APRN Contract Week 5: APRN Employment Contract

APRN Contract APRN Contract Week 5: APRN Employment Contract Group Critique

As a new graduate nurse practitioner, it is vital that when taking an offer for a position, a contract is clearly established. This is to ensure that the nurse practitioner is receiving what is in his or her best interest while embarking on this new scope of practice. Components of the contract or said agreement between the nurse practitioner and employer have been found to get quite complicated; therefore, the appropriate clarification and negotiation may even prompt the consideration of obtaining an attorney (Cleveland & Knoblauch, 2018). With these challenges in mind, it would be all the more important that the various categories of the employment contract are reviewed carefully before agreement to the position.

We will be critiquing as well as analyzing the contract we have obtained from nurse practitioner Eva Kim as seen in Appendix A. All personal information in the contract was excluded for the consideration of privacy.

Scope of Services and Population

With regards to the scope of services to be performed, this entails that the nurse practitioner conducts all duties that are deemed reasonable and are within the scope of practice in the state of New York (Appendix A). This was clarified in more depth in Exhibit A of the contract. Under this section, it explains that the position requires services such as consultation, direct patient care, collaboration, referral, and coordination (Appendix A).

In the event that it is necessary, direct care would involve clinical tasks like vaccinations or even phlebotomy (Appendix A). It is expected that a typical work week consists of 40 hours per week (Appendix A). In comparison, a survey done by the University of California found that nurse practitioners had an average work week of 34 to 35 hours each week with very little on call or overtime if any (California Employment Development Department, 2022). The population being cared for are pediatric patients, which range from infancy all the way up to adolescence (Appendix A). According to the National Association of Pediatric Nurse Practitioners (NAPNAP), the historic definition of pediatric care encompasses patients from birth up to 21 years old (Heuer et al., 2019).

Compensation

In terms of compensation, the rate per hour is clearly defined at $64 an hour (Appendix A). When comparing this rate to the national average, it is higher than the average of $55.05 per hour (U.S. Bureau of Labor Statistics, 2021). However, the metropolitan regions of Los Angeles, Anaheim, and Long Beach, California, have a higher annual mean wage at approximately $142,770, compared to New York’s $133,380 (U.S. Bureau of Labor Statistics, 2021).

This contract provided in Appendix A did not elaborate on the specifics of travel compensation, such as gas or mileage reimbursement, cancellations, on-call pay, or bonuses. The only mention is that there is no compensation for relocation (Appendix A).

Employment Duration

The duration of employment is outlined as a two-year contract with an automatic renewal of one year thereafter (Appendix A). However, either the employer or the employee can end the agreement with a 30-day written notice in advance (Appendix A).

Alteration of the Agreement

Changes or updates to the agreement are addressed in section 15 of the contract (Appendix A). It states that modifications can only occur with mutual agreement and permission from both parties (Appendix A).

Credentials Responsibility

Under employee benefits, the contract specifies the details concerning licensure (Appendix A). The employer is responsible for covering the full costs of licensure and the necessary Department of Education (DE) certification (Appendix A). This is beneficial, though it is not explicitly stated whether the nurse practitioner must maintain these credentials continuously to remain compliant.

Benefits

Regarding benefits, the contract states that the nurse practitioner is entitled to two weeks of vacation and all major holidays off (Appendix A). Paid time off is specified as 17 days annually (Appendix A). Additionally, up to $1,000 is allocated for continuing education, conference attendance, or professional development (Appendix A). Continuing education is vital for lifelong learning and advancing nursing professionalism (Agyepong & Okyere, 2020).

Typically, experienced nurse practitioners prefer benefits such as shorter shifts, reduced healthcare insurance costs, and higher employer matching contributions for retirement plans (Staebler & Bissinger, 2017). Nonetheless, these specific priorities may vary based on individual circumstances and institutional policies.

Competition Restrictions

Non-compete clauses restrict employees from practicing within certain regions or with specific competitors after leaving a position. Such contracts often specify a radius and time period to prevent practice within competitive markets. For instance, aesthetic aesthetic clinics may enforce non-compete clauses prohibiting former employees from practicing within 25-50 miles for at least two years to protect trade secrets and client bases.

The contract in question does not include any non-compete clause (Appendix A), which may provide greater flexibility for the nurse practitioner post-employment.

Termination

The initial employment term is two years, with automatic renewal for an additional year unless either party provides a 30-day written notice of intent to terminate (Appendix A). The contract also states that the nurse practitioner can be terminated immediately in cases of breach of contract or violation of laws, such as HIPAA (Appendix A). The termination clauses are straightforward and align with common employment practices.

Support Services

The contract does not specify details about support staff, such as medical assistants, nurses, or administrative personnel (Appendix A). Support staff plays a crucial role in primary care clinics, assisting with patient management, administrative duties, and ensuring quality care (Rimmer, 2019). The absence of specific mention could indicate that support services are provided but should ideally be clarified to prevent miscommunications.

Expectations on Patients Seen

The contract states the nurse practitioner is responsible for seeing at least 20-30 patients daily (Appendix A), which is typical for primary pediatric clinics. During pediatric rotations, seeing around 20-25 patients daily was customary. It is important for the nurse practitioner to have administrative time to complete documentation and other non-clinical tasks, though details are typically included in job descriptions rather than contracts (Appendix A).

Non-Clinical Work Expectations

While the sample contract does not specify non-clinical duties, these are often scheduled as administrative or charting time. Proper delineation of this time ensures balanced workload and compliance with productivity standards (Kleinpell & Kapu, 2017). Clear expectations regarding non-clinical duties should be documented explicitly to avoid future misunderstandings.

Performance Evaluation

Periodic performance evaluations are standard practice but are not detailed in the sample contract. Typically, evaluations may encompass productivity, patient satisfaction, and adherence to protocols (Kleinpell & Kapu, 2017). Establishing explicit criteria for performance reviews can support ongoing professional development and accountability.

Conclusion

The analyzed contract presents a clear outline of the basic employment terms but lacks certain specifics, such as non-compete clauses and detailed support staff roles. For new nurse practitioners, thoroughly reviewing all contract aspects, possibly with legal assistance, is essential to safeguarding professional interests and ensuring clarity in employment conditions. A comprehensive contract promotes a positive working environment, enhances patient safety, and contributes to the overall quality of healthcare delivery.

References

• Agyepong, E., & Okyere, E. (2020). Analysis of the concept continuing education in nursing education. Journal of Education and Educational Development, 5(1), 96–107.
• California Employment Development Department. (2022). California occupational guides. Retrieved March 18, 2022, from https://www.edd.ca.gov/
• Cleveland, K. A., & Knoblauch, D. J. (2018). Ensuring a return on your professional investment. The Nurse Practitioner, 43(10), 14–17.
• Heuer, B., Hunter, J. M., Hatton, A., Lee, A., Lofgren, M., Reyes, I., & Keesing, H. (2019). NAPNAP position statement on age parameters for pediatric nurse practitioner practice. Journal of Pediatric Health Care, 33(2), A9–A11.
• Kleinpell, R., & Kapu, A. (2017). Quality measures for nurse practitioner practice evaluation. Journal of the American Association of Nurse Practitioners. Retrieved from https://doi.org/10.1002/2327-6924.12407
• Rimmer, A. (2019). Primary care will not meet demand unless practices take on more clinical support staff, say experts. The BMJ. Retrieved from https://www.bmj.com/content/365/bmj.l932
• Staebler, S., & Bissinger, R. (2017). 2016 neonatal nurse practitioner workforce survey. Advances in Neonatal Care, 17(5), 331–336.
• U.S. Bureau of Labor Statistics. (2021). Nurse practitioners. Retrieved March 18, 2022, from https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm