WORK/LIFE BALANCE FROM A MOM AND NURSE PRACTITIONER

Tips for searching for a job as a new nurse practitioner

9/29/16
I've been to quite a number of job interviews as a new nurse practitioner, and nailed several and bombed several. I have some take away points I hope new graduates out there may find helpful in finding and landing a job.

GETTING THE INTERVIEW

Get a CV together and make the information relevant to the job applied for. For example, I did some work in aesthetics per diem, which is hardly relevant to urgent care jobs or family practice jobs so I eliminated that experience for certain positions I applied for. Highlight any seminars, publications, and awards or training you have completed in addition to your required education. For example, I did a three day skills workshop for minor procedures and emergent care. Play up your duties at your previous positions, especially if you were involved in any quality improvement projects, employee training, or management positions.


SCHEDULING THE INTERVIEW

Some employers will want to do a pre-interview phone screening before an in-person interview, which I hate. In past when I have had these screenings I have felt ambushed and completely unprepared when I got the phone call . My advice is if you get a call wanting a pre-interview phone screening to reschedule it at a time when you are free of distractions, and make sure you prepare as you would for any interview, as often the questions are the same. I also hate when employers want to do an interview the same week or next day. I always try to get at least a weeks notice to prepare. This gives me time to update my CV, get my interview attire dry-cleaned, research the employer, practice interview questions, and find out how to navigate myself to the interview location.

WHAT TO WEAR
Keep it as simple, comfortable and as conservative as possible. Wear a suit (it doesn't have to be expensive, see examples below). I've often felt overdressed at some interviews, but it's definitely better to be on the overdressed side.



WHAT TO BRING
Again, be over-prepared. Bring three professional references (at least one who has supervised you), three copies of your CV, your RN and NP licenses. Many times I have not been asked for any of these items, but always have them. I like to carry all of these in a leather folder, such as the one below, to keep them flat and readily available. I also keep a notepad in the folder to jot down notes during the interview.



COMMON INTERVIEW QUESTIONS
If you are interviewing for a larger organization chances are you will be asked a standard set of the same questions as all candidates. The most common ones are:
*Describe your strengths and weaknesses.
*Describe a time you've had a conflict with a coworker and what was the outcome, or alternatively a conflict with a patient and how you changed the outcome.
*Why do you want to work for this organization?
*How have you implemented a change at your previous workplace?
*How would your former coworkers describe you?
*How many patients do you feel comfortable seeing in a day, or how many patients do you see per day at your current job?

The most important thing to prepare for these questions is to use specific examples. It's okay to embellish, but don't just say, "I'm a hard worker" Give specific accomplishments to back up your statements that are directly relevant to the position you are interviewing for. When describing your conflicts and weaknesses, make sure you use examples that have had good outcomes, not a time you nearly killed a patient, or were fired over a conflict.

If you are interviewing at a smaller practice, you may get a few of these questions, but the interview tends to be much more informal and just getting to know you better in terms of your skill set and personality.

QUESTIONS TO ASK THE POTENTIAL EMPLOYER


What is the expected patient load per day?
Some employers are very number driven, and expect 2.5-3 patients an hour in an ER/urgent care setting, and some want 20-25 patients seen a day in primary care.  Some employers may include a quota in your contract. These are challenging expectations to start off as a new graduate, so it's important to know if you are expected to hit these numbers straight off the bat.
What support staff do you have?
You will generally have a medical assistant in the outpatient setting, and a techs or RNs in the inpatient setting, however the duties can be greatly different in each setting. It's also important to know if you have access to diabetic educators, social workers, or case managers.
Some ER or other acute care settings will have scribes, whom are immensely helpful. As a new NP, the more support staff you have access to the better.

If you work in a state requiring a collaborative agreement, ask about your level of autonomy and if standardized procedures are in place. Some places of practice will require you to have your charts and orders cosigned by a physician.

State laws dictating NP authority vary greatly from state to state. Make sure the employer is in line with state requirements. As a new NP you do not want to start at a location without any supervision or person to refer to, however you do not want to start at a place where you are given no autonomy either, as this will not allow you to grow professionally.

Ask about training periods. Some jobs may expect you to jump in and start without any training. My first job offered a three month paid training period, where I was supervised and expected to be asking for help. This training period was profoundly helpful, and I had incredible mentors helping me.

FOLLOW UP AND ACCEPTING AN OFFER

It is completely acceptable to send a follow up email in this day and age. Make sure you always thank the potential employer for their time promptly after the interview.
A few things to consider when accepting an offer with a new NP position.
First and foremost, salary. Many employers will ask you at the interview what your salary expectations are, and DO NOT ANSWER THIS QUESTION DIRECTLY. I have been burned doing this, and it leaves you no room to negotiate. Many employers, especially public sector jobs and larger organizations have pay grade levels based on experiences, and thus will be no room for negotiation. Some employers, such as agencies that contract with hospitals, will pay a flat rate to all employees regardless of years of experience, and give bonuses for productivity. If you are interviewing at a smaller office or practice you do have room for negotiation, so the best answer if asked about salary requirements is say you expect a competitive rate that will take into consideration experience (if you have some), benefits (or lack there of) licensing, malpractice insurance, and CEU fees. If a position does not offer any benefits, as some do not, you can negotiate a higher rate to compensate for this. If you are a new nurse practitioner without any paid experience, don't be too picky about your starting salary. The most important thing is that you are getting a fair rate.
The second thing to consider when accepting an offer is, do I actually want this job? If you are only interested in a high salary or are unsure of your ability to perform to the required expectations of the job, think twice. As a new NP it is crucial to get experience in the field of your interest. I interviewed for jobs in aesthetics and pain management, both with lucrative salaries, but did not take these jobs as I knew I wanted to get experience in family practice. Although you may get a higher salary offer in a field outside of your interest, make sure this field interests you, and have the qualifications for the position. I also got calls to interview for  hospitalist positions, which I did not interview for because I felt in no way in my experience or training prepared me for these types of roles. If you are considering a position in a specialty, consider doing additional training, such as a residency. post-masters degree, or additional certification. Nurse practitioners are not required to do a residency, and thus being adequately prepared for a highly specialized role such as in oncology or cardiology may be challenging without adequate training. If you have previously worked as an RN in a specialized field however, this may have provided enough experience. I did interview and accept a position as NP in the ER, however I had previous experience as a RN in the ER. Had I not had this experience, I would have in no way felt prepared through my education alone for this position. AANP is now offering a certifications for FNPs specializing in ER. Another piece of advice I have to offer is if you are offered a position with an employer for which you have interned, or previously worked as a RN,  take the position. As a new nurse practitioner already being familiarized with a workplace setting will allow you to focus on the new role, rather than getting to know the charting system, new coworkers, and resources. Lastly, think about work-life balance. What is important to you in terms of hours and flexibility. When I was interviewing for my first job as a NP, I did not want a traditional 9-5 hours due to childcare issues, but I knew that meant working holiday, evening and weekend hours. Think about what your priorities are for a job, whether it be money, location, area of expertise, experience, or flexible schedule. Chances are you will have to make some compromises, so know what is most important to you, and what your long-term career goals are.

PAY ATTENTION TO RED FLAGS WITH POTENTIAL EMPLOYERS
As a new nurse practitioner you want to be in an environment that is supportive. If you sense that you will have a supervisor that is not approachable, will not have adequate training or support staff, think twice about accepting the position. If you sense disorganization, also think twice about accepting the position. At one interview for a new NP position I was kept in the waiting area for an hour after I had arrived promptly for the scheduled interview time. After an hour of waiting and reminding the front office staff I was waiting, I was directed to take a typing test. By this point, I realized this was not an employer I would care to work for, so I told them I was no longer interested and got up and left. At another interview, the person conducting the interview answered her cell phone and took a personal call during the interview. This seemed very disrespectful and disorganized to me.

BE PATIENT

Licensing and board certification can take several months. If you accept a job requiring credentialing, this can take up to six months. Some public sector jobs, and larger hospital organizations require a lengthy application process that can take several month to up to a year. Hang on to your current job if you are working, and don't get discouraged in the process.
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