How detailed of a job description?

TakeTwoAspirin, MSN, RN, APRN · Aug 31, 2015

You are correct to want some structure in your job description, along with other terms and conditions of your contract. If you do not stipulate anything at this stage you are open to abuse. They will use you how and when they wish and you will have little recourse. If they truly don't have a clue, give them one. Use the text you have to craft your own contract and terms and tell them this is what you want. Negotiate from there. My guess is that once you get proactive they will quickly have a much better definition of what they want from you than they are currently sharing. Don't give them all the cards!

Barnstormin' PMHNP · Aug 31, 2015

Thanks, you put into words my feeling about the situation. I am not sure if they have a standard contract for the hospital FNP's, and being the first PMHNP they are hiring should give me some room to tailor the job description to what is appropriate. I don't want to be stuck being a glorified team leader.

allnurses Guide · Aug 31, 2015

My question is how much detail do you expect when looking at contracts? I want to know exactly what my duties will entail isn't that to be expected? But he has me worried with his lack of definition of the role, although I will be the first NP at the unit so it might be that he just isn't sure yet.[/quote']
I always suggest to my students that they seek an initial job with an employer that is experienced with novice NPs. The reason for this is that it is in your own best interest. The first year (or two) of practice is a steep learning curve and having the appropriate support and work environment can make or break your career.
Employers with no experience with novice NPs often create unsafe and unsustainable work environments.
If you do take a job, plan to clearly outline your expectations: on-demand support, increasing patient load on a gradual scale, direct supervision and reflective practice, financial CME support, etc.

Jules A, MSN · Sep 1, 2015

I agree that being the first NP on a unit, which I did as a new graduate, can be challenging but I also used it as a medium to establish the role. I made it clear that I was in the same role as a physician boundary-wise and required an excellent salary. Since you already work there and know the routine I think it will be a relatively easy transition. Remember of course in most cases they expect us to hit the ground running even as a new grad.

Since it doesn't sound like you are working with a hospitalist group, my guess is you will probably be hired through HR as an employee so there won't be a contract but instead a salary. Hopefully they consider you medical staff rather than nursing staff. I only know one hospital in this area that lists NPs as nursing staff and there is no way I'd work for them. Imo your listed duties aren't all that important, you will do whatever the Docs do. My concerns would be more about your productivity expectations. Since we function on the same level as psychiatrists I would find out what their deal is regarding caseload and call expectations. If they carry a patient load of 8-10 on the unit and see additional patients for medical floor or ED consults find out approximately how many and make sure your salary is appropriate.

If there are other NPs at the hospital HR will try to drag down your salary due to the fact that they have long term employees working as NPs for low wages. As a psychNP do not accept this rhetoric. You will need to investigate what other psychNPs in your area are making and go in with evidence to support your requirements. I usually make about $30 per hour more than FNPs in my hospital. This will make administrators uncomfortable because they don't want throes of menopausal women banging down their door if they get wind of your salary, jk. Seriously though this is not your problem. If they were able to practice in our field they could make these wages also. Ortho surgeons aren't reimbursed the same as a GP. I don't apologize for that or allow that to in any way reduce my salary requirements. It sounds like they are hot on your tail so I'd take advantage of that to get a good deal. This job will probably be harder than you could have ever imagined and you will be cranking them out so make sure you are compensated appropriately. The bottom line is even if they are overpaying you as a NP, in their opinion, you are way cheaper than a psychiatrist, if they can even find one.

Barnstormin' PMHNP · Sep 1, 2015

Thank you both for your replies, there were points raised I had not considered, I will add them to my list of questions to ask/resolve.

The comment about a caseload and productivity expectations is spot on Jules, I know the locum tenens psychiatrist utilized has had an ongoing contract dispute over this very detail. I will get info on it.

I am surprised that as a salary employee (which the position is), there is no contract, is that always the case?

Jules A, MSN · Sep 1, 2015

I am surprised that as a salary employee (which the position is), there is no contract, is that always the case?

Speaking only for myself, I have worked at three large hospital systems as a NP employee and have never had a contract. The plus for me is health benefits, PTO and of course as an employee, even in an at will state, there is the Just Culture thingy so while I can resign any time it would be more difficult for them to can me without an established pattern of poor performance. Not that its ever been an issue but I do make top dollar so I figure it is probably somewhat safer than PRN or the waiting game that can go on with contract re-negotiations.

Definitely pick the brain of the Locum who is there now.