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Do RNs make more than PAs in Norcal?


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Does this concern you guys or seem a bit weird? And if so, do you think it will change? I periodically see arguments from doctors when increased PA pay comes up that PAs shouldn’t be making any more because they’d be getting too close to physician pay territory and how that would be basically a huge slap in the face (and reduce incentive to become a physician) considering their debt and sacrifices, etc. I get where the docs who say that are coming from, but, with that same line of thinking in mind, it’s a little bizarre that RN salaries aren’t a part of the conversation. I’m gonna have an obscene amount of debt when (if lol) I graduate, and I’d really like to do a residency if I can (which won’t help the debt). Maybe it’s fair because RN work is harder? I dono. I’m grateful to have the opportunity to become a PA and I don’t regret my decision. I just would have expected the salaries to look more like RN<APC<MD/DO.

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This isn’t exclusive to NorCal. Some of it depends on what field too. Back in NJ I was in an icu setting and one of the RNs disclosed to me she made $170k. I was earning about 60k less than she was and carrying an entire ICU as solo provider overnight. The disproportion is getting worse. I’ve also found in CA that NPs are paid on a higher scale than PAs for the same exact position. I feel like our pay is falling behind and I hope it changes soon because most of us are also buried in debt like doctors


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1 hour ago, NYCPAC said:

This isn’t exclusive to NorCal. Some of it depends on what field too. Back in NJ I was in an icu setting and one of the RNs disclosed to me she made $170k. I was earning about 60k less than she was and carrying an entire ICU as solo provider overnight. The disproportion is getting worse. I’ve also found in CA that NPs are paid on a higher scale than PAs for the same exact position. I feel like our pay is falling behind and I hope it changes soon because most of us are also buried in debt like doctors


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I hear you and I completely agree we should make more than RNs, but how many hours was this RN working? 70-80 hrs/week, holidays, weekends, nights, etc...? 

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2 hours ago, camoman1234 said:

I hear you and I completely agree we should make more than RNs, but how many hours was this RN working? 70-80 hrs/week, holidays, weekends, nights, etc...? 

Often in NorCal, the base pay for RNs is equal to or greater than that for PAs. It’s not always a matter of night differential/OT. The RNs who do CCT in my area are making around 65 an hour (base pay) and the ED RNs are making 80.

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I'm not sure about Northern California, but I have also noticed that RN pay is the same if not more than the lower end of pay for PAs, especially in the early PA career. I haven't heard of such high ($>100k) salaries for RNs though....interesting food for thought in that area.

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  • 2 weeks later...

Not data, just another anecdotal story: a friend of mine finished FNP school and then did a primary care residency in the Bay Area. She finished the residency and started working as an FNP in a primary care practice. She was making less as an FNP than she had been as a nurse on an inpatient unit and has since gone back to working part time as an RN since she can make more money in that job than as an FNP


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On 3/29/2018 at 5:29 PM, LT_Oneal_PAC said:

Anyone have hard data to back this up?

If you browse job listings in the Bay Area, there are a lot of RN jobs from John Muir, Kaiser, etc. listed in the 120k-160k range. I know nurses can typically rack up a lot of OT and night differential pay, but this seems to be base pay and not necessarily night shift listings. I work as an EMT and the RNs doing CCT at my company make 65/hr. It seems like from what I read on here and other forums that the expectation for PA salaries here is in the lower end of that range or less.

I don’t doubt there are PAs making over 160k here but it seems more the exception than the rule. I also understand that the Bay is competitive for RNs and not a new grad market but I do know one new grad working in the ED for John Muir here and I know a couple others who got jobs here with John Muir after getting one year experience outside of the Bay.

The Bay Area is unique because col is insane, but it seems like the RNs have done a good job of advocating for pay that accounts for the col. The PA salaries seem to be lagging.

(A lot of this was anecdote, but at least the job listings are a little more data-ish.)

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On 4/9/2018 at 0:36 PM, Corpsman2PA said:

In Sac I work with RNs in the ED that start as new grads at $58/hr. Most make $150k/year doing 3-12s. I know a few that gross >$200k but typically work a little more or pick up extra shifts.


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So what are your thoughts? Are the PAs here selling themselves short?

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So what are your thoughts? Are the PAs here selling themselves short?



Not at all. We all make over 150k easily, doing 130-140 hrs a month. The problem is RNs and the California RN union have positioned themselves into making NorCal a Mecca for RN salaries. People literally fly in from out of state, work their shifts and fly home.





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  • 2 months later...

I heard RNs make more in NorCal but didn't realize exactly how lucrative it was until my friend mentioned her hourly rate at Stanford was $66/hr.  I even asked her if that was the hourly rate or her salary lol She recently graduated from RN school and this was her starting salary as a new grad in medsurg.  My starting salary as a new grad in the ER last year- $57.50. It definitely felt like a slap in the face although as I thought about it I figured it was probably because the nursing association is a huge influence and backed by a union.  I still am happy to be a PA and grateful to be in the profession we are in.  

Also to compare how much more RNs make in NorCal, an RN I work with in the ER works both in California and Colorado (she grew up here but her family resides in CO).  She mentioned that the hourly rate in CO is somewhere around $30 where in NorCal it can be anywhere between $60-$90 depending how close you are to the Bay Area. 

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On 3/19/2018 at 9:07 AM, NYCPAC said:

This isn’t exclusive to NorCal. Some of it depends on what field too. Back in NJ I was in an icu setting and one of the RNs disclosed to me she made $170k. I was earning about 60k less than she was and carrying an entire ICU as solo provider overnight. The disproportion is getting worse. I’ve also found in CA that NPs are paid on a higher scale than PAs for the same exact position. I feel like our pay is falling behind and I hope it changes soon because most of us are also buried in debt like doctors


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Pretty impressive. Everywhere I look suggests that's CRNA levels of income, which means CRNA's around NorCal must make more than the PC Physician average?

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CNA (California Nurses Association) is well known as one of the strongest and healthiest labor unions in the nation.  They rule Northern California hospitals and health systems.  It’s interesting that quite a few FNPs in Cali will preferentially work as RNs from time to time for the longer shifts and high salaries with night/weekend/holiday differential.  They also have the strongest nursing staffing laws in the nation and can literally shut down units for not enough RNs that would be acceptable in the rest of the country.  This naturally raises salaries.  

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