How a Nurse Practitioner Should Negotiate a Contract | Nursing Contract Negotiation

How should a nurse practitioner negotiate their NP employment contract? There are many ways to go about this. But I like to start with how much leverage you have, and when I say leverage, I mean, are you just out of school and have no experience? So, you’re going to need a lot of training and support, then you’re going to have less leverage. Are you experienced in this specialty? Have you worked there for many years? You’re not going to need much training. You can kind of hit the ground running and then you’re going to have more leverage. Also, you want to consider it depends on which state you’re in. As you know, as nurse practitioners, your scope of practice kind of depends on which state you’re in.

If you’re in Arizona, you have a lot of autonomy and you need less supervision and oversight. In more states, it’s more likely that you would need a supervising physician, depending on what kind of services you’re going to be providing. You also want to think about how much experience you have, how much training is going to be required, and how much supervision is needed in your state. That kind of gives you where you are on the leverage scale. Normally, you’re provided with an agreement. So, they’re going to hand you either an offer letter, or a letter of intent, or they’ll just start with the employment agreement and it’s going to have their terms listed on there. Now, these are negotiable, it’s customary in your industry, when you receive a contract that there’s a little bit of back and forth.

Then you’re going to look at the document itself and you’re going to see what’s important to you. And what do you want to kind of use your leverage to negotiate. Most people start with your base compensation because when you start a new job, what you’re really thinking about is the money. And I totally get that. It’s exciting. It’s attractive when you see that number on there and you want to ask for more, but I start with the non-compete clause. First, are you in a state where a non-compete clause is enforceable? If you are, I would read that very carefully and that’s the first thing I would negotiate. And the reason why I say that is because if you have an overly restrictive non-compete and your employment ends with this employer, do you have to move out of state? I mean, are there options for you? Do you know if you’re going to be in violation of this non-compete or not? That’s what I would first negotiate. Non-competes are normally for either one to three years.

I would try to negotiate it down to at least a year, if not six months. And then the area. You want to consider if this job ends, are you going to stay in the area? And if the answer to that is yes, I would negotiate that restricted area down, the mileage down. And then also, if there are multiple locations, you should try to negotiate it to only attach to your primary location. Non-compete clauses, in my opinion, are the first thing that I would try to negotiate. And then I would kind of go from there. Then you can kind of decide on your salary if you want to negotiate more. A lot of people have different strategies. They never say yes to the first number. If you feel uncomfortable with it, you can reach out to the employer and ask if they’re open to negotiating that amount.

Nurse Practitioners and Salary Negotiation

You can kind of do your research. You can speak with a contract review attorney such as myself. We’re very familiar with the industry. So, we kind of know the ranges for your salary. But when you’re negotiating your compensation, you do want to consider not just that base number but any type of bonuses, signing bonuses, relocation bonuses, any type of quality assurance or production, and patient encounters. I mean, they really vary. The scale is huge on the extra compensation you can get. You not only want to think about your base salary, but you want to think about it in relation to all those other bonuses that you could potentially be receiving. So, we’ve gone over the non-compete. I feel like that’s the most important when you’re negotiating and then your salary or compensation. Then I would probably go to sort of other benefits.

I would try to negotiate that they’re going to be giving you some type of CME, continuing medical education allowance. Typically, that’s anywhere for nurse practitioners from like 2000 to 4,000. You want to negotiate this amount because this is something you must do annually to keep your license valid. So, your employer should be giving you some type of allowance for this. And then also, I would negotiate any type of licensing fees, dues for professional organizations, and for sure your DEA license if you’re able to have one in your state because DEA licenses are expensive, and that price just keeps going up. Those sort of ancillary benefits or business expenses is something that you also want to kind of keep on your radar. Don’t just negotiate your salary, you must think bigger than that.

Another thing, you can look at your without cause termination. That means, you can give notice and then terminate your employment. You normally have to give notice anywhere from 60 to 90 days, that’s standard. However, I have seen in some rural areas or high-need areas, that the notice period is anywhere from 120 to 180 days. That means you give notice, you want out, but you have to stay there for 120 days. So, that’s another thing I would negotiate down to at the very least 90 days because that gives everybody plenty of time to fill your position, especially if there’s some bad blood there, you don’t want to be forced to hang around in a place that you don’t feel comfortable with for such a long time.

There are lots of things you can negotiate in an employment contract. Sometimes the employer will tell you that this is standard for all physicians. But I don’t think it hurts to still ask for what you think you deserve. Especially non-competes, don’t forget about your non-competes, your compensation, and don’t just think about that base salary, you have to think about your bonuses as well. And then business expense reimbursement, and then just sort of benefits, but normally, benefits are non-negotiable because they are standard. It’s just, these are the benefits, health insurance, disability, and life insurance. And that is normally standard that I would say is probably not negotiable, but everything else you want to take into consideration together.

NP Offer Letter and Contract Negotiation

What should be included benefit-wise in an offer letter for a nurse practitioner? An offer letter is normally step one of your employment with your prospective future employer. In the offer letter, it’s normally going to outline a couple of things. One is going to explain what your position is. If you’re specialized, what kind of services are you going to be providing, what location and what setting, is it a hospital, clinic, hybrid? Kind of just depends on your specialty. Normally, there will also be something in there roughly about your schedule. Sometimes it will just say 40 hours, or it may break it up if you’re helping in the OR, or a hospital setting will say 70% this, 30% in the clinic.

And it may discuss if you have any call duties, so like nights or weekends, that’s typically included in an offer letter as well. Now, let’s talk about the benefits. What benefits are going to be included in that offer letter? Let’s start with some of your health benefits. Normally, you don’t get a detailed outline or even a benefits package at this level when you’re just first receiving your offer letter. Once you receive the offer letter, it will normally just state that you will get some sort of health insurance, vision, dental, life insurance disability, maybe long term, short term, and then some type of retirement. And it’s not going to say a detailed explanation of how much each policy is going to pay out, like all that stuff. That’s going to be in a benefits summary or a benefits package. Sometimes that’s included later in your employment agreement, but when we’re just at the level of your offer letter, it just states this is what they provide.

So, that’s going to be the number one, probably it’s just going to outline them briefly, just say the name of what it is. Then the next set of benefits you’re sort of like your ancillary benefits. Those are normally included also in your offer letter. That’s going to include any type of continuing education allowance, licensing, fees, dues, especially a DEA license right now. Those are normally always included in there. If you have any type of board expenses that they’re going to be paying for, that also would be in there, and then also for sure, it will be your compensation. Probably the number one thing you want to look at is what is your compensation and how is it calculated? And then PTO time will also be in there as well.

How much you’re offered if you have any additional PTO days for continuing education, that’s something you always want to look out for as well. And then any type of signing bonus or relocation bonus, all of those will be in the offer letter. The purpose of the offer letter is to start the process of negotiating and to start the process of you becoming an employee. Now, if you sign an offer letter, you’re not agreeing to become employed by the practice. You’re agreeing to enter into negotiations for your employment. And normally, offer letters are pretty good, too. They’re going to be forthcoming with your benefits because they want to entice you to become an employee. So, they’re going to show you all the good stuff right up front.

Your benefits should always be included. You’re going to look for all those health benefits like we just talked about retirement but go further and look and make sure there’s continuing education, there’s reimbursement for those expenses like dues, licensing fees, DEA license, any type of boards that you may be taking, all that kind of stuff you’ll want to look for as well. And then lastly, always look for PTO, how much you’re getting, and look, are you able to calculate it? Sometimes it gets a little confusing. I know it’s popular right now to do a four-day work week, but when your PTO time is calculated in hours, sometimes that can get a little confusing. So, you may want to reach out and ask them to clarify what that is, and how many weeks is that with your four-day work week if that makes sense.

How to Negotiate a Nursing Contract 

Now, you want to be careful, read it carefully. There could be some sort of bonuses or non-competes that would apply, but you are allowed out of the contract. It’s a huge red flag if there’s no way to terminate the agreement. You could be stuck in this contract for however many years unless the other party breaches or you’re let out of the agreement. So, this is a huge red flag. Always look for a without cause termination. And then you want to look for how many days’ notice you must give before you can get out of that contract. Another big red flag I see a lot is overly restrictive non-compete clauses. It kind of depends on the laws of your state. But you want to read your employment agreement carefully because non-competes can be kind of sneaky. Sometimes they go by different names, or you don’t understand what a restrictive covenant is, which is just a promise not to do something.

You’re promising not to compete with your employer. But you want to be careful that you fully understand what that non-compete is restricting. For how long, normally, that’s straightforward, but when we get to red flags, it’s normally the area that you’re restricted for. It could be too many miles. If you are in New York City and they’re restricting you 20 miles, well, that takes out a huge area. That would be a huge red flag. And then also, you want to consider how many locations your non-compete applies to. It’s a red flag if you are restricted from all the locations of the practice even if you don’t provide services there. Another red flag is if you are restricted from locations where you provide any services for.

Considerations to Make About Your Nurse Practitioner Employment Contracts

Newly minted nurses who have completed their education and received their certification to practice nursing are justifiably excited about the opportunity to finally work in the career field that they have been training for their entire life. When they receive their first job offer, they are over the moon. Caution is advised in these moments though. The contracts that nurses receive to begin work at a specific facility are very detailed, and it is smart to keep a level head about things in order to put yourself in the best possible position as far as contract negotiations are concerned. 

There are several factors that every nurse should look over when they are handed their contract and asked to sign. They may even consider hiring a nurse practitioner contract attorney to review their paperwork with them to ensure that everything seems correct. 

Salary

Everyone goes to work to earn money, it is as plain and simple as that. Yes, nurses also often find great satisfaction in the work that they do, but they will still tell you that they wouldn’t do this work if there were no money involved. No one can blame a nurse for wanting to make a living for themselves. 

Nurse.org gives the statistics about what a nurse may expect to make: 

In addition to being professionally and emotionally gratifying, becoming a nurse practitioner provides the security of knowing you’ve chosen a career that has tremendous job security and is also financially rewarding. The average nurse practitioner salary is $111,680 according to the U.S. Bureau of Labor Statistics as of May 2020.

Not every nurse makes that much annually. That figure is an average, and that average includes nurses with many decades of experience. It also includes nurses who work in many different states with the various salary expectations that come in those states. Clearly, there will always be some variation from state to state and even based on the experience level of the nurse. However, this gives you some idea about how much a given nurse can demand as her salary. 

A Lawyer Will be Happy to Help with your NP Contract

We have plenty of experienced lawyers who will be happy to help you through the entire contract process that you are working through at this time. They specialize in these types of contracts (and independent contractor agreements), and they will make sure of the following: 

• Your contract is written in a way that abides by all local, state, and federal laws
• You have the benefits that you desire from your contract
• There are no hidden clauses or stipulations that you need to be aware of 
• Your malpractice insurance and tail costs are taken care of

Essentially, our lawyers will stand by you and be your biggest advocate in this whole process. We only need to be compensated for the time that it takes to read and go over your contract. If you will contact us today, we can start to look over the critical elements that make up your contract for you. We know that you want to get started on your new job as soon as possible, and we want that for you as well. Just give us the chance to make sure everything is tied up nicely for you before you do so.