APRN Employment Contract Critique: Key Clauses Analyzed

Introduction

An employment contract is defined as the agreement between an employee and an employer governing the terms of their employment relationship. Contracts may be temporary, permanent, or independent. When nurse practitioners are looking for employment, they search for positions that best suit their skills, abilities, and experience (Brodie, 2011). After a nurse practitioner has been interviewed and offered a job, the most important step becomes contract negotiation. Bargaining for salary is one of the most crucial aspects of that process, as it is the first step toward achieving personal and career goals.

The responsibility of a family nurse practitioner (FNP) is to provide primary medical care to patients ranging from children to adults. This essay provides a critique of a sample nurse practitioner employment contract (included in the appendices). The critique addresses various factors including compensation, bonuses, on-call time, vacation, restrictions on competition, expectations regarding the number of patients seen daily, expectations regarding non-clinical work, support services to be offered to the NP, travel compensation, mileage, time off, reasons for termination, and other relevant provisions.

A nurse practitioner deals with a wide range of health services for both children and adults. These services include the diagnosis and management of acute and chronic health problems.

Compensation and Travel Reimbursement

Compensation in this context refers to the money paid to an NP for the services they provide to a hospital or medical center. A nurse practitioner should receive an average wage of $111,375, excluding overtime and bonuses. The average salary also depends on years of experience. In the United States, an entry-level nurse practitioner will earn approximately $97,000 per year. Nurse practitioners with three to nine years of experience earn approximately $110,000 to $119,000. Given the nature of their profession, their specialized skills, and their societal importance, they should at no point be paid below $90,000 annually. Salaries may vary from one hospital to another. Top-paying employers for nurse practitioners in the United States include Signify Health, which pays NPs $492,455 annually, and UCLA Health, which pays NPs $180,406 annually (Dillon & Hoyson, 2014). The employment contract should ensure that nurse practitioner salaries are no less than entry-level standards.

One positive element of the highlighted employment contract is that nurse practitioners will be paid biweekly. This is beneficial because, particularly in the context of economic uncertainty such as that brought on by the COVID-19 pandemic, more frequent payment helps cushion employees from financial hardship.

Nurse practitioners — especially family nurse practitioners who travel to provide care in patients' homes — need to be compensated for time spent traveling on work assignments. Transportation is generally the employee's responsibility; however, the company is required to cover travel expenses when the NP travels out of town or attends conferences on behalf of the firm. Travel compensation functions similarly to overtime payment, and the NP is required to submit the appropriate forms to ensure accurate disbursement without complications.

Gas and mileage reimbursement is part of travel compensation. While it is ordinarily the NP's responsibility to cover transportation costs, if the NP is sent on a mission outside the hospital, the firm should bear the associated costs, as such travel falls outside the NP's personal budget. The NP is required to complete a reimbursement form and retain receipts as evidence of extra fuel costs incurred.

On-Call Time, Bonuses, and Duration of Employment

The on-call responsibility of an NP is to ensure that patients continue to receive appropriate care and remain on their prescribed medications when the physician is away. On-call time allows the nurse to receive physician instructions regarding patients currently under treatment. On-call responsibilities should not, however, infringe upon the NP's standard working hours. Despite on-call obligations, the NP has the right to work only within their assigned shift and to leave at the end of it. Any additional time spent in the hospital — including on-call time — should be treated as overtime. Nurse practitioners should also ensure they remain reachable during on-call periods to support continuity and efficiency of patient care.

Bonuses are generally not guaranteed. NPs should be evaluated every six months, with evaluations based on multiple performance factors. Nurse practitioners who perform well may receive a bonus — a measure intended to promote performance and boost morale. In the present contract, it would be beneficial to clearly state the amount that an NP may earn as a bonus upon reaching a specified performance level. Such transparency promotes fairness and equality throughout the process (Dillon & Hoyson, 2014).

The NP's contract shows that the initial employment period is one year, with options for renewal on a periodic basis. Many professionals today are employed on temporary contracts that are renewed based on performance. The nurse practitioner is expected to work from 8:00 a.m. to 4:30 p.m. Any additional hours worked beyond this schedule should be compensated with the clear consent of the human resources department.

Conclusion

PRESCRIPTIVE FEES

All state and federally regulated prescriptive fees, including DEA and state narcotic licenses, are a condition of employment and must be submitted to management prior to employment for verification. Current copies of these documents shall be kept on file at all times. Payment for Health Professions Bureau "Prescriptive Authority Advanced Practice Nurse" fees will be issued by the Corporation, including prescriptive authority, controlled substances registration fees, and DEA licensure verification.

COMMUNICATION

Communication devices will be supplied by the Corporation and remain corporate property for the duration of employment. Devices shall not be used for personal communication and must be returned upon departure. The employee is responsible for maintaining equipment in good condition and reporting any defects or malfunctions. Repairs and replacements are the responsibility of the Corporation.

TRANSPORTATION

Transportation is the responsibility of the employee. The Corporation will provide transportation only when the employee travels out of town for a meeting, conference, or required educational offering. All receipts must be submitted for reimbursement. Transportation to satellite offices is the employee's responsibility. Dependable transportation is an expectation of employment.

INSURANCE

Medical Insurance: The employee may select a plan within the financial parameters defined by the Corporation, and the selected plan should be submitted for corporate review with details including plan type, cost, and a contact person at the insurance company.

Malpractice Insurance: The employee will be covered under the primary physician's medical malpractice insurance for the duration of employment. The NP may also purchase separate malpractice coverage at their own expense. Upon employment, the Corporation will provide a copy of the employee's updated coverage details.

PROFESSIONAL ISSUES

The Corporation will bill the nurse practitioner's fees for the duration of the contractual agreement. It is the employee's responsibility to properly code patient superbills on the electronic medical record system, for which training will be provided. An Information Systems Security Agreement shall be signed between the employee and the Corporation. The Corporation maintains sole ownership of all patient charts, mailing lists, and electronic patient data. Use of this information outside the practice constitutes a violation of patient HIPAA rights and will be prosecuted as such.

Promotion of the Company: The employee shall represent the Corporation professionally and may participate in promotional activities including newspaper advertisements, business cards, and other printed materials. The employee's name and credentials may be used in promotional materials, and the employee shall have the opportunity to review and provide written or verbal approval of any material bearing their professional identification. Objections or suggestions will be given careful consideration. Weekend promotional events are not mandatory and will not influence the practitioner's employment status.

COOPERATIVE AGREEMENT

The primary physician of the practice, or any designated legal physician agent of the Corporation, will execute a cooperative agreement for the purpose of satisfying legal requirements for the continuing practice of the NP.

SIGNED:

_______________________________________      _______________________________________

MD                          Date                  FNP-C                          Date