Job negotiations and exploitation of nurse practitioners by the healthcare industry

burned out nurse practitioner

So you’ve been offered your first job as a nurse practitioner. You feel grateful to have an offer and feel validated in your abilities that someone wants to hire you. You’ve heard a bit about negotiation and how it’s a great thing to do, but when you go to your prospective employer to propose a counteroffer, you are dismissed.

What happens if your prospective employer will not negotiate AT ALL? They say no to everything, “we don’t negotiate.” There are a few things to unpack here.

First, the healthcare industry is not used to providers (especially NPs) negotiating. Negotiation very much catches them off guard because it’s rarely done. The healthcare industry is used to exploiting providers—especially nurses and NPs. There is a culture where the advantage is with the industry and employers, not the providers.

So, when you come along and negotiate, they may brush you off and say, “no, the offer is what it is” because they can just find someone else. And they probably will. Now you might be disheartened by this and think, why negotiate at all?? The reason is that the more you practice negotiating, the better you get and the more comfortable you become with doing it.

If the employer says “no” to any negotiations, you have two options. 

If you feel you are worth more and the offer is not something you can see yourself accepting, you should tell the employer, “thank you, but I will have to respectfully decline your offer” (and pursue employment where your value is recognized). Basically, what LeBron James said—”I’m taking my talents to South Beach” (or wherever it is you’ll be going). You can say that last part or not, up to you. Essentially, you are saying no because you are more valuable and armed with your first negotiation; you can continue practicing your skills as you find a job that fits your needs. 

Your second option is to accept the offer. This is a perfectly acceptable thing to do if you want to accept the offer as is. BUT there is a pre-requisite to accepting this offer—you must enter this job recognizing that your employer sees you as replaceable, a cog in the machine, and may not budge on other issues down the road (e.g., if you voice concerns about having too much documentation to take home after work or being double or triple booked with patients and feeling overwhelmed, or any other concerns you might have). Your employer has shown their true selves during the negotiation regarding how they treat employees and will likely continue to do this once you are employed. If you know this ahead of time and can accept that, then when you take the job offer, you will be less dissatisfied/resentful while working there.

Both options are acceptable (walking away or taking the job). You just need to understand the nuances behind your choices so you can make decisions from a place of knowledge and empowerment.

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