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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

You Must Venture Out On Your Own. NP Academia is Going to Destroy the Job Market.

How much more motivation do you need to venture out on your own? Look no further than advanced nursing academia.

Every single one of you reading this blog knows that nurse practitioner schools are cranking out vast numbers of graduates. But you say “There is such a shortage! All these statistics say there is a huge demand and it will get even better as more and more people get older!”


This might be true for certain geographical areas, but many NP’s out there live in very saturated markets. You are lucky to get a job out of nurse practitioner school that pays better than RN salary that makes the increased responsibility worthwhile.

I hear time and time again how certain areas of Texas like Houston are just awful for new grads. There are NO JOBS. Therefore new grads are required to venture further outside the cities and begin saturating those markets.

I am from the southeast. It was bad. So many new grads were unable to find jobs. I knew multiple “board certified nurse practitioners” still working as RNs 2 years after graduating. Their career ended before it even got started.

I knew another NP who was offered a job at an oncology office. They started her at $75,000 a year. Yeah you read that right. She was working 60 hours a week for this guy. She had no choice. It was the only job she could find.

In home medicare assessments? Ya, many are flocking to those jobs because they have no choice. Total waste of your training, time and talents. You are a glorified home health nurse. Paperwork and more paperwork. You are not practicing medicine. People get “stuck” in these type of positions. It becomes a job, not a career.

It continues to get worse. There are no official statistics proving what I am saying because it would be detrimental to the higher nursing academia agenda. But look and talk to others. Call a recruiting agency and ask how many resumes one nurse practitioner job receives. IT IS ASTOUNDING.

I hired multiple nurse practitioners for a telemedicine practice of mine during its startup phase. WOAH. I was bombarded with 100’s of applications when I posted a few positions on Most of them were new grads from online degree mills. Many have been out of school for 6-18 months with no work experience. This was just a few job postings from a small mom and pop outfit. I couldn’t imagine how many applications other positions get.

I was curious about that so I called many of the big medical recruitment agencies. I was astonished with what they told me. They said position after position receives hundreds of applications from nurse practitioners throughout the country. One recruiter in particular told me that if she sees a graduate from a large online degree mill she simply tosses the application. Same if they have no RN experience. I was doing the same thing for my small telemedicine practice. The amount of applications became overwhelming.

Our profession is going to become more saturated as the years continue. Therefore you must protect your career from the glutton of nurse practitioners entering the market.

There are two ways to do this:

  1. Move to a high demand low supply area. There are areas in this country where NP demand is still relatively high and the supply is low. You will have to venture west of the Mississippi for the most part though. The east coast is over saturated and the practice environments suck overall. There is a reason most western states have independent nurse practitioner practice. They don’t have a choice. The supply of medical providers is very low. When the supply is low and the demand is high it creates a very favorable and profitable environment for you. When I moved out west I increased my yearly full time position salary by $50,000 a year. This isn’t even factoring in the money from all the businesses I started because of the independent practice freedoms.
  2. Start your own business. Is the going rate $55 an hour where you live? Guess what? You can easily make $150-200 an hour running your own practice. Good luck negotiating higher rates in a saturated market. It is not going to happen. They have 20 other applications and 20 more when next semesters students graduate. When you start your own practice it does not matter what the practice environment is around you. You make your own way. The harder you hustle, the more you make.

Do not think getting a DNP is the answer to set you apart either. The DNP is the standard now so everyone has one. Big deal. One more year of research. It does not provide any additional clinical benefit and does not teach you real world business tactics. This is not an all inclusive statement but applies to the vast majority. Don’t waste your time or money. Those resources can be used actually furthering your life. The amount of time you spend in DNP school could be used to easily create 3 side businesses.

Nursing academia is doing us no favors by making nurse practitioner school easier, increasing enrollment rates, and pushing the DNP. It only lines their pockets and saturates the market for us on the front lines.

IT WILL CONTINUE TO GET WORSE. Just watch. The market will get saturated and large healthcare organizations are going to take advantage of this. They only care about profits. They don’t care about your experience. You are a number that provides a service. Why would they pay you $80 an hour when they can get some other desperate patsy for $55?

You need to venture on your own. Pack your bags and move somewhere rural where the demand is high. If you cannot relocate than start a side business or two or three or four. Multiple part time businesses is what I teach and advocate. Prepare for the future because there could potentially be some dark times ahead for our profession in our current environment.

27 Responses

  1. I am scared but ready to open my own clinic. Moving from Alabama to Arizona as soon as I get my license. I am one that does home assessments. Using no skills but NOTHING else in my area. We will always be crippled in Alabama as long as the physicians has a voice in the decision to give us FPA.

    1. NPs without a few years of experience should NOT be opening practices. That sort of thinking will completely destroy our profession. Sheesh!

      1. NP academia is going to destroy our profession. New grad NPs have no fighting chance. Starting a small side practice as a new grad is totally doable as long as its a low risk/low liability practice.

    2. What are some good examples of side businesses for Masters prepared NP in an over saturated market who lives in a state that must have physician oversight?
      Thanks! Presently I graduated last year but have been fortunate enough to get in with a Hospitalist group.

      1. I usually say the possibilities are numerous but with your situation it depends on what your supervising physician is comfortable with. Good side businesses are medical cannabis, hormone replacement, integrative medicine, suboxone. Find something that is somewhat niched with a need in your region.

  2. I completely agree and don’t understand why our standards have become so low. Insurance reimbursements have also dropped. I own a practice in TX and made an excellent income after overhead for years. Now Im barely able to pay overhead and seeing more patients, not even taking a lunch. This is horrible. The NP role was not meant for everyone to obtain easily. I am thinking our future looks bleak.

  3. Very realistic scenario, I’ve been an NP about 11 years and have found a lot of success in the rural health care setting. I wouldn’t want to be a new np in the current market environment

  4. This is so powerful. I am in houston texas and nurse practitioners are being paid $45-60 an hour without benefits. Thank you for this piece.

    1. I work in rural underserved area of West Texas and make 75 dollars an hour with benefits. I would not want to be in a Big city in the current work environment. Venture out into rural areas! So many people need us!!

      1. May I ask what geographic location you are working in? We are thinking of moving to Texas and not sure where to start. My husband works from home essentially, so we can go wherever I find work.