Compensation:

Financial compensation is often on a new graduate's mind, with conversations about salary and hourly rates occupying significant time and thought. Salary is only one component of compensation. Additional areas addressed in this contract category may include work hours and other work-related conditions, profit sharing/bonus plans, recruitment incentives and billing/reimbursement practices. 
  • Salary:

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    • This is understandably a critical component of a contract. We live in a society that equates value and status to the dollar amount one makes. 

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    • What is the dollar value of the advanced practice nurse? What is appropriate compensation for an experienced, educated professional, albeit new graduate? 

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    • Many factors influence salary determination and may include:

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      • Market demand

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      • Geographical location

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      • Specific job responsibilities

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      • Type employer

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      • Specialty area

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      • Practitioner gender.

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    • An excellent resource for national salary data is the NP Central web site. 

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    • State nursing associations are often good resources for local/regional salary data. 

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  • Work hours and other work related conditions:

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    • Confirm expectations regarding work hours and other work related conditions before agreeing to salary amount. For example, you might ask:

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      • "Is time allowed in the workday for charting and telephone calls to patients?"

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      • "Is attendance at business related meetings expected and compensated for?"

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    • Consider the following: A salary of $60,000 annually represents an hourly rate of about $29.00 for a 40-hour workweek, but only $19.00 if your workweek is 60 hours long. 

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    • Define work hours, workdays and work sites. Persons are often compensated at higher rates for working evening or weekend hours as well as working at different sites, such as urgent care, a hospital or nursing home. 

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    • Pursuing such details is appropriate and will give a more accurate estimation of the actual worth of your salary.

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  • Profit sharing and bonus plan programs:

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    • Participation in these programs is a relatively new phenomenon for nurses. Many organizations have a structure that provides this benefit to physicians and administrators. APNs may or may not be included. 

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    • If this information is not readily offered, it is appropriate and recommended that you inquire about the availability of this benefit. If available, ascertain the criteria for determining bonuses. If not available, determine how open the employer is to considering instituting this benefit for APNs, especially if bonuses are available for other professional groups in the organization. 

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    • There are two excellent resources regarding bonus practices related to the advanced practice nurse:

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      • The NP Central web site - go to the salary data category; then the productivity bonus category.

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      • Buppert, Carolyn. "Employment Agreements: Clauses That Can Change an NP's Life." The Nurse Practitioner 22(8) (August 1997): 108-109, 112, 117-119.

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  • Recruitment incentives:

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    • Incentives can include relocation allowances, sign on bonuses and loan repayment.

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    • Most employers will provide a specified dollar amount to support an employee's relocation from a distance. 

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    • The availability of sign on bonuses and loan repayment programs is less common, but often available in areas where recruitment of health care professionals has been difficult such as rural or under-served areas.

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  • Billing and reimbursement practices:

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    • The advanced practice nurse should inquire about how his or her services will be billed. 

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    • These practices may influence financial compensation. This may occur either directly through salary determination, or indirectly via bonus formulations. 

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    • Recent and ongoing changes in reimbursement regulations that impact APN practice have been significant. 

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    • Please see Dr. Linda Lindeke's module on reimbursement for a more detail discussion ofthis issue. 

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