APRN Employment Contract Critique

APRN Employment Contract Critique

Advanced practice registered nurses (APRNs) are nursing professionals with advanced education in nursing beyond the registered nurse (RN) level. APRNs have either earned a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP). APRNs’ advanced level of education equips them with the required nursing skills and competencies to perform various advanced care services. APRNs can specialize in various roles, including the clinical nurse specialist (CNS), nurse practitioner (NP), certified nurse midwife (CNM), and nurse anaesthetist (CRNA) (National Council of State Boards of Nursing, n.d.). Due to their advanced levels of education, some states in the United States grant APRNs full practice authority. This enables APRNs to work as primary care providers as well as negotiate work contracts to match their level of education and scope of services. This paper will analyze, review and critique a sample APRN employment contract (SEE – Appendix)

Scope of Services to be Performed and Population

The scope of services for the NP as per the contract is to provide family care services and work in collaboration with the physician with a focus on Pain Management. The responsibilities may include pain diagnosis, care planning, medication administration, and rescheduling. These assigned NP responsibilities are in line with the NP roles as defined by the APRN Consensus Model (National Council of State Boards of Nursing, n.d.). Despite the implementation of the full practice authority, this contract limits the scope of practice of the NP regarding working independently when the physician is not on duty. This kind of arrangement has been associated with a reduced supply of NPs and access to care (Kandrack et al., 2019). Hire our assignment writing services in case your assignment is devastating you.

Compensation

Salary

As per the contract, the position attracts an annual salary package that aligns with the nation’s average. The contract also considers biweekly paychecks, which benefits the NP position. Additionally, an opportunity for an increment in salary compensation on the basis of a performance review is in line with major strategies of staff motivation toward dedication to their job roles.

Travel Compensation

The contract terms require the employee to be responsible for their travel expenses. However, compensation is provided if the travel expenses occur during out-of-town travelling to attend a meeting, conference, and other organization-related operations. The NP must provide receipts to be compensated for the costs and time.

Gas/mileage

The contract does not cover the NP’s gas or mileage, although considerations are made for the related expenses if they are related to the organization’s duties.

Cancellations

There is no clause related to compensation for cancellations.

On-Call Time

The organization may, at times, require the NP to perform all patient assessments, diagnostics, treatment, and prescription of medications when the physician is unavailable. Additionally, they will assess emergencies and authorize a referral. The NP is further expected to provide consistent patient care by being on call 24/7, supporting patients in scheduling appointments and managing their medication outside their agreed work times.

Bonuses

The contract considers financial rewards as important for good work. Although not guaranteed, such bonuses are paid annually based on NP’s value in terms of their productivity and performance. Bonuses also depend on the profitability of the corporation.

Duration of Employment

The duration of employment is one year. However, the contract is renewable for five years after the first year.

Altering or Updating the Agreement

The contract does not provide the basis for altering or updating the agreement. However, it provides the considerations for the termination of the contract.

Responsibility for Maintaining and Paying for Credentials

The contract considers credentials such as Memberships to Professional organizations as important evidence of professional development and competence. However, they are not necessarily a requirement for employment. The NP is responsible for ensuring they are a member of such associations and obtain the necessary credentials. The corporation provides corporate funding for memberships to professional bodies upon request. The corporation in the contract document agrees to pay for all certification or licensure for the NP as long as such credentials are considered beneficial to the organization and in the provision of pain management.

Benefits

Time Off And Expenses For Continuing Education

For time off, the contract requires the NP to make requests for personal leave at any point based on reasonable requirements, and if the time off does not interrupt patient care, the NP’s responsibilities or impact on the operations of the corporation. The time off will be considered part of the agreed-upon vacation time and deducted from such arrangements. Paid time off is also provided during all official national holidays. The NP will also not be compensated for the time off requested. The NP is also entitled to sick leave if the NP has an acute illness, and notice should be provided to the corporation before the sick time off.

The employing corporation commits to support the NP’s continuing education as long as the NP focuses on advancing their education in pain management. The contract agreement notes that the corporation will bear full responsibility for scheduling educational seminars for the NP’s educational advancement. For this, the corporation will also cover expenses related to transport, lodging, and meals during the seminars. The NP will, however, bear full responsibility for expenses related to continuing education outside of pain management.

Vacation Time

The NP will be allowed a 2-week vacation during their first year of employment as a part of the contract’s benefits. The patient will also be salaried during their vacation with related vacation benefits. However, other benefits not provided in the contract will not be paid during the vacation. The vacation time will be increased as well as related vacation benefits from the third year of employment in case the contract is renewed. The third year will have three weeks of vacation, and the fifth year of employment will have four weeks of vacation and benefits. The scheduling of vacation time should be communicated six weeks prior with consideration of the corporation’s physician availability and patient schedules. Requests for vacation outside of the planned dates require a written request stating reasons for the requested vacation time.

Paid Conferences or CME

The corporation covers all expenses related to continuing medical education as well as pays all benefits to the NP during related conferences.

Restriction on Competition

The employing corporation considers skills and knowledge on pain management gained during the NP’s employment and training as an important asset to the organization. Therefore, the contract has a non-compete agreement. The non-compete agreement will require the NP not to practice or be employed by another organization within a 50-mile radius of the current corporation for a period of two years. The NP will only be allowed to practice pain management if they can serve only 10 per cent of related patients within the region. Within the period of two years, the NP shall also not see any patients related to the corporation.

Reasons for Termination

The terms of termination of the contract are well set. The organization reserves the right to terminate the contract based on a performance review, NP malpractice issues that risk care quality, patient safety, and the corporation’s financial position. The NP can also choose to cancel the contract; however, a 60-day notice is required.

The Extent of Support Service to be Offered to the NP

The corporation employs secretarial support staff within its will offices through the agreed-upon work days and periods. The support staff maintains patient assistance at check-in, telephone handling, patient scheduling, and the direction of patient flow through the clinic day.

Expectations Regarding the Number of Patients seen per Day

There is no stated number of patients that the NP is expected to see in a day. However, NP is expected to work from Monday through Friday between 8:00 am to 4:30 pm and a total of 40 hours a week. Other on-call times may be arranged on Saturdays and Sundays based on patient requests or, when necessary, as per the patient’s load. Hours beyond the 40-hour work week are compensated at the normal hourly rate of $40 an hour.

Expectations Regarding Non-Clinical Work to be done by NP

The NP is expected to engage in other non-clinical work per the corporation’s requests and to the extent of validity of the contract, such as presenting the corporation in a professional capacity.

Release to the NP of the NPs Quality Performance as Measured by Health Plan Auditors

Performance evaluation will be done annually. The results will be released in accordance with applicable state and federal guidelines regarding prescriptive issues and quality performance.

Conclusion

In conclusion, nursing employment contracts are agreements that bind the employer and the employee and ensure both remain responsible and accountable to their respective capacities. Nursing employment contracts are important because they help an interested applicant determine what to expect, such as their salaries, benefits, hours of employment, and contract termination terms.

References

Kandrack, R., Barnes, H., & Martsolf, G. R. (2019). Nurse Practitioner Scope of Practice Regulations and Nurse Practitioner Supply. Medical Care Research and Review, 78(3), 208–217. https://doi.org/10.1177/1077558719888424

National Council of State Boards of Nursing. (n.d.). APRN Campaign for Consensus. NCSBN. Retrieved January 28, 2023, from https://www.ncsbn.org/nursing-regulation/practice/aprn/aprn-consensus.page

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Students may work alone or in groups of two to three. Students will locate a sample FNP employment contract (may not use the example in the course text) and will review and analyze the contract according to the outline criteria:

Scope of services and population (paediatrics, geriatrics, family, etc.)
Compensation
Travel compensation?
Gas/mileage?
Cancellations?
On-call time?
Bonuses?
Duration of employment
How the agreement can be altered or updated
Responsibility for maintaining and paying for credentials
Benefits
Time off and expenses for continuing education
Vacation time
Paid conferences or CME
Restriction on Competition
Reasons for termination
The extent of support service to be offered to the NP
Expectations regarding the number of patients seen per day
Expectations regarding non-clinical work to be done by NP
Release to the NP of the NPs quality performance as measured by health plan auditors
This should be an APA formatted paper, and the above items should be listed as section headings where the student or group will give a brief critique under each section of the contract, using the weekly readings as guidance for the critique. As with any scholarly paper, there should be an introduction and conclusion. There should be evidence of analysis (not simply reporting the facts about the contract) by means of comparing some items (i.e. salary) to national or regional norms. Some of the sections may be combined. If the contract is missing a section, note this in the critique. Include the sample contract in the Appendix, and please remove all identifiers if using a real contract from a colleague or preceptor. Once you have submitted the assignment Dropbox, please also post your final product to the discussion board for information sharing only (no responses are required, and the discussion component is not graded).