Sue Schrand, MSN, CRNP
Executive Director
PA Coalition of Nurse Practitioners
PA State Representative for AANP
sschrand@pacnp.org
Almost Time for Graduation!
 Getting your data together
 Becoming “Board Certified”
 Submitting your application for licensure
Professional Associations
 Belong now! Take advantage of student rates
 How engaged should I be?
State Level
National Level
 Specialty Organizations
Professional Associations
Networking Opportunities
Mentorship
Continuing Education
Practice and Legislative Consultations
Representation in Harrisburg and Washington DC
Resources:
List Serve
Employment/Career News
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
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
Certification Options
 American Academy of Nurse Practitioners (AANP)
http://www.aanpcertification.org/ptistore/control/ind
ex
Family Nurse Practitioner
Adult Nurse Practitioner
Gerontologic Nurse Practitioner
 Membership to AANP offsets testing price
Certification Options
American Nurses Credentialing Center (ANCC)
http://www.nursecredentialing.org/Certification.aspx
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Acute Care
Adult
Gerontologic
Family
Pediatric Nurse Practitioner
Family Psychiatric and Mental Health Nurse Practitioner
Adult Psychiatric and Mental Health Nurse Practitioner
Certification Options
 American Association of Critical Care Nurses
(AACN)
http://www.aacn.org/DM/MainPages/CertificationHo
me.aspx?menu=Certification
Acute Care NP
Certification Options
National Certification Corporation (NCC)
http://www.nccwebsite.org/Certification/default.aspx
 Women’s Health
 Neonatal Nurse Practitioner
Certification Options
Oncology Nursing Certification Corporation
(ONCC)
http://www.nccwebsite.org/Certification/default.aspx
 Oncology Nurse Practitioner
Certification Options
Pediatric Nursing Certification Board (PNCB)
http://www.pncb.org/ptistore/control/exams/index
 Pediatric Nurse Practitioner – Acute Care
 Pediatric Nurse Practitioner – Primary Care
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!
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
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)
Licensure in Pennsylvania
SBON Requirements for Application
1. Active, unrestricted professional RN License
2. Completion of Accredited NP Program
3. Proof of National Certification
4. Maintain Professional Liability Coverage
5. Written Collaborative Agreement with a
Pennsylvania Licensed Physician
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
Licensure in Pennsylvania
3 Documents Issued From BPOA to practice:
 RN License
 CRNP Certificate
 Prescriptive Authority Certificate
Licensure in Pennsylvania
Licensure Fees
RN Application
Initial CRNP Application
Initial Prescriptive Authority
Each Additional Rx Authority
Rx Authority Renewal
Rx Authority Change Form
$65
$100/75
$50
$30
$25
$30
Licensure in Pennsylvania
Where Do I Look for Scope of Practice
parameters?
Professional & Practical Nurse Laws
Pennsylvania Code
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…
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
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
Professional Liability
 1 million per occurrence / 3 million annual
aggregate
 Commonly Used Companies
1. Marsh Affinity
2. Nurses Service Organization (NSO)
Professional Liability
 My Own Coverage or Employer Coverage or
both?
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
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)
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Ignorance is no excuse!
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
Finding Your First Position
 Patient Factors
 Colleague Factors
 Clinic Factors
Szanton & Alhusen, 2010
Patient Factors
 Type of Practice
 Patient Population
 Patient Acuity
 Resources Available
Szanton & Alhusen, 2010
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
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
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?
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
What to Negotiate?
“Everything Is Negotiable”
 Pay
 Benefits
 Schedule
 Goal/Profit Sharing
 Restrictive Covenants, Termination Clauses, etc.
Resources
 AANP Website – “Contract Negotiations for NPs”
 NP Central, ADVANCE
 Books
(Carolyn Buppert, Sally Reel, Kevin Letz, Heidi
Bourne)
Resources
 Market Review—know your location/practice setting
Is it comparable?
 Online review
ADVANCE Salary Survey
Salary.com
Payscale.com
 Corporate ‘Pay Grades’
Q&A
What questions can we answer for you?
References
www.pacnp.org
www.aanp.org
http://www.portal.state.pa.us/portal/server.pt/community/state_boar
d_of_nursing/12515
Articles:
Philipsen & Grandjean: Comprehensive Malpractice Insurance (2010) The Journal for Nurse
Practitioners, Vol 6 (9): 703-6.
Lavoir-Vaughan: Negotiating Employment Contracts (2010) ADVANCE for NPs & PAs
www.advanceweb.com/NPPA
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): 356-360