I have a psychiatric nurse practitioner who manages medication for my OCD. She maintains her own practice. She writes her own prescriptions. And her office exclusively works on psych meds. She is doing the work that a psychiatrist would do. At my GI's office the NP is who you see. All the time. The only time you see the doctor is if he's doing your colonscopy or endoscopy. It's her name on all of the prescriptions. As for pay, the going rate for a floor nurse in this town is around $45k - $55k. On the super low end, there are some public roles where an RN can make as little as $35k for similar work. I am confident that any employed NP is making at a minimum $80k in this town. Most are over $100k. With the caveat, of course, that if you're running your own practice then you're earnings are much more variable. This isn't Neuhaus speculating. I know the market rates and I've verified a few of them since the largest hospitals nearby is a state facility and therefore subject to public reporting requirements so I cna look up individual salaries. [/QUOTE] Maybe we're just in very different areas, Rich. Or maybe you are operating off of less recent information. I'm not sure. But the pay gap between an RN and an NP is pretty vast these days. Nurses, like all people, get older. And to go back to being a floor nurse is not something that many nurses can actually pull off if they've been doing more administrative work for a while. Floor nurses have an incredibly high disability rate. Lifting people and slipping on floors can destroy a body especially over the course of decades. I've not encountered a nurse who ever went back to that after finding higher paying and less physically demanding work elsewhere. Now, have I seen NPs bounce to work for insurance companies reviewing claims? Yes, absolutely. And burnout may very well be a factor there since the pay is, at best, comparable for those making that transition. But NP to working a floor again? I've never seen it. That doesn't mean it doesn't happen. And, admittedly, it's been almost 10 years since I hired nurses. But the rush of RNs wanting to become nurse practitioners has only been going up and I haven't seen any data to suggest that they are churning at the rate you're describing.