Nurse Practitioner salary…mindset is more important than you think

womens hand holding money

Whenever people hear the words “salary negotiation,” they often feel tense and unsure. Predetermined and not actually done or effective. I’ll be working in a hospital, and hospitals don’t really do that. I’m new anyway; what kind of leverage could I have to “negotiate”?

Salary negotiation is not thought of as flexible, especially in a structured environment like healthcare, especially with new graduates. How dare you think you are worth more than we tell you? The truth is, you have the most power and freedom at the beginning, before you accept your first job, then at any other time. You are valuable.

Your initial contract and salary is an anchor point psychologically for yourself and future employers as well. It can be difficult to climb substantially higher in the future with your salary, especially if you remain in this same job. The larger jumps in salary and other negotiable benefits occur when jumping from job to job. Even then, sometimes employers try to learn your previous salary to utilize as a benchmark for how much to offer you at this new job.

Let’s say you do get a raise after your first year of employment for all the hard work, productivity, and improved patient outcomes you have delivered. Likely your company, unless it’s someplace like Google, will (maybe) offer you a 2 to 3 percent raise. While that’s better than nothing, 2 to 3 percent is barely enough to keep up with inflation. If you’re keeping up with inflation, then it’s like you’re making the same amount you did the previous year, except now you have more experience and are more skilled at your job.

You should be making more, much more. But appropriate raises don’t often occur at companies. That’s why it’s so important to negotiate when you are initially hired.

The most leverage you will ever have is before you are hired. Not just after being hired, not when they’ve seen the amazing work you can do months into the job, but before you even sign on the dotted line.

The reason for this is because your employer needs you, that’s why they are hiring, so this is when they are most willing to accommodate some things. When you are working for them in the coming months and years, they already “have” you, so they no longer need you (or forget that they need you because they take you for granted because they have you…make sense?).

There are a lot of nuances to salary negotiation, but one important aspect of negotiation relates to mindset. Effective negotiation depends on what you feel you are worth compared to what the market will pay for your services. If you feel you are worth $400,000 and most NP positions pay low six figures, then we have a significant discrepancy to work out. Conversely, if you feel you are worth $60,000 and most positions pay significantly more, that is also something to be addressed.   

One exercise to utilize to understand your value is to use the normal distribution curve or bell curve. Don’t worry; this isn’t a lesson in statistics. We’re just going to use the bell curve to get a sense of where you fall along it. Now, most people fall in the middle of the bell curve; they are just “average.”

You need to ask yourself: “where do I fall along the bell curve in terms of my value as a candidate for this job?”.

Well, what kind of student were you in school? Were you a straight-A student or a B/C student? Are you in the 40th percentile or the 99th percentile? These questions can help you be honest with where you fall along the bell curve, and likely, if you are above average in your work as a nurse practitioner student, you are above average as a candidate applying for a job and should not look at the market rate to see what you are worth. You are at the higher end of the bell curve and thus should be seeking a higher salary. 

Salary negotiation should become so commonplace by prospective employees that it’s expected that it occurs by employers. We’re nowhere near that standard yet, as many employers try to limit the opportunities for negotiation, and many prospective employees don’t negotiate at all.

Know that salary negotiation or other offer benefits are always on the table, and it’s up to you to experience the short-term discomfort to negotiate your worth and with a mindset that you deserve the compensation. With this mindset, you will pursue and accept jobs that recognize your value as you do the important work of improving patient lives.  

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