Organizational Behavior and Business Influences and Advanced Practice Nursing Case Studies
NR 510 Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One
NR 510 Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One – You are a family nurse practitioner (FNP) employed as a contract (1099 independent contractor) in a busy primary care practice for 2 years. The providers in the group include one physician, who is also the owner of the practice, and two other nurse practitioners, who are staff employees (W2 employees). The owner of the practice recently made comments about the need to produce more revenue. You relate with his concerns and feel that you have several strategies that could be helpful. Organizational Behavior and Business Influences and Advanced Practice Nursing Case Studies. Your contract is up for renewal in 3 months. You are highly satisfied with your job and want to stay with the group. You see 20 patients per day on average and take call every third weekend.
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NR 510 Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One Discussion Question:
NR 510 Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One
This week we learned the importance of contracts and negotiation skills to the Advanced-Practice nurse. There is a significant financial difference to company revenue between 1099 contractors and W-2 employees. 1099 contract workers have more independence and flexibility when it comes to schedule making, and are more autonomous than their counterparts (Fitzgerald, 2016). W-2 employees have benefits of overtime, health insurance, paid leave, retirement benefits, and workers compensation (Fitzgerald, 2016). Being a contract employee saves the physician money as he does not have to provide these benefits. Organizational Behavior and Business Influences and Advanced Practice Nursing Case Studies. Studies have shown that contract nurses have lower rates of nurse and patient satisfaction (Hockenberry & Becker, 2016). Work environment and the nurse-to-patient ratio, or workload, also seem to affect patient satisfaction (Hockenberry & Becker, 2016).
As we learned in Chapter 10, an efficient Nurse Practitioner can increase productivity and numbers (Buppert, 2015). Every third-weekend call is ideal because there are three Nurse Practitioners. They can rotate through call. Although this would not be beneficial for the W-2 nurses, making everyone a 1099 contract employee would save the company money. Contracts would also ensure the nurses are treating patients extra great. Their jobs would be under contract and unlikely to be renewed if best care was not given. I could also mention paying for my own continuing education or license renewal if the company was paying for it. If the employer saved enough money by making everyone 1099, he could potentially hire another contract nurse to bring in more patients. In my opinion, my suggestions for the company and work ethic should be enough to renew the contract. The individualized care, without rushing, may make the patients more satisfied. I do not want to work myself to death and should negotiate to benefit both myself and the primary care office. Organizational Behavior and Business Influences and Advanced Practice Nursing Case Studies. I have never had to arrange terms or a job, so this was somewhat difficult for me to come up with. Only ask for what is right and earned. I am interested to see strategies for contract renewal that everyone else suggests.
Fitzgerald, C. (2016). When tech startups outgrow the 1099 model: Moving firms out of the kiddie pool. Vanderbilt Journal of Entertainment & Technology Law, 18(3), 629-652.
Hockenberry, J. M., & Becker, E. R. (2016). How do hospital nurse staffing strategies affect patient satisfaction?. ILR Review, 69(4), 890-910. doi:10.1177/0019793916642760
Buppert, C. (2015). Nurse practitioner’s business practice & legal guide (5th ed.). Retrieved from https://bookshelf.vitalsource.com. Organizational Behavior and Business Influences and Advanced Practice Nursing Case Studies.
NR 510 Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study Part Two
NR 510 Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study Part Two – As revenue generators, NPs must be aware of how their work contributes to the overall revenue of the clinical practice. You see 20 patients per day on average and take call every third weekend. According to Buppert (2011), an NP who sees 15 patients per day at $56 per patient visit, on average, brings in $840 per day. Allowing 1 week off for continuing education, 1 week off for illness, and 4 weeks off for vacation, this NP will bring in $193,200 a year, potentially. However, not all bills are paid. With a 90% collection rate—a reasonable collection rate for an efficient practice—this NP actually will bring in $173,880 per year. An NP who sees 24 patients per day will bring in $1344 per day, or $309,120 per year in accounts receivable. With a 90% collection rate, this NP will bring $278,208 to the practice (Buppert, 2011). Organizational Behavior and Business Influences and Advanced Practice Nursing Case Studies.
Establishing a salary can be a challenge for NPs. Deducting 40% of the NP’s gross generated income for overhead expenses (rent, benefits, continuing education, supplies, malpractice, lab expenses, and depreciation of equipment) leaves $104,280 for the 15-patient-per-day NP and $166,925 for the 24-patient-per-day NP. Further deducting 15% of that figure to pay a physician for consultation services leaves $88,638 in salary for the 15-patient-per-day NP and $141,887 in salary for the 24-patient-per-day NP. Deducting 10% for employer profit leaves $79,775 in salary for the 15-patient-per-day NP and $127,699 for the 24-patient-per-day NP (Buppert, 2011).
What salary would you propose for the contract renewal? How does your salary proposal fit in with the community standard for an NP in a similar practice? Use logical reasoning, and provide evidence based rationales for your decisions. Organizational Behavior and Business Influences and Advanced Practice Nursing Case Studies. Keep in mind that your negotiation terms and conditions must be within the legal scope of practice for an ANP.
NR 510 Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study Part Two
After reading through the case study, there is definitely some figuring to think about. In all honesty, I would feel that the 24-patient-per-day salary is what I would propose for, because of many reasons. Where I currently work as a RN in the Emergency department, we occasionally float to the urgent care to work. This is a rural hospital, but it is a very busy facility. During the winter months, it is not uncommon to see upwards of 60 patients in a 12 hour period. This is definitely a large patient load for 2 nurses and one nurse practitioner. I have worked in that setting, and seen the struggle that it can be, but 24 patients in an 8 hour setting is 3 patients an hour, on average. Organizational Behavior and Business Influences and Advanced Practice Nursing Case Studies. The AANP suggests that the majority of nurse practitioners see 3 or more patients an hour (AANP, 2018)Organizational Behavior and Business Influences and Advanced Practice Nursing Case Studies.
To be honest, I would want to suggest a higher salary if I was applying for a position in an urgent care such as this one. If I was seeing 60 patients a day at $56 per patient visit, I would be bringing in a revenue of approximately $870,000. This is nearly 3 times as much as a 24-patient-per-day nurse practitioner. Granted, this is for 24 hour shifts, where the 24-patient-per-day is more than likely an 8 hour day. The nurse practitioner may treat four or more patients per hour throughout the entire work day in an urgent care setting (n.a., 2016). Working in the urgent care doesn’t have the luxury of having a schedule, so the amount of patients that you may see could be greater or lesser than 4-per-hour. Organizational Behavior and Business Influences and Advanced Practice Nursing Case Studies. On average, it will all even out. I think that when determining salary, it matters where they anticipate you to be working. I would like to work in an urgent care versus a primary practice, so I would want to have a higher salary than what the 24-patient-per-day nurse practitioner proposal states.
NR 510 Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study Part Two References
AANP, (2018). NP Fact Sheet. Retrieved from https://www.aanp.org
n.a. (2016). How many patients should FNPs expect to treat per hour. [Web log post]. Retrieved from https://www.midlevelu.com