NP in Critical and Acute Care setting

Advanced Practice Columnist / Guide · Jan 26, 2007

Are you pursuing the ICU NP route then? I notice you have an ANP but you have experience as an ICU nurse. I am an ACNP currently employed in an ICU setting. Some info about our practice:

Academic hospital setting with a major heart and lung surgery program including transplants, CABG, valve surgeries, and VAD's.

5 NP's work in Cardiothoracic Surgery ICU under the SICU intensivist service. 1 PGY 2 general surgery resident who rotates with us for 2 months duration. 1 ICU fellow at times but not all months.

Credentialed to perform triple lumen cath, insert and float Swan-Ganz, insert introducer/Cordis, thoracostomy tubes, arterial lines, bronchoscopy.

Paid salary with provisions for overtime pay, weekend and shift differential.

All procedures and notes all billed under NP but we receive no compensation for each per se. We are paid a salary by the hospital. The docs are the same way. It's a closed medical model where all docs and midlevels are part of the hospital medical group.

Contracts are already in place from the hospital before I was hired.

Review courses: did FHEA for ACNP exam. FCCS certification for ICU.

Editorial Team / Admin · Jan 26, 2007

hi all,
i'm new to this site. there are some very wise words being exchanged and i thought that i may pick a few of your brains. i am a year away from graduating with anp. i've been in critical care for 13 years and feel pretty comfortable there. however, i am still exploring my options.
please.... this whole thing makes me a bit nervous. i want to be in an enviroment that i love, but i don't want to be taken advantage of especially with the liability involved.
please share thoughts!!!
also, anyone take a review course for adult and critical care np? i'm looking and am not sure of which ones are best. thanks for input!
rossi

:melody:hello, rossi and welcome to allnurses.com:melody:

it is great to have you with us.

how did you negotiate your contracts?

this last entity, they had a contract to review. i added to it - negotiated, they refined.....i refined, it was finally accepted. you need to bring with you, outline of what you will offer the entity, stats regarding your type of services that you will provide including previous stats regarding productivity numbers. or, at least, be familiar with these stats.

are you under the entire intensivists practice ( 6 doctors in ours...)?

under the direction of the medical director. 5 other physicians on staff as well with whom i consult/refer.

did you negotiate bonuses for productivity?

yes, after a certain amount of time elapsed after hire, would revisit for productivity raises. initially, productivity bonus for x amount patients/revenue generated.

weekend, holidays and call?

yes, this was addressed.

are you certified for line placements or invasive procedures and if so are you compensated?

no extra compensation for additional certifications. some certs were a requirement of the position.

educational assistance or experiences for ceu were they negotiated?

negotiated all continuing education expenses paid, including all certification and licensure fees.

pay increases and ability to be a part of growth in research and protocols?

yes. negotiated for profit sharing. also, negotiated to be chief in designing/implementation of protocols for the clinic. revisit pay increases after first 6 months, yearly thereafter.

negotiate for paid medical and dental insurance, Liability Insurance, lodging (if needed), automobile expenses, retirement, vacation, sick time, life insurance, disability insurance, comp time (i am salaried).

i am also on staff at the hospital for ed call and that is totally seperate from the clinic. this was a different negotiation.

hope this helps.

rossi · Jan 28, 2007

Thanks fo info. Helps to get perspective.

Rossi

rossi · Jan 28, 2007

Thanks, sounds like you have your hands full. Excellent!

rossi · Jan 28, 2007

Since I have not worked as a NP as of yet I really won't have a prevouis stats or any numbers of productivity. Were do suggest that I find stats that I would be able to become familiar with? Very helpful. Thank you.

Advanced Practice Columnist / Guide · Jan 28, 2007

This is usually something you bring up after you have been in the role for a while. What our group did to support our case for a raise is to gather data pertaining to number of ICU consults and notes and how they were coded by billing, number of procedures done, early extubation data for post-CABG patients and whether we are meeting national benchmarks, incidence of line infections, and patient satisfaction surveys. These are some ideas you can utilize. I would wait until you actually have the job.