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?

[umbdude, MSN, APRN]

18 hours ago, MentalKlarity said:

If you're pursuing psych for telehealth I would definitely not count on it.

There are quite a few people out there doing exactly this - wanting to break into PMHNP (from ICU, ER, FNP, or whatever) imagining that they no longer have to work in person. Never had any interest in psychiatry.

[Hoosier_RN, MSN]

1 hour ago, umbdude said:

There are quite a few people out there doing exactly this - wanting to break into PMHNP (from ICU, ER, FNP, or whatever) imagining that they no longer have to work in person. Never had any interest in psychiatry.

I feel like a PMHNP should have a minimum of direct psych experience. There are so many nuances to many of the personality disorders, that it just seems natural that some experience should be warranted. But that's just me...

[NurseBlaq]

Where are these programs with hundreds and thousands of students? It's literally less than 40 people in my cohort. But I digress, I don't attend an online program.

[djmatte, ADN, MSN, RN, NP]

18 minutes ago, NurseBlaq said:

Where are these programs with hundreds and thousands of students? It's literally less than 40 people in my cohort. But I digress, I don't attend an online program.

Online environments definitely allow a school to get more students. The question is really at what point do outcomes suffer. My school FNU awards about 800 degrees a year spread across MSN FNP, WHNP, PMHNP, and their DNP students.  They publicly display their statistics to include graduation and retention rates and board pass rates. Places like Walden don’t which is a good sign of a school that has a questionable curriculum or business model. But if in one year, we’ve added at least 35000 new NPs, it’s a good sign some of these schools are pumping out much more.  My school accounts for only 2% of the totals and has a fairly stellar track record of prepared NPs. 
 

https://frontier.edu/about-frontier/frontier-statistics/

[djmatte, ADN, MSN, RN, NP]

Another thing to consider is the USnews ranking. They have 574 total masters nursing schools and 330 DNP schools which to my understanding has some online and brick and mortar schools. I only presume this because FNU has placement in both their overall list and their online only list where others aren’t.   I guess FNU is more hybrid given their in person requirements. Their online school list is at 173 schools. Also note Walden is unranked in any of these lists.  Probably for good reason.

Most brick and mortar are going to have smaller cohorts. Maybe a graduation of 20-40 if not smaller per degree program. Especially since they typically have an annual start.  Frontier has a new cohort quarterly and typically is about 30-50 per degree program. 
 

Without knowing how many of those ranked schools are brick and mortar for sure, I’d argue the ranked brick and mortar and hybrid schools probably account for half the 35000 new NPs and the other half toward the online only list. 

[MentalKlarity, BSN, NP]

Walden publishes their annual graduation list and last I checked the total MSN nursing cohort was around 5,000 annually.

[djmatte, ADN, MSN, RN, NP]

2 hours ago, MentalKlarity said:

Walden publishes their annual graduation list and last I checked the total MSN nursing cohort was around 5,000 annually.

Though an MSN there can be everything from FNP to education to management. 

[MentalKlarity, BSN, NP]

1 hour ago, djmatte said:

Though an MSN there can be everything from FNP to education to management. 

Yes but I just checked their Winter commencement and they had nearly 2,000 overall MSN graduates. They have two commencements a year so assume around 4,000.

 

Imagine thinking you're getting anything more than a pre-fab, boxed, McDonald's style education with 4,000 classmates in your graduating class. It would be laughable if it wasn't so extremely sad for our profession and future patients. 

 

The only effect the Waldens of the world will have on our profession is to push it toward saturation while graduating students that are more likely to make the kind of mistakes that will lead to us eventually losing independent practice.

 

 

[umbdude, MSN, APRN]

23 hours ago, MentalKlarity said:

Imagine thinking you're getting anything more than a pre-fab, boxed, McDonald's style education with 4,000 classmates in your graduating class.

I call this DIY NP education. The program literally hands student a list of readings, set up a chatroom for online discussion board, and refers folks to watch Youtube videos. There's close to zero investment on the school's part and that's the reason for large cohorts.

[FullGlass, BSN, MSN, NP]

I just don't understand the level of fear about "saturation."  Why are you all so scared?  There is no reason to be, if you are confident of your qualifications and worth.

1.  Employers that don't pay enough for their area simply don't get applicants.  I have seen this, even in "undesirable" locations.  An employer advertised for an NP, with a ridiculous salary, and the job goes unfilled.  Some of these places are really stupid, because I have literally seen the same job vacancy for 2 years!

2.  I have always had to compete for jobs.  That is good!  It means that the crap candidates don't get hired!  Most of us had to compete to get into a decent NP Program.  This group is always complaining about crappy schools that allow anyone in with a pulse.  Why don't you think competition for jobs is good?

3.  I don't understand why some of you think all employers are idiots.  Whenever I have applied for a job and been interviewed, the hiring manager is always an MD or an NP.  They know what the good schools are!

4.  Projections are just that - projections!  They are not the gospel truth.  I think the demand for healthcare is underestimated:

a)  We are headed toward national health insurance.  This might take awhile, but we are headed there.  That means a huge amount of unmet demand for healthcare will be freed up.  We still have a lot of people who don't have health insurance.  In addition, the ACA caused premiums and copays to skyrocket.  If these issues are solved, it will also cause a huge surge in demand.

b)  The COVID lockdown has caused use of health care to plummet.  That is going to go back up now.  In addition, it has caused an incredible amount of psychological trauma, so I predict the demand for mental health services will continue to increase for some time.

5)  With regard to PMHNPs, I see plenty of jobs advertised for high pay.  Telehealth for mental health is here to stay.  For one thing, the normal "no show" rate for mental health appointments is quite high.  Prior to COVID, when I had in-person mental health apapointments, on some days 50% of the patients would not show up.  With telehealth, the no-show rate is almost zero.  Most of my days, every single person shows up.  This means that telehealth will generate more revenue for psych.

At my previous job, when I lived in the middle of nowhere, providing primary care. the clinic had a full-time psychiatrist providing care via telehealth.  It was the only way they could get a prescriber.  The psychiatrst lived in PA and the clinic was in CA.  I've been thinking of marketing myself to rural health clinics to provide telehealth services.  I'd even be willing to spend 1 week per month on-site, on a rotating basis.  Myoglobin has posted here numerous times that he makes great $ providing mental health telehealth - he lives in FL and works for a place in WA.  

I advise you all to calm down.  Yes, do your due diligence about becoming an NP.  But if you are passionate about becoming an NP, have realistic expectations, and are willing to be flexible about that first NP job, have good education and skills, then you will get a job!

6.  Yes, the first NP job may be in an "undesireable" location.  After that, though, one should be able to get a job in a more desireable location.  That is why it is important for new grad NPs to be flexible and open-minded.

7.  Job hunting is also a skill.  Some people just have good skills for landing a new job.  This can be learned.  There are thousands of books on this.  If you are sending out your resume, and no one responds, then you have a crappy resume and/or you are sending your resume to the wrong places.  Get a good honest opinion on your resume.  Learn how to network.  Learn good interviewing skills.  Do you groom and dress yourself appropriately for an interview?  What is your demeanor?  Do you know how to engage the interviewers and answer questions well?  Honestly, a lot of people don't know how to do these things!  

 

[djmatte, ADN, MSN, RN, NP]

43 minutes ago, FullGlass said:

I just don't understand the level of fear about "saturation."  Why are you all so scared?  There is no reason to be, if you are confident of your qualifications and worth.

 1.  Employers that don't pay enough for their area simply don't get applicants.  I have seen this, even in "undesirable" locations.  An employer advertised for an NP, with a ridiculous salary, and the job goes unfilled.  Some of these places are really stupid, because I have literally seen the same job vacancy for 2 years!

 2.  I have always had to compete for jobs.  That is good!  It means that the crap candidates don't get hired!  Most of us had to compete to get into a decent NP Program.  This group is always complaining about crappy schools that allow anyone in with a pulse.  Why don't you think competition for jobs is good?

 3.  I don't understand why some of you think all employers are idiots.  Whenever I have applied for a job and been interviewed, the hiring manager is always an MD or an NP.  They know what the good schools are!

4.  Projections are just that - projections!  They are not the gospel truth.  I think the demand for healthcare is underestimated:

a)  We are headed toward national health insurance.  This might take awhile, but we are headed there.  That means a huge amount of unmet demand for healthcare will be freed up.  We still have a lot of people who don't have health insurance.  In addition, the ACA caused premiums and copays to skyrocket.  If these issues are solved, it will also cause a huge surge in demand.

b)  The COVID lockdown has caused use of health care to plummet.  That is going to go back up now.  In addition, it has caused an incredible amount of psychological trauma, so I predict the demand for mental health services will continue to increase for some time.

5)  With regard to PMHNPs, I see plenty of jobs advertised for high pay.  Telehealth for mental health is here to stay.  For one thing, the normal "no show" rate for mental health appointments is quite high.  Prior to COVID, when I had in-person mental health apapointments, on some days 50% of the patients would not show up.  With telehealth, the no-show rate is almost zero.  Most of my days, every single person shows up.  This means that telehealth will generate more revenue for psych.

At my previous job, when I lived in the middle of nowhere, providing primary care. the clinic had a full-time psychiatrist providing care via telehealth.  It was the only way they could get a prescriber.  The psychiatrst lived in PA and the clinic was in CA.  I've been thinking of marketing myself to rural health clinics to provide telehealth services.  I'd even be willing to spend 1 week per month on-site, on a rotating basis.  Myoglobin has posted here numerous times that he makes great $ providing mental health telehealth - he lives in FL and works for a place in WA.  

I advise you all to calm down.  Yes, do your due diligence about becoming an NP.  But if you are passionate about becoming an NP, have realistic expectations, and are willing to be flexible about that first NP job, have good education and skills, then you will get a job!

6.  Yes, the first NP job may be in an "undesireable" location.  After that, though, one should be able to get a job in a more desireable location.  That is why it is important for new grad NPs to be flexible and open-minded.

7.  Job hunting is also a skill.  Some people just have good skills for landing a new job.  This can be learned.  There are thousands of books on this.  If you are sending out your resume, and no one responds, then you have a crappy resume and/or you are sending your resume to the wrong places.  Get a good honest opinion on your resume.  Learn how to network.  Learn good interviewing skills.  Do you groom and dress yourself appropriately for an interview?  What is your demeanor?  Do you know how to engage the interviewers and answer questions well?  Honestly, a lot of people don't know how to do these things!  

 

There are a few presumptions in here that I don't necessarily agree with.  Particularly with my personal experience.

1.  I used to work in Flint, MI.  I negotiated up for my pay, but saw multiple mid levels to include PAs and NPs who took whatever they were thrown.  This included salaries over 10k less than I settled for.  Flint MI is neither desirable or a remotely easy location to work.  Neither my pay and especially the other's remotely reflected the money we made for our clinic.  Which is where pay should be focused for all locations (NOT cost of living).

2. Competition only benefits the employer.  Period.  Even in case of superior training vs inferior, the employer still has the opportunity to reduce their overhead.  Many clinics really don't understand the value of some NP education backgrounds.  Certainly some schools are more noticeable.  But not always.  I do recall a position where the physicians had nothing but rave reviews of a Walden NP.  Despite known quality issues with their education and outcome concerns.  To suggest they won't hire non-quality NPs is false.  Many are all too OK with rolling the dice and OK with insurance picking up where things fall through.

3. My first hiring manager (the COO) had only a healthcare administration degree.  Yes I had my second interview with both the COO and the CEO who was an MD.  This MD promptly undercut the COO by outwardly saying in this interview he didn't want to lose me over something as trivial as 10k.  This was a windfall for me, but doesn't speak to the negotiating tactics or intelligence of the owner of the company.  This is also not a failure of a company as they are consistently expanding through their region. 

4. Some of the same people who denounce projections somehow come back and say they are gospel.  And vice versa.  But I do recall a time in the late 90s where IT was the place to be.  Then that bubble busted and many I knew who were actively working in that sector lost everything.  Things are on the back swing in the past 5-6 years, but certainly not for those who were involved back then.

a) National healthcare does not benefit most in healthcare.  Even if that is the direction we are heading, doctors are actively suggesting NPs are somehow going to create a sub-class of clinicians for people who have less.  I denounce the suggestion that we are somehow "saving" money in healthcare.  If we are expected to perform the same role in many cases without help as an MD, we absolutely should be paid similarly.  We aren't. And we shouldn't be viewed as a cost savings or an option to bring more for those with less.  This thought dismisses the jobs and tasks we do daily.  

b) Covid certainly caused a drop off in in clinic use of healthcare.  But I would argue it caused more clinics to throw in the towel regarding access than necessarily people not using healthcare.  In our area, 3 clinics called it quits leaving multiple well employed mid-levels with no employment.  Ours closed one clinic due to reduced numbers, but we moved those clinicians to the other 3 clinics and adjusted to telehealth where we could.  We still all maintained 20-30 patients per dey throughout the pandemic.

 

I personally have gainful experience and should more options open for independent practice, then I won't worry much about this profession.  But I worry more about quality of candidates and the future of our profession. Poor quality still drags us down; even if we have established our own well-regarded reputation.  More IP will especially exacerbate disparities in quality should the thousands of grads from low-quality NP schools take advantage of it.  I will always be able to get a job and maybe continue to improve my salary on my own merits.  But newer grads will find themselves being at a significant disadvantage.  Especially as they get suckered into schools like Walden who make them think anyone with a pulse should become a provider.

 

 

 

 

[MentalKlarity, BSN, NP]

3 hours ago, FullGlass said:

I just don't understand the level of fear about "saturation."  Why are you all so scared?  There is no reason to be, if you are confident of your qualifications and worth.

1.  Employers that don't pay enough for their area simply don't get applicants.  I have seen this, even in "undesirable" locations.  An employer advertised for an NP, with a ridiculous salary, and the job goes unfilled.  Some of these places are really stupid, because I have literally seen the same job vacancy for 2 years!

2.  I have always had to compete for jobs.  That is good!  It means that the crap candidates don't get hired!  Most of us had to compete to get into a decent NP Program.  This group is always complaining about crappy schools that allow anyone in with a pulse.  Why don't you think competition for jobs is good?

3.  I don't understand why some of you think all employers are idiots.  Whenever I have applied for a job and been interviewed, the hiring manager is always an MD or an NP.  They know what the good schools are!

4.  Projections are just that - projections!  They are not the gospel truth.  I think the demand for healthcare is underestimated:

a)  We are headed toward national health insurance.  This might take awhile, but we are headed there.  That means a huge amount of unmet demand for healthcare will be freed up.  We still have a lot of people who don't have health insurance.  In addition, the ACA caused premiums and copays to skyrocket.  If these issues are solved, it will also cause a huge surge in demand.

b)  The COVID lockdown has caused use of health care to plummet.  That is going to go back up now.  In addition, it has caused an incredible amount of psychological trauma, so I predict the demand for mental health services will continue to increase for some time.

5)  With regard to PMHNPs, I see plenty of jobs advertised for high pay.  Telehealth for mental health is here to stay.  For one thing, the normal "no show" rate for mental health appointments is quite high.  Prior to COVID, when I had in-person mental health apapointments, on some days 50% of the patients would not show up.  With telehealth, the no-show rate is almost zero.  Most of my days, every single person shows up.  This means that telehealth will generate more revenue for psych.

At my previous job, when I lived in the middle of nowhere, providing primary care. the clinic had a full-time psychiatrist providing care via telehealth.  It was the only way they could get a prescriber.  The psychiatrst lived in PA and the clinic was in CA.  I've been thinking of marketing myself to rural health clinics to provide telehealth services.  I'd even be willing to spend 1 week per month on-site, on a rotating basis.  Myoglobin has posted here numerous times that he makes great $ providing mental health telehealth - he lives in FL and works for a place in WA.  

I advise you all to calm down.  Yes, do your due diligence about becoming an NP.  But if you are passionate about becoming an NP, have realistic expectations, and are willing to be flexible about that first NP job, have good education and skills, then you will get a job!

6.  Yes, the first NP job may be in an "undesireable" location.  After that, though, one should be able to get a job in a more desireable location.  That is why it is important for new grad NPs to be flexible and open-minded.

7.  Job hunting is also a skill.  Some people just have good skills for landing a new job.  This can be learned.  There are thousands of books on this.  If you are sending out your resume, and no one responds, then you have a crappy resume and/or you are sending your resume to the wrong places.  Get a good honest opinion on your resume.  Learn how to network.  Learn good interviewing skills.  Do you groom and dress yourself appropriately for an interview?  What is your demeanor?  Do you know how to engage the interviewers and answer questions well?  Honestly, a lot of people don't know how to do these things!  

 

I'm just so flabbergasted by someone not understanding job economics well enough to understand that when labor supply increases more than demand that wages/benefits fall. This is literally econ 101. You have some bizarre magical thinking to believe we can have 100 applicants for every NP job and the employer is still going to offer 125K and 4 weeks PTO when there are people so desperate for a job they're willing to sign for 70K and 2 weeks off. Like, do you honestly think that's how the employment market works? That employers will just continuously pay higher and higher wages even when they don't have to? That job seekers will "hold out" and go on unemployment if their offer isn't high enough? 

 

Please do some research on labor supply and demand and economics before making these statements about what would happen if the market was totally oversaturated. Better yet, go look up salaries and jobs for ANY.OTHER.PROFESSION after a market saturation. Let me know if you find any data showing employers just decide to pay more just for the fun of it ?