I was recently speaking with another master's prepared nurse who works in informatics about becoming an Acute Care NP and my experience as an NP student. Her immediate response was "why would you want to do exactly what the physician does for a dramatically reduced salary"? At first I was offended and was really peeved that a nurse would be so unsupportive of advanced practice nursing and gave her the long winded "why advanced practice nursing is awesome speech" but after a few days I gave thought to what she said.
In my area (NYC metro) NPs start as low as high $90k (RN start out at the same salary) and may hit maybe $160k at the top of the range, with a few outliers here and there. As a student I have witnessed how much work the acute care NP may contribute to a medical service and have seen the MD being the ''overseer'' on some units with the NP & PA managing quite sick patients and responsible for many emergent procedures such as intubation, central line placements.... Although I love the thought of being so involved in patient care I have wondered if NPs (specifically acute care) will be compensated more by facilities for our ever increasing scope of practice? I was surprised to see some services where the so called "midlevels" entirely manage extremely sick patients and the attending only appears when the patient is deteriorating.
I was also at a conference recently where some rural and highly experienced NPs stated that at times they were the only provider in a hospital overnight with maybe an ER doc, or that they managed emergencies on their own or as part of a team of NPs.
I'm wondering if this is part of a whole push by hospital executives to use advanced practice nurses as cheaper medical provider for cost savings.
This has dramatically altered my outlook as a soon to be graduate. I question if I want to be a ''forever resident'' performing all the scut work on the unit while only being payed a small fraction of what the attending (who seem to have the last say in regards to patient management) makes.
Acute care NPs diagnosing, managing, and running emergencies, also having to have the knowledge of a full fledged physician to only make 30-40% of what the attending makes sounds a bit troublesome to me. I still love the nursing profession, it's been my career home for 15 years but I do wonder if this is setting up to be a catch 22 with the corporate hospital system reaping massive benefits off of cheaper labor?
With the push for more autonomy and scope, will our salaries commensurate?
