Before Your NP Employment Search, Take Time for Reflection

Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP

Every year at this time, thousands of students have completed their NP studies and are ready to embark on a new career. This article is dedicated to the NP Class of 2021. The COVID-19 pandemic has presented some unusual challenges for this year’s NP class. While many NP students were able to graduate close to schedule, there are those whose graduations are behind schedule due to the pandemic. We realize this is extremely disappointing, but we know that university faculty are working to help students graduate as soon as possible. The information in this article is relevant to both new grads and soon-to-be grads. Best wishes for success and welcome to the profession!

An oft-quoted rule of job hunting is that the more competitive the employment market and the more responsible the position, the more you need to prepare for the job search (for tips on initiating your search, see Dr. Vanessa Pomarico’s article “Searching for Your First NP Position Amid the Coronavirus Pandemic”). With a wider variety of practice opportunities and increased responsibility for NPs, new NPs seeking a job must be well-prepared to find or create the right position. NPs must also develop sophisticated negotiation skills to maximize the compensation for their new position, as well as effectively leverage the clinical experience many NPs bring to the workplace. Few NPs, whether they are new to practice or are longtime clinicians, feel adequately prepared to take on the task of high-level employment negotiation. The following information has been developed to help you with this important step in your professional journey. Before embarking on this next step, set time aside for reflection. You might be tempted to skip this, believing you do not have the time; however, you have devoted tremendous energy, resources, and time to becoming an NP. You owe it to yourself, and to those who have supported you in your professional and personal development, to invest in this. During this time of reflection, write down your answers to the following questions. You do not need to share your answers with anyone, but personal dialogue can serve as a guide as you look for the NP position that is the best fit for you. As you ponder these questions, you might also realize that you have strengths that you have not appreciated.

Q: Why did I become an NP?

A: If you are a new NP graduate or about to graduate, you might now find yourself asking the question, “Why did I choose to become a nurse practitioner?” You left a comfortable and respected role in your former nursing practice or other line of work. Now, as a newly graduated NP or soon-to-graduate NP student, you are in the rather unfamiliar, often uncomfortable, role of the novice. As you seek your first NP position, remember what motivated you to make this change.

Q: How do I view the contribution of NPs to healthcare practice? How does the NP role enhance the delivery of healthcare? How is it similar or different when compared to the physician, physician assistant, registered nurse, or other members of the healthcare team?

A: The ability to clearly articulate the NP role, both for what it is and what it is not, is crucial. A well-developed frame of reference will help you communicate your vision for the NP role. This will help you develop personally and as you interview for NP positions.

Q: What have I achieved professionally to date in my career?

A: Most NPs have been professionally successful, whether they are relatively new to nursing or seasoned nursing clinicians. Draw up an inventory of your professional history, highlighting the high and low points, successes and challenges. Identify what you have learned from both the good and the bad. Your responses will help answer the next question.

Q: What do I do well and enjoy in my current professional role? What do I not enjoy or need to work on in my current role?

A: Answering these questions will help your personal and professional growth and will help you to set the stage for success and avoid difficulties in your NP practice.

Q: What are my clinical strengths? What are the diagnoses I handle the best? What areas of clinical expertise do I need to continue to develop?

A: Generate a list of the clinical problems that you can handle most proficiently; you should focus this on the skill set you have developed as an entry-level NP as well as the skills from your prior professional experience. This can be a powerful marketing tool, as well as a reminder of the skills you have gained. You have probably developed expertise in the areas that interest you most. When you look at this list, do you see a common thread? Will this information help direct you to a certain type of practice? All clinicians have clinical weaknesses as well as strengths. However, you should have a plan to expand your knowledge and skill base. Successful NPs are truly lifelong students of their work.

Q: How do skills acquired in my current role translate to other practice areas?

A: Often, an NP approaches the job search with significant experience in healthcare and in other fields. While all work experience contributes in some way, the healthcare marketplace will probably not be impressed simply by the number of years you have been in practice. However, do not overlook the expertise you have gained from your current position that translates into NP practice. Make a list of the skills you now have that are common to all areas of healthcare. Be able to verbalize these skills well, such as the ability to deal with families in crisis, work effectively with limited resources, supervise and direct professional and paraprofessional healthcare staff, assess rapidly changing situations, set priorities, and alter plans of care in a timely manner. These are skills used daily in nursing and other types of professional practice.

Q: Where do I envision myself professionally and personally in 1, 5, and 10 years?

A: Long-term professional goals can be hard to visualize. However, by thinking in terms of the future about your contribution to NP practice, you can help set the stage for your practice transition. Keep in mind that interviewers often ask candidates about their professional goals. Professional and personal issues, of course, intersect.

Think of how your personal goals will have an impact on those you set professionally.

Q: How will holding a graduate degree influence the salary I am offered?

A: You likely needed to earn a Master of Science (MS), Doctor of Nursing Practice (DNP), or postgraduate certificate during your NP education. You probably assume that the salary offered should reflect your educational achievement; however, the marketplace often views graduate studies simply as a vehicle for NP preparation. Identify the subset of valuable skills that are acquired in graduate education. These skills include the following:

  • Grant writing and program proposal development skills: These were no doubt gained during the development of your thesis, scholarly project, or other capstone project.
  • Teaching skills: Remember all the presentations from your graduate program? Did you teach or tutor undergraduate nursing students? Did you work with families? You most likely have considerable teaching experience, even if you have never held a faculty position.
  • Design and development of community and patient education programs and materials.

Q: What do I know about my state’s requirements for NP practice?

A: The educational preparation needed for entry into advanced practice nursing, as well as the NP’s scope of practice and prescriptive authority, is determined at the state level. Prior to applying for any position, be prepared to answer questions about your state’s requirements for advanced practice. You can find more information at National Council of State Boards of Nursing (NCSBN).

Also, become well-versed about your ability to obtain a federal Drug Enforcement Administration (DEA) number, which is needed to prescribe controlled substances. To find out the scope of NP controlled substance authority, and to learn more about controlled substances schedules, visit the Drug Enforcement Administration’s Diversion Control Division.

Learn about Medicare, Medicaid, and other insurances and their policies regarding
reimbursement to NPs. Find out how to obtain your National Provider Identifier (NPI).

Have a plan in place to become nationally certified as an NP. Many employers require this as a condition of employment, and most states require this as a condition of obtaining an advanced practice nursing license. Acquire the necessary paperwork and organize your documents so that you can proceed with certification in an expeditious manner. Taking a Fitzgerald NP Certification Exam Review will help prepare you for the exam and practice.

Q: How can I explain to others what the NP role is?

A: By the end of these exercises, you should be able to briefly explain your view of the NP role. Having a print resource on hand can also be very helpful, particularly when dealing with a practice that has no NPs currently on staff.

The American Association of Nurse Practitioners has helpful documents on its website, including an NP Scope of Practice Statement and NP Fact Sheet.

Now that you have completed your time of reflection, it is time to begin to launch your new career. All of us at Fitzgerald wish you great success in the best work on Earth!