Getting started as an NP/PA

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As our healthcare system continues to evolve, so does the demand for NPs and PAs. The United States Department of Labor forecasts remarkable current and future employment opportunities for both professions.

In response to increasing clinical demand, NPs and PAs now collectively represent an integral component of our healthcare system, and this demand for practitioners creates a desirable job market for new graduates.

Early job market

New graduates will likely find several job opportunities in initial job searches. However, these opportunities may not be ideal. While there may be no shortage of work, the better jobs usually come after a few years of experience.

“The first job may not be the first choice, but each job opportunity will provide invaluable experience to build and practice skills,” Michele Herrara, PA-C, of the Anna Jaques Hospital in Newburyport, Mass., told Clinical Advisor.

She suggested that new graduates consider the first few years of their career to be a learning experience and warned that the transition from NP/PA school to practicing clinician may challenge, and possibly overwhelm many new graduates. As practicing clinicians, NPs/PAs are expected to make quick, difficult clinical assessments and decisions independently.

New graduates may find themselves in certain practice settings where they are without adequate supervision, but are expected to perform like an attending MD. Because of this expectation, Herrera recommends new practitioners seek employment in practices offering strong support and/or supervision, such as teaching hospitals and institutions where preceptors supervise the new or the inexperienced.

Early salary expectations

The salary range for new graduates varies widely with compensation often depending on a number of factors including geography, education, specialty and practice setting. New grads looking for a pay boost may want to reconsider relocating to an area of high demand.

The different levels of education within the NP and PA field also affect salary. For example, NPs with doctorate degrees can expect to earn more than colleagues with a master's degree. However, the greatest determinants of salary for NPs and PAs are practice setting and specialty.

The highest-paying PA specialties are emergency medicine, cardiovascular medicine and surgery, neurosurgery, and dermatology. Similarly, the highest-paying NP specialties are emergency medicine, acute care, surgery, and dermatology and aesthetics.

Julie Phaneuf, an RNP in geriatrics for more than 15 years makes an important point regarding salaries for new NPs. She said that a seasoned RN who transitions to become a RNP will likely initially experience a pay cut. Depending on setting an accomplished RN can expect to forfeit seniority, along with the pay rate and benefits associated with tenure to begin practicing as an NP.

Belonging to a professional organization

With the many challenges, decisions and questions facing new NP and PA graduates, joining a professional organization may offer help and guidance. The NP and PA professions both have national organizations that offer members useful professional resources.

Also, most states offer supportive organizations or professional coalitions with specialty chapters allowing local practitioners to utilize each other as resources. The PA profession has its own special-interest organization dedicated to helping new graduates transition from PA school to clinical practice. New graduates can look to these organizations for help in understanding the expectations of their chosen profession.

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