Unlike physicians and RNs, nurse practitioners report remarkably high levels of job satisfaction thanks to a rise in opportunities to practice independently, and confidence that their earning power will increase.
A small survey gauging job satisfaction among nurse practitioners [PDF] found that 100% of them are upbeat about their profession. The survey also found that 99% of NPs are optimistic about their future, 97% would recommend becoming an NP to their children, and 96% are optimistic about the future of their profession.
The survey sample was limited and included responses from 222 NPs who attended the June annual meeting of the American Association of Nurse Practitioners in Las Vegas. Phillip Miller, vice president of communications at Irving, TX-based healthcare recruiters Merritt Hawkins and Staff Care says there are about 155,000 nurse practitioners in the United States and he conceded that only limited observations could be drawn from such a small sampling.
"It is not a scientific survey but it is more of a weathervane indicator of where things are going," Miller says. "The reason we think it is somewhat significant is that the response to the questions was overwhelming. Literally all 222 said they felt positive about it, even if it is not that great to that extent we think it is an indicator that they are pretty happy in their profession."
"And unlike physicians and even nurses we have surveyed we have never seen satisfaction rates as high. We usually get 10%–15% of the people who have something to grumble about or something that didn't meet their expectations or who have regrets. We got almost none of that this time."
High Pay and Emotional Rewards
Miller says NPs have a lot to be upbeat about.
"They are feeling pretty heady about where the scope of practice for NPs is heading. It is broadening," he says. "They are getting more autonomy. More states are allowing NPs to practice independently. There is a sense of confidence that their income and prestige are going to increase."
When asked what they plan to do in the next three years, 63% of NPs said they will continue in their practice. However, 10% said they would work independently, 10% said they would work in temporary practice, and 12% said they would work part-time.
The NPs reported seeing an average of 17 patients per day and earned an average of $95,800 a year. Miller says it is not uncommon for NPs to command six-figure salaries. "It's a good return on investment on your time and money and education for what you get," he says. "They also get the emotional rewards of taking care of patients."
The results of the NP survey provide a sharp contrast to surveys gauging job satisfaction among physicians. A recent national survey of physicians conducted by Merritt Hawkins found that 32% of respondents said they feel positively about their profession, 13% said they are optimistic about the future of medicine, and 42% would recommend medicine as a career to their children or other young people.
Shifting Roles
"NPs and doctors are a mirror image of each other," Miller says. "The things that NPs are happy about, increasing income and clinical autonomy and the feeling of more power within the system, most doctors are experiencing exactly the opposite. Doctors feel like their clinical autonomy is being eroded and that reimbursements are being cut, and in a lot of cases they are. Before they were preeminent on the healthcare team and now it's more like they are part of the team and not the dominant player."
Miller says other surveys have found dissatisfaction among registered nurses. "They're dealing with a lack of autonomy. Everyone is breathing down their necks. They have a physically more demanding job than an NP, who is pretty much interacting with patients and nurses are doing physical things such as lifting the patients and running from bed to bed in a hospital. They actually complain a lot about their bodies just not holding up," he says.
"Nurse income is not that bad but it is not as good as what you're getting as an NP. They don't have that satisfaction and they are not really feeling like they are managing the patient's care like an NP would but they are doing sort of the grunt work."
Overextended
While much has been said about NPs and physicians' assistants alleviating the physician shortage, the survey shows that 75% of NPs said there is a national shortage of NPs. More than 80% of NPs said they are overworked in their practices or are at full capacity. NPs said they spend an average of 25% of their time on non-clinical paperwork.
"We have this hope that NPs and PAs are going to ride to the rescue in the doctor shortage but we are already seeing evidence that NPs and PAs are already overextended," Miller says.
While the future looks rosy, when 100% of the responses are positive there is no place to go but down.
"The only negative I see is be careful what you wish for," Miller says. "When you become an independent practitioner the onus of running a practice and having the responsibility falls on you and a lot of doctors find that to be a challenge. That is the only caveat I see there out there right now."
The survey was conducted by Staff Care, a temporary physician and NP staffing firm and an affiliate with Merritt Hawkins under AMN Healthcare.
John Commins is the news editor for HealthLeaders.