1st NP Job Offer... Need Advice!

Advanced Practice Columnist / Guide · Jun 19, 2008

i just received my certification as a acnp and got my 1st job offer. i'm really excited about the position... in a major teaching hospital in the field i'm most interested in, but i don't know how to approach a couple things.

congratulations!

1) the job is a salary position and i don't get paid for > 40 hours/week. so... how can i be sure i don't end up working 50 or 60 hours a week? do i take their word for it and hope for the best??

it's nearly impossible to not work more than 40 hours a week in most settings. that's where you will have to negotiate some form of overtime pay, bonus pay, or a higher base salary to make up for the unpaid work hours. i personally think that you don't necessarily need to push this agenda with your employer right now. once you get your foot on the door and get a feel of what the job is like and the docs get a feel of what you are like, it's easier to ask for more accomodations.

2) they've told me the credentialing process (can't apply for my license until i have a job) will probably take > 3 months. if i wait around and go thru the whole process, how do i know the position will still be there 3-4 months from now? that seems like a long time for a md to wait on a np to start work. i asked them if i could start orientation/training before i get my credentials, and the recruiter told me no. she said b/c i'm a new grad, it shouldn't take as long to credential as a np w/ experience... that gave me a little more job security.

i assume this is a hospital credentialling process you are referring to. that time frame is dependent on specific hospitals. it used to take about that long for my hospital to credential non-physician providers. now, the credentialling board meets twice a month to review applicants for credentialling and this has made it much faster for np's to get credentialled. our credentialling board also solicits volunteers from the mid-level pool working in the hospital. any np who belongs to the mid-level council can volunteer to review a prospective np's file. also be aware that there are specific documents required for credentialling and every document (professional reference letters, certifications, transcript of records, ceu records, etc.) need to be on file for a review to begin.

going back to your specific questions, i am suprised you can't apply for a license until you have a job. is that a state requirement where you practice? if the employer is aware that it will take 3 months time for credentialling to go through, then i would assume they are willing to take the time for you to finish the process and have you on board once the process is completed. my first job as an np, i did not start until 3 months later per my request as i was tied up with a prior professional commitment. my second and current np job, i waited more than 3 months before i started because of credentialling which worked out great with my prior np job because i was able to give enough notice that i was leaving.

Ren25, ACNP · Jun 19, 2008

Thanks for they reply...

Actually, the hospital credentialing process can take 2 months or more, I was told. The earliest I can get my NP license is late August/early Sept b/c I must have a collaborating physician for licensure. So the hospital credentialing won't begin until I have the license. But yes, the employer is aware according to the recruiter so hopefully it'll turn out ok.

Advanced Practice Columnist / Guide · Jun 20, 2008

Thanks for they reply...
Actually, the hospital credentialing process can take 2 months or more, I was told. The earliest I can get my NP license is late August/early Sept b/c I must have a collaborating physician for licensure. So the hospital credentialing won't begin until I have the license. But yes, the employer is aware according to the recruiter so hopefully it'll turn out ok.

So if this service already hired you, can the main collaborating physician or the service chief sign a collaborative agreement with you now so that you can get your state license and start the credentialling process? May I ask which state this is that requires a collaborative agreement prior to licensing of NP's?

Ren25, ACNP · Jun 20, 2008

I'm in north carolina. Yes, in order to apply for my license the physician has to sign as the collaborating physician.

core0 · Jun 20, 2008

North Carolinas system is a little confusing. You first need to apply for registration. You do not need a collaborating physician for this. Once you get your registration you can then apply for approval to practice. This does need a supervising physician. After you turn this in you should get your interim license within two weeks. You should be able to use this to get practice privileges (this will not include prescriptive authority). Your application will then be acted upon at the next nursing board meeting and they you will get your license with a prescribing number.

You should be able to do credentialing with an interim number. They will usually just stipulate that you have to have a full license without stipulation to prescribe. Also while a lot of hospitals say its three months to credential, if you are a new grad and keep on them it should take less time. Make sure you have everything in by the appropriate dates. Finally while it is getting less common, ask about temporary privileges. Some hospitals still have them.

David Carpenter, PA-C

jemrn56 · Jun 21, 2008

My first PNP job was in NC in 1994. I was able to function as a NP Applicant until the NC Board of medical examiners approved my license at their scheduled meeting 2 months after my application was rec'd. I worked in a private practice so I did not apply for hospital privleges until I rec'd my "official" NP license. Does your supervising MD have a private practice where you can work until your hospital privleges are final? I rarely worked a 40 hr week in a private practice; I negotiated for a half day off and the following yr a full day off and more money. Good luck on your new position!