Benefits, Extras, Perquisites and Lagniappes
The survey showed a tie for most prevalent employee benefit: paid time off and health insurance were offered to 17% of respondents by their employers. Other common benefits were malpractice insurance (available to 16% of respondents), paid continuing education (16%) and retirement plans (15%).

Nonmonetary extras, such as flexible schedules and autonomy, may not be the first things that come to mind when you think of employer benefits. But our respondents ranked those aspects high on the list of extra perks to weigh when considering new job opportunities.

"If we shouldn't be dictatorial with our patients, but work with them for best health care in the perspective of their lives, then we should also as NPs work together for the best work environment based on each other's lives," explained Glenda Clemens, NP, a practice owner in Norman, Okla. "Allowing my employees the freedom to live their lives in the best way possible, combined with work, keeps them happier and more dedicated."

Working for a consulting company that serves nursing homes allows Lois C. Hamel, NP, the opportunity for schedule flexibility. She gets paid according to the billables she generates and has no appointments, so she can come and go according to what fits her personal life.

"Schedule flexibility for me means being able to go to lunch with a friend, sleep later in the winter while the sun is helping to clear the icy roads, or to make an appointment without a problem," she said. "The downside is there is no paid time off."

NPs who have rigid schedules, working at night or at odd hours, said the associated higher pay and benefits were worth it.

"I have found a niche in the market, and it provides a great salary. I work a 48-hour weekend: in the hospital from 7 a.m. to 7p.m. on Saturday and Sunday, and then on call from home from 7 p.m. to 7 a.m. both nights," said Jennifer Baker, NP, an adult nurse practitioner employed at a hospital in Orlando, Fla. "This allows me to stay home with my children Monday through Friday and participate in their activities. I do miss out on some weekend things that are important, such as sport events and church, but the trade-off works for us at this time in our lives."

- Sarah Lebo

A Rewarding Profession
The honor of being the oldest nurse practitioner to fill out our survey goes to 79-year-old Jean Wertz.

An adult NP in New Mexico , Wertz tried to retire in 1993, but she just wasn't up for it. She opened a solo NP practice in 1996 and continues to work part time - volunteering at a health clinic for the homeless and working poor and making hospice visits pro bono.

Wertz became an NP in 1978 after 30 years as an RN. "I do recall the 6-day-a-week-plus-call split shifts of the '40s - the sharpening of needles, the patching rubber gloves, the mixing gooey penicillin in 50-cc syringes and melting codeine in a heated metal spoon," Wertz said. "It is nice to have sterile supplies prepackaged and not spend time in an autoclave room. We do seem to be a throw-away society now."

- Jill Rollet

Ringing Up Retail
Nurse practitioners all over the nation are finding new job opportunities in the retail clinic setting. Our survey showed that 3% of our respondents now work in this area, at an average salary of $81,154.

"The competitiveness and fairly rapid growth of the convenience clinic market has driven NP salaries up a notch," explained Kevin Letz, NP, CEO of the Organization of Convenience Clinics, a consulting firm. "NPs [in retail health] can expect to make an additional $4,000 to $5,000 more per year in contrast to other positions in their area. This may be related to the often unattractive evening and weekend shifts, as well as some NPs' reluctance to work in this environment."

Many NP respondents shared glowing reviews of the salary and benefit offerings provided by retail clinics. One 57-year-old NP in Virginia was able to swing a $14,000 pay raise. She left a position at a large multispecialty clinic to take advantage of a retail health opportunity.

"As an NP, I like to see the salary range bumped up as a result of the clinics, but what I would really like to see is for NPs to take some ownership in the services they are providing in this setting and actual ownership in the clinics. I think many will find that the benefits of ownership far outweigh a higher salary at the end of the day," Letz said.

Be a little suspicious if you are seeing an exceptionally high salary compared with other jobs in your area - it might be tied to daily pressure to see a lot of patients and worries about the financial health of your employer.

"While the higher salary offering may help attract NPs and benefit NPs in the interim, it may lead to the financial demise of the clinics down the road, which is not good for anyone," Letz explained. "The reality is that clinics paying salaries up toward six figures will struggle to stay in business. We often recommend that clinics get creative, such as offering NPs equity [ownership] in the business rather than continuing to hike up salary offerings."

Many respondents shared a love for the concept of delivering quality, affordable health care to everyone. While reservations about scope-of-practice restrictions may exist, there's no question about the stable benefits offered at most retail clinics.

"As a recent nurse practitioner graduate, my salary is far better than I could have ever imagined," explained Jacinda Hurt, an NP who works for Take Care Health Systems in Milwaukee . "National retail clinics not only offer a flexible and creative work schedule, but also a competitive salary and benefits package. Retail clinics truly value the nurse practitioner."

- Sarah Lebo