Week_3_Discussion_

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Running head: APN 1 Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One As a family Nurse Practitioner (FNP) employed on a 1099 independent contract basis in a primary care practice for 2 years, a number of strategies could be used when proposing contract renewal. Buppert (2015) states that in contract renewal, it is paramount to prepare, probe and propose. NPs should recognize how to compute revenue they bring into practice. In addition, NPs should also ask regarding the financial health of the practice and propose what they deserve. Hence, I will focus on the degree of worthiness in nursing practice, call and benefits. The degree of worthiness is determined by the capacity to attract return patients, which contributes to increased profit margins. Therefore, the number of patients attended to per day or week is the basis that determines the worthiness of nurse practitioners. Generally, in private practice, roughly 15 to 20% of patient rate as the profit. Hence, attending to 20 patients’ means that practice gets 15 to 20% off. Based on the cost charged per patient, I would be able to determine my worth to the practice. It is also important to take into account call earnings. With respect to the case study, there is a call on every third weekend. According to AANP (2018), if nurse practitioners are expected to take a call, it is imperative to determine the percentage of other providers’ salaries in the practice so as to fact it into salary. Another factor to take into account when negotiating a contract are the benefits including professional development allowance, vacation, sick leave, malpractice insurance and health insurance. W2 employees are permanent workers of the health facility and have a right to benefits including 401k, paid leave and vacation, life, health and disability insurance. On the other hand, a 1099 contractor do not receive these benefits. This means that employing a 1099 contractor staff is cost-effective in comparison to W2 employees. Hence my role as a 1099 contractor would be beneficial to practice in terms of cutting down costs related to W2 employee benefits. In relation to reinforcing my value in practice, I will highlight my length of employment and a revenue generator.

APN 2 My dedication in the past two years in the primary care practice has led to improved positive provide-patient relationships, eventually leading to increased patient satisfaction, in addition, to my two year working experience. In practice we would lead to improved quality, word commitment while cutting down revenue. Specifically, quality will help in meeting patients’ healthcare needs, and reduce readmission. Evidence shows that providers’ job satisfaction is linked to education level, work experience, workplace conditions and so forth (Janicijevic, Seke, Djokovic & Filipovic, 2013). Under the contract, I will be ready to articulate non-monetary contributions to the practice including improved patient satisfaction, increased return patients and reductions in the non-show appointments. References American Association of Nurse Practitioners. (2018). Employment negotiations. AANP . Retrieved on 23 July 2018 from https://www.aanp.org/practice/reimbursement/68 articles/579-employment-negotiations Buppert, C. (2015). Nurse practitioner's business practice & legal guide (5th ed.). Retrieved from https://bookshelf.vitalsource.com Janicijevic, I., Seke, K., Djokovic, A., & Filipovic, T. (2013). Healthcare workers satisfaction and patient satisfaction – where is the linkage? Hippokratia , 17 (2), 157–162.Retreived from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743622/

APN 3 Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study Part Two. Salary is a sensitive issue for not only the advance nurse practitioner (ANP) but also the employer. The proposed salary for the contract renewal will depend of the current salary and the media salary in the area. In the job offer, base salary is the first issue an employer addresses. Therefore, the ANP salary is determined by specialty area and nurse practitioner in the geographical region. Again, it is essential for the ANP to review practice expectations to establish if it promotes full or restricted scope of practice. In addition, checking the practice barriers can help in salary negotiation. The important aspect is in the contract renewal is to benefit the employer and APN while ensuring efficiency and improved health outcomes. There are inconsistencies in salary; hence probing how it’s derived is important (Brown & Dolan, 2016). According to the case study, consulting 20 patients daily and responding to call every third weekend would generate revenue of $262,752 for the practice. This revenue reduces to $157,651 after deduction 40% of overhead expenses. This assumes that the nurse practitioner receives full benefits as contract staff that is not always the case working as a 1099 contractor. Moreover, Buppert (2011) argue that there is a further 15% deduction for physician consultation service and leaves a salary of $ 134,003. The salary seems fit and even slightly higher than median annual salary for nurse practitioner in Virginia, which can be a good basis for negotiation (Nurse Journal, 2014). In salary negotiation, it is imperative to be flexible, especially if the other party is hesitant to the base of $130,000. For this reason, putting emphasis on a mixed method of salary as well as bonus or profit is vital. For instance, a base salary of $110,00 and 10% bonus or alternatively the same base with 7% profit sharing. The issue here is that during salary negotiation to outline my values and non-monetary contributions that I bring to the practice. Similarly, the employer makes the final decision on the proposed salary, thus, the NP can accept, renegotiate or find employment somewhere else (Buppert, 2015).

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APN 4 References Brown, L. A., & Dolan, C. (2016). Brief report: Employment contracting basics for the nurse practitioner. The Journal for Nurse Practitioners, 12 (1), 45-51. doi:10.1016/j.nurpra.2015.11.026 Buppert, C. (2015). Nurse practitioner's business practice & legal guide (5th ed.). Retrieved from https://bookshelf.vitalsource.com Buppert, C. (2011). Nurse practitioner’s business practice & legal guide ( 4th Ed.). Sudbury, MA: Jones and Bartlett.

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