Ep #76: Job Offers: Green and Red Flags

Welcome to Becoming a Stress-Free Nurse Practitioner, a show for new NPs and students that want to pass their board exam the first time and make that transition from RN to NP as seamless as possible. I’m your host Sarah Michelle. Now, let’s dive into today’s episode.

Hello soon to be NPs and new NPs, Anna here. I am going to be hosting the next few episodes of this podcast and I am so excited to be with you all. I hope you all are having a great holiday season so far, it truly is the most wonderful time of the year.

I know so many of you are testing soon with this big graduation surge, or maybe accepting job offers for the new year. So today I wanted to talk about green flags and red flags of job offers. I think a lot of the time when new NPs are offered their first job, they say yes out of excitement right away and forget to really look at if this job is a good fit.

And I don’t say this to scare anyone away from good job offers because most are great offers and are wonderful opportunities as NPs. But I would hate for anyone to be trapped in a less than ideal offer all because they did not look at the fine print or really read through their offer contract.

As always, I recommend you have a lawyer look through any contracts. But remember, lawyers are only there to make sure everything is legal or explain what some of that jargon means. They are not going to be able to advise you on the makings of a fair job offer.

So let’s start out with the good or the green flags. These are things I would look for in any job offer. But do keep in mind that green flags may vary depending on exactly what you are looking for. So for instance, someone with small children who wants to be around during the week may look for weekend hours, while someone else who wants to spend weekends at home would not find an offer with required weekend hours or maybe even call shifts to be appealing.

So in the end it is all about what you are specifically looking for. If you don’t know what that is yet, definitely spend some time thinking about what will work best for you and your current situation.

Let’s start off with the first green flag, and this one is a biggie. And that one is a generous orientation period and clear points of contact. When you transition into a new role, either from RN to NP or even moving roles as an NP, it is so, so, so important that there is a proper training and orientation period.

I am often asked what a good amount of orientation time is, and this truly varies. For someone starting out in a brand new role as a new NP, I really like to see a full month of orientation. Now, some settings like a surgical role or in-patient my need even longer for orientation, which is totally fine.

When you are signing a contract I want you to really think about the skills you have and the ones you would like to develop before being on your own. And then think about your overall comfort level in whatever setting you are going into. You know, it’s truly impossible to ever truly feel 100% confident as a brand new provider, but I want you to advocate for yourself so that you are feeling prepared, and you are feeling supported.

So another large piece of this is having a point of contact. So whether this is your supervising physician or another provider in the office, having a designated person to go to for any questions or guidance is also so important. Before you sign any contract, be sure to ask about these things and never, ever be afraid to ask for more training time. If it is what you need to be fully prepared to be one your own, your new place of employment should understand.

Another green flag that I implore new NPs to look for in contracts is time off. No one can be our best selves without taking some time to do the things they enjoy. Whether that’s a hobby, travel, or my personal favorite, just taking some time off to relax with a staycation at home. It is so, so, so important to be sure that you have built in time off in your contract.

Much like orientation time, what the ideal amount of time off looks like is different for everyone. So some people are okay with accruing time off, meaning it adds up the more you work. And some people like to have a set amount of time off per year. The important piece is that you are offered paid time off and the amount of time is reasonable to you and your life. It is always worth asking for more time off if you feel that you would like more built into your contract. The worst thing they can say is no.

A huge, huge, huge green flag that sometimes gets overlooked but can literally save you thousands out of pocket is paid continuing medical education, or CME hours, and license renewal. These may seem like trivial things to ask for and have included in a contract, but a DEA license alone is over $800. And that’s just for a DEA number, not a state license or other prescribing licenses you may need.

CMEs are also something that employers frequently offer to pay for, which again, these can really add up. You also may be able to ask for additional days off, not counted in that PTO to use for CMEs. Again, green flags are waving, I love to see companies helping further NP education by providing this time off and reimbursing for these expenses.

I also want to mention admin time here. Admin time is essentially set aside time where you can catch up on charting without bringing your work home. Now, not all jobs will need admin time, especially if you have longer visits or a smaller patient load and you can get all of that done during the normal work day.

But we have all likely experienced a clinical rotation where patient visits were scheduled every 15 minutes the entire day and you are already behind by patient four or five. Sound familiar? Admin time could look like a few hours a week where you don’t see patients, and instead you can get everything else completed.

So, now that we’ve talked about some green flags, what about those red flags? We have the obvious ones that I would always caution against, things like no time off, no orientation period, and absolutely no flexibility in the contract, meaning they will not discuss or compromise on anything. Those are always big red flags for me, and I would really caution you against signing any contracts that don’t meet your needs.

But what about lesser known red flags? What are some of those that you should be on the lookout for? Let’s discuss. A big red flag that seems to be unique to medicine is non-compete clauses. A non-compete clause is basically a part of your contract that states after you leave the job or you’re let go, you cannot work within X amount of miles for X amount of years.

And y’all, these have truly been wild lately. I have seen ones that state NPs can’t work within 50 miles for five years. So that basically wipes out every potential employer within a reasonable driving distance from the current position. So unless you move far away or you’re okay driving hours and hours to a new job, you’re stuck.

The original idea behind non-competes was to stop job hopping from clinic to clinic in the same area. But they really have evolved to a point where they can really trap you in a job. Non-competes are actually even illegal in some states. So this is something I would implore you to have the non-compete removed or greatly reduced in any contract you are going to sign.

It’s really easy to say, “Oh, I’m going to stay in this job for a long time.” But life changes and you do not want to be trapped if this happens. It is a huge red flag as well because companies who implement these strict non-competes tend to have providers who do not stay long, which really should get you thinking, why does that happen?

Another red flag to look for before you sign a contract is a lengthy contract term. Ideally there will not be a term so that you are never trapped in a job that does not suit your needs. But if there is a term, I would recommend one year or less. Going back to the point I talked about earlier, jobs with high provider satisfaction do not need lengthy contracts because their staff love their jobs and want to stay in them.

And again, today you may say, “Okay, I can see myself in this job long term.” But life can change at any moment, y’all. And you absolutely do not want to be stuck paying back some crazy amount of money simply for leaving a job that does not meet your needs. Even if it means walking away from a situation that you feel is good otherwise, I would absolutely not sign a contract with a lengthy term.

And building off of that, I would not sign any contract that requires you to pay back any amount of money for breaking the contract early. This is a huge red flag because it shows me that the company likely does not have providers that happily stay with them. And instead, they may stay due to the money they have to pay back if the contract is broken early. This is a true recipe for disaster and something, again, I would look to be negotiating or not signing that contract at all.

A red flag that goes almost without saying and applies to all settings, not just being a nurse practitioner, is high provider turnover. This is something that I would ask about in interviews. Ask how long have the providers been there and what is their favorite part of the job?

If all of the providers are new, or a lot are leaving or have recently left and they really can’t tell you what they like about the patients or the job, I would probably start to look elsewhere. Now, every job is not sunshine and rainbows all the time, especially in health care, we know this. But at least having a sense of humor and some daily happiness is extremely important.

Another reason why you do not want to be amongst all new providers is because you will be learning. It is nice to have those to learn alongside, but you also want to have some seasoned professionals who know how the flow of the office works and are able to answer any clinical questions you may have, and even just know simple things like how to work the EMR. These are all important pieces to be able to thrive in your new job.

And perhaps the largest red flag, and one I really, really want you all to be looking for with any contract you sign is lack of detail. Even if HR has told you you will get a certain amount of time off or you will be compensated a certain amount, and will never ever, ever have to take after hours call, get that all in writing, friends.

I have seen way too many times new NPs be told that they are not expected to work late, or they’re not expected to take call, only to find out that it is expected. And since it wasn’t included in their contract, they now have no way around it.

Even something as simple as salary and benefits, you really need to make sure are clearly written in any contract you sign. You do not want to sign a contract on a verbal offer alone because, as we know, those can change. And if you are not happy with the compensation amount or you were told a higher amount before, then advocate for yourself. Be polite, be factual, do some background research, and most times HR is willing to work with you.

But you really need to be sure that everything from CME hour off, to paid time off, holidays, salary, sick days, license, and certification reimbursement, absolutely everything is written down clearly in your contract. That way, should you need to, you can always reference back to your contract if things are changing in a way that you do not agree with and that you did not sign on to.

All right my friends, that is it for this episode. I hope you all learned a little bit about what to look for in those contracts. I know that you all are going to be absolutely wonderful providers and you’re going to be responsible and advocate for yourself before signing anything. Until next time.

As an extra bonus, friends, if you’re looking for support, no matter what phase of your nurse practitioner journey that you’re currently in, I have communities available for both students and new nurse practitioners. In these communities we work to uplift one another and grow this profession together every single day. Links to join will be included for you in the show notes.

Thanks for listening to Becoming a Stress-Free Nurse Practitioner. If you want more information about the different types of support we offer to students and new NPs, visit https://www.npreviews.com/resources. See you next week.