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Features
2007 Salary Survey Results: A Decade of Growth
By Jill Rollet and Sarah Lebo
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Mike, after about ten years of engineering training resulting in a PhD, I do in fact make about what a NP or PA makes. But you should not be wanting NP/PA salaries to fall. You should want them to rise, but for our profession to have an even greater rise than theirs does. BOTH professions are severely underpaid.

Lauren, Tina, I'm sorry, but the bottom line is that the training of a PhD engineer is every bit as difficult as the training of an MD and just as long. I took my basic science ten years ago and scored 13 on the physical science portion of a practice MCAT with NO review of the physical sciences because the MCAT physical science questions are child's play in comparison with what is asked of engineers. Engineers not only have to understand science, they have to be able to do so both qualitatively and quantitatively using mathematical tools that make most MDs, NPs and PAs weak in the knees. In fact, to most engineering students, MCAT physical science exam is a joke.

Engineering PhDs just graduate with far less debt. I don't need the MD's large salary to service debt and malpractice insurance, though. As for responsibility for life and death- engineers bear even more responsibility over life and death than do you. That is why licensure standards for engineering are so tough. You don't see it or understand why, though, because you trust an engineer with your life every day when you walk inside a building, step on an airplane, or even drink water from the sink that has been treated by a plant run by engineers. Your health and safety is constantly in the hands of engineers, and because we are so good at what we do professionally because our training is so rigorous, you never even have to think about how much you do trust us with your life.

These comments are not made to belittle the work you do as a NP, only to tell you that you completely misunderstand the difficulty and intensity of the work required to prepare a PhD engineer. If salaries are truly based on the difficulty of the skills required by the profession to learn, engineering PhDs should be on the same level as an MD, and these people should be the highest paid groups of people in the country.

As for comments about family time being used for study to get an NP, do you even realize how long many engineering PhDs delay the start of a family? I'm 28 and have never had a girlfriend! Don't complain to me about your education taking up family time- YOU HAVE ONE!




Mark November 15, 2009

To Mike the engineer,
I do hope you stubble upon this page again. I can't help but feel sorry for you. You or family members have obviously never been ill or had care delivered by a NP. I challenge you to spend one day in a local hospital and watch what RNs do at the bedside. NPs do not provide bedside care but this is because we have advanced training and we are diagnosing and treating patients. However, to make to this point, we have to be RNs first with a bachelors degree and then go on to get a masters to become a NP. So when you talk about years of education, you don't have that much on us. Also, an engineer does not balance life and death in his or her hands. You have to take into consideration the kind of work we do. You walk into our offices, practices, and hospitals and expect us to tell you exactly what is wrong with you and fix it in the smallest amount of time possible. Not only do we try to meet all of your health needs, we also provide education to you and your family, spend time with your family as they deal with the stress of your illness, and as a NP, provide all of this care at a reduced rate than a physician. Lastly, if you are not satisfied with your salary, which from what I hear in the area that I live, engineers tend to do very well, do something else. Don't use your dissatisfaction of your salary to try and bring down health care workers who do some of the greatest, most compassionate care in the country.


Lauren ,  RN, BSN, FNP/MSN studentSeptember 27, 2009
TN

As a new NP of approx 6 months i have enjoyed my new role However i still work as a staff nurse as my salary as a staff nurse is at least 20-30 thousand more than as an NP. There is something very wrong with a system that pays more money to less educated nurses with less responsibity. New grads are manking more than NP's. this is a system with multiple problems where new grads are paid more than 30 yr nurses with advanced degrees. There should be an ability to advance salaries as experience and responsibity increases. NO NP should make less money than new nurses. We the community of NP's need to show group support and educated the public on what we do and why we are worth more than a new grad out of nursing school. We need to demand pay equal to our experties, education and experience.

marla schlesinger,  NP,  SubacuteSeptember 16, 2009
tarzana, CA

Mike have you considered that an electrician or plumber will frequently make more than a nurse practitioner. People think nothing of paying higher salaries to fields that traditionally employ men. But if the area of expertise is traditionally held by women people somehow think it should be volunteer work. The level of education required to become a Nurse Practitioner is time consuming and expensive. The licenses and continuing education is also quite expensive. Where do you propose we are to get this money from to pay these expenses. Finally the amount of time spent devoted to obtaining our education, getting our positions and caring for our patient's is often at the expense of time with family. Your comments suggest that we as a group are so insignificant as to not merit reimbursement for the considerable time and stress we invest and endure.

Tina ,  ARNP,  Private PracticeAugust 20, 2009
Federal Way , WA

In response to Mike the engineer, I am quite frankly appauled at your comments regarding health care providers and can't help but wonder if you or a family member has ever been sick/hurt and needed these services. I'm not sure how many other professions there are that routinely pose risks to your own health (exposure to infectious diseases such as HIV, hepatitis, TB and exposure to resistant organisms such as MRSA, VRE) while dealing with the pressures of life and death. Moreover, this article was about NPs not bedside nursing. NPs are able to manage a patient's care much like a primary care physician and are far more cost-effective than physicians. There are numerous professional studies published demonstrating this. A career as an NP is very demanding, stressful, and carries a tremendous amount of responsibility. And with all that, there are still the constant concerns of protecting yourself from medical malpractice lawsuits. We all have career choice. If you're unhappy with the pay of engineers, then maybe you should choose to do something else.

Nancy August 14, 2009
CA

Interested to know why some people feel that nurses are 'know it alls', insignificant, over paid beings. I would definitely like to see them survive in a hospital or clinical setting with physicians that are in and out of the room in less than 10 minutes not stopping to listen to true complaints and mindfully not ordering needed interventions for direct patient care. It is because of those deligent nurses that listen to their patients and anticipate their needs, that some patients do get the proper care that they need. So if nurses at times come off as 'know it alls' to engineers, then maybe it is because they are required to know a great deal more than they should. And yes some nurses are truly underpaid for the amount of work that they do but because they love their jobs and love what they do, they continue to work and risk their lives everyday.

Dana August 09, 2009
MS

I am a Electrical engineer and just stumped on this thread by chance. I see so many PA and NP's whining about low salaries. from my point of view medical profession is overall overpaid just because people need them and they blackmail the society. There are no ethics and it is all about money. PhD Engineers after 10+ years of post high school education earn much less than these blackmailers. I hope salaries of these professions decrease overall. nurses think they are doctors on first day without any proper knowledge....it is a ridiculous health system. Hope medical professionals realize they are only as important as other sections of society with same inputs and education...whiners, blackmailers...shame on you...

Mike ,  EngineerAugust 03, 2009
IL

Interested to know the average salary in Gastroenterology speciality.

simi mathew,  ANP,  PrivateJuly 27, 2009
Chicago, IL

Interested in some feedback on salaries in NJ

deb ,  NPJuly 04, 2009
toms river, NJ

I have been working 3 years for an hourly rate. I will be going fulltime (4 days a week) soon and feel this is the time to re-negotiate my benefits, of which I have none at this time. Please give some ideas of your salaries, number of vacation/sick days, CE payment etc. to ask for. I will also be taking phone call.

Grace ,  FNPJune 18, 2009
TN

What are some of the salaries that NP in palliative care are getting in the acute care setting here in the North East?

Deborah Moyer,  NP studenetJune 11, 2009
philadelphia , PA

My mom has been a PA for over 20 years and has found that some facilities and docs do specifically want NPs while others want PAs only. I agree that specialties for NPs should come only after a good primary care background. I entered NP school right after undergrad and I think being a nurse from the start will help me in the future.

David ,  RN, BSN, Family Health NP studJune 06, 2009
TX

To Rob and Jameson,
You say tomato--I say you're idiots. I would be glad to go head to head against you or your PA colleagues in practice with regards to overall knowledge base and patient satisfaction. The difference lies in the fact that most NP's have an undergraduate degree and training as a registered nurse first. I think that this in some ways is threatening to our physician counterparts. Before becoming a NP, I had two undergraduate degrees and a Master's as well as seven years of experience working as a RN in the hospital setting. I went through a joint program where I was alongside 21 year-old P.A. student-kids who didn't even know how to interact with patients, much less perform invasive procedures that I had been doing in the hospital setting for several years. Many of them were more concerned about their hangover headaches than learning from their clinical training. The PA we have in our practice was a social worker first--btw she does a wonderful job.

I agree with one point and that is that most NP's are much better suited for primary care and that is where we are needed. I see more and more NP students that I precept wanting to go right out into specialty services and i think it's very sad. We need more well-rounded and caring individuals in primary care who are patient and willing to listen to their patients.

Dave ,  NP-CMay 15, 2009
MD

I make $111K/year as a Surgery NP and have been out of school for ~5 years. Just wanted to clarify that not all NP's are flooding the market and working for low wages. I make over 25K more than the PAs in our surgical department. Obviously not all places/areas are created equally based on some of the earlier comments.

Angela ,  NPMay 04, 2009

I've been a PA for 12 years. Personally I feel NPs are flooding the market and killing it for all mid levels. As far as jobs you can find jobs that abuse you for time and pay or keep digging till you are happy. It's that simple. Being able to move and/or not being tied to one geographic location or having kids makes a HUGE difference obviously as well. I have a LOT of personal insight in both PA and NP stuff off the record if anyone would like to e-mail me.

Rob ,  PA-CMay 02, 2009
KY

Let's be honest, most PAs are just as independent/autonomous as any NPs are, in practice. In most states NPs have to collaborate with a MD, which is the same thing as what a PA does. You say tomatO, I say tomAto. The difference in salary comes from the fact that PAs are trained in surgical subspeciaties, and can act in first assist (and other) positions whereas NPs have a harder time getting to this place. These specialities command higher salaries (no matter what pratitioner is practicing), and therefore PAs make more $$$.

jameson bell,  PA StudentFebruary 18, 2009

Living in the most expensive part of California-Marin County I get paid well below what I made in Boston, working Emergency Medicine. I took a 10$/hour pay cut! The schedule better, no weekends although for what is expected in a nurse practitioner run clinic its appauling.
Regina Powers
Larkspur, CA

Regina Powers,  FNP-C,  NCHJanuary 06, 2009
San Rafael, CA

When I left Tennessee 10 years ago, NPs were having a tough time getting any jobs, with many falling back on their RN licenses and prior jobs. I interviewed and then moved to Arizona to work with the VA and later a retail health clinic. The VA salaries vary with locality but can be found on the web nationwide. The VA utilizes an electronic medical record, allows the NP tremendous autonomy and annual salaries with longevity exceed annual $100,000. Also the VA includes 5 weeks paid vacation, federal holidays, and no need for malpractice insurance.
The retail care clinics in this area also pay FNPs 45-53/hour. I'd say if you are not getting what you are worth, then look/move on. Don't be so naive or depend upon "your doctor" to have your best professional or financial interest at heart.

Terry Caldwell,  NP,  CBOCJanuary 02, 2009
Tucson, AZ

It's a shame that Nurse practitioners who are "independent practitioners" are making less money than physicians assistants who are "Dependant practitioners."

Something is wrong with this picture.

Matthew Lindquist,  NP,  Mid-America Psychiatric Consultants, LLC.December 31, 2008
St. Louis, MO

After being an NP for 9y, I still can't believe how some physicians don't want to pay for what we are worth. EVERYONE needs to be aware of how much you are billing and what percentage of billing is collected. Average collection in primary care is 45-55%of billed. If you are billing $700,000 in a year and they are collecting 350,000 and you get paid 65K.... that is not enough. If you are aware of this, you would be SHOCKED to see we usually only get paid 15-25% of what they collect. Yes, they have to pay the bills but lets not let them be greedy either! Some of us are doing more for them than was agreed upon... i did this for 5 years only to be sent packing w/ 2w notice b/c she was getting a divorce and needed to work fulltime again! Salaries have not gone up much in 9yrs! I currently work ER/Urgent care despite the poor hours, i get more time off, don't have to take charts home and get paid more w/ better retirement. I don't know when we will be valued as an important part of health care... maybe in another 50 years? LOL!

R.  Torres,  Np,  HospDecember 16, 2008
San Antonio, TX

It is really quite sad to think that there is such a feeling of disconnect between NP's and PA's. First, I would like to clear up that as a NP I find it very discourging that any new practitioner would feel that they were better than the next. I can only speak for NP's and the majority of us who have experience as a nurse are already making a salary that is almost the same as our practitioner positions. For those of you coming straight from school to the practitioner position the salary is great, and regardless the model of learning the one thing I have noticed between NP's and PA's is that no matter what model you learned under we are and can do the same job. Maybe the threatening feeling come's knowing that NP's have to collaborate with MD's and PA's have to be supervised by MD's in the clinical setting. It is a real shame to have feelings like this as over time both professions are equally qualified providers. Maybe we should start learning from each other, there is always much to know about medicine.

melissa ,  Family Nurse PractitionerDecember 02, 2008
Buffalo, NY

Jennifer,
I can see how frustrated you might be when the public constantly compare you to nurse practitioners. The truth is, nurse practitioners do not become clinicians "OVERNIGHT". They are nurses FIRST in a clinical setting. Physician assistants do not have the opportunity to establish any clinical knowledge until they are in clinicals. I have many friends who are P.A's and they value the knowledge of their nurses and NPs. Maybe you should do the same.
Dina

dina gonzalezNovember 14, 2008

My practice is doing a survey regarding salaries in the area. Does anyone have any specific data regarding NM NPs' salaries, and benefits?

coral November 06, 2008
Albuquerque, NM

Just to clarify for the NP's who are under the impression that PA's are able to undergo 2 years of minimal training and become clinicians overnight, please know this... Physician Assistant training is based on the "Medical Model." Our education is similar to that of a medical student, though it is condensed. We need a minimum of a bachelor's degree to practice in addition to the pre-requisite "hard sciences" in chem, physics, biology, statistics, etc. Additionally, enrty to PA school requires a clinical background, usually of at least 2000 hours. Please go to aapa.org for accurate information.

Jennifer ,  Physician AssistantNovember 04, 2008
NY

There really isn't that much difference between the physician assistant and nurse practitioner pay scale. The physician assistant survey didn't include academia as a specialty when considering pay scale. Historically education doesn’t pay and this is skewing the data. It is difficult to compare the two pay scales by the data because the NP used setting and the PA used specialty.
Some of the data which could be correlated.
ER : PA = $94,684 NP= $95,157
Plastic surg. PA = $88,135 vs. Skin care practice NP= $87,773
Hospital Medicine PA $84,470 vs. Hospital NP $86,630
Psychiatry PA =$ 80,967 vs. NP mental health NP= $82,978
Obstetrics/gynecology = $75,275 vs. Women’s health NP= $76,483
Endocrinology PA=$76,467 vs. Diabetes/endocrinology clinic NP=$79,032

I also tried to group some of the PA data into settings similar with NPs
Avg. of surg PA $91688 vs. Surgical setting NP $86,256
Avg. pediatric/radiation/medical oncology PA $81,987 vs. Oncology clinic NP=$84,578
Avg. pediatrics PA = $78,393 vs. Pediatric setting NP= $78,120

As you can see aside from surgery the pay scales are similar.

You can find the PA salary by specialty at Advance for PA
http://physician-assistant.advanceweb.com/Article/PA-Salaries-by-Specialty-2008.aspx


Colin DoyleOctober 12, 2008
Buffalo, NY

There really isn't that much difference between the physician assistant and nurse practitioner pay scale. The physician assistant survey didn't include academia as a specialty when considering pay scale. Historically education doesn’t pay and this is skewing the data. It is difficult to compare the two pay scales by the data because the NP used setting and the PA used specialty.
Some of the data which could be correlated.
ER : PA = $94,684 NP= $95,157
Plastic surg. PA = $88,135 vs. Skin care practice NP= $87,773
Hospital Medicine PA $84,470 vs. Hospital NP $86,630
Psychiatry PA =$ 80,967 vs. NP mental health NP= $82,978
Obstetrics/gynecology = $75,275 vs. Women’s health NP= $76,483
Endocrinology PA=$76,467 vs. Diabetes/endocrinology clinic NP=$79,032

I also tried to group some of the PA data into settings similar with NPs
Avg. of surg PA $91688 vs. Surgical setting NP $86,256
Avg. pediatric/radiation/medical oncology PA $81,987 vs. Oncology clinic NP=$84,578
Avg. pediatrics PA = $78,393 vs. Pediatric setting NP= $78,120

As you can see aside from surgery the pay scales are similar.

You can find the PA salary by specialty at Advance for PA
http://physician-assistant.advanceweb.com/Article/PA-Salaries-by-Specialty-2008.aspx


Colin DoyleOctober 12, 2008
Buffalo, NY

I'm taking my own poll about this survey. totally scientific (not) so go ahead and vent your spleen.

Why, since the educational requirement is typically shorter and the experience in health care is usually less, do PA's get paid more than NP's?

1) Gender (sex-sex-sex-sex-sex! Now, where were we?)
2) The "P" word (physician)?
3) A unified, organized professional society?
4) Cultural differences?
5) Educational foci?

Add your own to the list and/or comment as you see fit - FLAME ON!!!


Steve EdelmanOctober 09, 2008

I am interested in cardiology salaries for NPs that work in clinic as well as general rounding of all patients, including critically ill cardiac patients. Thanks!

Lisa Murphy,  FNP-BC,  Private PracticeOctober 06, 2008
Columbia, SC

Does anyone have salary comparisons for cardiology specialty NP's--hourly rates if possible and number of pt's expected to be seen. thanks

Jennifer Mabry,  FNP,  Tennessee Heart, LLCOctober 01, 2008
Cookeville, TN

I suspended my busy family practice at the end of '04 to care for my elderly Mom, who lived with me and required total care. After her death at the end of '05 I married my childhood sweetheart after fifteen years of widowhood, moved to North Carolina, became licenced and recertified as NP through ANCC and am ready to get back to work. I live twenty miles north of Asheville, and have just begun my job search. I would like to become active in an NP organization and will seek to locate the local association. If there is any advice for me from others I would welcome it.

Linda "Lyn" Johnson-Sklar,  FNP-BC,  PendingSeptember 24, 2008
Mars Hill, NC

I'm looking for a job in Indiana and a hospitalist group wants to talk with me. Does anyone have any ideas what a reasonable salary/hourly rate would be? I know it should be more than office practice, but don't have any numbers in mind.

Beth September 24, 2008

Whats in a name?? "Why do Physicians Assistants" make so much more than a "nurse practitioner"? Think about it!

Joseph Foley,  Critical Care NP,  Akron Children's HospitalSeptember 09, 2008
Akron, OH

Sorry. Meant usajobs.gov! (not usajobs.com)

Catherine ,  Psych-NP,CNS,  Community Mental HealthAugust 26, 2008
Fairfax, Virginia, VA

1. When asking for feedback regarding salary, make mention of the locale you are in (state, rural, city, restrive NP practice regs etc.) or where you want to be.
2. The Gal from New York should probably ask for triple figures (I was offered 110K to move to Conneticut last year at this time) I am happy now in the WashingtonD.C. area making a little less.
3. Hospitalists should ask for the moon! And not agree to administrative duties to "augment" their position! (i did this for two years on salary and ended up working 70 hours per week).
4. Consider federal work or contract work with DOD... you can travel, negotiate your expertise and bone up your resume...see usajobs.com first. Hawaii was lovely and I did not have to feel my way around the archaic laws around Hawaiian NPs.
5. Keep advocating for our profession by walking away from organizations who think they can get something for nothing.


Catherine ,  Psych-NP,CNS,  Community Mental HealthAugust 26, 2008
Fairfax, Virginia, VA

Am currently beginning a FNP program this fall and have been approached by a physician (whom I currently work with in the operating room) about sponsership for the program. What should I expect in this meeting? What is a reasonable committment?
Should I be ready to negotiate salary now?

Help!

Amy
FNP in 2010

amy barkerAugust 23, 2008

I'm interested in obtaining information about the salaries for Nurse Practitioners who work in (non-profit) community health centers. Also, is there is difference in salaries for NP's who work in a speciality like GYN vs primary care?

Nancy Gregory,  FNPAugust 19, 2008
Martinsburg, WV

I am a consultant trying to research an average on-call pay for Nurse Practitioners (per hour, case or any variation) who cover Skilled Nursing Facilities. Our client who wanted help with NP On-Call Pay is in the MidWest. Any input?

Thank you!


ZMS August 04, 2008
Phoenix, AZ

I been a PNP for 5 years, but just recently joined a pediatric practice. I have been a ED nurse for 8 years and still work on the weekends partially due to the income "cut" I took when I joined the practice. I usually see 30-35 patients per day and work alone one day a week. I guess my frustation fuels from one, making more money as a nurse, secondly, we agreed on 25-30 patients per day but everyday more and more patients get placed on my schedule, when I discuss this the physician, who by the way solely owns the practice, the response is "we have to pay the bills". I was just wondering if this is typical setting for Pediatric NP's. My salary is 65/yr and I work 4 1/2 days a week. I am in the office by myself one day a week and will be responsible for Saturday clinic in the fall. Please, let me know is this the norm?

Amber ,  PNPAugust 01, 2008

Reading the Salary Survey results makes me appreciate what I have. I work 36hrs/wk, no weekends, no call, no pressure to see more patients (I have 23 slots per day but usually only see 16-18/day) with paid health, life, disability, sick, vacation, liability, and continuing education. I've gotten 3 bonus' in 18months, and a 6% raise without asking. I make above average pay for the state of NM. New Mexico allows practice and full prescriptive authority without any collaborative agreement. Now why can't we get more PNPs to come to practice here?

Micki Burger,  CPNP,  Silver Health CareJuly 29, 2008
Silver City, NM

what can an NP with 10 years experience expect to make in a specialty clinic that is hospital based in NYC?

karen brownJuly 13, 2008

Does anyone know of any scholarships and/or loan repayments for WHNP students?

malaika oliver,  SWHNPJune 22, 2008
Indian Head, MD

I work in a clinic which is also a hospital based practice,therefore,the RNs that I work with have a union (a very good union). I make less than the RNs in the office, have two more degrees than them, am responsible to co-sign their notes at times,bring in revenue,etc. I approached administration, and gave them a dollar amount per hour that I wanted so that I would be "in line" with the RNs, They did give me a good raise but fell $1 short of what I asked for. If NPs could form a union, I know that we would be better off, because RNs have come far with unions to support them. Administrations KNOW how valuable NPs are; they are paying one third the cost of an MD to do the same thing! Now please don't misunderstand me: I do not begrudge RNs their salaries; I'm an RN too and have worked on the floors. I also do not begrudge MDs their salaries; they have worked hard, do call, etc. I just want NPs to receive what they deserve as well. Patients love us! Don't sell yourselves short! :)

Kate ,  WHNPJune 21, 2008
Massachusetts



I am a family nurse practitioner, but have worked in specialty since I graduated 6 years ago. NP's do make more in these practices. I was in Allergy 2 years and now work in Pulmonary. I would say the average pay for specialities such as these (including cardiology) is between $43-50. This may vary per state. A lot of practices will also pay for your malpractice insurance and DEA on top of that. Best advice is figure out how much income you bring in per year and then negotiate your pay on top of that. Good luck!

Shawn DeStasio,  FNP-CJune 19, 2008
Torrance, CA

Does anyone have information on salary averages for public school NP's who are given state benefits?
Any input would be helpful.

Staci  ,  ARNPJune 11, 2008
KY

I would like to hear from anyone doing specialty practice such as allergy...I would like to see how salaries for FNP's who work in specialty areas fare since the practices are making so much money. I think there is an attempt to compare NP's working in family practice with those in specialty care and the income of those physicians is vastly different due to the billing for procedures and in allergy that would include vials and shot revenue.


Editor: See Table 4 for average salaries by practice setting. You'll see that NPs in different specialty settings can have very different pay scales.

Deidra Sanders,  ARNPJune 04, 2008
Louisville, KY

Hello Everyone, I am certified as an adult and geriatric NP. I am currently working in an internal medicine clinic. When I was hired, I asked for $40 hour (I had been making 45-50 per hour as a locum tenen), but agreed to 35 per hour as it was 3 miles from home. I have now been there for one year, and am about to approach them for a higher hourly rate. I work four 9-10 hr. days per week and one Sat. per month. I have no call or hospital responsibilities. The physician gives me no benefits. I pay for my DEA, DPS, re-certification and license fees and malpractice insurance.
My question: I see from the 2007 salary survey, the average hourly rate is about $40. Do you think that this rate includes benefits? I feel very underpaid, yet I enjoy the patients and the clinic. Does anyone have any advice as to what I should be making, and how I can go about increasing my hourly rate? I would appreciate any help- I am not very good at being assertive. Thanks, Jo Nell


Editor: Take a look at Table 11 for the wording of the survey questions. You'll see that we asked, "If full time, what is your current annual salary (including bonuses and call pay, but not including nonmonetary benefits) as paid by your employer." Good luck with your negotiations!

Jo Nell Costello,  ANP, GNP,  Internal Medicine ClinicJune 03, 2008
Katy, TX

I agree that NP's should be paid much better than what they are considering the amount of responsibility and liability they have. However, being a NP student currently, I am looking forward to having NO NIGHTS WEEKENDS AND HOLIDAYS. I love being a nurse, the hours suck though. I want the clinic hours without the clinic pay cut. If you think you are taking a pay cut, how about being pain $14 to work as a clinic nurse! Not for me, besides that, is nursing all about the money? There is a general misconception in the profession and in the general public that nurses make 'big money'. Well it's wrong, but I don't care. I am living comfortably and I love what I do. I am looking forward to helping my patients prevent getting sick and ending up in the hospital - or worse. The money I make is one of the perks of the job. If anyone has been taken care of by a mean, nasty nurse you know what I am talking about. Our patients need to feel safe and well cared for. Our love needs to show through. Think about how many lives you touched the next time you get paid. How many compliments does it take from 'good' patients to make up for the 'bad' ones. For me it only takes one. Look into your heart and ask yourself why you became a nurse in the first place. If it was for the money - you are in the wrong profession.

Sandy Schnoor,  RN June 03, 2008
Scribner, NE

The salaries are a disappointment, but I believe that nurses are in large part to blame. There is too much fragmentation in our education. We don't stick together and we have altogether too many titles. Instead of dreaming up another confusing category of practice like the DNP, why don't we unionize and get a national voice and a national identity. There is no confusion about the role of a PA, but there is enormous confusion about the role of an NP, or APRN, or whatever label we're allowing academic credentialing organizations to afix to us today. The more lables, the more confusion regarding our academic preparation there is, the more diluted our salaries will be. Incidentially, academia certainly expects a huge amount of tuition from such a poorly paid bunch of professionals.

Ellen Glazier,  FNPJune 03, 2008
White Plains, NY

Brace yourself for the harsh truths. There are two main reasons why PAs are paid more than NPs: 1) Most NPs are women, and they get paid less in every field, mostly because they tolerate it, and 2) PAs are more trained like and closely supervised by physicians, whereas NPs are more independent are are considered a threat by some MDs, so they want to keep us under their thumb. Another reason our salaries are lower than they should be is supply and demand, which runs capitalist societies like the U.S. There are a lot of unhappy RNs out there that want more pay and recognition, so they go back to school to be an NP. The market gets flooded, and this increased competition forces down salaries. Medical school and even many PA and Physical Therapist programs limit their enrollment precisely to keep this from happening, but nursing programs want the extra cash from letting more students in, and they screw the whole profession. I have been in nursing for 15 years, and my mother was a nursing faculty member, and I can tell you we are our own worst enemy. If we had unions, limited enrollments, and all contributed financially to a national organization that lobbied in D.C. on our behalf, we would be very powerful! The problem is, there are so many women desperate for jobs out there, many of them single moms, that they would break any union strike and are willing to accept far less money than they deserve. Until these issues are addressed, NOTHING WILL EVER CHANGE.

Julie ,  FNP-CMay 22, 2008
TX

After reading some of the comments--I decided to post one as well. The np is eastern Pa. is not alone--it is pretty much the same in Western Pa. Our practice is big and a speciality in both Nephrology and Endocrinology--one luxury is that I have 30 minutes for follow-up pts. and an hour for new pts. All the other work like labs, charts, e-scribing I do for 5 endocrinologists. Salary is below the national average but I choose to stay because I love the patient care and hoppefully I make a difference for the diabetes patients that I see.

Susan  Steiner,  CRNP, CDE,  Renal-Endocrine AssociatesMay 12, 2008
Pittsburgh, PA

I have worked as an NP for one year. Heme/onc, I make 63,000 yearly, pay half my own health insurance, 2 sick days per year, no 401k, and I see about 30 patients per day, I write all the notes, and do all the "skut" work. The doctor has never billed one patient under my number, which I think is medicare fraud. I get paid for 8 hours, work 9.5, I have certainly taken a pay cut from my RN days. This is the norm in my local, eastern PA. To make a better wage, I have to pick up and move, something my children would not appreciate.

Ann 658848,  crnpApril 29, 2008
PA

I didn't see location as part of the survey and I understand that is part of the calculation. It seems Florida pays much lower than other areas. I work in an interventional pain clinic performing many intra-articular injections, various nerve blocks and ligamentous injections. I see almost as many patients as a family practice practitioner, with more potential for harm by the nature of the work, yet make less. Something doesn't seem right here.



Editor: Location certainly should be part of your salary calculations. Check out Table 8 Average Salary by State, where you'll see that Florida's average is just a few hundred dollars below the national average. On Table 9 Average Salaries of Select Cities, though, you'll see that the average for Orlando is a bit lower than the average for the state, but the average for Miami is much higher. Table 10 lists averages by population setting: urban, suburban and rural.

D April 19, 2008

T. RN, Neo NP's are in huge demand. If you want to live in Hawaii, Kapiolani and Kaiser are always looking for that. Kap Childrens uses them to fly and transport the really sick kids. I see adverts all over the country for Neo NP's CKS

Cynthia S,  PNP,  LocumsApril 18, 2008
Kapaa, HI

I took a big cut in pay when I started as newly minted NP and my over 18yrs of hospital and home health experiences didn't help. Now I can use my 8yrs and additional skills (language) as a negotiating leverage. What I don't understand is why the PA's have higher salary? Is it specialty?

Hello Gary, El Paso. I went to UTEP for my MSN.

Carmen Ching

Carmen Ching,  CRNPAdultApril 15, 2008
Wheaton, MD

I am writing in reference to the comment that it looked like becoming an NP means lower salary than staff nurse. That happened to me. I have not yet found work as NP that would pay more than a staff nurse. Of course I worked weekends, hollidays and nights to get the higher salary, but still, as NP i have much more responsibility. It takes much more knowledge, alertness and diligence to do no harm, for example. Every NP job I have had is in place where there would be no health care if the NP's were not the providers.

Gary Petz,  Nurse Practitioner,  Centro San VicenteApril 13, 2008
El Paso, TX

I am a new nurse. I have been a nurse for 1 year now in an adult intensive care unit. I am highly considering going back to school to obtain a Masters in Neonatal NP. Are there any neonatal NP's out there? I have shadowed a few. I just have more questions about job availability, practice settings (other than the hospital), and salary averages. I love infants, especially high risk infants. I am looking forward to obtaining any information anyone can give me. Thanks.

T. ,  RNApril 07, 2008
Ann Arbor , MI

The results of this survey are very disappointing. If I had access to this information before I started my NP program I would not have started it.

According to the survey, I can expect to take a significant cut in pay by entering advanced practice versus remaining as a floor nurse. I want to expand my role and responsibility as a NP. In addition, I want to increase my income as there is no possibility for promition from my current position. This is very disappointing.

Marty

Martin Greenberg,  Staff Nurse,  VA Medical CenterMarch 30, 2008
Seattle, WA

I am relocating to St. Louis. Has anyone worked as a NP there? What salary/hourly range can I expect? I have 30 years L&D and am trying to decide whether to continue with L&D or the 10 years of those I've worked in an OB/GYNE MD office setting as WHNP.

Ann ,  NPMarch 25, 2008
Chicago, IL

To the person below working in the rural setting making $75,000 per year: You may have to leave in order to get more money as they seem pretty pleased with your salary. If you want to continue to pursue it, you need to have access to your productivity numbers. If you can get the numbers, one of the bases for increasing your salary is how much revenue you generate. After working at that clinic for that amount of time, I am sure you are generating alot more than the other NP's or docs. If not well, your salary may be adequate then. How about negotiating a productivity bonus? If they wont go for that, how about negotiating a few more weeks of vacation time to possibly work somewhere else to generate more revenue for yourself. And if they ask you why you need more time off, be honest and say why. I know it is very easy to stay in one place, however I was laid off by a large corporation, to make the doc more productive. It was the best thing. I too negotiate anywhere from $45 to $125 per hour depending on how busy and where. Its harder to work in the rural settings, so the thought of working in the big city for more money shouldnt fly. I am presently working as the solo provider for $150,000 per year plus benifits in a small rural town in New Mexico doing workmens comp pts. In the year since working here, revenue has increased over 50% as I have learned to work smarter, not harder. It still grinds me that PA's are getting paid on the average more than NP's. Good luck and remember: your worth it.

wanda  poncik,  FNP-BC,  center for industrial medicineMarch 25, 2008
hobbs, NM

I have practiced as a NP for over 16 years in private practice and a Independent contractor, and cont. to do both. I am shocked at conferances when NPs tell me there salaries! Quit selling yourselves short! You must be prepared! These are business people! My rates are $60.00-135.00.... I am worth it, and so are you!

Patricia   March 25, 2008
WA

Are NP's required to have physician supervision in Nevada?

Gilberta Theonnes,  RN,BSN,  AcuteMarch 18, 2008
Portales, NM

I have been a women's health nurse practitioner since 1976. I worked in public health for the first 16 years and then I joined an Obgyn office with 4 physicians. We now have 7 physicians, and 2 other nurse paractitioners. I work 5 days a week 8hrs per day. I have my own gyn patients which keep me very busy as well as seeing most of the daily work-in problems. I refer my surgery patients to a phy. of their choice within our practice. I have now been here for 16 years and recently asked the practice administrator for a raise and I was told he would discuss it with the phys. I presented him your article and salary survey. He still feels I am being adequately paid for our rural area. I pointed out to him that according to the practice numbers that I see more Gyn. patients than anyone else in this practice. My salary is $75,000 and I feel my experience and work ethics relates to a higher salary. I did not receive a bonus at the end of 2007 because of large expenses which the clinic had with buying new equipment and adjoining land. The clinic does cover my health insuance, malpractice ins. and I do have a 401K which I participate in. The practice administrator feel these "perks" make up for a really good salary. Am I being unreasonable?

Nell ,  ARNPMarch 18, 2008
TN

Regarding the hospitalist position, as a one year grad not knowing your experience that first year, I recommend evaluating the number of hours you will work, the number of patients you will see on a daily basis. So if you're working a 40hr/wk or are you working on 7days off 7days etc. You won't have to deal with call time or with the hassles of private practice such as: patient calls, rx refills, CMN's DME's etc. You need to find out what your billable rate will be as well remembering you recieve 85% of what the MD recieves. As a relatively new NP you can negotiate a salary increase that coincides with increased independence in your practice. Good Luck and one other thing, always let the employer go first, when they ask what salary you're looking for, turn it back to them and ask what they are offering and go from there.

Lisa ,  CNP,  Private PracticeMarch 12, 2008
Cleveland, OH

I've been a nurse since 1984 and an NP for five years. I just finally got a raise to 90K after pointing out to my boss that he was paying his new grad a PT NP with less than five years experience as an RN an hourly wage that when she logged hours similar to mine, a higher salary. I negotiated firmly that I either had to leave or things had to change pointing out the number of patients I saw on a weekly basis, the actual number of hours I was working, and all the non-billable paperwork that I did etc. At first he allowed me to adjust my schedule to a 35hr work week, and said he couldn't pay me more, but then within a month following a very busy period of time he bumped my salary as well as her hourly wage realizing that our contribution to the practice was priceless.

Best advice to everyone, is we have to stay united, you must keep a personal log of your productivity and show your employer surveys such as this to back it up. We are worth every penny and more!!! Often physicians are unaware of all the work you do and you have to point it out to them.

Lisa ,  CNP,  Private PracticeMarch 12, 2008
Cleveland, OH

I have seen lots written about salary...however I am thinking of working as a private contract provider. I have 4 years of experience and was wondering what the percentage rate I should negotiate for. Up till now I was on a salary. But the house were long and I did not feel adequately compensated for my efforts. I feel working as a private contract provider I will have more control over my time. But how do I prevent being under compensated? I would appreciate these issues bieng addressed in a future article. Thanks

geri ,  arnpMarch 11, 2008
jacksonville, FL

I feel the same way, we work just as hard as the MD see as many or more patients, get paid less then PA's and do more. Some one call the walk and i will march side by side with my fellow NP's. We deserve more and i feel we more then justify what we do, for our patients.

margaret cocuzza,  nurse practitoner,  privateMarch 11, 2008
brick, NJ

My salary is $100.000/year and I do first assist in spine and brain cases about 10-15/week, besides being an NP thier. I bring over $350.000 to this office and I still don't get what i deserve. I am amazed how PAs who can be some one with a computer or sales back ground go through a 2 year program and yet make as much or even more when compared to NPs. That really hurts. I think this is because of the fact that NPs education concentrates on research/ book knowledge and not much "hands on practice". Also, the fact that PAs are often hired by surgeons makes a difference in their pay scale in general. If I had to do it all over again I would go through a PA program. We are not being appreciated the way we should. The fact the Board of medicine and doctors are supporting PAs makes a difference, apparently.

Gity S.,  ANP-C, RNFA,  PrivateMarch 11, 2008
Orange County, CA

I have been a NP for 13 yrs. Just 5 months ago, I finally began receiving a salary that was more in line with what NP's should be paid. In order to get that salary, I had to leave the midwest for the east coast, and fight for every penny and every measly benefit. (negotiate was too tame a word for the process, it was more of a wrestling match). My niece, who is an RN, works weekends only and makes just slightly less than I do. I don't know what it is going to take to make people understand that the work we do is very valuable, and we SHOULD be compensated accordingly. Ihave never understood why PA's earn more than we do. Can anyone explain this to me?

Patricia RobinsonMarch 05, 2008
VA

To Dee White,
I too just completed the DNP (a ton of work!!). I personally went to our HR department and worked with the Nurse recruiter to look at a pay difference for people who get their DNP. They currently give a 3% raise for people who obtain any certification. After several meetings the organization made a policy that for people who get their DNP, they will give them a 3% raise also. It may not be much but it is better than 0. One thing that was discussed during those HR meetings was how does the DNP make a difference in their job. This is where you may have to show them the value of the doctorate degree.

Anne ,  DNP, RN, CPNPFebruary 28, 2008
Minneapolis, MN

We must unit! Employers for the most part want us to "play doctor" see as many if not more patients than t hey do, yet want to pay RN wages. What can we do? If I had stayed at the hospital as an RN I would be earning more and would have job security.

A A,  np,  privateFebruary 28, 2008
fresno, CA

I think everything comes with experience and how you negotiated for your pay and job. I realized that I'm getting paid more than average base on this article, but I had to negotiate for every penny, benefits, and schedule. There are other opportunities out there, if your willing to risk and Waite you will get what you want. I think employers know that it's very hard to get good help, but are they willing to pay for it. I left my fist job of 2 years as an FNP for better pay. I agree, PAs gets paid more than we do, for doing the same thing, we need to catch up. Negotiate! Negotiate!

Chan, FNP ,  FNPFebruary 28, 2008
Merced, CA

I have just completed a doctorate in nursing practice, at first my administration was extremely supportive, after it was all said and done, there has been no change in my salary nor has there been any opportunity for advancement. I feel it is ashame that we as a profession are not recognized by our employers for the hard work that we do or for our achievements. Does anyone else feel the same, or am I just way out there?

Dee White,  Doctor of Nursing Practice,  Rural HealthFebruary 27, 2008
Selma, CA

I agree- make sure if you take a new role that you consider the possibility of weekend call/coverage- in addition to your scheduled weekly hours. I am in a similar situation- working 10-12 hours/ more per week that my salaried position. not being compensated...think of this. The staff RN's make their salary plus overtime. If your position is salaried- negotiate!

donna ,  NPFebruary 27, 2008
NJ

Damon,
I just left a position as an inpatient NP for an academic facility due to being much overworked. Get in writing your expected work week hours (IE M-F, 8/day). A fair wage depends on your location in the state. Is it rural or urban? For the Indianapolis area, I saw salaries for NPs that ranged from $66,000 to more than 100,000. Good luck.
Robin


Robin Viviano,  FNP February 27, 2008
NC

I have just been offered a job as a hospitalist NP for a 600 bed hospital. I have 10 years of critical care experience but I have only been an adult NP for about a year. I'm not sure what a fair wage and hours would be. Can anyone help?

Damon ,  NPFebruary 26, 2008
IN


     

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