand for an inexperienced NP. That doesn’t mean I’ll work for nothing—but I’m not going to demand six figures with zero experience. 

[djmatte, ADN, MSN, RN, NP]

10 minutes ago, renatanada said:

Um, that’s quite a leap. I only said I’d take whatever job I can get assuming there won’t be much demand for an inexperienced NP. That doesn’t mean I’ll work for nothing—but I’m not going to demand six figures with zero experience. 

Except you can and should be paid 6 figures out the gate. Minimum if you think you will be seeing at least 15 Patients a day. You will likely be seeing 20+ before you know it. Many if not most clinics will expect you to work at or near that output quickly.  The point is there are NP jobs that pay peanuts and some grads are more than willing to take anything that looks higher than they made as a nurse without consideration for their role/expectations. 

[FullGlass, BSN, MSN, NP]

3 hours ago, djmatte said:

Except you can and should be paid 6 figures out the gate. Minimum if you think you will be seeing at least 15 Patients a day. You will likely be seeing 20+ before you know it. Many if not most clinics will expect you to work at or near that output quickly.  The point is there are NP jobs that pay peanuts and some grads are more than willing to take anything that looks higher than they made as a nurse without consideration for their role/expectations. 

Pay is going to vary by area, just like it does for RNs and MDs.  I suggest new grads know the market rate for new grad NPs in their area.  In many parts of the country, it is below $100K.  A decent NP school can advise students on what to expect in their location.

[djmatte, ADN, MSN, RN, NP]

4 minutes ago, FullGlass said:

Pay is going to vary by area, just like it does for RNs and MDs.  I suggest new grads know the market rate for new grad NPs in their area.  In many parts of the country, it is below $100K.  A decent NP school can advise students on what to expect in their location.

Except reimbursement doesn’t vary by much by area. What you bill insurance is the similar in all regions from everything I see. Different state Medicaid reimbursement can be exceptionally different though as they set their own parameters.