I see on multiple Facebook groups and message boards nurse practitioners who are accepting very low salaries. I understand that many nurse practitioners out there are desperate to secure employment. You need some income, I get it and I feel for you, but the issue is that there are too many nurse practitioners accepting low salary positions. The market is getting more saturated, employers know this, and they are taking advantage of it.
There are two things that happen when a nurse practitioner accepts a low-ball offer:
- It decreases the overall salary average.
- It justifies employers to continue to pay less and less.
When the overall salary average decreases, it drives salaries down across the board. Many employers and large organizations use these averages to determine the salary of a new position. As the average goes down, the salaries go down. This is happening folks. Nurse practitioners are getting paid LESS than what they were 10 years ago in many areas of the country. It is absolutely INSANE.
A nurse practitioner who has been practicing for 20 years is making less or the same amount they were when they first started practicing. Are administrators making the same or less than what they were 10 years ago? HELL NO! They are making SIGNIFICANTLY more now. You are busting your ass and making your employer hundreds of thousands if not MILLIONS of dollars a year. Do you see any of the fruits of your labor? The managers and high-level administrators certainly love how productive you are!
I worked for a medical group once where I had a capped salary. I made a lower base salary but earned production up to a point, and then I made nothing more for the rest of the fiscal year. Do you know how much the CEO was making in his quarterly bonuses? $100,000-$200,000… This was not some huge organization, there were about 20 practices within this medical group. This guy was making a million dollars a year and they had the audacity to cap my salary because that is what the “average” is nationwide. Oh blow me… Guess what happened after I hit my production cap? I became less productive. Surprise surprise…
The employer JUSTIFIED paying me a low salary because that was the “average” according to the MGMA (google it). This average is based off the droves of nurse practitioners that are accepting low salary position after another. It lowers the salary expectations across the board. It is a real disservice to our profession when nurse practitioners accept low salaries.
So, what can we do about it? We must band together as a profession, put our foot down, and say NO to low salaries. You are more valuable than you think. Nurse practitioners are becoming the backbone of the healthcare system in this country. We provide quality care at an affordable rate. Why should we not be fairly compensated for the hard work we do day in and day out? Why should a bunch of pencil pushers enrichen themselves off our sweat? Why should physician collaborators enrichen themselves by “collaborating” with us when in fact they do very little most of the time?
We all need to understand what we bring to the table. Once you understand that, you will expect a higher salary. When you accept a low salary, it lowers the salaries for everyone else. Compound this by the thousands of nurse practitioners being pumped out of school and you get the perfect storm for low salaries. There is a large supply of fresh blood entering the market and there are droves of nurse practitioners accepting these insultingly low salaries. This is a very nasty and dangerous storm for the future of our profession friends.
Talking to legislators will do nothing. Going to the various boards of nursing will do nothing. Asking our credentialing organizations such as the AANP could possibly help push the issue, but I doubt it will change much. Remember, the AANP and ANCC want as many nurse practitioners to graduate as possible, it increases their revenue through testing and certification. Therefore, it is in each one of our hands to shape change.
What you can do is talk to your fellow nurse practitioners. You need to educate them about how valuable they are. You need to encourage them to NEGOTIATE a salary vs. accepting the low-ball offer. Share this article with them. Open their eyes to the power they harness through their license.
You don’t need to take insultingly low salaries; you can negotiate that salary higher. I have NEVER accepted the first offer… In fact, I start the setting point during salary negotiation. Remember, the first one who makes the offer SETS the starting point. Read this article about job negotiation here.
This is all we can do folks. Once thousands and thousands of nurse practitioners get on the band wagon then salaries across the board will increase. Getting your DNP or another certification will not increase your salary. If it does, it usually won’t be significant enough to justify the time investment it took to obtain it. What will increase your salary is learning how to negotiate,mustering up the courage to say NO, and walk away from low salary positions.
Lets band together and say no! Everyone who does so will be the ones trail blazing our profession to new heights. The others are just doing a great disservice to everyone else.
Of course, one way you can give a middle finger to the entire system is to just start your own business… Then there is no chance of having a low salary. In fact, you will be that CEO giving yourself six figure bonuses! It is the only way I have found to be compensated what I am worth. If you feel like your only worth $90,000 a year, then you need to open your eyes to what you can do. If you feel like you are worth $300,000 a year, then get over your fear, negotiate a high salary, and start a side practice.
If you are a new reader to the blog, review The Elite Nurse Practitioner Model and integrate these principles into your life. You will be far from “average” and begin to walk the path towards financial freedom. I have, and so have countless others…
Love this. I was SHOCKED when I moved and was offered 10-20/hour less than I was making. The problem is a lot of times NPs shoot ourselves in the foot. I can’t tell you how many NP groups I’m in where someone gets trolled and bullied for complaining about their pay “we don’t do this for the money we do it for the patients”. Bottom line employers show they value their employees through pay and they are showing the world how little they value us.
EXACTLY! Listen, if you did this solely to help patients, then FINE, go volunteer or work at a community health center. For the NPs who did it to help patients AND make a good living, the low salaries are becoming a real issue. Why work yourself to death, deal with irate patients, take on the liability, etc. for a salary that could easily be made doing other things like real estate? Thank you for your comment and support!
I’m laying in the bed on our mini vacation at the beach thinking about how I won’t ever get a raise unless I’m super productive and tired as hell. I’m in charge of multiple units now since COVID hit. I needed to read this today. I already have the ebooks. Now I need to find my damn niche and I swear I don’t know what I’m good at. ??♀️
Tiara listen, you are in charge of MULTIPLE units… What do you mean you don’t know what you are good at?! They just don’t hand that kind of responsibility to an idiot. What is it that impressed your supervisors to hand you this type of responsibility? If you can figure that out, that is a start in determining your niche. What kind of clinical experience do you have?
Hey Justin! I’ve been an RN over 16 years and NP almost 1.5 years. I come from home health, OR, wound care, case management (Medicare, Medicaid, disability). I’ve done a lot. I swear I just don’t know where to pin point that one specific thing to do.
It can be difficult to find that niche service. Explore the rest of the blog for ideas on niches and look at todays article about providing services that insurance does not cover. All the courses are essentially clinics in a package if one of them interests you, we have more courses coming out soon as well. I have found that sometimes it is best to just choose something and roll with it. After you do that, you will fall into something else, make connections with others, and it just snowballs from there. The hardest part is just getting started!
Your post is timely as so many providers [Physicians, NPs and PAs] have been furloughed across the country in light of Covid-19, in step with the graduating NPs entering the workforce…
Your post on salary negotiation was greatly appreciated and will certainly have great utility for me personally moving forward.
Thank you for the kind words Debbie! I am very thankful I have helped you! Always negotiate that salary, NEVER settle… You should never settle on the first offer, EVER!
I am in current negotiations and I made the first offer. Waiting to see what they return with. I have made it a point to run my own reports and see what bringing into the practice so I have bargaining power. Crossing fingers for response soon! I also train all of my students how to chart and bill well and to not take lowball offers!
Good for you, we need more teachers like yourself. It is time to change the current environment for NPs, and people like you are helping with that effort. Thank you! I wish you the best of luck with your negotiations.
How do you run the report? All the best in your salary negotiation.
I just cm across this article and it is so timely. I have been getting stuck in moving forward my telemedicine business and almost to the point of dejection. I just want to own my time! I saw a job offer and wondered about negotiating the salary.
Negotiate what you think you are worth. HERE is an article about negotiation.