[NPInfo] NP salary vs RN

Fri Feb 9 13:47:38 PST 2007

Point taken.  My little O'l Michigan mind has a hard time wrapping itself around an hourly rate of $50.00+  an hour when I suppose on average we make about 70-80k here.  In the area I live, the average house is probably more like 200-250k although I haven't looked in a while.  My dear friend who graduated with me in 1997 makes 65k which is only a couple more than where she started.  And like I said, benefits are scarce in family practice which is where we both were.  I am now in retail and follow the threads about the retail clinics closely.  I wish I had solutions instead of questions and complaints.  It is still discouraging to discover that hospital RNs are making more than we are without the additional liability.
I made my bed...
Deb

-----Original Message-----
From: galdena at sbcglobal.net
To: npinfo at nurse.net
Sent: Fri, 9 Feb 2007 4:10 PM
Subject: Re: [NPInfo] NP salary vs RN

We are both in the SF Bay area... where salaries are high but cost of living 
higher!  The majoirty of RNs here are union and the union has A LOT of clout!  I 
just found out this morning from the CNA Union's handbook that if I came to work 
here as a RN with full benefits, I would make $10/hr more than I'm making now. 
When I moved here from Texas, I made $20,000 more a year athan I did there and 
all my Texas friends were terribly jealous... but then my rent is $24,000 more a 
year than I paid in Texas. 

  It is all a matter of supply and demand... there is a RN shortage (especially 
in CA), not a NP shortage. The hospitals are desperate, the nursing union is 
strong. The staff RN has all the pwer right now-- and all the money!!
  Dena Galler
  (sitting in an empty office for my last day... and spending this last day 
doing another stupid, useless chart audit!!)

debcfnp at aol.com wrote:
  Dena and Christine, where do you work/live? If I am reading you both right, 
Dena, you were making $97,000 per year (47.00 per hour x 2080 hours full time) 
and still underpaid compared to registered nurses in your area. And Christine, 
you were making $114,000 per year (55.00 per hour x 2080 fulltime) and you too 
were still making considerable less than nurses in your area? IF that is the 
case I need to relocate and work as an RN again. For those wages I could 
sacrifice my Masters degree and autonomy. I would even be willing to wipe butts 
again. God knows I wiped my fair share in the past and for a whole lot less. It 
is always so discouraging to hear that RNs are making more than NPs, and 
typically as hospital nurses, they are are also getting far better benefits!

Please tell my why I am considering a DNP???
Deb

-----Original Message-----
From: galdena at sbcglobal.net
To: npinfo at nurse.net
Sent: Thu, 8 Feb 2007 9:26 PM
Subject: RE: [NPInfo] Retail Clinics.......Chapter Two

Tomorrow is my last day at my job... As a Master's prepared NP for almost
14 years, with two national certifications, almost an entire life-time in
nursing, and over three years in my current position with 3% performance
eval raises each year, I make $47/hr. I am making $20-22/hr less than the
AND/BSN RNs (who have no certifications) that I am expected to train,
educate, and work with in my role as Neuroscience Clinical Coordinator. The
nurses are not only unionized but also have a career ladder. Being in an
"administrative" position, I don't qualify for either. It has been an
extremely frustrating situation for me and, because there was no resolution
in sight (despite many promises the past year), I have been forced to leave.
Interestingly enough, my position is now being split into two separate
positions-- CNS and Stroke Coordinator. They wouldn't pay me any more for
all the work I did for them, but they'll now be paying TWO people to do the
job that I did alone. And good luck finding TWO people who will be stupid
enough to work for what they were paying me!! LOL

My "Mother Company" (the hospital chain I work for) has started a chain of 5
retail clinics and is paying NPs $45/hr. I noticed the ad ran in the San
Francisco Chronicle for many weekends in a row. I like to think they had
difficulty finding takers for that salary .

My new job will be paying me $17,000 more a year, with much better benefits,
and it is based on my education, years of experience, my certifications, and
on all the accomplishments listed on my past three annual performance
evaluations from my current job (I sent the new employer copies). Although I
still won't be making as much as I could if I went back to work as a staff
nurse, it is so nice to finally be recognized for my accomplishments,
experience, and education. 

But I will certainly miss this job terribly...
Dena Galler

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Christine Smith
Sent: Thursday, February 08, 2007 5:16 PM
To: NP Info
Subject: Re: [NPInfo] Retail Clinics.......Chapter Two

I think compensation for NPs/PAs is ridiculous too. I make $55 per hour and 
cannot comprehend making less unless my job is lots less stressful. The 
first 4 hours I see uninsured patients as the sole provider in my clinic - 
last night I saw 23 patients in 4 hours. Mostly BS complaints, but still 
require documentation, my time and faking some sympathy for yet another 
snotty nose. The second 7 hours I worked in the ER, seeing more BS and some 
acute pts that actually deserved to be in the ER. I bill an average of $480 
per hour and this is only for my time. It does not include what I bill for 
the hospital, including meds and supplies. It only includes the time I spent

on the patient, the skills I did include lac repair, I&Ds, monitoring, 
reading x-rays, etc. The patient gets two bills, one from me and one from 
the hospital. My average pt gets billed at $269 (yep, snot noses cost a lot 
if you go to the ER).

Many of the RNs make more than I do and that is distressing to me. I do not 
get night shift or weekend differential though I work minimum of two 
weekends a month and every single night (6pm until at least 2am). The docs 
get a shift differential on nights starting at 7pm but they voted against 
giving NP/PAs a shift differential even though many nights I am there until 
5am saving their ass because the ER is inundated with patients. They just 
started giving us a holiday "bonus" if you work on Thanksgiving, Xmas or New

Years - $150 per shift. That is not even time and a half like the hospital 
staff gets. The docs all make over $150 per hour. They also get huge 
compensation pay for being on various committees - several thousand per 
month. I get my hourly pay only.

It is unfair and I am not sure how to fight it. I work my ass off, I 
generally have the highest productivity in the dept every month, both in 
billing and in patients per hour. Sometimes it does not seem worth it. 
Interestingly, I could quit my job as a NP at my facility and come back as 
an RN (I know they would hire me in an instant) and be making far more 
money. A PA who I work with is talking about doing this. He is an RN too. 
We wondered if it would send a message to our company that contracts with 
our hospital. Would they care, would they reconsider? Very sad that we are 
not valued by so many of our employers - we are seen as cheap labor.

Sorry, but Megs letter got me going. I am so burned out from seeing every 
runny nose and fever in the county in the last month.

Christine Smith

----- Original Message ----- 
From: 
To: 
Sent: Wednesday, February 07, 2007 6:33 PM
Subject: [NPInfo] Retail Clinics.......Chapter Two

> Retail Clinics....Chapter Two
>
> Tracy Klein's article on Medscape addresses many of these issues and more 
> through a series of tough questions and answers....I have always 
> maintained these clinics need providers with a solid background in primary

> care, family practice and/or Emergency Dept....then.. skin cancer (etc) 
> won't be missed and appropriately referred to a dermatologist in the area.

> A good business sense and legal savvy would be helpful as well when one 
> considers being employed by a retail clinic corporation. Review of one's 
> contract before signing is equally as important; Carolyn Buppert helped 
> our group work out details and changes in a contract. Her insight is 
> invaluable.
>
> Compensation for these retail clinics is lower then I had expected and 
> with a seasoned provider working alone for 12 hours, $45-$50 per hour is 
> very reasonable (higher compensation needed for weekends and Holidays) 
> (pay scale: $34-$38 is usual)...consider: if one sees 4-6 people per hour 
> at $59 per visit (baseline)....leaving $300 for the corporation's coffers 
> (+) (-). The clinic overhead is about $100,000 (or so) (probably higher) 
> per year (salaries, equipment, supplies, rent, etc). I also believe 
> compensation across the board for nurse practitioners and physician 
> assistants in many settings is, in a word, embarrassing. Seasoned 
> providers working for $32.50 a hour ( in many clinic settings) when the 
> clinic bills out $600 (+) per hour is intolerable.
>
> I think David Mittman has some very valid and serious concerns providers 
> ought to be troubled about with the proliferation of these retail clinics,

> how we are being portrayed and the value these concerns should be for all 
> of us.
>
> http://www.medscape.com/viewprogram/5982
>
> Meg (Portland, OR)
> _______________________________________________
> NPInfo mailing list
> NPInfo at nurse.net
> http://lists.nurse.net/mailman/listinfo/npinfo
> ***************************** 

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