PMHNP Job Offer

resilientnurse · Feb 18, 2014

Hi there,

You may want to consider the following points (not in any order of importance):

1. What is your general patient population? Were you hired to tend to a specific subpopulation? If so, why?

2. Salary, benefits, etc.

3. Paid time off work and vacation is very important. Will you have some time off this summer although you are just starting now?

4. Timing for appointments, med reviews and psych evals?

5. How long do you have to complete and sign documentation?

6. Will you have an assistant or nurse to field calls and help put out fires?

7. What is the electronic record program? Who will train you?

8. How long is the credentialing process?

9. Is there malpractice insurance? Will you be covered?

10. Can you get them to pay for your DEA number registration?

11. How long is orientation? What does it entail?

12. Can you shadow an existing NP or Psychiatrist that works there already during the on boarding process?

13. Who will be your collaborating physician? Meet with him or her beforehand. How accessible will they be? Can you call or text them with issues on their cell?

14. If there is a scheduled drug that you cannot prescribe in your state, which psychiatrist will sign your prescription for it?

15. Time for continuing education and conferences?

16. If patients need documentation completed by you for social services, social security, etc., what time will be allotted to do that?

17. Can you work OT if you want and if so how will that be compensated (1.5 or comp time)?

18. Is there a patient quota per day, per hour?

19. Are there psychotropic samples available? Which ones and dosages?

20. What security measures and man barriers are in place? Is there a panic button in your proposed office?

Well, I cannot think of anything else. I hope this helps. Good luck. Let us know what you decide.

mzaur · Feb 19, 2014

Thanks for that resilientnurse! Bookmarking this to read for when I graduate :)

twinkerrs · Feb 20, 2014

Thank you for the questions. I am already being "groomed" by the psychiatrist I want to work with after graduation and I really want to be prepared when we do finally sit down to hash it all out.

ch120677 · Feb 26, 2014

Thanks a ton resilientnurse! I decided not to take the offer as they were really pushing on having me start ASAP. After finishing up this semester in school, I need a bit of time to recuperate and take care of my own mental health :) These questions will definitely help me out in my future job search!

resilientnurse · Apr 26, 2014

I wanted to add a few things to that list...some of which I have been running into months after beginning my contract.

21. Will the organization contribute funds towards completion of your CEU completion and conference attendance? This is very expensive.

22. Tuition reimbursement? Maybe you want to study for your DNP, get certified in substance abuse or get a Post-MSN in something else complimentary.

23. How much administration time will be scheduled into your average day? Taking work home is a serious issue.

24. Company paid telephone? I am being constantly texted, emailed and phoned about patient issues.

25. Company laptop?

26. Are they expecting you to give injections? Please try to avoid this. I have a colleague who is required to do so as apart of her job and she hates it. They need a RN to do this.

27. Insist upon training in coding and billing. Most RNs know little about this, but as a APRN you must select your own codes and perpetual errors will get YOU in trouble. Also, make sure the organization is not changing your codes to bill for more money after you sign your notes.

28. How do they handle drug rep visits? They always seem to come at the most I inopportune time.

29. What is there general policy/philosophy on benzos and stimulants prescriptions? Some organizations prescribe them like candy to insure the patients keep coming back each month. While others refuse to prescribe them. Is there a benzo titration policy in place? You need to know the work culture you may be walking into.

30. Get lots of time off! It is incredibly depleting work listening to person after person all day everyday. Not to mention the reality of patients that complete suicide or overdose on drugs. I am trying to get one week off every month or at least one week every two months.

31. Do they treat patients with a dual-diagnosis?

32. Are they expecting you to do psychotherapy?

33. Do they pay for yearly State license renewals?

NEGOTIATE HARD!!! RNs are simply unprepared by traditional training for this type of world as prescribers. But toughen up quick even if you are a new grad. Insist upon everything you want or walk away. They will call you back. Psych NPs are in high demand and you can literally write your own ticket. My RN salary more than doubled the day after I passed certification. The ink was not even dry and I had multiple job offers. Be cocky and confident, fake it if you have to until you can get there. Advanced practice is very different from working on the floor.

twinkerrs · Apr 27, 2014

Thank you so much. I am learning how to be tough. And have bought a few books on the topic of the business side of being a aprn. It is kind of scary thinking about all of this stuff.

I like that you mentioned benzos. Since I will primarily be doing child adolescent I don't have to worry much in the hospital setting. His outpatient office initial paperwork contract states we do not prescribe benzos and the patients sign it on their first visit so that nips it in the bud. Yippee because I am not a fan of benzos. I will be doing dual diagnosis since he does and he is paying for that certification. He is also going to pay for me to take a course on functional psych treatment/vitamin supplementation. Which I am super excited about.