Regarding the February 2012 article, “Challenges in Making a Business Case for Effective Pain Management in Nursing Homes” (Bakerjian, Prevost, Herr, Swafford, & Ersek, 2012), my question is, in what universe does an advanced practice nurse receive only $25 per hour? For that matter, most of the wages listed in the Table concerning first-year costs are off by a factor of two—at least for California, which Dr. Bakerjian should have known. It is possible (though unlikely) that these wages represent the norm somewhere in the country, but certainly not here.
Kate Reeves, RN, MA, CHPN
Mountain Center, California
The author discloses serving as an expert witness for various attorneys and employment with the Visiting Nurse Association of the Inland Counties hospice.
- Bakerjian, D., Prevost, S.S., Herr, K., Swafford, K. & Ersek, M. (2012). Challenges in making a business case for effective pain management in nursing homes. Journal of Gerontological Nursing, 38(2), 42–52. doi:10.3928/00989134-20110112-01 [CrossRef]
We thank the reader for the question related to the advanced practice nurse (APN) wages listed in the article. We are sorry for any confusion to the readers. We did not indicate anywhere that an APN would make $25 per hour anywhere in the United States, and certainly agree with the reader that the APN wages are significantly higher in California. The three roles in the article that relate to APN wages relate to those of management consultant, APN project manager, and staff training. Our estimates were national averages obtained from the surveys conducted by ADVANCE for Nurse Practitioners and Physician Assistants (
For the management consultant role, we have estimated that APNs who are external consultants charge from $65 per hour up to $250 per hour. The estimates were derived from a convenience sample of APN colleagues who do this type of consulting. We chose a relatively low figure of $100 for purposes of the Table because that was the most frequently discussed role. These APNs would be experts in the area of quality improvement and/or pain management.
For the role of APN project manager, we were using an annual salary of $100,000 and figuring that the project manager would work 0.25 full-time equivalent (FTE) hours or 25% time. We assumed that this APN could be an independent consultant and would need to pay self-employment taxes from any earnings.
Our third indication was an hourly rate of $39 to conduct staff training. This would be an annual salary of $81,120 for the APN, and we assumed this would be an APN employed by the nursing home with some benefits.
Again, these wages were based on national self-reports of APN wages from two reliable sources. It is possible the reader may have misread the Table and thought the 0.25 FTE related to the project manager was indicating $25 per hour for APNs instead of 25% time. By the way, the annual wages for California APRNs (self-reported) in 2010 was $88,206, with an hourly rate of $56.71 (California Board of Registered Nursing, 2011).
Debra Bakerjian, PhD, RN, FNP
The author discloses grant support from the MayDay Fund.