Category : Nurse Practitioners – NPs

COVID-19 has infected your NP job search

It’s no surprise NPs are wondering whether this is the right time to look for a position.  The global pandemic has not only changed the way we live but has also impacted the NP job market in some ways we have never seen before and to the casual observer don’t seem to make much sense. NP job seekers are wondering if this is even an appropriate time to look for a new job. New graduates are beginning to have serious concerns as graduate NP prospects are rapidly dwindling. This blog will unravel the mystery surrounding the current NP market to assist you in making the best decision for your job search.

Where did the NP jobs go?

We have shifted from what was a steadily expanding NP market to one that is rapidly transforming before our very eyes.  In the middle of a pandemic, we are seeing many healthcare sectors begin to decrease hours, lay off or furlough personal.  For the first time in my memory, NPs have actually experienced active job offers being retracted by employers.

One of the areas most impacted are urgent care, which may seem somewhat counter intuitive when everyday we are hearing how the Coronavirus is straining our healthcare systems.  The reason, however, is that patients are being strongly encouraged not to seek face to face care for complaints that are not deemed to be essential.  For instance, cold and flu symptoms which are one of the leading reasons people seek care, are told to stay home unless they are experiencing more concerning symptoms such as respiratory distress.  If at risk for COVID-19 they may be directed to screening centers.  Concern over use of PPE and supplies is also prompting urgent cares to scale back.

Primary clinic hiring has also dramatically decreased, and some have actually begun to claw back outstanding job offers. Why? Like urgent care, daily patient visits have declined. Many are refilling prescriptions for stable chronic conditions without visits in order to minimize direct contact. The result is that patient loads have dropped by half or more in these clinics, so staffing has decreased accordingly.  Hiring has also partly halted because the workload is not there to support their current staff.  Remaining staff are working hard to adjust to changes and employers have redirected resources to support current staff. The result: hiring has been put on the back burner.  There is so much uncertainty surrounding how long this crisis will last, so increasing staff at this time is not a good business decision This new way of doing things is likely to have many repercussion going forward as healthcare organizations will be evaluating how they do business in the future.

Other areas impacted are centers that specialize in anxiety disorders. Again, it seems like we might need more of them, but in during this crisis where we must weigh risk vs benefit, they are deemed to be less urgent.  Specialty practices which refer patients to hospitals and same day surgery centers are essentially on pause because of cancellations for elective surgery.  Booming esthetic and cosmetic type practices are deemed “non-essential” and are another sector retracting offers.

Who is hiring?

There are sectors where you can get a job right now. These tend to be in areas such as long-term care, cancer care infusion centers, senior living facilities, residential care facilities, drug and alcohol treatment, and correctional health.  The common thread here is care that must be continued.  Patients can’t simply be discharged from these settings. Reservations continue to hire. Check areas that don’t have a high number of COVID-19 infections as they may still be hiring. If you have surgical skills or respiratory skills and willing to work in the trenches you are likely to find an opening.  Mental health evals are in high demand so Psych NP hiring will remain strong with a likely shift to more telehealth visits.

“If something cannot go on forever, it will stop”

Don’t get discouraged, this is not about you, it’s the pandemic. We are in new territory. This doesn’t mean you shouldn’t be looking.

My next blog will outline how you can adjust your job search tactics now to maximize your prospects for when hiring begins again.

How did caring become so complicated?

It is no coincidence that the number of Nurse Practitioners are showing a growing interest in non-clinical positions. There isn’t a week that goes by when I don’t hear from one or more nurse practitioners who are looking to leave direct care.

Burnout is not a new phenomenon, especially for nurses. It’s long been recognized that the strain of continually caring for others can take a toll on the caregiver. “Compassion fatigue” is the term used but I am not so sure that is what is going on here. NPs are telling me that it’s not caring for patients that has worn them down, in fact it’s quite the contrary.

Barrier to Caring

Nurse practitioners WANT to care, it’s what keeps us going. We went into this business to form relationships and make a difference. We were drawn to this role because we were told we would have more time with patients, and we would use this time to educate, inspire and empathize. Instead, what we are encountering in practice now is what I like to call “compassion frustration”. Despite the focus on patient satisfaction it seems too many current practice models are doing everything possible to create barriers that result in encounters that turn out to be unsatisfying to everyone involved.

Decreases in visit time coupled with increasing documentation and payer requirements are getting in the way of therapeutic relationships. One of the most frequent reasons NPs tell me they want to leave direct patient care is that the clinic has become like a treadmill and the clinician is feeling the pressure to either keep up or fall off. Fifteen minute visits, of which 5-7 minutes are taken up by rooming, leaving less than 10 to see the patient and document then on to the next, and the next, and the next. Rinse and repeat. Oh, and answer calls and emails, do prior authorization and of course don’t forget the billing. And because NPs love their patients they maximize their time with the patient and the end result is the NP staying long past clinic hours to finish documenting and completing these other tasks.

Using only the wisdom that administrators and analysts possess, instead of simply giving the clinician an additional 10 minutes with a patient, more extraneous persons have been added to the patient experience. Time for documentation is a problem? We’ll hire a scribe! Non-adherence to a treatment plan? Let’s hire another person to find out why!

More money spent on endless mailings touting a staff of coordinators, educators and of course the website. We now have a host of different people employed to do different aspects of what used to be done by the one person who knew the patient best. How does that save time? Or money? It doesn’t. And it certainly doesn’t increase provider or patient satisfaction. Quite the opposite. Adding more water to the soup doesn’t make it more filling.

I’m waiting for the study that shows fancy programs and initiatives are not a substitute for the good old-fashioned relationship between caregiver and patient. A girl can always dream but I am not holding my breath…

NP Career Coach interviewed in Clinician 1 podcast

Join me as i speak with Jordan G. Roberts, PA-C and I will tell you why it is SO important to de-clutter your resume, offer a few tips (and cautions) on job searching in the current job market along with a few other job seeking gems. Oh, and i will tell you all about going to jail… for the right reasons. All this wisdom is delivered with a healthy dose of humor.

Hello! What Does it Take for a New Grad to get Some Attention Around Here?

 

Dear NP Career Coach: 

 

I am a new grad NP and I am in the process of job search. I am struggling to get even an interview. Could you help me with how to market myself so that I can get the recruiters to look at my resume?

 

Dear New Grad NP:    

 

When crafting your new grad resume keep these points in mind.  
  1. Your resume needs to demonstrate that you have the skills the employer wants.
  2. The only thing that matters is what the employer wants. 
  3. As a new graduate the most marketable experience you have is your clinical rotations. 
    To be successful your resume must contain clear and easy to find information.  You can’t get an interview if the recruiter can’t determine whether or not you meet the requirements.   Your resume will have about 30 seconds to catch the eye of the employer, so it’s important to be sure all the info in your resume is easy to find.  The reader shouldn’t have to strain or work hard to figure out who you are. 
    In today’s market employers are expecting to receive a resume that is tailored to the position.  When creating their first NP resume many new graduates get carried away and include too much extraneous information.  Remember, your resume is just a snapshot to show the employer you are a match – not your entire life history.
    First, you must make it clear to the reader that you possess the appropriate educational preparation.  Place your educational section at the top of your resume. Make sure you have included your degree and the dates it was earned (or will be earned).   You can safely omit elements like your GPA, thesis, or doctoral project.   This simply adds clutter to your resume without increasing your marketability.  I know you worked hard for your GPA, but it doesn’t belong on your resume. 
    Second, clearly indicate your certification.  You will be seen as ineligible for the position if information relating to your certification status is missing. Identify the name your certifying body and note either “current” or the expiration date of your board certification. If you have not yet taken boards note “pending” or your scheduled test date.     Also, be sure you list your RN licenses.  This may seem like a no brainer but it is important that your nursing license(s) be on your resume.
    Next is your experience section.   As a new grad your clinical rotations are your most pertinent and relevant experience.  Take a look at the job posting and find the skills the employer has stated are a requirement.  Then make sure you mention those skills in your student experience section.   Avoid statements that reflect minimum entry levels skills.  It’s a waste of space on your resume to say “manage acute and chronic conditions” or “history and physical exam skills”.  That won’t set you apart.  Give the recruiter some real data about procedures, specific conditions and populations.   You should find this data in your clinical logs. 
    Finally, take care not to focus on your RN experience.  Employers like to see that you had RN experience but they are not interested in your RN duties.   A simple entry indicating the department where you worked in will be sufficient.   You are applying for an NP job and you are a new NP graduate, however, you are competing against candidates who have NP experience.   To put it bluntly, what you did as an RN will not trump actual NP experience so it’s best not to waste the resume space because it won’t make you more marketable.  If the employer wants to hear more about your RN jobs they will ask you about them in an interview. 
    Oh, and a nice cover letter will help you get noticed too. 
    I will send you my cover letter and resume guides via email. 
    Good luck and keep me posted on your job search. 
    ~Renee
     

Employment Contracts and Never Having to Say You Are Sorry

Count contracts among the top things you want to get right, or as close to right, as you can before you sign on the dotted line.
TIMING IS EVERYTHING
You should receive a copy of the employment contract either at the same time the offer is extended to you or shortly thereafter.  NEVER, EVER accept an offer until you have had time to fully review the contract.  In my experience, it is not so much that NPs and PAs regret the items they agreed to in their contracts as much as they lament what they neglected to include.

A typical contract is 1-2 pages and commonly uses boilerplate language.  It is sort of a one-size-fits-all form where the employer fills in the proposed pay rate, whether employment is full time or part time and a general description of benefits.  Many may also include a non-compete of some sort.

 
THE BALL IS IN YOUR COURT
Upon receipt and review of the contract you can either 1. accept it, 2. reject it, or 3. negotiate the terms.  Life is easy if you just sign it, which is what the employer is hoping.  And to be honest, quite a few of us feel just a little intimidated and so we close our eyes, hope for the best and comply.  Why? One reason is because we lack the training on employment contracts.  This is especially true for the new graduate NPor PA who has no prior experience in contracting and feels unsure about what is appropriate or how to respond.  It can also be a little intoxicating to receive that first job offer. I often compare it to a marriage proposal in which we are so flattered that we just say “yes” before thinking it fully through.
COUNTER OFFERS
Contracts needn’t be “standardized”. It’s your prerogative to negotiate and you can choose to include anything that is important to you.  In addition a wise NP or PA will clarify any points that they find to be murky or lead to possible confusion down the line.  So, rather than just signing as is use the option to add or delete information and send the edited the contract back.  That’s called negotiation.
*Note – etiquette dictates that you submit a counter offer only once. Employers have little appetite for a prolonged back and forth so you need to carefully think through your response.  In other words, you don’t want to find yourself in a situation where you are countering your counter.  Know your bottom line and leave it at that. 
WHAT TO INCLUDE
Wouldn’t it be nice if you had a handy checklist of items so you could more fully evaluate a proposed employment contract?  I want to share with you a reference that is the most comprehensive list for contract negotiation that I have come across.   It is identified as a “sample NP contract” but would work nicely for a PA as well. Click here 
The only thing I disagree with in this sample contract is the term length.  The sample utilizes a term of 5 years.  That’s an awful long time to commit to a new relationship!  I suggest a shorter term of 1-2 years.  Healthcare is changing rapidly and a shorter term gives you the chance to renegotiate sooner.
If you need more explanation on how healthcare changes can impact your employment please read my article “Contracts:Avoiding the Wrong Regrets”

 

I’m sorry, I couldn’t hear you over what your clothing was saying!

Initial impressions are strong and lasting.  It has been said that we will form our opinion of someone within the first 5 minutes of meeting them.  Of course, since we cannot truly begin to “know” another person in only 5 minutes it only stands to reason that our first opinion will be based mostly on what we can readily observe.   

Let’s apply this information to your next job interview.  An interviewer’s first, and most conscious, observation is going to be your attire and grooming.  Both of those factors create a very strong first impression. Unfortunately it is one of life’s little ironies that bad impressions will tend to make a bigger impact and last longer than do good impressions.   

 

This is why you need to get it right.  If you want to have a successful interview and get hired it is essential that you be remembered for what you had to say rather than for what you were wearing. 

Do not make these 3 mistakes: 

  1. 2001 is calling and wants their outfit back.  You really should update your interview wardrobe more often that you vote in a presidential election.  Yes, even the “classic” looks change over time.  Have you been holding on to an old suit because you think it will come back in style? Oh it will, but those sneaky designers will change it just enough that everything you saved will now look old rather than retro cool. 
  2. It’s never a good idea to look too trendy during your interview either.  Here is another tip – if you look in the mirror and think “oh, that’s really cute!” then don’t wear it.  Adults shouldn’t look “cute”. When you interview you want to appear to be professional not juvenile.  Stay away from loud colors, flashy shoes, plunging necklines and pretty much anything else that could do double duty on a Saturday night at your favorite nightclub.   
  3. Remember, it’s an interview and not a date.  Keep your jewelry simple, skip the perfume and tone down your makeup.  I recently interviewed a perfectly nicely dressed and otherwise very mature candidate, that is, except for the white sparkly eye shadow she was wearing.  I couldn’t stop looking at it!  What was she thinking? Well, I know what I was thinking – here is somebody with poor judgment

Stress is Contagious all Year Round

 

Have you heard about “secondhand stress”?  Turns out that stress may be transmitted from one person to another as easily as germs.  Dr. Amit Sood, who is an expert on stress at the Mayo Clinic, recently told the Star Tribune that “Stress travels in social networks,” and “It is highly, highly contagious.”

 

No surprise to any of us who have experienced stress in the workplace.  All it takes is one chronically anxious or irritable co-worker to start the wheels in motion and next thing you know the whole atmosphere at work has become toxic.  Early symptoms include decreased productivity, lack of morale and general mistrust.  Eventually, if not treated will result in chaos, back-stabbing and rapid staff turnover. 

 

No one wants to work in a toxic workplace.  The problem is that like many disorders, the condition is not always apparent to the casual observer.  And some organizations have become quite skilled in hiding their dysfunction. 

 

Since there is no known vaccine to prevent secondhand stress the best defense is primary prevention. In other words, you should avoid contact with the afflicted. 

If you are searching for a new Nurse Practitioner job,
the following suggestions will help you identify a potentially troubled workplace so that you do not fall victim to secondhand stress.     

Ask questions  

 

What happened to the person who was in the job before?  Why did they leave?  If your interviewer is hesitant or stumbles over their answer this could signal a problem.  Be especially alert for signs that the previous employee left suddenly or unexpectedly for reasons other than personal illness. 

 

Are there any other new staff?  If there seems to be an awful lot of new employees it could mean the organization or clinic has recently had a mass exodus.  If that is the case then you need to know why all those folks left.  

 

How long has the clinic manager been in their position? If there is new management, it could mean the organization is currently undergoing big changes and staff is still adjusting.  Some changes might be good ones, but change is still stressful.   

 

How long has the position been open?  Some jobs are open a long time for a perfectly good reason, but it could also mean no one wants the job. 

 

Do some cyber-snooping

Google the organization.  Many healthcare websites have ratings and allow comments.  Disgruntled patients can be a sign of an unhealthy environment.  Facebook and twitter might also give you a snapshot of what employees and patients are saying about the hospital or clinic.  Granted there will always be a one or two complainers but if you see a pattern then you should start to wonder what is going on. 

See for yourself

 

If you still have that nagging feeling that something doesn’t seem quite right you might consider asking for a “Shadow day”.  It’s easy for an employer to put on a good face or talk a good game during an interview.   Spending a half or whole day shadowing is a great way to get a feel for an organization.  Stress is hard to hide.  According to the article, the source of the stress can be compared to a vibrating tuning fork that causes everything close to it to vibrate as well.  Trust me, it won’t take you long to pick up on vibrations. 

Nurse Practitioners: Have you Branded Yourself?

 

Nurse Practitioners specialize in a number of areas from Acute Care, Family, Adult, Oncology and Woman’s Care just to name a few. Because of these highly specialized required skills set employers can have trouble finding top talent to fill their positions through traditional job postings. That means corporate healthcare recruiters turn to recruitment agencies and social media for help source the right candidates. Nurse Practitioners should take this opportunity to brand themselves on their social platforms because recruiters are looking to the web in places like Google Plus, FaceBook, Twitter, LinkedIn, Blogs and other online platforms to find the best talent!  

 

What do I mean by branding? Branding is simply a way to promote yourself much like the way Pepsi brands and promotes their products. Personal Branding is a way to showcase your unique abilities and skills as a professional nurse practitioner. Check out Dan Schawbel’s PersonalBranding Blog. He’s an expert on building personal brands and has incredibly useful information to help you brand yourself. I also recommend using the platform Brand Yourself. The Brand Yourself website is free and will help you clean up your online identity with the goal of your name and brand rising to the top of recruiters’ organic searches for “Nurse Practitioners”.

Once you have established your personal brand and identity it’s time to update your social media profiles to host the same information. Keeping your message clear and consistent will help your profiles rise to the top of Google searches and will nicely package your online personal brand. Carefully select which social media profiles you wish to be professional. Starting with LinkedIn is always best and then make decisions as to whether you want to add Twitter, Facebook, Pinterest and blogs. When settling up your profile information make sure key information like your name (first and last) and title are public. The information that is public is the information searchable by recruiters.

After your brand has been establish and your profiles are updated you can begin to network. Start with linking in to like professionals, past professors and any professional connections you’ve made through your work and schooling. Participate in LinkedIn groups and Twitter conversations. Seek out companies you wish to work for and their human resources recruiters and/or hiring managers and make connections. Just like in the “old” days networking has been very effective in helping people find and gain employment. In today’s world both traditional and social media networking is important in building those relationships and will help you stand apart from the rest of the competition.

As a professional healthcare recruiter I see firsthand how online branding can increase the chances of top talent being found. So go forth and take ownership of your personal brand today!

Guest Blogger:My name is Bonnie Ungaro. I am a corporate healthcare recruiter for Centegra Health System. We are a fast growing healthcare system in McHenry County Illinois (A northwest suburb of Chicago). Currently we are seeking multiple Nurse Practitioners to fill our newly created Acute Care positions.. We are also seeking Nurse Practitioners to support our physician practices in local nursing homes.
If you’re interested in this opportunity we would love to hear from you!!  To learn more about our positions I invite you to check out our Careers page here.

If you’re interested in learning more about our Acute Care Nurse Practitioner positions please contact me at: [email protected]

5 Steps for an Effective New Grad NP Job Search

Hello New Grads!

Abe Lincoln once advised “If I had 8 hours to chop down a tree, I would spend 7 sharpening my axe”.


Don’t get worried, I don’t actually want you to chop anything down! My point is that I want you to be well prepared before you begin your NP job search.

In my last column for Advance for NPs & PAs I outlined 5 essential steps to include in your job search plan.

In my column you will find advice on

  • Applying too soon (yes, you can apply too soon)
  • Finding and choosing the proper references
  • How to sell yourself and your skills
  • Handling the dreaded “strength and weakness” interview question.

Click here to read more

Successful Job Searching after 60

Many of my posts are aimed at the New Graduate NP or PA but recently I had a question from a reader who was concerned about finding a new job after 60.

Dear Career Coach: I am wondering if you have any thoughts or advice about finding a job after age 60. I have been in practice for about 18 years. I am finding it rather scary to quit my job because I am worried about whether I will really be able to get another job. What do you think?

Dear Mature Job Seeker: Employers are looking for two main characteristics when they hire an employee. The first characteristic is your skills and expertise. After 18 years in practice I think we can safely say you should have no problem meeting that standard. But having experience isn’t enough, because the second thing most employers are looking for is employees who will stay with them for the long term. We all know that technically (and legally) an employer is not allowed to factor your age into their hiring decision, but I think we would both be kidding ourselves if we think that an employer is eager to hire someone who is within shouting distance of their retirement. The truth of the matter is that hiring a clinician is expensive and time consuming, and employers don’t want to have to go through the hiring process every couple of years – especially during tough economic times.

One option you may want to consider is doing a temporary or locum tenens assignment. You might find that short-term assignments are a nice fit with where you are in your career journey. This is the one setting where long-term commitments are not required or expected. Assignments can range anywhere from a few weeks to a year in length. When I was recruiting I filled many of my temp positions with “mature” clinicians who liked to work temp positions because they enjoyed the freedom and the variety. And did I mention the pay? Temp jobs usually pay very well. If you are willing to travel the opportunities are even greater.

Teaching is another idea you might want to entertain. Many colleges and universities employ folks in our profession in an “adjunct” type position to work with nursing or other healthcare students. They may have a need for teaching or assisting with specific courses or for supervising the students in their clinical rotations.

Above all, no matter what your age, I never advise that you quit your current job until you have a new job secured

Click here to read my original post and comments. 
Seems I stirred up a bit of controversy!