NURSE PRACTITIONER SALARIES: WHERE ARE THEY NOW?

19 Pages·2012·0.45 MB·English

NURSE PRACTITIONER SALARIES: WHERE ARE THEY NOW?
By(cid:1)
Cassandra Whittington, BSN, RN(cid:1)
A clinical project paper submitted in partial fulfillment ofthe requirements for the degree of:
MASTER OF NURSING(cid:1)
WASHINGTON STATE UNIVERSITY-VANCOUVER(cid:1)
Intercollegiate College ofNursing(cid:1)
Spring, 2008(cid:1)
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To the faculty of Washington State University:
The members of the committee appointed to examine the clinical project of CASSANDRA
WHITTINGTON find it satisfactory and recommend that it be accepted.
ot~jL: __(cid:1)

Chair: Louise Kaplan, PhD, ARNP
Melody Rasmor, ,ARNP
Tracy Klein, MS, FNP
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TABLE OF CONTENTS(cid:1)
ABSTRACT 3(cid:1)
LIST OF TABLES 5(cid:1)
INTRODUCTION 6(cid:1)
LITERATURE REVIEW 6(cid:1)
National and state NP salary data 6(cid:1)
RN salaries 8(cid:1)
Limitations of data 9(cid:1)
Washington State ARNP Survey 10 (cid:1)
Purpose 10 (cid:1)
Method 10 (cid:1)
Presentation of Data 11 (cid:1)
Average state salary 11 (cid:1)
Average salary by education, gender, years of practice 11 (cid:1)
Employment location 12 (cid:1)
Type of practice 12 (cid:1)
Salary by workforce development areas and cities 13 (cid:1)
Salary satisfaction 14 (cid:1)
Discussion and Implications 14 (cid:1)
References 16 (cid:1)
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NURSE PRACTITIONER SALARIES: WHERE ARE THEY NOW?(cid:1)
Abstract(cid:1)
By(cid:1)
Cassandra Whittington, RN, BSN(cid:1)
Spring 2008(cid:1)
Chair: Louise Kaplan
Appropriate financial compensation is essential for nurse practitioners. Several national
salary surveys have been presented in the last few years. Until recently there has been
little nurse practitioner salary data that is state, regional or city specific. This article
reports on Washington State nurse practitioner (NP) salaries. Washington NPs are legally
autonomous professionals who assume demanding roles and provide high quality care to
hundreds of thousands of people. Salary data was analyzed using factors such as level of
education, place of employment, type of practice and by regional and local areas. This
study supports the value of having local state and city salary data in order to negotiate for
fair salary practices.
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Tables
Table 1: Salary by education 18 (cid:1)
Table 2 : Salary by years of practice 18 (cid:1)
Table 3 : Salary by enlployment location 18 (cid:1)
Table 4 : Salary by type of practice 19 (cid:1)
Table 5 : Average salary by workforce development area 19 (cid:1)
Table 6 : Average salary by city 19 (cid:1)
Figures
Figure 1 : Map of workforce development areas 17 (cid:1)
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Introduction
In the past decades, roles for nurse practitioners (NPs) have grown markedly. As legally
autonomous professionals, they play an integral role in providing health care to both the insured
and the underserved uninsured individuals. Annual salaries and practice characteristics are
topics that most employed professionals are interested in and nurse practitioners are no
exception. Most NP salary surveys report data from a national or regional perspective. While
this is useful, most NPs may be interested in data that reflects salaries that are more local since
employers typically recruit from their own locale, especially if there is a nurse practitioner
program in the area.
This article presents results from a 2006 Washington State ARNP (Advanced Registered
Nurse Practitioner) survey which had a strong response rate of 65%. Salary variants were based
on practice characteristics such as practice location, type of employer, type ofNP practice, and
gender. NPs who are entering the profession as well as NPs who are seasoned providers can
benefit from a salary survey which provides data necessary to negotiate for appropriate financial
compensation. The Washington State survey can also serve as a model for NPs in other states
who may wish to conduct a salary survey. State and local data is more representative of and more
useful than national data.
National and State Salary Data
Currently, there are three major sources of national salary data. Surveys were conducted
by the American Academy ofNurse Practitioners (AANP) in 2007 and the journals Advance for
Nurse Practitioners in 2007 and The Nurse Practitioner in 2005. Survey data is reported as
national and regional figures, with the exception ofAdvance for Nurse Practitioners which also
presented state average salaries.
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The most recent of these three reports on NP salaries is the 2007 survey conducted by
Advance for Nurse Practitioners (Rolet & Lebo, 2008). They published their questionnaire in the
2007 July through October issues, as well as online. Respondents submitted their replies by fax
or mail. The survey respondent numbers totaled 6,162. In order for them to ensure the accuracy
and validity of their data, they did not tabulate responses from advanced practice nurses other
than NPs. Further, salaries were separately averaged for part-time (less than 35 hours per week)
and full-time (35 or more hours per week) NPs. The 2007average national salary from this
survey for full-time NPs was $81,397. The average hourly wage for part-time NPs was $40.32.
This salary data indicated that over the past two years the average nurse practitioner
salary rose 8.8%. ADVANCE attributed this pay hike to public relations gains as the public
reflected on NP capabilities and their contributions to the health care system or contribution to
physician income. The top earners, who reported an average income of$95,157 were emergency
department NPs while the lowest incomes of $68,624 were from NPs who focused on teaching.
ADVANCE briefly reported geographic salary variants among two to three cities within a
randomly selected five states. For California, Oakland salaries were $88,143, much lower than
the salaries of San Fral1cisco, $112,551 and Los Angeles, $102,599. For the east coast, New
York salaries varied from the $96,955 earnings within New York City to the $75,762 earnings in
Buffalo.
The American Academy National Practitioner (AANP) NP Compensation Survey
(www.AANP.org) was conducted in 2007 during the month of April. The survey was sent by e
mail to a national random sample of 32,869 NPs of which slightly more than half were AANP
members. The response rate was 24%. The average national base salary for full-time NPs,
defined as working 35 hours per week for more tllan 47 weeks per year was $81,486. The
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average hourly wage based on the income of the entire sample was $42.58. The highest paid full
time NPs were those certified in acute care with a salary of $86,460 with the lowest paid being
women's health NPs at $77,460.
The Nurse Practitioner collected data in 2005 using a convenience sample by placing a
salary and practice survey in its August through December 2005 issues with an option to reply
online (Newland, 2006). There were 549 respondents. The average income for this nationwide
sample was $70,960 for NPs who self reported working full-time. However, NPs who reported
working 35 or more hours per week had an average annual salary of $72,060. An hourly wage of
$35.10 was reported for NPs who self-reported working part-time.
National average salaries may not reflect state or local salaries. This realization prompted
the Northeast Tennessee Nurse Practitioner Association (NTNPA) to conduct a local/regional
salary survey in 2005. NTNPA compared the average full time NP salary of $69,316 in
northeast Tennessee to the Tennessee average of $71 ,068 and the national average of $74,812 as
reported by Advance for Nurse Practitioners the prior year (Sharp, 2006). From the 441 response
surveys, a response rate of 41 %, it was concluded that the average annual NP salary in northeast
Tennessee was $1,752 lower than the state average and $5,496 lower than the national average.
RN Salaries
While NP salary surveys provide rich data for negotiations, it is also important to review
the salaries earned by registered nurses (RNs). The nursing shortage has strengthened salaries for
RNs which can create an opportunity cost that may be factored into the decision about whether to
enroll in NP education. NP salaries that are comparable to or even less than those of RNs may
serve as a disincentive to seeking NP education. Salary ranges for RNs are affected by factors
such as employment setting and location, degree earned, union membership and overtime
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worked. According to the Bureau of Labor Statistics, the 2006 national average salaries for RNs
was $57,280 (ww-w.bls.gov, 2008). The highest 10 percent ofRNs in 2006 earned mean wages of
$83,440. However, as was found with the NP salaries, there are large variations in state average
salaries compared to national average salaries. For instance, South Dakota and California
average RN salaries are $49,560 and $75,130, respectively. Further, if average salaries are
accounted for within a state's region there are even higher salary variants from the national
average: RNs working in the California metropolitan areas of San lose-Sunnyvale-Santa Clara
are earning, on average, $92,400.
Over 1,100 registered nurses responded to a salary survey conducted by Nursing 2006.
The average national RN salary was $51,000 (Mee, 2006). Interestingly, this was a decline from
the 2005 average RN wages of$58,600. This was attributed to a change in the profile of the
respondents with a higher percentage of the respondents working in nursing for less than five
years. Fewer respondents worked in hospital settings or as staff nurses where higher salaries
were usually earned.
Limitations of the data
There are nlajor differences among the national surveys which limit their generalizability
and result in wide variances. Methodologies vary. The American Academy ofNurse
Practitioners surveyed members and non-members. Advance for Nurse Practitioners and The
Nurse Practitioner surveyed the readership of the journal. Response rates varied from 549
responses with the Nurse Practitioner to 7,832 responses with the AANP. There is no way of
determining how respondents compare among the surveys nor is there a way to determine how
they vary from non-respondents. National or even regional data may not reflect state or local
salaries.
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Washington State ARNP Salary Survey
Until recently there has been little data about the salaries of Washington State nurse
practitioners. NP Central, a web based resource center, has collected salary data since 1993
however the number of respondents varies each year ranging from a low 78 to a high of 505
between 1997 and 2007 with differing methodologies for data collection by year (NP Central
2007). A statewide survey of all licensed advanced practice nurses in 2003 obtained salary data
using ranges rather than asking for a specific amount earned (Kaplal1 & Brown 2004).
Appropriate financial compensation is essential for Washington State NPs. As legally
autonomous professionals with full prescriptive authority and third party reimbursement,
Washington State NPs assume demanding roles and provide high quality care to hundreds of
thousands of people in the state. The salary data presented in this article was obtained as part of a
statewide survey ofNPs conducted to evaluate the impact of a 2005 law that authorized fully
autonomous practice. Those practicing independently are also asked to assume more risk of
liability and assume more financial responsibility for their practice than those employed by a
practice or hospital.
Methods
This quantitative study utilized survey methodology. The study instrument was
developed based on a review of the literature and results of two prior statewide NP surveys
conducted by the investigators. After obtaining institutional review board approval,
questionnaires were mailed to all NPs licensed in Washington with addresses in Washington,
Oregon and Idaho. People not responding to the initial mailing were sent up to two additional
mailings. A response rate of 65% was obtained. Respondents were included in the study if they