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Launching Your NP Career

Launching Your NP Career. Sue Schrand, MSN, CRNP Executive Director PA Coalition of Nurse Practitioners PA State Representative for AANP sschrand@pacnp.org. Almost Time for Graduation!. Getting your data together Becoming “Board Certified” Submitting your application for licensure.

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Launching Your NP Career

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  1. Launching Your NP Career Sue Schrand, MSN, CRNPExecutive DirectorPA Coalition of Nurse PractitionersPA State Representative for AANPsschrand@pacnp.org

  2. Almost Time for Graduation! • Getting your data together • Becoming “Board Certified” • Submitting your application for licensure

  3. Professional Associations • Belong now! Take advantage of student rates • How engaged should I be? State Level National Level • Specialty Organizations

  4. Professional Associations Networking Opportunities Mentorship Continuing Education Practice and Legislative Consultations Representation in Harrisburg and Washington DC Resources: List Serve Employment/Career News

  5. Professional Associations Resources: (continued) Partnership Opportunities PA Drug Card Malpractice Coverage News AlertsFellowship / Grant / Awards Strengthens Your Negotiating Power It’s Your Professional Obligation

  6. National Certification Requirement for initial applicants as of February 7, 2005: “Shall hold current National certification in the specialty in which the professional nurse is seeking certification.” Your choice will be driven by your educational program

  7. Certification Options • American Academy of Nurse Practitioners (AANP) http://www.aanpcertification.org/ptistore/control/index Family Nurse Practitioner Adult Nurse PractitionerGerontologic Nurse Practitioner • Membership to AANP offsets testing price

  8. Certification Options American Nurses Credentialing Center (ANCC) http://www.nursecredentialing.org/Certification.aspx • Acute Care • Adult • Gerontologic • Family • Pediatric Nurse Practitioner • Family Psychiatric and Mental Health Nurse Practitioner • Adult Psychiatric and Mental Health Nurse Practitioner

  9. Certification Options • American Association of Critical Care Nurses (AACN) http://www.aacn.org/DM/MainPages/CertificationHome.aspx?menu=Certification Acute Care NP

  10. Certification Options National Certification Corporation (NCC) http://www.nccwebsite.org/Certification/default.aspx • Women’s Health • Neonatal Nurse Practitioner

  11. Certification Options Oncology Nursing Certification Corporation (ONCC) http://www.nccwebsite.org/Certification/default.aspx • Oncology Nurse Practitioner

  12. Certification Options Pediatric Nursing Certification Board (PNCB) http://www.pncb.org/ptistore/control/exams/index • Pediatric Nurse Practitioner – Acute Care • Pediatric Nurse Practitioner – Primary Care

  13. Certification Options Whichever certifying body you choose, you must request verification of current national certification to be sent directly to the Pennsylvania State Board of Nursing Copies submitted by the applicant are not accepted!

  14. Certification Options May hold multiple certifications, but know you must maintain clinical hours and continuing education specific to each area of specialty. Recertification is typically every 5 years Can be a long process, so start with every CE certificate Credentials: NP-C, BC, NP-c

  15. Licensure in Pennsylvania • Pennsylvania Bureau of Professional & Occupational Affairs (BPOA) • State Board of Nursing (SBON)has sole regulatory authority over our profession • NP Legal Designation: Certified Registered Nurse Practitioner (CRNP)

  16. Licensure in Pennsylvania SBON Requirements for Application • Active, unrestricted professional RN License • Completion of Accredited NP Program • Proof of National Certification • Maintain Professional Liability Coverage • Written Collaborative Agreement with a Pennsylvania Licensed Physician

  17. Licensure in Pennsylvania Collaborative Agreements (CA) • See “Details of Collaboration” (Pa Code) • Effective 2009, CA must be in writing • Only Rx Authority CA needs filing with SBON • Must keep Rx Authority CA at practice site • Required to show upon request

  18. Licensure in Pennsylvania 3 Documents Issued From BPOA to practice: • RN License • CRNP Certificate • Prescriptive Authority Certificate

  19. Licensure in Pennsylvania Licensure Fees RN Application $65 Initial CRNP Application $100/75 Initial Prescriptive Authority $50 Each Additional Rx Authority $30 Rx Authority Renewal $25 Rx Authority Change Form $30

  20. Licensure in Pennsylvania Where Do I Look for Scope of Practice parameters? Professional & Practical Nurse Laws Pennsylvania Code

  21. Scope of Practice Know the regulatory language Intentionally vague, so can be confusing Not written in this form: a. May insert chest tubes b. May do this, but not that…

  22. Scope of Practice Good Recordkeeping while building your portfolio: • Document hours of clinical oversight • Categorize hours of CE pertaining to specific areas of expertise • Ask for letters of summary from Department chairs, collaborators, number of cases performed

  23. Nurse Practitioner Practice • Differs state to state; know the laws! • As a professional, and it is expected of you to know your practice parameters and scope • Don’t rely on other professions to define your own

  24. Professional Liability • 1 million per occurrence / 3 million annual aggregate • Commonly Used Companies 1. Marsh Affinity 2. Nurses Service Organization (NSO)

  25. Professional Liability • My Own Coverage or Employer Coverage or both?

  26. Maintaining Professional Licensure • Cycles every 2 years • All require renewal at the same time • Renewal can be done online • Continuing Education Requirements: 30 credits bi-annually, and 16 pharmacology credits to maintain prescriptive authority • Audits of Licensees

  27. When Do I Notify The SBON? • It is your obligation to notify SBON of: Name Change Address Change Criminal History Change / DUI Change in Collaborative Agreement (Rx CA) • Ignorance is no excuse!

  28. Transitioning To NP Practice • Anxiety is a common feeling • Know where to find resources to help you Professional Associations Faculty support Mentorship • Approach clinical site placements as a career possibility

  29. Finding Your First Position • Patient Factors • Colleague Factors • Clinic Factors Szanton & Alhusen, 2010

  30. Patient Factors • Type of Practice • Patient Population • Patient Acuity • Resources Available Szanton & Alhusen, 2010

  31. Colleague Factors • Will you have positive mentorship? • Does the practice style of providers foster a learning environment? • Clinical support staff available to you? • Has the practice used NPs for providers? Szanton & Alhusen, 2010

  32. Clinic Factors • Productivity expectations? • Mission of practice—is it aligned with yours? • Technology support? • On-call requirements? • Will you be required to supervise staff? Precept students? Szanton & Alhusen, 2010

  33. Contract Negotiations Questions to be considered during interviews or negotiations: • Know background on the practice (provider mix, patient pop, etc) • How much autonomy will you have? • Will you be able to practice to your full scope of practice? • Is the practice supportive of clinical research? Precepting? Publications? • What percentage of your time will be administrative? Clinical? • Are there special skills or training required for the job (i.e biopsies, suturing, etc.) • Is patient satisfaction evaluated? • What method of performance evaluation is in place for NPs?

  34. Position Benefits • Salary • Paid time off • Education/Conference Time support • Licensure, professional association, journal support • Cell phone, Smart phone, data packages for prescribing support • DEA coverage • Liability insurance

  35. What to Negotiate? “Everything Is Negotiable” • Pay • Benefits • Schedule • Goal/Profit Sharing • Restrictive Covenants, Termination Clauses, etc.

  36. Resources • AANP Website – “Contract Negotiations for NPs” • NP Central, ADVANCE • Books (Carolyn Buppert, Sally Reel, Kevin Letz, Heidi Bourne)

  37. Resources • Market Review—know your location/practice setting Is it comparable? • Online review ADVANCE Salary Survey Salary.com Payscale.com • Corporate ‘Pay Grades’

  38. Q & A What questions can we answer for you?

  39. References www.pacnp.org www.aanp.org http://www.portal.state.pa.us/portal/server.pt/community/state_board_of_nursing/12515 Articles: Philipsen & Grandjean: Comprehensive Malpractice Insurance (2010) The Journal for Nurse Practitioners, Vol 6 (9): 703-6. Lavoir-Vaughan: Negotiating Employment Contracts (2010) ADVANCE for NPs & PAswww.advanceweb.com/NPPA Szanton, Mihaly, Alhusen& Becker: Taking charge of the challenge: Factors to consider in taking your first nurse practitioner job (2010) Journal of the American Academy of Nurse Practitioners, Vol 22 (7): 356-360

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