New Grad - First Job

sailornurse · Nov 26, 2015

Sick Leave? 401K? How much for CME/CEU? $1500 per year? How many paid days off for CEU/CME?If you have to travel for a conference employer should pay for hotel, food, travel, & conferences. Who pays for: RN/NP license, DEA number (its $731 for 3 years last time I checked), pharmacy license, productivity bonus after you get up to speed. How much is the sign on bonus and what strings are attached to it?

LoloFNP · Nov 26, 2015

3 sick days annually, Roth IRA, $1600 CME or 1 week paid vacation, all licensing fees covered, $5000 sign on. If I broke contract, I'd have to pay back any benefits utilized (sign on, CME, etc).

TakeTwoAspirin, MSN, RN, APRN · Nov 27, 2015

Two weeks vacation is nowhere near enough, especially given how many patients they expect you to see. Up to 30 is A LOT.

They are going to be making a ton of money out of you with the kind of numbers they are throwing at you. Your base is OK, but for a two year contract I would want a documented increase at 6 months, 12 months, and 18 months.

The hours are too long, you may have a scribe to help with some of the charting, but you still need time to review charts, read labs, follow up on labs, etc. You must have hours built into your schedule that are not office visit hours, but administrative hours.

I would not agree to a two year contract at any point, but a two year contract for a new grad tied into such big numbers is terrible if you are not getting a bigger piece of the pie. While it is possible to build up to 20+ patients a day with the proper support, you need to negotiate a bonus structure that rewards you for every patient over 15.

You also have to have documented what support you will have - how many examination rooms will be dedicated to you so that you can "stack" your patients in rooms. Will you have a dedicated MA or have to share one (which means you may not be able to push through patients efficiently).

It sounds to me as if you will be killing yourself for these people for two years while locked into a new grad pay scale and benefits. Don't be fooled - they are making more out of you than they will be giving you in "experience". Everyone dangles "experience" in the face of new grads as a reason why they should give up much of their power. If you accept this offer without having them document some of the things mentioned here (along with other contributions from members here, I'm sure), they will be laughing all the way to the bank while you are burning out and hating life!

LoloFNP · Nov 27, 2015

Thank you. This is exactly the kind of feedback I was hoping to get. I have a family and I really don't want to be miserable for the next two years either. I have one more interview coming up in a few weeks, so I will be sure to address all of these questions. I was already feeling kind of hesitant about it anyway, so knowing which questions to ask and what I need to be aware of is extremely helpful. I don't want to get myself in a bad situation. However, it's nerve wracking as a new grad - I want it to be a good fit but I don't feel like I can be to picky choosey either.

Trilldayz,RN BSN · Nov 27, 2015

Yeah, don't take this job.

sailornurse · Nov 27, 2015

3 sick days annually, Roth IRA, $1600 CME or 1 week paid vacation, all licensing fees covered, $5000 sign on. If I broke contract, I'd have to pay back any benefits utilized (sign on, CME, etc).

What state are you in? Really 3 whole days to be sick? Minimum should be 5 days sick leave, so you said 2 weeks vaka in first post, now its one week or the $1600 for CME, not both? It should be the $1600 plus 5 days annually for conference, which 6 holidays? There are ten federal holidays. At least there is no mention of a non-compete clause. Read the contract very carefully. As a new NP you may be uncomfortable negotiating but you did post here for feedback so that tells me you aware it is typical to negotiate back & forth. Yeah, don't let them act like they are doing you a favor just cause you are new grad. Sometimes if the base salary is not going up, you can negotiate for say 3 weeks aka instead of 2 weeks. Also see if you can do one year contract instead of 2. Not sure Roth IRA is any benefit, I think you can set up your own. Now 401K where employer contributes or matches what you contribute is better. Also when they say "all licensing fees" make sure it says: NP, Rn license, pharmacy license, DEA license, and if you break contract it should be pro-rated by number of months you owed them, not full amount.

Also, in primary care new patients/paps are not 15 min visits, minimum 30 min visits. This also billed higher levels. I have worked with scribes in urgent care, and can see 5 patients per hour with good scribe, and a good MA, without scribe it's 3-4 patients per hour in urgent care, 3 per hour primary visit, usually followups are 20 min.

How long is your orientation? 6 weeks minimum. If you do not know the EMR, it will take time to learn just that, let alone get used to being new. You will second guess yourself, you will have to look up meds, you will have to calculate pediatric dosages. Are you expected to do procedure? suture, splint, cast, read X-rays? ?12 leads?

LoloFNP · Nov 27, 2015

Thank you for replying.

I agree 3 sick days is nothing.

It is two weeks vacation. But the CME is $1600 or 1 week vacation. So if I didn't use CME money one year, I'd technically get 3 weeks vacation.

The licensing does have it all listed out separately.

The 6 holidays are the basic ones - thanksgiving, Christmas, New Years, Memorial, July 4, and Labor Day.

Yeah, thankfully, there isn't anywhere in the contract about a non-compete clause. However, the are prorated.

I do have it on my list to ask about appt time for new patients, paps, and physicals.

They will train me for the procedures: suturing and splinting, etc. I will ask about X-rays and 12 leads. I also plan to ask if the block more time for procedures such as punch biopsies and ingrown toenails. There's no way that could happen in 15 min seeing as it takes 15 minutes to numb a toe sometimes...lol.

The plan to train me one on one with a physician for one to two months. Then I start at one patient per hour and build up from there and up to four patients per hour by 6 months.

sauce · Nov 27, 2015

pretty much every job people post on here for new grads is awful. They really do try to ream us nurse practitioners. Especially the new grads. Id laugh if they wanted me to see 4-5 patients per hour in primary care, then walk out the door. Unless they pay me 200k per year. Aint gonna happen.. maybe urgent care but not primary care with sick people. Shame on you people who take these jobs and undercut the market, you make all of our wallets shallower.

sailornurse · Nov 28, 2015

Thank you for replying.
I agree 3 sick days is nothing.
It is two weeks vacation. But the CME is $1600 or 1 week vacation. So if I didn't use CME money one year, I'd technically get 3 weeks vacation.
.

NO. The CME money should be for annual continuing education, not swapped out for one week vacation if you don't use it. This is your money for continuing ed. In New Mexico, I have to have 50 CEUs, 15 have to be pharmocology, & 5 of those 15 hours have to be non cancer pain management every 2 years. This is not ok, are you supposed to do all your CEUs on your days off, (ie your weekend off). I attend one conference per year, I learn a ton of stuff, not to mention networking with people in different parts of the state.

What state are you in? How many CEUs are you required to have to renew NP/RN license every 2 years. This should be non negotiable.

Goldenfox · Nov 28, 2015

I've never heard of an employer offering taking time off as optional vacation time if you don't use it for CME. How would that ever work to your advantage? CME is a requirement everywhere in order to keep one's license. How many credits are needed varies but its always more than just a few. Paid time off to do the CME as well as money to pay for the CME costs is standard fare. It has nothing at all to do with vacation.

How exactly would it work anyway? Let's say you used the CME time as vacation. So then you would be doing the CMEs on your personal time? Perhaps it would be reasonable to presume that if you opted to use the week as vacation time then you would also forfeit the CME money? So then you would be paying for CMEs out of your own pocket?

There are other issues with this contract but the other posts mentioned most of them. I would be wary of any place that is expecting a new grad to be seeing a different patient every 15 minutes, especially in primary care. Some of them may be quick if you know them and they are in for routine follow-ups. But some of them will be very sick and you will need to spend more time with them, especially if they are new to the practice. If they require that you perform even routine procedures like paps that takes extra time, too. Thirty patients per day is a lot of patients. They should be offering you more money for that kind of throughput expectation. A lot more money. They certainly will be making a lot of money off of you! The ones who know they are being greedy and unrealistic usually offer this in the form of some type of bonus or raise of pay after your orientation, or after 6 months....etc. But you didn't mention anything about that so I guess they didn't offer it to you.

I know that jobs are not so easy to get for new grads but I'm not so sure I'd be signing a 2 year contract to work at this place. I'd tell them that I'm thinking about their offer while I keep looking.

Chen808 · Nov 28, 2015

I have friends who are fortunate to have scribes help with charting - mostly in the ED. They are a time saver, but remember you are responsible to sign off on everything they write and you may still need to place additional notes in the chart.

When I think about 15 min a patient That would stress me out. It takes one involved patient to throw your whole day off. Sure 15 minutes if fine for about 80% of the stable patients, but 45 minutes may be required for some of the more complicated ones who walk through your door.

Also, two weeks off is laughable!!