APRN Employment Contract Critique
Family Nurse Practitioners (FNPs) are nurses who have advanced training and are usually registered. They work with other health care professionals to give care that is focused on the whole family. These types of nurses can work in a variety of clinical settings, including traditional doctor’s offices and hospitals as well as private homes and clinics.
They are known to lay a high focus on the need for general health promotion and prevention of infections and to provide treatment for every type of sickness that affects any community member. As these individuals seek employment, they are typically expected to negotiate an employment contract in order to prepare, investigate, and offer precise and substantial terms.
For instance, these doctors should be able to articulate and explain in a professional manner why they deserve the remuneration they are requesting in relation to the anticipated earnings of their services. Consequently, this paper is a review, analysis, and evaluation of a sample FNP employment contract based on the primary aspects included in various contract types.
At JJC medical center, the FNP will help patients deal with their pain. The contract was quite ambiguous regarding the family nurse practitioner’s responsibilities. The particular ages of the group receiving pain care were not specified in the contract.
No information was supplied regarding the sort of analgesia, either opioid or nonopioid, that will be administered to patients. FNP play a key role in the therapy of severe pain, and it has been demonstrated that its administration reduces patients’ pain and improves their ability to function (Arends et al., 2020). More detail about the nurse practitioner’s duties should have been included in the agreement.
In the state of California, the annual average salary for the position of a nurse practitioner is $ 123,111 (Salary.com, 2022). According to the contract, it is not clear how many years of experience the FNP has; nonetheless, the annual compensation that is standard for an FNP in the united states is 116,500 dollars on average (Salary.com, 2022).
This contract provides compensation that is less than the state of California’s typical annual pay. The contract specifies that it will be evaluated after 6 months, but it does not indicate if the salary would be increased considering the performance.
Travel, Gas, or Mileage Compensations
The contract stipulates that transportation compensation for out-of-state meetings or education will be supplied if it is necessary for the practitioner’s job. Henceforth, no compensation for transportation in-state conferences or meetings. This is comparable to the perks provided by other occupations; however, some firms offer reimbursement for gas mileage over a predetermined threshold (He, 2021).
Gas or mileage can be used to describe car allowances. This compensation applies when a contract permits workers to use their own vehicles, and the employer reimburses all expenses (He, 2021). The mileage compensation varies based on the number of miles driven.
This type of perk has a big drawback in that it is impossible to compute the actual amount of gas spent or to create proper expenditure reports and logs (He, 2021). In addition, the cancellation procedure is not included in the contract.
The contract stipulates that the FNP must be on-call at certain specified times to fill in for the physician. There is no mention in the contract regarding whether or not the service provider will receive additional compensation for being on call. When someone is required to work on-call, they typically receive additional remuneration for their time.
Additionally, the provider will be required to work on the weekends, but they will not receive any additional compensation for their efforts, either for working overtime or on the weekends. This agreement does not include the benefits that are provided by other FNP jobs, such as compensation for working extra hours or being on call.
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The payment of an annual bonus will be taken into consideration, considering the productivity, but the payment of such a bonus is not guaranteed. In the contract, the FNP’s performance will be judged on how on-time, well-documented, accurate, and accountable they are.
Duration of Employment and How the Agreement can Be Altered
The length of the employment contract is set at one year, but after that period of time has passed, the provider has the opportunity to extend their contract for an additional five years. Contracts for a number of occupations that are comparable typically last for one year and include an option to extend them for an additional number of years after that.
Even though the contract is only valid for one year, either party might choose to end it early if the expected requirements are not satisfied.
The agreement might be revised to include the demographic for which the provider will offer care. Additionally, the conditions of the agreement regarding reimbursement when on call, putting in overtime, as well as serving duties on the weekends should be brought up to date (Duquesne University, 2022).
Additionally, the compensation is lower than the state’s typical annual salary for residents of the same state. It would be beneficial to raise the compensation in order to make it more comparable to the opportunities that are now available in the nearby region.
Responsibility Credentials and Benefits
The contract stipulates that the service provider is responsible for keeping a license, as this is a condition of the position. The contract makes no mention of FNP reimbursement for license renewal. The supplier would also cover the prescribed expenses.
The contract specifies that failing to keep a valid license will result in suspension or termination from the position. Compensation for license renewal, as well as prescriptive expenses, ought to have been included in the agreement since the provider needs them to carry out the tasks for which they were contracted (Duquesne University, 2022).
Time Off, Vacations, and Continuing Education
The corporation encourages continuous education and will compensate FNPs for expenses incurred in furthering their education. When necessary for further education, housing, transportation, and meals would also be supplied. In addition, compensation for professional membership fees will be granted.
The fact that the company encourages its providers to participate in continuing education is significant not only because doing so is required for the renewal of the provider’s license but also because doing so gives the provider the incentive to understand evidence-based recommendations, which in turn improves the quality of healthcare services which is being delivered (AANP, 2022).
Providers are paid time off for holidays like New Year’s Eve as well or Christmas day. However, this paid time off is not counted toward the vacation time of the employee. In the event that a provider needs to take personal leave for any reason, that time will be subtracted from the total amount of vacation time that is available to them.
First-year employees receive 2 weeks of vacation, which increases to 3 in the third and 4 weeks in the 5th year of service. A minimum of six weeks’ notice is required prior to vacation approval. This employer provides only 2 weeks of vacation in the first year is inadequate compared to similar industries. New FNPs should be given at least 3 or 4 weeks of vacation (AANP, 2022).
The employer provides health insurance, and the practitioner is authorized to select the desired health insurance plan. The provider is also covered by liability insurance; however, it would fall under the physician’s policy. A provider should have occurrence-based insurance that covers them not only while they are employed but also after they have left their current position (AANP, 2022).
Restriction on Competition
The employer enforces the non-compete clause to prevent the employee from using the particular pain management skills they have gained at a neighboring competitor’s facility. The goal of the competition policy is to prohibit the hospital from exposing an excessive amount of information about its operations in order to give an edge to its competitors (AHLA, n.d.).
The non-compete agreement that is used by JJC health center is one of the laxest in the industry because it permits foregoing employees to work anywhere outside of a 50-mile effective range. Nevertheless, the clause permitting NPs to treat corporation-affiliated patients should be lenient. In a rule that seems unnecessary, the clause says that the NPs cannot take patients from the company and find new ones for themselves within two years after the contract ends.
Patients are emotional creatures similar to everyone else and could form a favorable attachment to the NP (Arends et al., 2020). People should not be denied access to the practice of their choice, regardless of where that NP is located.
Reasons for Termination
A sad fact about a contract is that it can be dissolved if certain requirements are not satisfied by any party involved. At JJC medical term, the agreement can be dissolved for a range of reasons such as a violation of its provisions by either side, the NP’s performance, the employer’s financial situation, or the NP’s desire to leave the practice for individual matters.
If any side wishes to end the deal, they must provide a written explanation within sixty days. The rule ought not to be followed in this instance since the worker could be abandoning the job due to an unexpected emergency.
However, if the employee’s actions endanger the health and safety of patients, waiting 60 days to terminate the employee may be unjust to JJC health center. Failure to follow the HIPAA rules, which puts patients and employers at risk, is a serious issue that needs to be fixed right away.
The Extent of Support Service to be Offered
Organizations should endeavor to offer NPs ample chances and support. The JJC medical center offers educational seminars to further the practice of pain treatment. The company will benefit greatly from the NPs’ increased knowledge since they will provide excellent care for patients.
On the contrary, one could contend that financing the NP’s continued education could be counterproductive, as the NP may quit after completing their degree. In this case, the employer would have endured a loss. Additionally, the organization should endeavor to provide more transportation options for employees. Most companies offer transport services for their workers (AANP, 2022).
Furthermore, extra support services should be introduced to help employees love their work and remain at their workplace (AANP, 2022). For NPs with babies and toddlers, additional amenities should include complimentary meals and a daycare center. As a result, NPs will be motivated to do their best work on a regular basis since they will feel appreciated.
Expectations of the Number of Patients to be seen Per Day
On average, it is estimated that the NP should examine 20 patients per day. Less than twenty patients per day would imply that the service is not sufficiently profitable (Weber, 2019). When designating a number, the organization should be acutely conscious of the condition of its personnel and mindful of their wellbeing.
The agreement should be clear and fair when it comes to the number of patients that can be seen on a given day. The first step in determining a suitable number of patients is determining how many patients a nurse practitioner may safely manage in a day (Weber, 2019).
The subsequent step is to assess how many clients can be evaluated in 9.5 hours, given logistical constraints (Weber, 2019). The JJC health center needs 9 hours of community service from Monday to Friday. In addition to this, the organization needs to consider the patients’ mobility, the extent of their communication skills, and the operational configuration of the hospital.
Expectations Considering Non-Clinical Work
Non-clinical work-related tasks can be performed by NPs at their location of employment. Non-clinical roles help to achieve organizational goals (Brom et al., 2018). They could assist in clinical research. Clinical research aids the hospital in developing innovative approaches to resolving problems and enables the NP to increase their knowledge base (Brom et al., 2018).
Positively, given that both parties expect to gain, this might be termed a win-win situation. On the other hand, the nurse is pressured to execute activities in which they lack experience, leading to inaccuracies. The JJC healthcare system requires NPs to provide secretarial assistance. They can also serve in administrative capacities, such as receptionist or scribe duties, or even as patient advocates or advocates for the underserved.
The Practitioners should be evaluated in order to improve their performance on the job. Acknowledging and correcting NPs’ shortcomings is one of the main goals of the evaluation process (Arends et al., 2020). The contract stipulates that completeness, accountability, correctness, and compliance must be considered throughout the evaluation of an NP’s performance.
However, the company must give all the necessary tools for the completion of these responsibilities in order to avoid being perceived as hypocritical and asking too much of the NPs. Every nurse practitioner should receive an individual answer from a health plan auditor, highlighting the areas in which they need to work on (Arends et al., 2020).
Each nurse practitioner should have a clear annual plan detailing their professional goals for the future year, which auditors are responsible for ensuring they have. Overall, the method of releasing excellent performance data should be consistent and non-coercive so that NPs feel that they are an integral part of the business (Arends et al., 2020). If the NPs are handled well during the process, they will try to follow the published guidelines.
To conclude, an attorney should be brought in to analyze any and all contracts to ensure that any anomalies are found and that the deal is fair. For the price of seeking legal advice to review the contract, studies show this service can be invaluable in helping NPs better understand their contracts and help them negotiate new contracts or revise old ones.
As with all NPs contracts that are unique, the second set of eyes can help ensure that both sides are getting what they want out of this agreement. This contract, too, appears to have emphasized and explored essential aspects in great depth.
AANP. (2022). Employment negotiations. American Association of Nurse Practitioners. https://www.aanp.org/practice/practice-management/employment-negotiations
AHLA. (n.d.). Ama-Assn.Org. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/ama-foundation/legal-operational-guide-free-medical-clinics.pdf
Arends, R., Anderson Elverson, C., Pike Keefner, T., & Mylant, M. (2020). Screening, brief intervention, and referral to treatment training for family nurse practitioner students. Journal of the American Association of Nurse Practitioners, 33(5), 375–382. https://doi.org/10.1097/JXX.0000000000000423
Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners, 30(3), 120–130. https://doi.org/10.1097/JXX.0000000000000023
Duquesne University. (2022, May 26). How to negotiate a nursing salary. Duquesne University School of Nursing. https://onlinenursing.duq.edu/blog/nurse-practitioner-contract-negotiation/
He, T. (2021, March 4). Medical mileage deduction: Everything you need to know. TripLog. https://triplogmileage.com/small-business/everything-you-need-to-know-about-the-medical-mileage-deduction/
Personal Support Worker HQ. (n.d.). Nurse practitioner salary in California explained (2022). Personalsupportworkerhq.Com. https://personalsupportworkerhq.com/california-nurse-practitioner-salary/
Salary.com. (2022). Nurse Practitioner salary in California City, CA. Salary.Com. https://www.salary.com/research/salary/benchmark/nurse-practitioner-salary/california-city-ca
Weber, D. O. (2019). How Many Patients Can a Primary Care Physician Treat? Physicianleaders.Org. https://www.physicianleaders.org/news/how-many-patients-can-primary-care-physician-treat
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