“I got the job! I like my salary and they’re offering great benefits. I guess you can say my work here is done!”
Congratulations on the new job! After countless, grueling hours of juggling Nurse Practitioner school with the rest of your life, you’ve finished and secured a job with stethoscope in hand, a huge accomplishment indeed.
Negotiating your compensation package can be a nail-biting, heart-racing all around anxiety-producing experience. While some of this anxiety might just stem from inexperience with negotiating a contract, you might also be worried about not knowing what to ask for as a new Nurse Practitioner. From what I've witnessed among my peers and coworkers, many Nurse Practitioners across the country are missing out on key job-satisfaction producing benefits on the table simply because they do not know they exist!
When thinking about compensation and benefit packages, many people think of salary, health insurance, employer-match retirement plans and vacation time. While these fundamental compensatory items are essential and should be negotiated with rigor, there are other non-traditional, but highly valuable benefits Nurse Practitioners should consider asking of their employer prior to signing on the dotted line and treating yourself to a new closet of nursing scrubs.
“I Wish I Had Asked for That”
During my final semester in NP school, our professor had three practicing Nurse Practitioners come to our classroom to answer our questions about the profession. Thanks to them, I was able to request some of the items they mentioned prior to my start date, and others I garnered within the first year of employment as an NP.
Administrative Time
This item is first for good reason. Administrative time is time within the workday when a provider is not slated to see patients. Healthcare providers can use these sessions to check lab results, catch up on charting, call patients, go to meetings and take care of personal life demands.
If Monday is busy, I know I’ll have Tuesday’s administrative session to catch up on call-backs, charting and collaborate with providers in other departments on complex patient cases. If I have to call a patient with a sensitive, time-deserving diagnosis such as a Breast Cancer; my administrative time is the perfect opportunity to give my patient my undivided attention.
Consider asking to be allowed to conduct administrative time remotely with the help of technology. Apps such as the Doximity Dialer app allow for you to call patients from your cellular device and your place of employment’s number will display. For those who share an office with other providers, being able to leave the office and return patient’s calls in the privacy of a quiet space is a patient-centered approach that adds to the patient’s satisfaction as well as a provider’s ability to concentrate.
Having administrative time improves your work-life balance, decreases incidence of burnout and increases provider and patient satisfaction.
One Day A Week Off
If working four ten-hour shifts is an option at your workplace, this may be a great alternative work schedule that fits better into your life.
It can be extremely nice to have a weekday where you’re able to grocery shop, go to the hair and nail salon, clean your home, get in a great workout and have some “you time” - a chance for a restorative break that so many healthcare providers and caregivers need to avoid burning out.
Money for CEUs and Conferences
This is an important yet often overlooked perk all providers should ask about. I’m allotted a sizable amount each year from the hospital nursing department towards education expenses such as conference registrations or the fees associated with continuing education courses. Separately, my Obstetrics and Gynecology practice reimburses me to stay current with my medical-related licenses. When I travel for conferences I am reimbursed for transportation as well as air travel.
The costs associated with staying current with your medical licenses can accumulate to thousands of dollars per year. Be sure to inquire about having these items covered and explicitly written into your contract.
Education Days – NOT from your PTO bank
Unfortunately, if we had to use our precious paid time off on conferences, many of us would not be up-to-date on the latest guidelines and cutting edge research being done in our fields.
Ask for education leave days that are separate from your standard paid time off. This should be seen as a win-win for your employer due to your ability to represent the practice while away. Conference goers return refreshed and reignited in their desire to practice up-to-date, evidence-based medicine. The best part is being able to bring the newfound knowledge back to colleagues for consumption, keeping the entire team current on the happenings in your area of medicine.
Malpractice Insurance
If you end up working for a small institution or private practice, be sure to ask about medical malpractice insurance coverage, also known as medical professional liability coverage. Though almost all larger institutions cover malpractice insurance costs for their employees, many small entities do not.
Shadowing/Orientation Time
New Nurse Practitioners or NPs starting in a new area of medicine should ask for an orientation schedule and time to shadow other providers. Ask about shadowing an NP, MD or PA colleague to see the patient flow, clinic operations as well as common practice.
Working in an outpatient OB/GYN practice; there are a lot of moving parts. I was given a much needed and appreciated one month orientation.
In addition to days set apart to learn the electronic medical record, I shadowed the Clinical Operations Manager, Nurse Manager, Genetic Counselor, Scheduling Associates, Clinical Technicians, Physicians and other Nurse Practitioner, Maternal Fetal Medicine specialists and the Sonographers. I even spent a day in the billing department. It is important to have a grasp on clinical operations and flow as well as firsthand experience so you can troubleshoot issues!
Modified Schedule
Practicing as a Nurse Practitioner is quite different from your days in your clinical rotation. A patient presentation you’ve seen one hundred times can look completely foreign when you’re on your own! In addition to self-doubt, which is common for any new healthcare provider, you’re navigating how to chart in the new EMR system, send prescriptions electronically as well as have the perfect History of Present Illness (HPI). This is difficult to do all of this within the 15 minute time slot many NPs are given to see an acute visit.
Advocate to start with all 30 min appointment slots, and if they are already 30 minutes, advocate for 1 hour slots for the first month. Being safe and patient-centered is the goal. No one wins when you’re running an hour behind because you were thrown in the proverbial shark tank.
“I’m so glad I asked for that!”
While all of these benefits may not be possible to obtain at the outset of a new job, having even one or two can significantly increase your quality of life, job satisfaction and longevity in the field.
While salary, healthcare benefits and retirement negotiations are vital, one’s quality of life is essential to his or her wellbeing and ability to perform with excellence and compassion.
Try to negotiate incorporating some of these suggestions into your compensation package and excitedly sign on the dotted line!
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What are some of your suggestions for benefits to advocate for when negotiating a contract as a new healthcare provider?
About the author:
Monica Elston MS, FNP-BC is a board certified Family Nurse Practitioner from Washington, DC where she currently works full-time in a busy, diverse Obstetrics and Gynecology practice. When she isn't working, Monica can be found traveling the globe with her husband and friends, enjoying new brunch spots around the city and volunteering in the DC community with her Sorority sisters; the ladies of Alpha Kappa Alpha Sorority, Incorporated. In true Maryland fashion, Monica considers a sunny day sitting out on the deck with loved ones eating Maryland blue crabs her perfect day off!
