First Comment
B. Considerations for successful employment negotiations
Job hunting and the interview process is daunting for any job. I think back to when I was graduating from undergraduate nursing school and the hours spent on resumes, job fairs, hospital mixers, levels of the interview process and not only the time it took but the stress it brought on. There were so many people saying you have to work at this hospital or there is no way a new grad will get a job in that specialty etc. The common theme through this process was doubting myself and the ability to land the specialty I dreamed of, but my most successful interviews were the ones in which I was confident and knew my worth as a potential valuable member of the team. Entering into this process all over again in and in a new role as nurse practitioner will have it’s hardships but I now know I can successfully grow my skills as a nurse and integrate into a new team. I am currently still employed in the job I entered as a new nurse. At the point in my career of accepting this job as a new nurse I didn’t feel I had enough leverage for negotiation in that role. I am glad this class is introducing these concepts to help me successfully negotiate my future job.
The American Association of Nurse Practitioners notes a few helpful points when considering a new position: determine payment style, per hour/per day/per contract, determine your net worth to the practice, how payment is processed for on call hours, benefits, continuing education, malpractice insurance, professional organization memberships, scope of practice, and barriers within the practice that may inhibit you from practicing your full scope of practice (AANP, 2021). These are very helpful points, some that I had not considered, for when I am in the position of searching for and in negotiations for roles as a new nurse practitioner.
Second Comment
Even though the State of Texas requires NPs to have a collaborative agreement to practice in any manner I have found it enticing to own my practice verses being an employee. My main thought is the advantages both the patient and the practitioner will receive. The most important from my view is the ability to set yourself how long is spent with each patient (Buppert, 2014). This allows more face time for the patient with their primary care provider ensuring high quality care and patient satisfaction. This in turn gives the power over one’s income to establish the threshold for annual patients seen. The patients will benefit by receiving both nursing and medicine combined. By owning the practice, you are able to ensure quality and quality control measures (Buppert, 2014). The NP is able to control referrals and be a billable PCP, rather than all of their work reflecting as the physicians work on paper (Buppert, 2014). Let’s face it, who doesn’t want to be their own boss, hire the employees that mesh well personality wise, and keep the profits of your labor.
The downside to this is the responsibility. The tedious tasks of payroll, marketing, and other administrative duties is daunting. Not to mention the red tape of becoming a PCP on major insurance provider panels (Buppert, 2014). Finding a collaborative physician and establishing a contract that meets the states criteria could prove difficult (Buppert, 2014). Getting referrals from local ED’s and other providers is essential yet you must prove yourself in the community first (Buppert, 2014). More red tape to cut through in order to get privileges at the hospital (Buppert, 2014). The biggest disadvantage is the lack of ability to admit patients to nursing homes, order home health, or order hospice care (Buppert, 2014). This lack of legal authority to provide patients with orders for these services greatly restricts one’s practice. All in all, I think the greater developed patient relationship that is grown from having more time with them in your own practice might be worth the headaches of barriers to owning your own practice.