1. Launching Your NP Career
Sue Schrand, MSN, CRNP Executive Director PA Coalition of Nurse Practitioners PA State Representative for AANP
Future PCNP leaders, Guinea Pigs for topics for student conference, Need feedback / suggestions

2. Almost Time for Graduation!
Getting your data together
Becoming “Board Certified”
Submitting your application for licensure
Programs should be advising you on what documents will need to be organized and sent out sealed or submitted by you directly to get process started.

3. Professional Associations
Belong now! Take advantage of student rates
How engaged should I be?
State Level
National Level
Specialty Organizations
Much of what we are discussing is supported by professional associations

4. Professional Associations
Networking Opportunities
Mentorship
Continuing Education
Practice and Legislative Consultations
Representation in Harrisburg and Washington DC
Resources:
List Serve
Employment/Career News
Much of what we are discussing is supported by professional associations

5. Professional Associations
Resources: (continued)
Partnership Opportunities
PA Drug Card Malpractice Coverage
News Alerts Fellowship / Grant / Awards
Strengthens Your Negotiating Power
It’s Your Professional Obligation
Much of what we are discussing is supported by professional associations

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
Some colleagues grandfathered, required for Medicare number, professional pride to be Board certified, Payers require, State-to-state transfer

7. Certification Options
American Academy of Nurse Practitioners (AANP)
Family Nurse Practitioner Adult Nurse Practitioner Gerontologic Nurse Practitioner
Membership to AANP offsets testing price

8. Certification Options
American Nurses Credentialing Center (ANCC)
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)
Acute Care NP

10. Certification Options
National Certification Corporation (NCC)
Women’s Health
Neonatal Nurse Practitioner

11. Certification Options
Oncology Nursing Certification Corporation (ONCC)
Oncology Nurse Practitioner

12. Certification Options
Pediatric Nursing Certification Board (PNCB)
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
Your certifying body will inform you of the credentials you can use, Hand out CE folders

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)
Must sign your notes with CRNP and carry this title after your name

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
Criminal History Review, Out of State Details to Note if moving into state, Timelines—see application for details

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
Verification of Rx CA can be checked on SBON website

18. Licensure in Pennsylvania
3 Documents Issued From BPOA to practice:
RN License
CRNP Certificate
Prescriptive Authority Certificate
Copy for workplace, but keep in secure file at home. Verification can be checked on SBON website.

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
Negotiate to have fees covered by your employer, if not tax deductible. These are most likely going to go up in the near future

20. Licensure in Pennsylvania
Where Do I Look for Scope of Practice parameters? Professional & Practical Nurse Laws Pennsylvania Code
Hand Out Books; PA Code online

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…
Hand Out Books; PA Code online

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
Hand Out Books; PA Code online

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
Hand Out CE Folder

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 Articles: www.pacnp.org www.aanp.org
Articles:
Philipsen & Grandjean: Comprehensive Malpractice Insurance (2010) The Journal for Nurse Practitioners, Vol 6 (9):
Lavoir-Vaughan: Negotiating Employment Contracts (2010) ADVANCE for NPs & PAs
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):