APRN Employment Contract Critique

Nursing educational advancements showcase a commitment to delivering high-quality and effective healthcare. Nurse practitioners are advanced-level professionals who play a role in bridging apparent gaps in modern healthcare. With varying nurse regulations and care environments, a definitive working framework is necessitated to curtail potential role confusion and conflicts between providers, their employers, and the system in its entirety. Employment contracts provide a structure for qualified NPs to provide valuable care services to patients in their jurisdiction. They outline the responsibilities of the providers, terms of employment, and any other information that may influence NPs’ operationalization within the organization. The objective of this article is to analyze and critique the APRN contract indexed in Appendix A.

Scope of Services

Advanced Practice Registered Nurses (APRNs) epitomize a high level of nursing care. Nonetheless, diversification in their roles and healthcare positions yields different specialties and translates to patient-level services provided by the nurses. Likewise, variations exist in regulating nursing practice and the practice environment across jurisdictions (Schlunegger et al., 2021). This warrants the inclusion of the scope of services provided by an APRN in an employment contract. The contract identifies pain management as an area of care in which the NP is expected to be discharged. However, the contract does not outline the specific responsibilities and duties of the position. To enhance the clarity of the employment position to which the contract is referring, clauses on the NPs’ roles and responsibilities ought to have been inserted.

Compensation

Compensation remains integral to service provision among APRNs. With an expanded role in care delivery, NPs command a competitive compensation that is commensurate to the services they provide. It is thus important that NPs can negotiate the form and volume of compensation (Scott et al., 2023). The provided contract outlines the form and volume of the compensation. It also mentions other compensation particulars, such as the frequency and growth prospects. Additionally, the organization voices its commitment to cover the logistical costs incurred when pursuing continuous education, such as transportation and accommodation. The corporation also pays the Health Professions Bureau fees for the employee.

Through the contract, the organization preserves transportation costs as an employee expense and does not shelve its compensation. The organization will, however, compensate the NP when they travel outside to further organizational interests, such as attending meetings, conferences, and educational programs. While particulars of on-call compensations are not clearly outlined, the organization reiterates its commitment to a value-based compensation that considers the NPs’ responsibilities and productivity and rewards them financially. The contract also mentions potential bonuses that the employee may get. As evident in the contract, the organization is skewed towards performance-based bonuses based on the performance of the employee. Performance-based bonuses and rewards are not a preserve of the organization but rather a common practice among value-based organizations (Fardousi et al., 2022). NPs, in this respect, should be ready to perform at a high level to receive the bonuses.

Duration of Employment

The contract clearly outlines the duration of employment. As evident therein, the contract duration is one year, with an option to renew for five years. The duration of employment is one of the highlights of all contractual agreements between an employer and an employee. It is a legal clause that signifies the validity of the terms of the contract (Martins, 2021). To the employer, it offers a sense of job security. Including the clause on duration of employment was thus warranted.

How the Agreement will be Altered or Updated

Contractual agreements are sometimes considered living documents that can be modified based on mutually agreed provisions. While there are no legal mandates to include modification clauses on existing contracts, including them often gives a sense of flexibility and recognition of dynamicity within organization operationalization frameworks (Niezna & Davidov, 2023). The contract under scrutiny does not contain a clause for future modification to the document. It, however, highlights possible grounds for termination. Adding a clause on possible contract addendum and amendments will demonstrate the livity of the contract. Notwithstanding, the NP can negotiate the terms of the contract based on a mutual understanding of the need to modify them.

Responsibility for Maintaining and Paying for Credentials

The responsibility to pay for and maintain credentials consistent with the qualification of the employee is shelved for the nurse. The contract requires that the NPs possess a valid state license for NPs. Failure to provide the document results in the cessation of salary and other benefits. It is not typical for healthcare organizations to cover the licensing cost for NPs.

Benefits

The contract outlines potential benefits the employee is subject to. As evident in the contract, the employee will be eligible for paid time off and vacation time as outlined. While there are no federal laws requiring organizations to provide paid time off and vacation times for their employees, the practice is common within the healthcare sector (Davison & Blackburn, 2022). It works to enhance caregiver wellness and can prevent burnout and fatigue accustomed to high work burdens and the challenging clinical environment. It was thus crucial that the contract capture the paid time offs and vacation times the NP is eligible for.

Paid conferences and continuous education are other benefits the NPs will receive per the contract. The organization voices its commitment to capacity development through continuous education. As evident in the contract, the organization will organize educational sessions for the NPs and provide grounds for attending external educational events that may not be related to the job description. In this case, the NP may attend an educational session unrelated to their roles in pain management upon a formal application and approval of the same. Likewise, the company will cover the logistical costs required to facilitate the educational event.

Restriction on Competition

The contract has a non-compete clause that is triggered upon dissolution or termination and remains active for two years. The clause restricts the NP’s ability to be employed within a 50-mile radius of the facility and requires that the proportion of patients served for pain management not exceed ten percent. Non-compete clauses are protective mechanisms that employers use to protect their interests. They prevent employees from using the information and skills acquired during employment to start similar businesses (Gilman, 2024).

Reasons for Termination

The contract outlines the reasons for termination. In this case, the NP’s contract may be terminated when the contract is breached, the employer violates any federal or state laws, does not meet the performance target of the organization, or desires to leave. The inclusion of a reason for termination is a legal imperative in formal employment contracts (Niezna & Davidov, 2023). It was thus important that the clause of contract termination be included in the contractual agreement under scrutiny.

The Extent of Support Service to be Offered to the NP

The contract outlines the number of hours the NP is expected to work and the secretarial support available. Per the contract, the NP will work from Monday to Friday within the designated hours, with Saturday work hours only scheduled when necessary. Likewise, secretarial services will be provided within the working hours. These provisions provide meaningful clarity on the expected conduct of the APRN and are consistent with other contractual agreements. Understanding the extent of services offered to them allows NPs to have a clear picture of what they are getting into and what their normal day at work looks like (de Leede-Brunsveld et al., 2023). This enables them to plan and prepare adequately for their roles.

Expectations Regarding Non-Clinical Work to be Done by NP

The contract does not highlight potential non-clinical work that the nurse will be expected to perform. It, however, requires that NPs attend educational programs to bolster their capacity in pain management. Non-clinical work, such as advocacy, is crucial to nursing advancements and should be included in contractual agreements between NPs and their employers (de Leede-Brunsveld et al., 2023).

Release to the NP of the NP’s Quality Performance as Measured By Health Plan Auditors

The contract does not indicate whether the NP will be provided with audit reports on their quality performance. However, including clauses on whether audit reports will be performed and the results communicated to NPs is crucial. This will allow the NP to prepare for the audits and utilize the findings for self-improvement (de Leede-Brunsveld et al., 2023). The highlighted contract details pertinent aspects of APRNs’ contractual agreements. While the contract included vital components such as compensation, duration of employment, reasons for termination, and benefits, it fell short of addressing some aspects integral to the contemporary APRN landscape, such as responsibilities. Contractual agreements between APRNs and their employers should be detailed to capture all aspects that may influence the operationalizations of NPs.

References

Davison, H. K., & Blackburn, A. S. (2022). The case for offering paid leave: Benefits to the employer, employee, and Society. Compensation & Benefits Review, 55(1), 3–18. https://doi.org/10.1177/08863687221131728

de Leede-Brunsveld, S. F., Bleijenberg, N., Verhoef, J., Holtkamp, C., & van Vught, J. A. (2023). Nurse Practitioners in Community Health Care: A Rapid scoping review of their role, tasks, responsibilities, and implementation in Northwest Europe. Health & Social Care in the Community, 2023, 1–18. https://doi.org/10.1155/2023/6678458

Fardousi, N., Nunes da Silva, E., Kovacs, R., Borghi, J., Barreto, J. O., Kristensen, S. R., Sampaio, J., Shimizu, H. E., Gomes, L. B., Russo, L. X., Gurgel, G. D., & Powell-Jackson, T. (2022). Performance bonuses and the quality of primary health care delivered by Family Health Teams in Brazil: A difference-in-differences analysis. PLOS Medicine, 19(7). https://doi.org/10.1371/journal.pmed.1004033

Gilman, D. J. (2024). A competition perspective on physician non-compete agreements. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 61. https://doi.org/10.1177/00469580241237621

Martins, P. S. (2021). Should the maximum duration of fixed-term contracts increase in recessions? evidence from a law reform. International Review of Law and Economics, 68, 106009. https://doi.org/10.1016/j.irle.2021.106009

Niezna, M., & Davidov, G. (2023). Consent in contracts of employment. The Modern Law Review, 86(5), 1134–1165. https://doi.org/10.1111/1468-2230.12802

Schlunegger, M. C., Aeschlimann, S., Palm, R., & Zumstein-Shaha, M. (2021). Competencies and scope of practice of nurse practitioners in Primary Health Care: A scoping review protocol. JBI Evidence Synthesis, 19(4), 899–905. https://doi.org/10.11124/jbies-20-00554

Scott, C., Sackmaster, S., Schembre, D., Rice, G. M., & Vicari, J. (2023). Best practice recommendation: Advanced practice providers contract terms and negotiations. iGIE, 2(3), 395–398. https://doi.org/10.1016/j.igie.2023.07.004

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Assignment Prompt
Students may work alone or in groups of two to three or alone. Students may not work with classmates from another section; you must work within your section with the same clinical instructor. 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 to be performed and population (pediatrics, 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
• 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
  

  APRN Employment Contract Critique

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.

Expectations

• Length: Approximately 1000-1500 words; maximum 8 pages, double-spaced, not counting the Appendices
• Appendix: Attach the sample contract as an Appendix
• Style Format: APA format with title page and references