Negotiating contracts

Specialties NP

Published

Specializes in CT ICU, OR, Orthopedic.

I graduate with my DNP in two weeks. I am hoping to take my ACNP boards in January. I have a position lined up already, only we haven't started any type of negotiating. We haven't even talked about salary. Before anyone says, "You shouldn't be in this for the money", I have to say that I need to make enough to have made the last four years worth it. The problem is, I have visited a gazillion salary websites, and can not find a consistent idea of what to expect. I have seen salaries ranging from $68,000-105,000 to start. I will be working with a very busy orthopedic surgeon. I will be working in the office, first assisting, and rounding in the hospital. I am anticipating long hours. I know that I will be on call at least one weekend a month. There are two physician assistants that also work with him. I don't want to be taken advantage of, nor do I want to be disappointed by expecting too much. I have 16 years of scrub experience, but none as a first assistant. I live in the metropolitan Detroit area. Any insite would be helpful. I know there are other considerations besides salary. Would appreciate your advice!

Thanks!

Congratulations! I would imagine it would be near the higher end you mentioned since it's an inpatient position at a hospital, these seem to be one of the better paid NP roles.. Also how many years RN experience do you have and does this hospital give you full credit for your RN experience?

Specializes in CT ICU, OR, Orthopedic.

Hello, and thank you! Well, I will be employed by the surgeon, not the hospital. I think that is where the huge swings in pay come in. I only have 9 years of RN experience. I had 10 years of scrub experience prior to graduating with my BSN. I worked in the CT-ICU straight out of school, but have a very a very strong background in orthopedics as far as the OR is concerned. I've known and worked with this surgeon in the OR for about 10 years. He knows my abilities and likely my weaknesses. I will need training, as I don't have a lot of suturing experience (I have some, but it is limited). Also, obviously, the office. I think this will be a fairly smooth transition for me. I just can't seem to find a clear indication of what to expect with contracts etc. People have told me to "make sure you negotiate for..." all sorts of things. I have never negotiated for a thing in my life! If I buy a car and they say a price, that is what I pay. It is all intimidating to me. :unsure:

Ahh I see. That's a tough call then. Regardless though I would also agree to negotiate to the higher end based on inpatient and surgical aspects of the job. Here's what I just found on a quick Google search on the 10 highest paid NPs... Check if you can find anything specific to your city to help you..

8. Surgical Nurse Practitioner ($91,023) Surgical nurse practitioners assist physicians in surgical procedures. For example, following a surgery, the nurse practitioner may be asked to suture a surgical wound. NP's may also see surgical patients at post-op visits and round on them during their hospital stay addressing any complications.

Sounds like a perfect fit for you!

Specializes in Peds OR as RN, Peds ENT as NP.

Please keep us updated. I am also an OR nurse working on MSN and plan to do the same thing!

Why dont you speak to the PA's working with the surgeon and try to get an idea from them on what to expect. Im sure your package will be very similar to theirs.

Specializes in CT ICU, OR, Orthopedic.

I feel funny asking private information about pay etc...Plus, the PAs have a lot of experience, so I'm sure my package will be much smaller?

When I was a nursing student I learned an important lesson from a visitor in one of my patient's room: Never refer to yourself or your experience as "just" or "only" and I think the same applies to salary/benefit negotiations. Do not downplay your experience or education.

Specializes in L&D, ICU, Family Medicine.

DNPstudent, I am in the same boat as you, as far as learning what is an acceptable pay range as a new grad NP. I am specializing in Family Medicine and have 6yrs exp as an RN in LDRP and ICU settings. I am MSN prepared and was offered a job at my first interview with a busy, well-respected practice in my area (5 min. commute, oh yeah!). I just went over contract negotiations today and was offered a $72K salary w/15% profit sharing paid quarterly. Now, being an RN at a large hospital franchise, I have become used to hourly wages and the incentives of working overtime and holidays to gain a bigger take home pay...so this number startled me. Now, I agree with you, it shouldn't be about the money and there are other things to consider. So, I have devised some pros and cons to this:

Pros: short commute, well established practice, 31 hrs required patient time, which leaves plenty of time for paperwork, ample support as a new grad (they are moving the more experienced NP to another office location that has a new doc, and I am taking her place w/the seasoned docs), no pressure to see 20+ pts right off the bat--my orientation pace is basically up to me, OTJ training for in-office procedures by the docs, 15 days PTO, 5 paid CME days, 1K toward CME, malpractice w/$1 and $3 million, 401K with 3-5% company match, licensing/DEA fees all paid. No weekends, no major holidays, 1 hr lunch breaks, 2 hr lunch break on Wednesdays, and pharm reps that cater lunches (this could be a bad thing lol).

Cons: No medical/dental-I will have to shop for private insurance for my spouse and child, not to mention we might add on to our little family in the near future and the kid needs braces.

In sum, the salary number alone irked me, it was hard for me to maintain my smile when they said it, but after discussing the average annual profit sharing within the practice amongst other NPs, I decided this job will be well worth it (you get what you put in, and I'm getting peace of mind to be in such a positive and supportive learning environment). I am hoping that by the end of my first year, my salary + profit sharing will amount to around 85K. I will definitely be asking for productivity reports to monitor my worth. I still haven't signed the contract, and may ask for a couple more vacay days and maybe another $500 for CME, since the next AANP conference is in Nashville (far for me).

But if you plan on working long hours, have a long commute, expect to have a very stressful first 6-12 mos of being thrown to the wolves, I would ask for something that definitely reflects the average to upper average pay scale for your area. I have a classmate who relocated her whole family to a God-forsaken city that's light years behind compared to the rest of the country to accept a position as an FNP at a state prison. She is making 120K/yr w/full medical bennies and PTO. Is it her dream job/setting? No. Is the pay good? HELL YES. Is she learning? You know it. Is it stressful? Like she never would have imagined. But it's working for her and she is getting great experience...will the money make up for the lifestyle change and environment? Only time will tell. Or maybe it will end up being her dream job. We just gotta get our feet wet and start somewhere.

Specializes in CT ICU, OR, Orthopedic.

I have heard profit sharing is a big plus to consider. I honestly do not know what that entails. I spoke to a PA that just started with another surgeon. She has experience as a PA, but virtually NO Experience in the OR (she didn't even know how to gown and glove). She gave me an idea of she feels I should expect. She said that as a new grad, I should not accept less than $90K, which is what websites indicated for starting surgical NPs in this area. She also said that she gets 13% of of the surgeon's fees for first assisting. I have weighed that I have extensive surgical experience, particularly ortho experience. Scrubbing is indeed different than first assisting, but I don't think the training will be that extensive aside from learning to suture, and I have had suturing classes, but will need more training. The office is about 15 minutes from my house, and the three hospitals are about 20 minutes away in each direction. I know I will be working long hours, and I have a 5 year old, so that is something to consider. Obviously, I don't know if my package will be even close to hers, but at least it gave me an idea.

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