APN Under Construction

Thanks TX RN. Contract states I will get yearly bonus based on productivity. When i asked to increase base further, they said they can increase, but do away with prodictivity bonus. So at this point I wonder: do I want $5K increase now without bonus or forget $5K and wait for productivity bonus (which I don't know how much it will be)

Thanks everyone for your responses, you guys rock! As a new NP, or employee not familiar with different types of taxation, it can be very confusing. In fact, had one of my friends not told me about 1099 I wouldnt have had any clue of what this entails! zmansc , I read though your comment and thought about the whole thing. You are right on the money! I visited an accountant and he was just puzzled about the whole situation. In fact, he wondered how they would be able to provide me with medical insurance, while I am not an employee. Then the MD's practice referring to themselves as the "employer" didn't make any sense either. An independent contractor is technically self employed. So when they talk about employer in contract, it doesn't make sense whose employer? (correct me if I'm wrong). I think someone is trying to get this MD into the 1099 situation but seems like they have no knowledge of the law. See as an independent contractor it is somehow difficult to negotiate for benefits. They did offer me some benefits though. its been such a roller coaster of emotions and decisions! Since my heart is with IM, and the schedule works with my baby, I might just have to bite the paycut and follow IM. Pay difference will be at least 10K but as a mom, sometimes you just have to make sacrifices. In 1 or two years, I should be a well experienced NP (thanks to getting on my feet with them). They will pay me what I'm worth or somebody else will. Still taking opinions :-)

I wrote to the manager seeking clarification if this is w-2 position but haven't heard back. As a new NP I agree that I may not get my dream job as first job, but also need to be careful not to find myself jobless with legal issues hovering over my license. I think I might have to tell them I will not take 1099 position. Sounds too complicated for me, especially since I feel like I would be more of an employee than Independent contractor. I might just have to walk away from this one, as I did with another contract offered by cardiologist that wanted me to sign strict "contract not to compete." I'm sure another opportunity will come across. Right now I do work same hours as Minute Clinic. I might just take MC offer and leep looking FP or IM opportunity.

Thank TX RN. I really would love an IM job, but the contract seems more of a roller coaster than anything. Seems like I can find myself screwed up. Last thing I want is to find myself illegal independent contractor.

So, I received the contract but haven't signed, don't even know whether or not to sign. Very confusing details: MD's business is referred to as "Employer" and I am referred to as "Nurse Practitioner". Benefits are said subject to change based on cost or availability. My relationship with MD is described as the Nurse Practitioner is an independent contractor of Employer for the purposes of the duties performed under this agreement. Is it possible for me as nurse practitioner to be an "independent contractor" with the MD's practice as my "employer?"

I like your vote TX RN lol.... I'm thinking of looking at it as an ooportunity for growth, which allows me a flexible schedule with my child. In terms of money, I might just be making what I'm making now as Medsurg RN working PRN with no benefits. In fact, last time I worked fulltime with benefits I made $30/hr, a w-2 salary of about $ 60K, with benefits. Based on what some have said, 1 year of Internal Med experience is better than 1 year of Minute Clinic nothing against Minute Clinic) experience?

TX RN, I was not told that it will be 1099, but I'm assuming that's the whole point of them insisting on me being independent contractor than employee. The way they described the situation gives me the impression that it's 1099. They said I will need to set money aside to pay taxes etc plus I can deduct stuff like mileage (the job is only 7 miles from my home). I don't think with w-2 I would need to pay my own taxes, woould I?

Thank you so much [COLOR=#003366]CarrotChardonnay for your enlightening post. Sounds like the 95K on 1099 comes roughly equivalent to almost 85,000 as W-2 employee? Almost $ 43/hour (currently I'm making $45/hour as medsurg RN working PRN without benefits) I really wish there was an easy conversion calculator so I can compare apples to apples! The more I learn about this Independent contractor option (1099) the more I feel like walking away. In fact, I am beginning to really hate the number 1099 itself. But then again I look back and realize I'm only a new grad NP with 4 years Medsurg experience. I do not have any ICU or ER experience. But I'm and NP regardless! I even learned that should she decide to fire me for one reason or another, I would not be eligible for unemployment benefits. The IM schedule is very very appealing but I feel like I'm being denied W-2 status, and I'm wondering what other tricks they would play on me! I am trying to be realistic with my new grad status, but while at the same time realize I do have bills to pay, especially as a recently divorced single mom who needs to refinance her house in less than 6 months! Minute clinic hours on the other hand are just so incompatible with my mommy status of a daycare aged baby. Today the MD's office is sending me the contract. I think I will tell them that I will sign it if they either change to w-2 status, or make pay $100k, which I had asked. I mean, I have two job offers and I'm even more stressed out than without any offers! As Carachel suggested a 4 days work, I might request to have a 10 hour day, so I can work probably from 7a-5.30pm. I might just bite the bullet and take the tricky offer without much expectation (in fact getting paid less than what I'm making as RN), and take it as a residency or internship. My goal would be to learn as much as I can absorb, equip myself with experience, which include seeing patients in office plus rounding in hospital plus LTACs and nursing home. With this kind of experience, I hope my FNP licence will be worthy of some decent income! I will plan to be as productive as I can be. By the end of year, I will have them significantly increase my numbers, or I'll be moving elsewhere, since I will have had some experience on my back, to decorate my Nurse Practitioner license. Keep those comments coming... All opinion are welcome!

Hi Core0, After reading your post I had to look at the paper again. You couldn't be more right. I looked at the list of benefits and yes; it states "health, dental and visual coverage available, medical malpractice, CMEs worth 1K, productivity bonus an, paid holidays and vacation." All this as an independet contractor. This sounds more like a full time position with benefits on W-2, until I read where it talks about "base salary of $90K - paid monthly as contract employee." This base was negotiated to 95K. I asked for 100K, was offered 95. Haven't agreed to 95K but I said I'll think about it. I don't know whether to be happy or upset. Upset because I would basically be a w-2 employee being made to sign 1099 and be responsible for taxes that come with 1099 (which I don't know by how much more?) Or should I be happy because this is a job that gives me the independence to work out my schedule the way I want (well that's the freedom that comes with independent contractor right?), with the 'added benefit of getting the benefits that I wouldn't otherwise be getting as independent contractor smh? No one taught us how to negotiate in NP school. All opinions welcome. No opinion is bad or unwelcome. Lets talk about this.

Thanks Carachel for your response. Your input is very welcome. Minute Clinic has the better offer in terms of pay and benefits. However, I am finding the hours to be a little harsh on me as single mom with no other family. For one, closing time is 7.30, which means that I won't be able to leave until at least 8.15 or even 8.30. pm. The problem that I'm experiencing is that all daycares in our area close at 6.30 pm or ealier. I have had to ask neighbors if they can pick baby up from daycare for me but no one seems to be available and willing. His dad can help pick him up in daycare, but him doing it 4/7 days a week plus be with him 1st, 3rd and 5th weekends makes him more of primary custodial parent parent than myself. (had nasty custody fight and he will use any excuse to snatch primary custody from me). So Minute clinic hours are not quite compatible with the situation. But their money and benefits are good. Downside of IM clinic is pay is lower, less benefits. I negotiated the base pay and they gave me and extra 5K, meaning starting salary is $95 as independent contractor (1099), with basic benefits eg insurance, 3 weeks vacation. I also get bonus at end of year based on productivity. Pay is negotiable after 1 year, based on productivity. But MD is willing to train, is very flexible. Will allow me to round at hospital, or at LTAC and nursing home, where she is Medical Director, if I prefer that to office work. Told me she is pro babies, and that I will not have to be in clinic beyond 6.00 pm.

Thirteengirl, Thank you for your intent to help out in this dilemma and taking time to comment.

Hi Thirteen girl... I was under the impression that as independent contractor filing form 1099 you pay more taxes? Also, I'm somehow a lil accounting challenged. $50/hr x 36 hrs x 52 weeks per year comes to almost $93,600 annual... Or is my math wrong? Since this is w2 position, isn't it more than 90k annual as independent contractor on 1099?

Thank you so much for your response. I had the same feeling but I thought id sought second opinion from others. The money seems to be more at Minute Clinic and I was just trying to see if others think it's worth. I was told about strict protocol adherence. Any decision making out of the protocols is regarded as practicing medicine without a license. I really appreciate the input.

Hi everyone, I recently graduated from Family Nurse Practitioner school and just got my licence to practice. I am having a problem choosing between two offers in Houston, TX. Retail Clinic in Pharmacy offered me $50/hr (Minute Clinic) and I met a really awesome doctor who is offering Annual of $90,000 with some benefits, with 3 weeks paid vacation. As a new grad, I am kind of wary about starting my first job at the retail pharmacy clinic. The good thing about this offer is it a full time employee position (W-2), with many benefits. The problem is that the hours of operation (extending till 7.30 to 8 pm in evening) does not sit very well for a single mother with a toddler to be picked up from daycare. But work days are 4 days a week. The internal med position sounds to be a good position, but I was told it is Independent contract position (No W-2). Hours of work are very compatible with baby in daycare, as i can work Monday to Friday 8-5 or 9-6 or however I want to work. The office seems very supportive and the the MD very nice. I have known him for a while. I am not very familiar with Independent contractors and I was wondering how this works, especially with me having to do my own taxes? 1. Anyone knowledgeable with 1099 tax form to help me figure what annual of $90,000 on 1099 compares to $50/hr (roughly 36-37 hrs a week) on W2? 2. What do you all think about working in Retail pharmacy clinic vs Internal Medicine, especially for new grad? Your prompt response is highly appreciated.

Thanks for response. I had purchased the AANP practice test from the website and before and after review. I scored 54% before review and 75% after. I so thought I was ready to test. But with the results from APEA test I'm terribly scared.

Hi everyone, I'm scheduled to take my AANP Exam on Wednesday. I attended the APEA review course in June and yesterday finished going through the book again, while listening to their audio. Basically, I can say that I know everything in the APEA manual, blow by blow. I found Amelie Hollier to be a really organized, instructor. Course was great. She used great examples and honestly explained things and made it sound so simple! So I was looking forward to take 150 question mock exam in order to gauge my understanding. The results of my practice test shocked me to the core. As a result of this, I am spending my time worrying rather than focusing on anything in particular. The problem is that the stuff that she taught on the review has minimal relationship with her own practice test! During the review, there were question and answer session and everything seemed to fall in place. Questions had relationship with review. But all of a sudden, taking her Mock exam I made a 60%, which is the lowest score I have ever imagined in my life. I have 4 job interviews waiting on me, which are all very promising, and I'm so worried that all will be lost if I don't pass this test :-( I do have a Leik book which seems pretty organized but I'm pretty discouraged on finding errors here and there. eg. She states most common skin cancer is Squamous cell carcinoma, which is wrong. I also have Fitzgerald CDs that I just received. Anyone found any of these (APEA review, Fitzgerald CDs, Maria Codina Leik book) to be useful on real exam? Any last minute advise would be really appreciated.

Hi everyone, I'm scheduled to take my AANP Exam on Wednesday. I attended the APEA review course in June and yesterday finished going through the book again, while listening to their audio. Basically, I can say that I know everything in the APEA manual, blow by blow. I found Amelie Hollier to be a really organized, instructor. Course was great. She used great examples and honestly explained things and made it sound so simple! So I was looking forward to take 150 question mock exam in order to gauge my understanding. The results of my test shocked me to the core. As a result of this, I am spending my time worrying rather than focusing on anything in particular. The problem is that the stuff that she taught on the review has minimal relationship with her own practice test! During the review, there were question and answer session and everything seemed to fall in place. Questions had relationship with review. But all of a sudden, taking her Mock exam I made a 60%, which is the lowest score I have ever imagined in my life. I have 4 job interviews waiting on me, which are all very promising, and I'm so worried that all will be lost if I don't pass this test :-( I do have a Leik book which seems pretty organized but I'm pretty discouraged on finding errors here and there. eg. She states most common skin cancer is Squamous cell carcinoma, which is wrong. Any last minute advise would be really appreciated.

Thanks Miranda. You're awesome. God bless u!

I really appreciate your opinion Linearthinker... I pray this fire gets put out at this meeting and doesn't go to BON. I'll keep your recommendations in mind. One thing I know is that this ain't happening again

So far, the matter has not been reported the BON. This is a Nursing peer review committee (NPRC) established by our facility (each facility is required to have one in place to review minor incidents, rather than report to BON.) In the letter, I am informed that the committee's purpose is to recommend whether or not a patient was exposed, or is likely to be exposed, unnecessarily to the risk of harm. The committee can report the issue to BON if they think it's necessary. In the letter, I received a copy of report which states the incident is treated as minor, no concern for chemical influence, and has not been reported to BON ... Errors mostly involve handling controlled. 2 are unaccounted for, but none others are missing. Patient safely issue is that I did not use scanner for pt id majority of the time. I previosly worked in a hospital that had no scanning so I didn't think it'd be a nightmare not to scan. Computer feature states "scan armband. Alternatively, click next to verify manually." I have ALWAYS, even when I'm using scanner, used at least pt name and date of birth before giving meds or anything...as required by JCAHO...

I edited my post after hearing moderator's opinion on posting too much info on the case, blow by blow info on this, even though no pt id info was on it. However, I just don't want to extend this problem into confidentiality matter, incase anyone familiar with the issue comes accross. There are 2 issues here (1. i did not know that Klonopin and Lyrica were controlled since I rarely have given them 2. Not aware that I was being timed on narcotics. I thought as long as I don't go home with them they shouldn't be any problems). I know this sounds stupid, but that's what happened. I haven't ever had any other disciplinary action before,... Yes, I'll take any advice on dos and donts when in peer review. I had contacted attorney in case I need one, who's wanting $5000 to go to peer review meeting with me, (even though they will not be allowed into the meeting, but I can request a recess to consult with him/her). Errors were reported to peer review as minor errors....

Linearthinker, I really appreciate your responses, which have been helpful. Your opinion helped me appreciate my boss more. It also helped me realize that I things could have been worse, like I could have had you for a boss and I could have got fired! At this time, I received written warning. Job is intact. I was just freaking about how to handle upcoming peer review committee; what's the most important thing to say or never say... etc some of my posts were deleted by administrators. Turned out I had given out too much info on the situation. I wanted for readers to understand exactly what the situation was. All the same I agree with the administrators. Enough for the bashing.... lets talk peer review, which infact was the reason for posting, not what anyone would have done if they were the boss :-)

1. already volunteered for drug screen, boss said not necessary. diversion not a concern (she's right about this). 2. I have alrady been in touch with our educator and got the necessary education on handling narcotics... since that edu, not problems (and never will be...)

I don't blame you Sandra... as one who's there, I know exactly why CVRN you're considering homehealth

I had to explain elevated liver enzymes in my pre emp screening cbc. even though I didn't drink.... didn't even know about it. didn't have insurance. (i quit my previous job for this one)