7 Things You Should Consider In a Nurse Practitioner Employment Contract

As a new nurse practitioner, I was so excited to have found my first NP position that I did a terrible job of contract negotiation- in fact, I didn’t negotiate at all.  Not only did I not negotiate any points in my contract, I also did not seek understanding on matters in the contract that lacked clarity or needed further explanation.  Big mistake.  Don’t assume your employer has your best interests in mind.  They may, and I hope they do, but make sure everything you have agreed upon is written in detail in your employment contract to protect yourself and ensure you are treated fairly should a discrepancy arise regarding your terms of employment.  What issues should you consider negotiating in your nurse practitioner employment contract?

1. Salary

I will begin with the obvious.  Of course, as a nurse practitioner you want to make some money.  How much do you ask for?  The average nurse practitioner is paid a salary of $90,583.  Nurse practitioners paid on an hourly basis earn an average of $47.63 an hour.  Use these numbers as markers in considering the offer your potential employer presents.  Working in a specialty clinic should pay more than average (see our list of nurse practitioners salaries by specialty).  If you have very little or no experience as a nurse practitioner, you can expect to make less than average.  Being paid on an hourly vs. salaried basis can make a difference in your career.  If you are paid a salary and frequently find yourself staying at the clinic or hospital late, you will be frustrated as you are “working for free”.  Being paid on an hourly basis may give you more flexibility and ensures you are paid for any extra hours you put in.  If your prospective employer offers you a low salary or hourly rate, reference the average NP pay as a way to negotiate a better income.

2. Bonuses

This is where my first nurse practitioner contract negotiation experience went bad.  If your employer offers productivity bonuses, make sure your contract states exactly how bonuses will be paid and when.  Make sure you understand your potential employer’s bonus structure in detail.  If the bonus structure is not well defined or the employer is not willing to define exactly how much you will be paid you should be wary.  My first employer had an ill-defined bonus structure that promised to pay out up to $25,000 a year based on productivity.  I worked very hard and was never paid a bonus at all.  Be careful of empty promises regarding bonus payments.

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3. Continuing Education Allowance

Most employers offer nurse practitioners a continuing education allowance to help pay for licensing fees as well as continuing eduction courses required to maintain your nurse practitioner certification.  This is a great perk as licensing can be expensive.  Continuing education conferences are also a great way to take a vacation and meet other fellow nurse practitioners.  Typically, for nurse practitioners continuing education allowances run anywhere from $1,000 to $4,000 each year.  The average allowance is around $1,500.  I would not consider this a make-or-break contingency of employment but it is definitely something you should consider in your contract negotiation.  If your employer offers an amount on the lower end of the spectrum you may want to ask for a higher allotment.

4. Insurance Benefits

Most employers offer some form of health and dental insurance.  In my opinion, health and dental insurance are often receive too much attention by NP’s looking for employment.  If you are relatively young and healthy and you do not like the plan your prospective employer offers or if the employer does not offer insurance, you may be able to get an individual plan at an affordable rate.  My employer does not offer health insurance.  Before I signed my employment contract, I was able to get an individual health plan for only $85/ month.  Because my employer paid a much better salary than other clinics where I was looking to work, it was worth it for me to forgo working somewhere where the employer offered a traditional health insurance plan.

5. Retirement Benefits

You should pay attention to retirement benefits offered by your prospective employers and consider them heavily.  If your employer offers a 401K match or contribution, you could end up with thousands of dollars deposited each year into your retirement account.  As a nurse practitioner, I have seen a wide variety of offerings among employers.  Some clinics do not offer any retirement plans, others offer an IRA type plan with no contribution while others put a set amount or a percentage of your income into a 401K account.  Make sure your retirement benefits are stated in your contract.

6. Schedule Flexibility

There is a lot to be said for how flexible of a schedule your work will allow.  Working longer shifts and fewer days each month may be beneficial to you if you like to travel or simply enjoy time off during the week.  If you have children and need a regular 9-5, longer work days may not be the best option for you.  Consider your lifestyle and what scheduling needs you have.  One of the best things about being a nurse practitioner is there are a wide variety of scheduling offerings available.  As a nurse practitioner, I have discovered the joy of the 3 or 4 day work week and can never go back!  I would highly recommend an employer who gives at least one weekday off.  If this is a perk you want, ask for it when you are negotiating your contract and get it in writing.

7. Vacation Days

As a nurse practitioner, you are going to need to take some vacations!  This will help you prevent burnout.  You also need to plan for family obligations etc. Most employers offer two or three weeks of paid vacation.  If you think you will need extra time, be sure to negotiate a few extra vacation days into your contract- two weeks of vacation gets used up quickly!  If your employer does not offer paid vacation, make sure your schedule is flexible enough that you can get away on occasion.

Is there anything you wish you had asked for in your NP employment contract?  Let us know!


21 thoughts on “7 Things You Should Consider In a Nurse Practitioner Employment Contract”

  1. Aimee Satterfield

    Oh My Lord, I am grasping for Anything here, been on the internet for days trying to figure out how to “right the wrong” of my negotiating naivety! Quick rundown- 5 months into my “dream job” and I am discovering that I made a Huge mistake of taking Much Less than I am worth (even as a rookie- although I did have 6 months experience as an ER provider, which was not easy)! I have no benefits at all and have had to defer my student loans (a Big No-No) because I took a job for the opportunity and not the money. Surely there is a balance, I just need guidance in getting there! I know that the revenue has had to increase in my short 5 months at this practice, although I have no idea how to get the numbers- and I can’t help but feel I am being taken advantage of (if even subconsciously)- since I am seeing almost all of the patients each day with minimal guidance. I know I am making probably 1/4 or less of what the MD is banking, even though he rarely sees a patient! I do not want to leave, just want to understand what I’m worth and how to ask for that! The last line on this site says “is there anything you wish you had asked for in your NP employment contract? Let us know!” I sure hope someone can give me guidance with this! Thanks in advance ~Aimee B Satterfield FNP-BC

  2. I am a new NP who still needs to sit for boards. I have bunch of question like interview skills, job, board exam and how to get more marketable with flexible hours and lucrative salary
    Any website, info or thoughts please???

  3. Hi Smiley,

    Check out these posts for some guidance:

    The Sweet Spot: When Will You Find Your Dream Job an an NP?

    How to Write Your First Nurse Practitioner Resume

    National Nurse Practitioner Certification Exam: What is the Best Way to Study?

    5 Steps to Nurse Practitioner Certification

    As far as finding a job with flexible hours and a lucrative salary I would focus on finding a job in a supportive environment first.  As a new NP you will have a lot of questions.  It’s better to find a job willing to help you continue to learn becoming more proficient.  Then, you will have the skills you need to ask for above market pay and find more flexible hours. 

  4. Hi Aimee, 

    I think a lot of NP’s are in your situation- right out of school they take a job just happy that they have an offer rather than negotiating their salary.  

    Here’s what I would do.  Set up a time to meet with your employer.  Have a proposal ready for the meeting with a copy for you and your boss to go over.  In it, I would out the average number of patients you see each day, how your skills have improved over the first months of your employment and your current salary.  Then, I would find the average salary for NP’s in your state and your city if you can find this information. Check out the post Nurse Practitioner Salaries by State: How Does Your State rank? for help.  Include this salary information in the proposal as well.

    In the meeting, ask for the salary you think is fair.  I would probably go with what is average for your state, certainly not more since you are a new grad.  Then, hopefully your employer will negotiate with you from there.

    If your employer isn’t willing to offer a higher salary, I would stay in your current position until you have been there for a year.  This way, you can show future employers you stuck out a bad situation for at least a year.  Then you can move on and work elsewhere for better pay. 

    Hope this helps!  Let me know if you have any further questions.

  5. I would add that you want to check your contact for the following:
    1. How much advance notice of termination does the employer demand–I recommend keeping it to 30 days–45MAX. If you find in time that you want to leave your employer, any prospective new employers will naturally want you to start ASAP. If you are “stuck” at your old job for too long before you can start the new one, you may be passed over for another candidate, and therefore remain “stuck”.
    2. How much notice does the employer have to give you if THEY decide to terminate your employment? It should equal what you are required to give them.
    3. How are disputes (if any should arise) to be handled? Some employers have clauses in the contract that stipulate “binding arbitration”–not always a good thing. I know…I know…we all think, “What kind of disputes could there possibly be?” BELIEVE ME: they can arise–especially in small offices. Disputes over bonuses not paid, vacation time you were supposed to get, but somehow, they can’t ever approve your time off because they’re too busy, and many other issues
    4. You should be allowed a 2-3 month probationary period during which either party (you or the employer) can just decide it’s not working/ not a good fit, and neither owes the other advance notice
    These are just a few things I learned (the hard way) to keep an eye out for
    Take your TIME!! Take the contract to an attorney BEFORE you sign! It will be money well-spent.

  6. Chrisy Etheridge

    I am an new grad from a FNP program and have a job interview today with a pulmonologist that I worked with as a RN in the ICU and during clinicals. He called me a skiing if I was interested in working at his clinic and rounding on his hospital patients. I have no idea what to ask for in terms of salary vs bonuses. What is a “normal day” for a mid level that sees clinic patients and hospital patients? Should I ask for hourly or salary?

  7. Does anyone have any thoughts on Noncompete clauses? I have an offer from a local community health center which includes a non compete clause restricting providing medical care within 10 miles of the center for 1 year after leaving. Many of the NPs I know don’t have a similar clause with their employers. Is this typical?….Thanks. Mike

  8. I have heard of some companies that don’t offer employment agreements. I would proceed with caution. Make sure the company provides you with proof that they are paying for your malpractice insurance if this is part of their verbal agreement. Getting at least the basics of the terms of your employment in writing ex. pay, benefits etc. is always best. If they won’t offer this, it is a sign you may be entering a poorly managed practice. If you do decide to accept the position, do so knowing full well that the terms of your verbal agreement may fall through. 

  9. I have been a fnp for 15 years. When I first started I worked clinic only but about 3 years ago I started working emergency room 1 to 2 days a week because I was approached due to need for coverage. The hospital and clinic are owned and managed by the hospital. I receive production of $3 per patients seen in clinic but none for working emergency room. I was salary up until 2 new grad fnp’s was hired 2 years ago when I was switched to a hourly rate and started clocking in and out. I miss lunches frequently when working er and then have to fill out missed lunch slips in order to get paid. The 2 new fnp’s refuse to work er which is their decision and I am fine with that but I found out recently that they get paid $ 1.50 an hour less than I do. Our production numbers are the same in the clinic even tho they are in clinic 5 days a week versus my 3 days and I am filling a needby working er. So I am looking at negotiating my salary. I am going to ask for a base salary for the clinic of $102,000 and ask for additional salary for covering the emergency room. I am looking for an opinion on this. I am unaware of how many fnp’s work like I do?

  10. I hired a a law firm I discovered on-line that specialized in physician/NP contract negotiations!! WHAT A FIND. I highly recommend it. There are three levels at different costs, one is to just review and make corrections, second is to review make recommendation and give you tips on how to negotiate, and the third level does all that and negotiates for you!! THis is WELL worth the investment!

  11. I was just given a contract with a “reimbursement obligation” stating I need to pay them $1,500 a month for 6 months for training. I think that’s outrageous and insulting. Should I even consider negotiating with this company if they think that’s okay?

    1. Wow, I am a physician looking at this site to see what NP’s are typically getting. I think this is great! I have been very angry in the past with the fact that I am paying a new NP to work for me while I am giving them a free education. Then they like to move on after I educate them to a more lucrative specialty or hospital job. I simply won’t hire an inexperienced NP now. Not to mention the NP students I have let rotate through for free while they pay their school for my services. . .

  12. Hi there! Someone in my Facebook group shared this site with us so I came to
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