From Bedside Nurse ➡️ NP Student: Looking For A Job

When looking for a nurse practitioner job, you have to ensure you are looking for a position that suits your individual needs. Are you looking for a position with a ton of autonomy where you update a physician in a summary layout, with generalized updates over several patients? Or are you looking to work with a physician directly with each and every patient encounter? Each position provides a different level of responsibility, yet each opportunity is available to nurse practitioners. When looking for a nurse practitioner position, you have to ensure you obtain information on the environment, compensation, teamwork, metrics, and shiftwork. As a nurse practitioner, you are a part of a larger team, and you must ensure you have the proper support to provide high-quality care. You are transitioning from student to provider, do not take this lightly. You have to ensure to have all the information in order to make an informed decision.

Environment

When seeking employment, there are various environments you, as a nurse practitioner student, can seek to work within. From office to hospital to clinic, there are multiple settings you can work in. The goal is for you to find an environment that works best for your professional needs. Are you over the hospital setting and want more of an outpatient setting? Or are you working at a doctor's office and seeking to enter the hospital setting? It all comes down to preferences and needs. Ask yourself, "Will this setting be something I can successfully work within in 2-4 years?" Everything in life changes over time. But the setting, the structure of employment... well, that's solidified and concrete. If you have an issue with the environment from the beginning, you are going to have a difficult time. I love critical care, but I got burned out and went into outpatient. I enjoyed outpatient but ultimately went back to critical care because I missed the hospital setting. It doesn't matter how much money you make if you are missing something your current position can't provide.

Sample questions: 

• Would I be in the hospital only or would I also have hours in the clinic?
• Is there a certain amount of time or days I would need to be in a certain setting?
• Is the expectation that I present every patient to the physician? What is the process?

Compensation

When looking for a job, it's best to put many feelers out in order to get in touch with the market and find out the general pay range for your area. If you don't feel like going on several interviews, join a Facebook group about nurse practitioner students seeking employment and find out what other organizations are paying for similar positions. I had no idea where to start compensation-wise. It wasn't until I joined a Facebook group for students that I found out where to start. The goal here is to find out what to ask for because when you are asked the golden pay question, you want to ensure your number is competitive. If your number is too low, you won't recover, ever! No amount of bonuses or incentives will ever allow you to catch up to your counterparts if you start at the bottom. Time is not on your side when it comes to compensation. You have to negotiate and be purposeful in your pitch. You aren't begging for a job here. You went to school, worked your butt off, and now it's time to show just how awesome you are. I know, you want to start your first nurse practitioner job as soon as possible. But, don't allow your eagerness to trap you into a low-paying job you will later regret. Trust me, there are many organizations and businesses looking to take advantage of a nurse practitioner student looking for his or her first job. The hours are long and the patient workloads are heavy. Make sure you are compensated appropriately.

Sample questions:

• Does this organization provide bonuses or incentives for productivity?
• Is the salary determined by years of experience or another metric/scale?
• Is overtime paid out on the following pay period or at another time?

Teamwork

In terms of healthcare, work is a team effort. You have to find out what your team consists of. Will you be working with nurses, medical assistants, office managers, etc.? What does the workflow consist of where you want to work? This section is often ignored. It's not interesting or sexy and depends on you asking a series of boring questions. But, if left unanswered, can lead to your being overwhelmed in the daily tasks of general patient care. Are you expected to simply see your patients, enter orders and write notes? Or are you doing the check-in process and vital sign procurement? Don't laugh. I know many of providers who do EVERYTHING because the setting is lacking the general team. Less people mean less money, and we all know how organizations love to save money. Some places push responsibilities unto providers and boom, you're taking time to check in patients and you haven't even started the visit yet. That wouldn't matter if you didn't have to see a certain number of patients daily but most places have metrics they want you to meet. Lacking a team will cost you time and it's good to know that up front.

Sample questions:

• Does the organization provide support in the form of medical assistants or nurses?
• If there is an issue, who would I be reporting to? Can I see an organizational chart?
• What is the process regarding electronic inboxes? Is there a required response time?

Metrics

No one talks about the metrics when you are in school. You just learn about them once you start working. Most organizations expect you to see a certain amount of patients daily. Being productive means the organization is productive and utilizing its assets appropriately, and that asset is you. We all want to help people and work towards their well-being. But let's not kid ourselves here. This is a business, and these organizations treat it as such. When looking for a job, you have to ask what metrics will you be evaluated on. Some places not only have a number of patients you need to see, there is also billing and coding requirements. Some organizations might want you to have teaching hours, while others might want you to have volunteering hours. Each place will be different, but there will be a scorecard you will be judged on, and you want to make sure you are okay with that level of critique. Nowadays, organizations are looking for well-rounded employees, so they are looking for more than mere patient encounters. Asking these questions up front allows you to see what is important to your prospective employer.

Sample questions:

• How many daily patient encounters will be required? Is it daily or based on AM/PM clinics times?
• Is there a difference in new patients versus established patients required encounters?
• Would there be a requirement for training, teaching, lecturing, and/or volunteering hours?

Shiftwork

I've worked day shift only, night shift only, and a hybrid of the two. And let me tell you something, it can make or break a job. It doesn't matter how much money you are getting paid. If you can't physically do the shift or it doesn't work for your lifestyle, it's not going to work. You must ask about this as most places love to tell you what something "should" be. Oh, this should be most nights or this position is mostly days. Don't accept vague answers. We are looking for specifics here. I have three children with special needs. I must know a work schedule on a granular level in order to see if it's going to work for me and my family. This sounds like a stupid thing to ask, but you will be surprised by what you find out by merely asking about the start and end times of a position. Not every office opens at eight in the morning. Not every hospital shift is twelve hours long. You can't assume anything, and don't allow someone to make you look like a fool for asking. This search is for a prospective job, a new relationship if you will, and all questions are appropriate and necessary. 

Sample questions:

• Is there a certain amount of night shifts that are required per month? 
• Are there on-call hours and if so, are they a weekly or monthly requirement?
• Would I be alternating with one individual's schedule or is there more than one person?

BONUS LEVEL: Contract

Please, please, for the love of Florence Nightingale, read the contract multiple times and ensure everything that was discussed has been included in the contract. So often, we are so desperate for a job that we sign and overlook general documentation. Treat the contract like a document at your nursing job. Read, review and verify all the things. And remember, if it is not documented, it did not happen. You won't be able to re-do this part of the process if something isn't included or mentioned. You will be bound to this contract for several years and don't get me started on non-competes. DO NOT sign a non-compete. Ever! The job market initially seems vast. Then you start working and realize your community is small and non-competes block you from getting general employment. If you can help it, do not sign one. You never want to think about leaving a company but when it's time, you don't want any legal barriers.