NR 510 Week 3 Discussion 2

Sample Answer for NR 510 Week 3 Discussion 2 Included After Question

NR 510 Week 3 Discussion 2

NR 510 Week 3 Discussion 2

As revenue generators, NPs must be aware of how their work contributes to the overall revenue of the clinical practice. You see 20 patients per day on average and take call every third weekend. According to Buppert (2011), an NP who sees 15 patients per day at $56 per patient visit, on average, brings in $840 per day. Allowing 1 week off for continuing education, 1 week off for illness, and 4 weeks off for vacation, this NP will bring in $193,200 a year, potentially. However, not all bills are paid. With a 90% collection rate—a reasonable collection rate for an efficient practice—this NP actually will bring in $173,880 per year. An NP who sees 24 patients per day will bring in $1344 per day, or $309,120 per year in accounts receivable. With a 90% collection rate, this NP will bring $278,208 to the practice (Buppert, 2011). 

A Sample Answer For the Assignment: NR 510 Week 3 Discussion 2

Title: NR 510 Week 3 Discussion 2

Establishing a salary can be a challenge for NPs. Deducting 40% of the NP’s gross generated income for overhead expenses (rent, benefits, continuing education, supplies, malpractice, lab expenses, and depreciation of equipment) leaves $104,280 for the 15-patient-per-day NP and $166,925 for the 24-patient-per-day NP. Further deducting 15% of that figure to pay a physician for consultation services leaves $88,638 in salary for the 15-patient-per-day NP and $141,887 in salary for the 24-patient-per-day NP. Deducting 10% for employer profit leaves $79,775 in salary for the 15-patient-per-day NP and $127,699 for the 24-patient-per-day NP (Buppert, 2011). 

What salary would you propose for the contract renewal? How does your salary proposal fit in with the community standard for an NP in a similar practice? Use logical reasoning, and provide evidence based rationales for your decisions. Keep in mind that your negotiation terms and conditions must be within the legal scope of practice for an ANP.

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According to salary.com the average US NP makes approximately $116,000 per year. The same site states that the average salary in my area is between $108,000 and $126,000 per year. Danielsen, Potenza, and Onieal (2016) suggest that you should not think that the salary of the position you are pursuing has a predetermined rate. Considering a previous rate of approximately 20 patients a day and a projected rate of 24 patients a day, a salary of $117,000 would be appropriate. Using Buppert’s equation, seeing 20 patients a day would produce an approximate salary of $106,000 and seeing 24 patients would produce an approximate salary of $128,000. If you take both salaries and average them it is approximately $117,000, a fair rate in the current market of NPs. This also leaves room for negotiation for the next contract when goals are met. Considering this position is a contract position, I would not hesitate to ask for a bonus based on performance, collection rates, and revenues. Independent contractors typically provide for their own medical insurance, malpractice insurance, and continuing education costs, this is a substantial savings to the practice. In New Jersey the cost of a family health care plan can cost an employer more than $20,00 yearly, while malpractice insurance costs approximately $2000 a year for a family practitioner (NSO.com). 

Resources: 

Danielsen, R., Potenza, A. & Onieal, M. (2016). Negotiating the professional contract. Clinician Reviews, 28-33. 

Decapua, M. (2016). How much revenue does a primary care nurse practitioner generate? Retrieved from https://www.bartonassociates.com/blog/how-much-revenue-does-a-primary-care-nurse-practitioner-generate/ 

Nurses Services Organization. (2018). Quick Quote for Individual Professional Liability Insurance. Retrieved from https://forms.nso.com/mustela/site?productName=HCI#/QuickQuoteDetails. 

Salary.com. Nurse practitioner salaries in Toms River, NJ. Retrieved from https://www1.salary.com/NJ/Toms-River/Nurse-Practitioner-salary.html NR 510 Week 3 Discussion 2

 it is always good to keep your options open in case something happens and you are in sudden search of a new job. Of course, if you have a great position that is always the best and something to stick with. Let’s say you are looking at 2 or 3 employers’ offers. The one you believe you would be the happiest with is also the lowest paid and you want to negotiate this without making the conversation too awkward. How would you bring up the offer for a higher salary and the request to negotiate salary at the position you want to take? 

As with any other job it is pertinent for nurse practitioners to be aware of what they are worth before entering an interview(Belfast,2013). If you yourself are not armed with reasons why you are the best candidate and undeniable reasons why they should hire you for the position what will make the employer want to bargain with you about salary? After the salary is brought up by the employer one may remind the employer of ones positive attributes and the ways they will benefit the practice. After doing this the hope is they will raise the offer if not you may make a vague counter offer by possibly saying something to the effect of I had hoped to make more butone actually says depends on what the person interviewing says to you.  

Get off to a good start with salary. (2013, Nov 15). Belfast Telegraph Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search-proquest-com.chamberlainuniversity.idm.oclc.org/docview/1458490845?accountid=147674 

I also think that it is important to know a nurse practitioner value when determining wages.  If this situation that Dr. Storms is suggesting would happen, I would want to be sure that before accepting or turning down any offer, I was aware of all of the benefits that I was getting with each job offer.  I would maybe even go as far as to counteroffer a wage or salary to the job that I particularly like.  I would let them know that I really want to work with them, but have also had other offers with a little higher of a wage.  I would try to make a negotiation that is suitable for both of us.  I like that you suggested bring up a positive attribute to the employer as well. This can help strengthen your worth when you remind them of your dependability to the job or compassion.  Great post! 

I had an experience to try to negotiate my salary as an RN when laterally moving from a per diem position to a full-time position at my current job. I was per diem and circumstances at the hospital meant that I may not be able to work as much as I would like. I took a position with a differential then before my transfer a full-time position opened on the unit I was working on. I wanted to stay on the unit, but I did not want to lose the differential of the other position since I was taking a cut in pay from the per diem position. I had a meeting with my manager and told her that I needed a little higher of a salary to take the position on my unit. Unfortunately, one of the hospitals in our system is union and there is a set protocol for pay. However, since my manager really wanted me to stay on the unit I was given the salary of an RN with 5 years-experience even though I was several months from that anniversary. I would have stayed even if I didn’t get more money. That was the job that I really wanted. Happiness in your position is sometimes more important than salary. Gillet, Fouquereau, Coillot, Cougot, Moret, Dupont, Bonnetain, and Colombat (2018) in their study of job satisfaction and quality of care found “the present results revealed that job satisfaction related positively to quality of care and negatively to turnover intentions” (p. 1215). 

Resource: 

Gillet, N., Fouquereau, E., Coillot, H., Cougot, B., Moret, L., Dupont, S., Bonnetain, F., & Colombat, P. (2018). The effects of work factors on nurses’ job satisfaction, quality of care and turnover intentions in oncology. Journal of Advanced Nursing, 74, 1208-1219. 

The way to sell yourself is always with your actions by showing the type or worker and team player you are.  It seems this was the case in the situation you described and it feels good to know that you are appreciated and wanted.  I find that people who need lots of words to sell their work have something they want to hide.  In every job I have ever held, it was obvious who the good workers were and where the dead weight was.  I think that having the confidence of knowing that you are one of the good ones will help you to negotiate from a place of confidence knowing that you will bring value to the practice.  Confidence is noticeable and can be the difference between being offered and not.  My intention is to take the best first job I can find which will help me develop my skills as a provider and to use this to propel myself to the next level in a year or so.  We all start somewhere and the folks willing to apply themselves tend to do very well. 

   Great points. Healthcare plans are extremely expensive, same with malpractice insurance. These negotiations are going to take some practice. Finding the right balance between being firm and fair is key to negotiation. In my younger years, I have bought cars on my own and having to deal with sales people. I knew I had the credit and enough money to put down so I had the advantage when walking in the car dealership. But as a new NP this can be difficult. I believe as new NPs we have to think of every possible way to give us more negotiating power and also keeping in mind that we will be looked at as new NPs, so we must not be too aggressive during this time. Dr. Storms mentioned a good point in keeping our options open. In able to keep our options open, we must apply for all the positions that attract our attention and hope we get more than one interview in a timely manner, which is the best case scenario. I am glad we are discussing these situations now, rather than having to find out the hard way when we are actually in the process of negotiating. 

I would propose a salary starting with the base of the 20 patients per day I would see and calculate from there similar to Buppert (2011), including costs, consults, sick time, vacation, and continuing education which would be around $105,000. This base rate varies by state and specialty, taking for instance the 2012 survey in Arizona depending on the nurse practitioners specialty the salaries range from 24,000 to 103,000 dollars (Widemark,2012). According to this scale the range would not be correct therefore it is important to know the state salary and living expenses in which you are in.  Another driver of the wages one will make as an nurse practitioner is the demand for nurse practitioners in that area, as the need for mid level providers increases the wages will increase until the void is fulfilled. According to the bureau of labor the number of nurse practitioners in some states is minimal yet they are being paid some of the highest in the country to keep up with the competitive salaries of those states with more demand for nurse practitioners (Bls.org,2017) 

Bureau of Labor Statistics,2017, Bls.org 

Widemark,2012. Nurse practitioner salary survey. Nurse practitioner world news 

 Some employers will pay a bonus or provide lower salary because they will offer incentives based on RVUs. Let’s say this was part of your contract and you are not getting the RVU bonuses you were promised. How would you bring this up to your employer professionally? 

I would agree that the salaries are based on the demand for NPs and also thae market where the care is to be provided.  I have several friends that have become NPs in New Jersey where I live.  The starting salaries have been from about $90,000 to $105,000.  A friend in private practice started at $90,000 that would increase to $100,000 when she received her hospital credentials.  One friend in primary care in a  hospital run clinic started at $95,000.  The highest salary that I have heard as a starting NP in my area is working at a urgent care center that is NP run with a physician on call.  These positions are starting at about $105,000.  I do not know what vacation time or other benefits they get for continuing education.  Thanks for posting. 

 Since I am a family nurse practitioner nursing student I could only make a guesstimate on what should be the proper salary for a practicing nurse practitioner.  Actually the only research I have looked into when it comes to nurse practitioner salaries is the common median salary for a nurse practitioner in the state of Texas.  From the various websites and from talking to actual nurse practitioners the median in Texas seems to be over $100,000.  I would have to learn more and actually become a nurse practitioner to figure out the true salary that I believe I deserve and would work towards obtaining in the future.  Apparently according to other nurse practitioners at the organization that I work at, the amount of patients that you see will contribute to salary.  I would strive to see a good amount of patients ranging from 20 to 24 patients based on the salary breakdown on the question above.  I would propose for $110,000 to $120,000 salary based median.

 I believe that fits with the common median of what a nurse practitioner who makes.  One also has to understand where the nurse practitioner is working because based on where the nurse practitioner is working it will affect and contribute to how much the NP will make in a year.   For example a nurse can work at a private practice office, a clinic, or even go a step further and work in the hospital setting as an advanced nurse practitioner.  It is important that a nurse practitioner keeps up with the current salaries because it is important that he or she gets paid the correct amount that he or she deserves. Nurse practitioners do  have more advocacy and independence then a bedside nurse however there comes more responsibility.   I do believe that as a nurse practitioner games more responsibility I believe that the salary needs to be revised and examined.  Patients are becoming more complex and critical and there is a shortage of actual practicing physicians .  This is  One of the reasons that nurse practitioners are gaining more responsibility and I believe as nurse practitioners gain more task and responsibilities that the salary should be increased. (Levine, 2015) 

Referances:  

Levine, J. (2015). Nurse practitioner practice characteristics, salary, and benefits survey, 2003. Clinical Excellence For Nurse Practitioners, 9(1), 49-58. 

Great informative post for someone like me who never even thought about how you could come up with a dollar amount for a brand new FNP.  I do have to agree that your salary will not only be based off the number of patients you see, it is also based off where or what area you are working in.  Current NPs at my hospital states that they make more than NPs in office clinics.  But there is a trade off for that.  Our NPs with our hospitalists work 12 hour shifts 7 straight days on, then they get 7 straight days off, then 7 straight days on again, and so on.  I think that while it’s great to start thinking about what place pays the most, you have to do some research and find out what would be expected of you with the numbers given. It is also important to know your worth, even if you are a brand new NP.  You must be prepared to show them and tell them why they should be paying you that specific amount.   

You are so correct. The salary seems to be based not only on the patients you see but where you work as well. I know I spoke with the NP that I see and she told me she makes around 75K a year. This is in a doctors office. She works Monday through Friday, 9AM to 5PM with no weekends or holidays. When I spoke with a NP in the emergency department, who was working as a contract NP, she told me she makes $110000 a year. She has to work 16 shifts a month and she may work days one week and nights the next. There is not set schedule and she has to work different shifts. She does not have a set number of patients she is to see. Some nights she could see 40 patients and the next night she may only see 20. It all depends on how many people show up for the emergency room that night. When I was setting my salary expectations I did it based on seeing 20 patients per day. I believe I asked for like $78000 a year. I agree without being a NP it seems difficult to determine the amount of money to propose. I had the same issue when I stopped being a travel nurse and decided to get a permanent position. I had no idea what a regular nurse makes. So I bid low on a few jobs but finally found a way to make travel nurse money in a regular nurse role. I enjoyed reading your post and look forward to learning more with you in the coming weeks. 

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