Red Flags in a Nurse Practitioner Employment Contract | Nurse Practitioner Job

What are some red flags in nurse practitioner employment contracts? This is kind of a long list, but I’m going to boil it down to the most common ones that I see in an employment contract. You always want to read your contract carefully. I think we can start with a red flag. If you ever read anything that you don’t understand and cannot get clarity on, that’s a red flag. You should seek out an attorney like us who are familiar with employment contract issues. And we can explain that to you. And then if we still don’t understand it, then that’s a red flag. You want to get those words clear in your employment agreement, so you know what you’re signing and what your expectations are.

Employment Agreement with a Practice

I’d say that’s kind of the first red flag. It’s very general, just understanding the clauses that you’re signing. I’d say the second red flag I always look for in an agreement, and if I don’t see this, it’s a big red flag to me. There needs to be a clause in your employment agreement. That is a without cause termination, meaning, either party but especially yourself can terminate this agreement without any sort of reason or no reason at all. So, without cause termination, you give your notice to the practice or the group company, whatever, and normally there is a specific number of days that you have to give notice. Normally, that’s anywhere between 60 to 90 days, you’ll give your notice of termination, and then you are let out of the 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.

You’ve gone there one time during your employment, and you’re now restricted from that area. So, you want to make sure that they’re reasonable. Otherwise, that’s a huge red flag, and a lot of times, people don’t think about non-competes when they’re signing the agreement. It’s exciting. You’re starting a new job. You’re going to be making money. But you need to think about, if this ends what are my consequences or how is this going to affect me? Am I going to have to move? Do I have to move out of the state? Even so, non-competes that are overly restrictive are a huge red flag. Another red flag probably would be confusing compensation models. When you sign your contract, you should know how you’re going to be paid and when you’re going to be paid. Normally, base compensations are standard, but when you get into bonuses, sometimes they’ll say something like it’s at the sole discretion of the employer and can change at any time.

It’s kind of a red flag because you don’t know what the criteria are. You have no idea what to expect. So again, confusing compensation models, I would say, would be a red flag. Another one would probably have to be with scheduling or call expectations. Sometimes employment agreements are completely silent on that. You have no idea what the expectation is of your schedule or if you are responsible for any on-call duties. So, that would be a red flag. Typically, an agreement is going to be general, but there should be some type of language that’s going to give you an expectation of what your day-to-day is going to look like. And then going even further than that, some agreements state that you are to provide 40 hours of clinical services that don’t include any admin time.

Contract Red Flags

That’s a red flag. You definitely want to address that because you don’t want to spend hours having to finish up your charting and records before you go home every night, then you’re going to be working well over 40 hours. Just like I said, look at the schedule, the on-call duties, and does it allow for any sort of admin? And then I would say, kind of circling back, it is a red flag if you don’t have any sort of ancillary benefits or business expenses reimbursed from your practice. Now, depending on the size of the practice or clinic that you’re going to be working for or hospital, you may not receive as many business expenses reimbursement, but you should receive some. That’s going to be your CME, you should get money for your CME annually. You should get your license and your dues paid for, DEA licenses, those are expensive.

And the renewals are expensive as well. So, those are things you want to be looking out for. If you’re not receiving those, and it’s completely silent, that’s a red flag. You should bring that up with your prospective future employer. So, to kind of go back through my list, I would start with any unclear terms, that’s a red flag. Non-compete clauses that are overly restrictive, a red flag. In compensation models, you don’t know how you’re getting paid, you can’t figure it out, that’s a red flag. And then not receiving any sort of CME, licensing, dues, that can be a red flag as well, and then not knowing your schedule or on-call duties. You have no idea what to expect whenever you start there, that’s a red flag as well.

Signing an Offer Letter with a Practice

What happens after you sign an offer letter? There are two main distinctions. One, a professional could be given an offer letter and that’s it. There’s no employment contract that follows. It’s just you kind of agree to the terms of the offer letter, and then you start the job. And then the second way would be the employer asking the potential employee to sign an offer letter, agreeing to basic terms. And then at that point, they’ll incorporate those terms into an employment agreement, offer the employment agreement to the prospective employee, and then that person needs to decide if they want to sign the employment agreement and then move forward with the relationship. Let’s first go with, if you begin an offer letter with no employment agreement to follow.

In that scenario, you’re most likely in an at-will employment relationship, meaning, the agreement or the employment relationship can be terminated at any time, for any reason, with no notice, unless it’s specified in the offer letter. And then, for the most part, there wouldn’t be any kind of restrictive covenants that follow when the employment relationship ends. Restrictive covenants could include a non-solicitation agreement and a non-compete. Those are the two most common or the two that matter the most for most employees. If you do negotiate, they provide you an offer letter that just goes through basic things, such as compensation, benefits, start date, and that’s about it. I would say most licensed professionals usually would sign employment agreements. Attorneys don’t for the most part, but almost anyone in healthcare, physicians, nurse practitioners, PAs, vets, chiropractors, dentists, always sign employment agreements.

Let’s say you’re in another situation where they give you an offer letter, you agree to the terms, and then they’ll follow up the employment agreement. Now, many people ask, alright, what if I’ve signed the offer letter, but then when they give me the employment agreement, it doesn’t look so great. Do I have to go through with the job? The answer is no.  Unless there’s strange language in the offer letter that states that it’s binding, which would almost never happen if they’re going to follow up with an employment agreement. You can still negotiate terms. Let me just give you an example. Let’s say in the offer letter, it just states there’s a non-compete, but it doesn’t have any of the details of it.

So, you get the contract and then you look in the non-compete and it’s five years and covers an entire state, right? Like you will absolutely have to move out of the state if you want to continue in your profession. Well, obviously, that’s not a reasonable non-compete, but that could make a job that may have looked great at a hundred thousand a year be only worth 200,000 a year if you’re willing to accept that terrible non-compete. Even if you’ve accepted the terms of the offer letter, it doesn’t mean you have to go through and execute the employment agreement. The employer is probably going to hem and haw about, well, you agreed to the terms and now you’re coming back to us. So, I find it is most effective if you can provide some context as to why it did look good at the beginning, but after reading the actual details of the employment agreement, it’s not so good.

I think most smart employers can understand and appreciate that. If you just simply come back at them and say, no, now I want to double the salary or double the bonus or whatever it is without providing any context at all, I’m going to assume the employer is not going to be pleased with that and may even pull the offer. So, what happens when you sign an offer letter? First, an employment agreement will likely follow, and then you’ll have to determine if you want to go through with that or they’ll just give you the offer letter. It’s kind of an at-will relationship and you can leave at any time and there likely aren’t any strings attached to it at all.

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. 

Continuing Education Allowance

Nurses do not stop learning the minute that they leave whichever nursing school they attended. Those schools give them all of the basic skills that they need to become a nurse, but they also need some continuing education in order to keep up to date on the latest in the healthcare sphere and make sure they don’t miss out on any new information or procedures that they need to be aware of. Given all of this, it is often the case that employers are expected to pay for the continuing education costs of their nurses. 

Continuing education may include: 

• Renewing licenses
• Certification
• Special training classes
• Online learning materials

Anything that can help a nurse continue to develop skills and stay informed may all fall under the umbrella category of continuing education. These are exactly the types of things that nurses should demand during the employment negotiation process. After all, why should they pay the thousands of dollars per year that this training can cost? 

Health Insurance

Many hospitals and other healthcare facilities are able to insure their employees for far less than the average employer. This is due in part to the fact that they can offer some services in-house in a way that other facilities simply cannot. Thus, low or no-cost health insurance should be part of the package for hiring on a new nurse. 

There is a give and take on this particular benefit. Some nurses are willing to overlook the lack of health insurance benefits if they can receive higher than normal pay. It all depends on how the math works out. If the extra pay is more valuable than the health insurance premiums, then some may decide to pay for their own insurance out of pocket using the extra money that they make at their job. Much of the decision on this one can come down to what the dollars and cents add up to. 

Work-Life Balance/Scheduling

A typical work schedule for a nurse may involve working three days with 12-hour shifts followed by four days off one week, and then four days of 12-hour shifts with three days off the next. Some nurses say that this works brilliantly for them and that they are thrilled to have the extra days off. Some use those extra days off to pick up another job, a hobby, or simply to relax and recoup from the long work week that they just endured. However, not everyone is as into this idea. 

The stress and mental fatigue of working a 12-hour shift is hard to overstate. This is a job in which the individual is standing virtually the whole time. They are not permitted to leave their workstations, and their meal breaks are short if they exist at all! Thus, it is incredibly important for any nurse who is about to enter the field to think carefully about the kind of schedule they would like to have and if they can find an employer who can work with them to create the most ideal schedule possible to balance out their work and life needs. 

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.