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How to Negotiate a Contract for Nurse Practitioner Employment

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As an advanced practice nurse (APN) with a master’s degree, specialty certification and a license that expands her scope of practice beyond that of the typical registered nurse (RN), a nurse practitioner is in an ideal position to negotiate a favorable employment contract with a hospital, physician or other health care provider. She may start the employment process by submitting a letter of interest accompanied by a professional resume, and then complete any paperwork required by the potential employer. Before coming in for an interview, the nurse practitioner should have the information she needs to negotiate a favorable contract.

Review the nurse practice act. The American Academy of Nurse Practitioners (AANP) recommends the APN familiarize himself with the regulations pertaining to advanced practice in his state. For example, he needs to understand what authority he has for prescribing medications and other medical interventions, and he must be aware of any requirements for collaboration with a doctor.

Research the practice setting. The AANP says it’s important to know what type of patients the employer treats, whether an APN has the autonomy needed to practice up to the full scope of her practice, how the APN’s time will be allocated and if the nurse practitioner will be a primary care provider who can treat patients independently.

Do a personal inventory. The AANP publishes an online tool that helps the APN decide what she is looking for in a position, and how flexible she can be. In addition to listing her strengths and weaknesses, the APN has the opportunity to identify her willingness to travel or take calls at night and to rank order the factors that are important to her when accepting a new position.

Determine worth of service. Before talking dollars with a potential employer, the nurse practitioner needs to estimate the cost of his services compared to the income he can bring in to the practice.

Create a win-win situation. The AANP recommends looking at ways that both the APN and the employer can benefit. The organization suggests the APN avoid making the first salary offer when possible, reserving the right to make a counteroffer. The APN needs to know the lowest salary and benefit package she’s willing to accept and be ready to leave the table if the employer can’t match that figure.

Negotiate benefits. The AANP points out that a nurse practitioner contract contains a salary figure as well as details about benefits. These may include health insurance, vacation and sick leave, travel allowance, continuing education money and malpractice insurance coverage.

Determine contract restrictions. For example, an employer may ask the APN to sign a “no compete” clause stating the APN will not open a practice in a given geographic area for a specific time after leaving the employer.


Employment contracts can be fairly complex, so it’s a good idea to have a knowledgeable attorney review the contract before signing.

  • Employment contracts can be fairly complex, so it’s a good idea to have a knowledgeable attorney review the contract before signing.

Sandy Keefe, M.S.N., R.N., has been a freelance writer for over five years. Her articles have appeared in numerous health-related magazines, including "Advance for Nurses" and "Advance for Long-Term Care Management." She has written short stories in anthologies such as "A Cup of Comfort for Parents of Children with Special Needs."

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