I have an NP friend, and this is what he said
Florida alone is estimated to have 7,640 FTE primary care NPs by 2025- but the projected demand is for 3,120. Similarly, Tennessee is estimated to have 3,100 NPs- with a projected demand of only1,400.
Even though there are geographic disparities in the distribution of primary care NPs, every state, plus the District of Columbia, is predicted to have an oversupply. No state is predicted to have a shortage of NPs by 2025.
“ believed that there is a shortage of NPs and that the shortage will continue. a recent report by the U.S. Department of Human and Health Services (DHHS) Health Resources and Services Administration (HRSA) says otherwise. HRSA predicts an oversupply of NPs.”
Also many nursing blogs of people reporting hardships finding jobs. Personally I have friends with NP new grad that haven’t found work yet--
Is this true? What have you found?
You tell us. Healthcare systems seem to be keen to improve the bottom line through the use of NPs, potentially displacing physicians. Are you seeing more referrals from NPs? Are doctors having a hard time finding jobs at salaries that they expect to obtain?
I’ll write you a book on this subject:
I’m seeing NPs getting jobs all over. I had more than 5 full on job offers before I even graduated, and for positions that had been posted for up to several years. My new Np friends that are solid characters have landed jobs that they cultivated through networking and good reputations as students. The changes I’ve seen have tended to center on folks who haven’t networked for whatever reason.... PAs coming back to town after graduating out of state, or NPs who didn’t make good impressions or figured they would jump in and apply sight unseen after not forging relationships as a student or an RN. Those folks are all having trouble. They are the ones putting their applications in a pile with a recruiter and not seeing much interest from employers. When they do get a bite, they get the kind of offers that one should expect when a boss has a pile of interested faceless candidates, which is to say they get mediocre offers. But with me and my ilk, I’m a known entity who isn’t a risk because I’m familiar to them. I don’t get lowballed because the places I talk to don’t suck, and aren’t interested in bargain basem*nt deals for poor performing providers. Instead, they want to forge long term relationships with people that represent the practice well. So the world where all the bad stuff is going on doesn’t exist for me because I’m not a schmuck, and I don’t try to work for schmucks, and most of my friends aren’t schmucks.
Am I waiting with trepidation for the critical mass of new providers, both PA and NP, to force the bottom to fall out of the market? I guess. But I feel like the cream tends to rise to the top in just about any environment. It’s important to pick the right friends and be willing to work hard for a good reputation.
I’m torn because I feel like any ground that NPs give up is just ripe for PAs to come in and take advantage of (their ranks are swelling as well). PAs don’t have independent practice rights anywhere, so NPs cutting back cedes the market for a profession that doesn’t have the wherewithal to adequately advocate for the advancement of nonphysician providers. NPs have led the way, and PAs have what they have, so anyone can look at all that and judge for themselves who is more apt for the struggle. I realize that my own station in life could theoretically be improved if both PA and NP matriculation numbers slowed down considerably, but where I’m at right now I don’t know how much that would really change things since I seem to be in demand as it is. As for the virtues of promoting the nonphysician provider realm as a whole, I have to say that I don’t have a lot of interest In drinking anyone’s coolaid. I’m not interested in seeing PAs be the NPP of choice, but I also don’t feel warm fuzzies for every bedside nurse chasing their dream of obtaining a prescription pad. However, I think it’s just as likely that the NP brain trust plan to flood the world with DNPs is just as likely to help their position as hurt it. They aren’t just flooding the market with prescribers, but also degree holders that have options to do all sorts of things with their degrees.... teach, manage, consult, advocate, research, drive policy.... lead. You could see them all over the place replacing a lot of folks in roles that you might not expect. When we get in these periodic conversations about DNPs, it exposes a lot of the ignorance that most folks have about the degree, since they think it’s just about prescribers. It’s not. I had boss on a regular hospital unit that had a DNP, and they were the unit director of the RNs, probably making at least as much as they would have if they were working the floor as a prescriber. I’ve seen healthcare executive level staff and CNOs that had them. Ive seen them in pubic health and in business roles. Then you have a bunch of them in academia. They are in regulatory roles as well. So they’ve made the degree into something with broad application. My friend has a DNP, and they work in a big hospital system training and consulting on electronic medical records. They’ve never used the degree to prescribe for patients. So from here, I think that there is a huge potential for all the DNPs who don’t find themselves in front of patients. They will get picked up on the back end. Nursing really wants to take over healthcare as a whole. Lately I’ve seen nurses in my former facility who are now in charge of departments such as radiology, and supply chain... places that used to be headed by folks who had little to do with nursing. Almost all education seems to be headed and staffed by nurses. there doesn’t seem to be a job that RN leadership thinks can’t be filled or overseen by nursing. Think about occupational health nurses, school nurses, public health.
So think about those kinds of roles for all the fat that is left over after the prescriber roles are filled by the better performing NPs. There are always going to be places for the excess NPs of the world. The folks who need to worry about over saturation are the PAs, because they don’t have a similar professional infrastructure like nursing does. If they aren’t in front of a patient doing their thing, then they don’t have a job doing anything remotely marketable. Maybe they can go be a drug or device rep if they think they can compete against all the folks who are sales sharks that know how to sell ice to eskimos. I’m seeing a lot more desperation with PA new grads than with the new grad NPs. The NPs who want to prescribe, and that don’t get picked up quick tend to just bide their time working their 3 shifts per week pulling in decent money as is, surviving pretty well, and making minimum payments on school loans that tend to be far less than PA school debt. If there are still no takers, they can go teach, move up the chain into management, go dabble in part time NP work, get on doing in home provider care, work for insurance companies doing utilization reviews, etc. I literally could have set up shop seeing cash paying patients and managing their psyche meds for around $200k per year if I hadn’t landed a job out of school. I have a classmate that does just that.
That all is basically a glimpse at the pulse of the NP field right now from where I sit. I’d suggest that if you see a bunch of unemployed DNPs sitting around, they probably aren’t despondent, but rather are waiting for something to happen. Those folks probably should be chasing a more defined goal. Are the underutilized? Probably. Are they in trouble? Probably not. I literally have friends who have graduated and are waiting for the right job, or going on a post graduation vacation, or taking several months off to relax. I personally wasn’t in a huge hurry to start working because I liked my RN job, and money wasn’t tight.
