confirmation of hire?

Advanced Practice Columnist / Guide · Oct 19, 2012

I've been employed by hospitals as an ACNP in the midwest and here in California. These are the documents I've received when I accepted a job offer and prior to starting the job:

1. A formal letter of job offer detailing salary and date of hire, status (full time), name of manager, collaborating physician and department. The process of getting on board by meeting with HR, setting a date for pre-employment physical exam, and receiving a credentialing packet is included in the letter.

2. Credentialing packet. And in California, a Standardized Procedure Document to go over and sign.

Once credentialing went through and prior to start date, these were the things I had to do:

1. Complete the pre-employment physical exam.

2. Attend a hospital or health system orientation (even though I worked in one of the hospitals as an RN). I was luckily excused from attending Nursing Orientation.

3. Fill out tax forms, employment eligibility forms, and sign up for benefits.

It's pretty similar to starting as a new RN in the hospital. There is no contract.

Advanced Practice Columnist / Guide · Oct 20, 2012

Just to add about credentialing...my current hospital has Credentialing Analysts, these are clerical staff who work for the Medical Staff Office and assist providers in the process of getting credentialed. One analyst was assigned to me to update me of time frames (i.e., dates when the review board meets and can discuss my case) and how well I'm meeting it in terms of documents turned in. They are great as far as communicating by email or phone but can be inefficient and unaware of technicalities in Nurse Practitioner practice so that can be frustrating at times.

tryingtohaveitall · Oct 20, 2012

It's been over 22 years since I started a new job at a different hospital so I've forgotten what all transpired. :)

I refuse to resign my current position until I get something written detailing my salary, PTO, etc. It doesn't seem too much to ask and since my current hospital said one thing verbally and then did something else, I trust no one. I called HR 9 days ago and they said they'd e-mail me a letter. I sent an e-mail two days ago asking if the confirmation letter was coming via e-mail or USPS. I have heard/seen nothing.

I did receive an e-mail from the woman in charge of my credentialing stating that she has received my paperwork. So I guess someone is at work on my hire.

Advanced Practice Columnist / Guide · Oct 20, 2012

Here's a few things I would suggest. One, be patient because sometimes getting providers on board is not as easy as hiring an RN to work at the bedside.

Two, if you're really worried, the best way to handle this is to talk to the physician that hired you. Make sure that this physician is still committed to bringing you over. I had the same frustrations as you when I was in the Midwest in terms of the pace in getting things started (I didn't have the same snail pace here in California because the hospital here is bigger and has a well-established NP group). I got in touch with the physician by email and on each occasion, she would tell me that she is very much anticipating my start date. There should also be a practice manager of some sort - this person is typically not a physician but a business person and should be the one handling your case. In my experience, HR is never helpful and know nothing about credentialing, all they were able to help me with were knowing about my benefits.

Three, ask for an actual letter, not one sent by email. My letter did come from HR but I think it's very unprofessional for this hospital that hired you to say they will send it by email. Mine came in the mail typed and signed on an official hospital letterhead.

Four, yes, do not resign until everything is in place.

tryingtohaveitall · Oct 20, 2012

Juan,

Thank you for your advice. It's helpful to hear I'm not asking too much and also that sometimes it does just take a while. I am impatient, no doubt. I do want to be able to make plans but I don't feel I can until I have something official in my hands. This is a well known hospital, so I assume everything is fine just taking a while.

Thanks again. Have a great weekend.

tryingtohaveitall · Oct 24, 2012

Still haven't heard from HR. I'm giving them til tomorrow and will call again. Ironically, I heard from another new APN that I will be working with, she never received a hire letter either.

Advanced Practice Columnist / Guide · Oct 25, 2012

Well then it's safe to say that you're OK. Have salary been discussed? In the midwest, salary determinations tend to be convoluted and take a while to be approved. For instance, I was told the delay in my letter when I was hired was due to the fact that new salary grades for NP's were being determined and the final numbers haven't been decided though I was given a ballpark figure which was higher than my RN pay so I took the risk. Here in CA, some hospitals are unionized (and that includes nurses and APN's). Salary is determined based on a grid that includes total experience in nursing -- makes it really easy and eliminates the haggling for the right price.

tryingtohaveitall · Oct 25, 2012

Yes, they verbally told me a salary. There was also a negotiation re: PTO that was discussed verbally. I want to see that in writing since I clearly stated, "If you can get xyz approved, then I will accept the offer." Yet I haven't seen that in writing and have a feeling it won't be there if I'm not adamant about it. To further explain, the manager said she would give me this additional benefit but HR said it would have to be approved.

tryingtohaveitall · Nov 1, 2012

After asking a THIRD time today and setting a deadline, "Can I have a confirmation of hire letter by ___" I finally received my letter today. Shesh. Unfortunately, they still can't confirm that I will be able to start next month since we are waiting on credentialing, so I am still in some limbo, but I feel much more at ease that I actually have seen it on paper. :)

Aymese · Nov 2, 2012

OP,

Glad you finally got your letter!! I found the red tape associated with the NP hiring and credentialing process to be stressful myself.