Have you seen The Devil Wears Prada? If not, head to your sofa and tune in to Netflix, now. The film falls among my favorite watch over and over again chick flicks. But, I think we can all agree the level of new grad friendliness of Andy’s job as an assistant for fashionista Miranda Priestly is at an all time low. While new grad nurse practitioners aren’t typically charged with Starbucks runs and tracking down unreleased copies of Harry Potter novels, new grad NPs all too often find themselves in positions that aren’t supportive of their inexperience.
Many nurse practitioners find the learning curve associated with being a new graduate surprising. They also find themselves taken aback by how little support their new employer offers. One would think sufficient training would be part of the hiring package, but many clinics and hospitals don’t have adequate provider staffing to offer the support new nurse practitioners may need. Others are all about the bottom line and have a sink or swim attitude, newbie or not.
Advertising your inexperience and need for continued learning in an interview isn’t advisable. After all, employers are looking to hire NPs who will be an asset to the practice, not a drain on resources and energy. Fortunately, there are a few questions new nurse practitioners can ask in a job interview to determine if the position on hand is likely to be new grad friendly.
1. What challenges do nurse practitioners working here commonly face?
Asking about challenges nurse practitioners face in a practice environment gives you a hint as to the hurdles you will personally need to overcome as well. If an employer answers this question by saying “nurse practitioners often have trouble keeping up with the pace of the clinic”, “NPs often find their administrative workload demanding” or “the acuity of patients we treat here can be overwhelming”, the job may not be the best place to start your career. If the answer is something more like “working overnight hours can be difficult”, you can expect logistical challenges which are certainly something new nurse practitioners can overcome.
2. What is your patient volume? How many patients do nurse practitioners working here typically see per hour?
Getting an idea as to the number of patients nurse practitioners are expected to treat per hour as well as the patient volume of the practice as a whole is a clever way of ascertaining what will be expected of you personally should you accept the job. Clinics expecting nurse practitioners to treat more than four patients per hour are unlikely to be set up for new grad success. Practices expecting nurse practitioners to treat three or fewer patients per hour will be more practical places for new nurse practitioners to work.
Give bonus points when considering a position to clinics offering a graduated patient load. These clinics offer new nurse practitioners a lighter schedule for a few months letting them build up to the standard volume of the practice. This indicates the clinic has realistic expectations as to what new grad can handle.
How success is measured quickly gets down to the mission and values of a medical practice. If the practice measures success based solely on revenue, expect to be overwhelmed if you are a new graduate. Clinics focused exclusively on billing tend to be “patient mills” encouraging high volume and aggressive billing practices. Practices with a more balanced measure of success including patient satisfaction and quality of care are more likely to provide a solid new graduate nurse practitioner experience.
4. Have you ever hired new graduate nurse practitioners in the past? Do you have any concerns about my ability to succeed in this position?
Practices that have hired new grad NPs in the past and are continuing to do so often make the best places to start your career. These practices understand the learning curve nurse practitioners face after graduation and have worked through the education to practice transition with other employees.
Following this initial question up by giving the prospective employer an opportunity to address any concerns he/she might have about extending you an offer does several things for you. First, it shows professional maturity. You understand you aren’t going to be an MVP day one on the job. Second, it highlights your willingness to learn and accept constructive criticism. Addressing your weaknesses is the first step toward improvement. Finally, it gives you a chance to reassure the prospective employer that although you are a new graduate, you plan to become a highly productive member of the practice.
5. How will I be paid?
Nurse practitioners are typically paid on one of three compensation structures. They may be paid on an hourly or salaried basis, or based on productivity. Productivity-based practices or those where compensation is heavily influenced by a bonus structure aren’t easy places to get your bearings as a new nurse practitioner. A pay structure encouraging you to treat a high volume of patients isn’t as conducive to learning as an hourly or salaried position.
6. How closely do physicians, nurse practitioners, and other providers collaborate?
Even if laws in your state require nurse practitioners to work under a supervising or collaborating physician, this doesn’t necessarily mean the MD will be readily available should a question arise. Practices that value collaboration and work together on some level in treating patients make the most supportive environments for new nurse practitioners. Practices with multiple providers and/or shared office or desk space are ideal. This makes asking questions convenient and the burden of helping you doesn’t fall on one individual.
7. Can I stop by for a few hours to observe before signing a contract?
If you are offered a job, it’s perfectly appropriate to ask if you can stop by the practice to observe or job shadow another nurse practitioner for a few hours to make sure the setting feels like a good fit before signing on the dotted line. Not only does this give you a firsthand look as to what the job in question looks like on a day-to-day basis, but other employees are also likely to share their opinions of the employer and position. Be careful-don’t engage in gossip etc. if it comes your way. Remain neutral and professional. You are still in the hiring process even if an employment agreement is sitting in your inbox.