Nurse Practitioner Has Been Rated as the Best Job in the USA. But Is It Really?

Happy nurse at hospital

According to the 2024 U.S. News and World Report “Best Job Rankings” list, a nurse practitioner is the best thing to be! However, not all nurse practitioner positions are made equal. Read on for a deep dive into the factors that make an NP career both appealing and disadvantageous, plus ways to leverage your qualifications to obtain optimal work/life balance and financial freedom.

What makes nurse practitioner the best job?

The Best Job Rankings list determines the value of a job through several factors, including:

  • Median salaries
  • Unemployment rate
  • 10-year growth volume and percentage
  • Upward mobility
  • Stress level
  • Work/life balance

This data was compiled via studies, literature reviews, and economic analysis. While a nurse practitioner job may look good on paper, several other factors should be considered when outlining your career trajectory. Many nurse practitioners absolutely love their job because of the above criteria. On the other side of the coin, many nurse practitioners are not fulfilled. They may be overworked, burnt out, or simply exploited by their employer. Here are some questions to ask yourself as an established nurse practitioner, or an NP in training:

Do you work in a setting that you are passionate about?

Are you being compensated fairly?

Do you truly feel autonomous?

Are you professionally fulfilled?

What are the biggest challenges in the NP field?

The nurse practitioner field is becoming more and more saturated, which is leading to fewer and fewer jobs. This can cause NPs to get stuck in a position they are not that thrilled with. With competition from physician assistants, this problem only gets worse.

There is a career ceiling for a nurse practitioner. Ultimately, many nurse practitioners do not feel fulfilled or autonomous working for huge corporate healthcare conglomerates and being forced to practice a certain way because of insurance, Medicare, and Medicaid restrictions. Being a nurse practitioner can be tough when schools are pumping out 25,000+ new graduates every year. This ‘flood’ of newbies leads to talent saturation, stagnant salaries, and high unemployment amongst new graduates.

The findings from U.S. News and World Report don’t take into consideration the individual experiences of NPs across the country. Amongst members of Elite NP’s online nurse practitioner community, many are struggling. Here, we debunk several claims from the publication.

Salary

According to this U.S. News and World Report article, nurse practitioners can make $120,000 or more per year. This may be true, but NPs were earning the same salary over 15 to 20 years ago. This indicates poor wage growth. This salary estimate does not take important factors into account—such as location, restrictive practice policies, or high operating costs.

Unemployment rate

While country-wide unemployment rates are low, many members of the Elite NP community struggle to find work. Many qualified NPs are working as RNs because they are not paid enough as a nurse practitioner, or not granted enough work hours to pay the bills. While there may be a lot of jobs out there for NPs, this data does not consider the quality of these workplaces. Many practices demand long hours, handle an impossibly large patient base, or treat populations saddled with demanding health challenges.

The NP positions currently available may not necessarily have upward mobility or growth potential. While the Bureau of Labor Statistics predicts a higher demand for healthcare workers in the future, this trend may not come to fruition for several years. This leaves current NPs with student loan debt or other financial obligations without resources or opportunity.

What can I do to succeed as a nurse practitioner?

While there is ample opportunity within the nurse practitioner field, smart moves and determination are needed to flourish. In addition to careful investment and saving, there are several routes to success for new NPs.

Find a job that brings you fulfillment that pays you fairly

While this type of position is less pressure from a business standpoint, this position keeps you dependent on an employer. While there are some solid employers out there who genuinely care about their staff, your job is ultimately not secure. When times get tough, layoffs begin. If administrators and investors want to boost revenue, their first step will be salary reduction and talent restructure. As you move up in salary bracket, there is always the chance that you will be replaced by someone with equal qualifications willing to earn less.

Start your own practice

Starting your own practice as a nurse practitioner is the ideal way to earn what you are worth. Outside of the financial incentives of owning your own practice, it is a way to be autonomous and gain flexibility in and out of the workplace.

You are more secure owning your own practice than working for others. When you are in control, you make the rules. Many NPs have had their expertise and talent hindered by poor decisions made by upper management in private practices. When you own a business, you can create the roadmap of your life. If you want to earn more money, you see more patients. If you are content with your time commitment, you can put on the breaks and cruise.

Starting and operating your own business can also be fun! There may be stress during the startup phase, but running an established business can allow you to exercise creativity, pursue your preferred focus areas and enrich lives.

Justin’s take on the Best Jobs report:

“I am not saying being a nurse practitioner is not a great job. It is a great job, but I fear for the future of our profession amongst an ever-increasing saturated market. Articles like this only feed into that market saturation, and more and more people are desperate to find six figure jobs. The market flood further compounds because nurse practitioner training is relatively simple with enough time and brain power.

Our market will become more saturated, and it will become more difficult to find a decent paying job. I saw a job posting the other day for $30/hour for a nurse practitioner. ARE YOU KIDDING ME? How is even $120,000/year even reasonable for what we produce? A productive nurse practitioner at a general medical practice or urgent care should EASILY produce $600,000+ in revenue per year. Nurse practitioners in the ER (or busy urgent care) are producing $1 million+ in revenue and are compensated a whopping $60 per hour for their time and efforts. Thanks for being so generous, healthcare industrial complex and fat overpaid CEO, I praise you! *insert eye roll*

I pay myself a salary of $180,000 per year from my men’s health practice. I work 4 to 6 hours each week. I make more than a neurosurgeon. When you factor in the amount of time I put into my practice and how much I am paid, it comes out to almost $700/hour. Good luck making that in an urgent care. Additionally, my business is secure. We continue to grow and the demand for the services I offer are only increasing. Plus, I don’t have to deal with the headaches of insurance because I am 100% cash only AND I actually enjoy the work. I don’t dread it like when I worked in an urgent care seeing a ridiculous number of patients.

Unfortunately, I am going to disagree that being an employed nurse practitioner is the best job in the country. I know happy bartenders, electricians, car salesmen, and marketers who make the same (or more) as nurse practitioners with a fraction of the stress and hours they put into their job. So, if U.S. World and Report wanted to use my situation for their article, then yes—being a nurse practitioner entrepreneur is the best job in the country.”

14 Responses

  1. I agree with you Justin, in that being a NP is a great job to a certain extent. For my first job, as a NP I started out working for a small practice run by two greedy people who started off ok and then during the pandemic tried to assign me upwards to 30 patients per day. I also had terrible benefits and paid around 1800/month for health insurance for myself and husband. Took them 4 years to give me a raise and I only received it after threatening to quit. They later responded with my plea for more help with “can’t right now” the business was then sold to a venture capitalist. I’m working for another company now who solicited my help a number of years ago. They are decent people with good front office support staff but the pay for my level of risk, time and investment is not spectacular. I made more as a ED RN with much better benefits. Additionally, they do not furnish any sick time, health benefits or CEU time. They advertised health and 401 benefits when looking for additional people but later pulled the ad when I requested these benefits a second time.
    in my opinion, owning your own business is the way to go. I have started my own business and taking my time, learning from your pod casts and CEU classes as I go. I already have a number of patients who followed me from the first job so am off to a decent start.
    thank you for all of your guidance!

    1. Perfect! At least you saw the light and are doing your own thing. It is a great job if you are independent, but I don’t think it is a great job if you are employed…

  2. I’d love to have been able to make anything close to $120,000 as an NP. The most I have ever been paid is less than $90,000 a year working around 60 hours a week. It was awful. I saw this and thought…I bet they didn’t actually talk to working NP’s about what it is really like. Thank God I found Justin and his guidance because I can’t even get a job around my area. Was advised the hospital here could not afford me and they were going to offer me less than I made an RN working agency….I felt insulted to say the least. 20yrs experience and a DNP. So, I am so blessed to have been able to get my own business started and doing well so far! Thank you a million Justin!

    1. Rose, you are not alone in terms of getting screwed over as an NP. Luckily though, you saw the light and ventured on your own. So well done, I applaud you. You have done more than what most NPs will ever do.

  3. I just had this conversation with my brother today, who is considering making a career change into the healthcare industry. I have just left my job and am looking at a building tomorrow to start my own weight loss practice! Thank you so much for your guidance!

    1. Yep… being EMPLOYED in healthcare is not a great move IMO… but being an entrepreneur in it IS a great move. Best of luck on your weight loss clinic 🙂

  4. Woah, you make $180,000 working only 4-6 hours per week?! That is the dream 😍
    I’m currently a DNP student and graduate in December 2023. I am expecting job offers to be around $90,000-$100,000. I don’t want to accept that, but I also know as a new grad I don’t have as much wiggle room for negotiation. Im planning on signing up for several of your classes because my end goal is to open my own clinic someday. I just need to figure out how to get the initial capital to set that up.

    1. Meghan,

      Oh, I make much more than that through my businesses. That is just the income from one of my men’s health clinics. I own 2 other clinics.

      So, you are a new grad yes… And yes, you don’t have much wiggle room so this is my suggestion:

      Take the $100k a year job if jobs are tough in your area.

      Live well below your means for 1-2 years and save as much money as you can.

      Begin taking some of our courses and begin building out the business. You can start VERY cheaply as a little mobile clinic at first and just seeing a handful of patients to get your feet wet.

      Then once you get more experience under your belt and $20,000 saved, pull the trigger and really go in on your business.

      You will NEVER regret starting your own practice. I guarantee it!

  5. I am an FNP but currently working inpatient surgery, down the road I want to own my own clinic, but I don’t have family practice experience other than the student FNP experience, what can I do in this case?

  6. Great article! I live in South Florida and this area is saturated with NPs and PAs looking for work. I remember applying in indeed.com to several jobs and I would see at the end how may providers applied. You would find that over 100 providers would apply for the same position; one time I even saw 195 applicants. Thankfully, a former classmate referred me to a job in a cardiology group that has seven offices in the area and I have been happily practicing there for over two years. It also helped that I’m bilingual. In the long run, it depends on who you know and the connections you make. Now, my wife graduated as an NP as well and she will start working in the same practice the following month.
    Sergio Roman NP

    1. Ya, you gotta have connections anymore for employment in many areas of the country… but it is so saturated everywhere and it is just getting worse.

  7. I just opened my family practice in Aug of 2023 and am converting to a RHC as I am in a very small town. However, am looking very closely at your mens health and weight loss classes as the nearest “larger” city with any specialty is an hour away from me. Add these side business could certainly increase revenue for me and bring much needed care to patients in my town.

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