Negotiating job description

[ChickNlady]

I am currently finishing my last semester of FNP school and i am expecting a job offer in family practice within the week. I love everything about the place except for the job description. They plan on using me as a "physician extender" meaning acute problems, follow ups and for those patient who need a little extra education and TLC.

I do not want to just collaborate with the Docs, I want my own patient panel. I would like to manage patients on my own, make my own decisions and to focus on wellness, not just illness.

I spoke with one of my professors and she suggested that I negotiate that in my contract.

Ive had 3 interviews and they have expressed frustration that they cannot retain nps.

I would love feedback, thoughts, experience and ideas on the subject. I'm all for giving this a shot but I need Help building a solid list why changing their office NP role is a good idea. Thanks

[allennp]

Well I think you are taking the best step now by identifying the problem and searching for solutions. You can have a contract that can say most anything, I knew of someone who had her own drawn up. I do not know what state you are in and the level of independence by law you have. It is tough though when/if the culture is one that is not allowing full utilization of your liscenceure, you need to identify the stakeholders as it is said, and determine rationale for resistance. Also a red flag to me about the turnover. Sounds like though you are thinking about it from the start which is excellent!

A

[scottaprn]

The most important question someone taught me to ask to a doctor in a nurse practitioner interview is "What is your definition of collaberation between a physician and a nurse practitioner".

If the doctor's answer sounded like a strict supervision role of the nurse practitioner I would suggest that a physician assistant would be a better fit. APRNs sign collaterative agreement while a PA signs a supervisory agreement. It sounds like the physicians are looking for a PA not an APRN.

Know your state practice act and educate the physicians on your scope of practice. Tell them that in addition to the role they see there is so much more you can do. Give specific examples of how you can see and treat patients and just as importantly bill for the services (Money makes the world go round)

It is possible they never thought of what you mention or the second possibility is they aren't interested hiring in a role that will allow you to practice at the level of which you are capable. Either way you need to know what they are looking for to make sure it is a good fit. Once two parties have aligned their philosophies writing the contract gets a lot easier.

I am very lucky to work with a great surgeon who really respects my skills and we collaborate on patient care- whether the office visit is scheduled with him or me. It isn't unusual at all for either of us to present a patient to the other one looking for ideas. The last time I caught something he hadn't considered on a patient was today- simply because I had extra time talking with the patient and her son. The last time he came up with a differential that I hadn't considered on a patient of mine was Tuesday. It is a true collaboration between 2 medical providers to result in quality patient care. When you find that job take it in a second.

[Julia77]

Thanks for starting this thread.

There is a perceptual disconnect between the role the NP is prepared for and the role some institutions and individuals wish for the NP to fill.

On the one hand, I want to be a team player and can do lots of tasks -- such as ECG's, IV starts, however, I see that in clinical I am expected to account for each 5 minute that I am in clinical, and these kinds of tasks are not necessarily helpful in gaining proficiency in my new role.

Anyways, I know that's a bit different than what you're talking about, but I appreciate you bringing this issue up, and I think that an important piece for NP's and student NP's is helping to educate about the NP role.

Thanks, everyone.

Julia

[sasini01]

As a fellow new grad, I would suggest perhaps starting small, but discuss expectations for growth, e..g. by 6 months in you would manage X number of patients independently, by 12 months Y patients etc. This will allow you time to learn the ropes and gain confidence, while providing you with realistic goals.