NAPNAP Career Resource Guide
Organizing Your Pediatric Nurse Practitioner Job Search
To maintain your momentum, establish daily and weekly goals. This will help you keep your job campaign focused. Here are some suggested weekly activities:
- Visit NAPNAP’s Career Connection to find opportunities that match your criteria.
- Identify people in your network that have a relationship with the jobs you have identified, set a time to talk with them, and ask them if they have information on the job, work environment, culture, and links to contacts.
- Track your network leads and contacts in your tracking tool.
- Establish a realistic list of search activities for the week.
- Review and document your activities.
- Review the previous week’s calendar for follow-up activities for the new week.
- Don’t forget to keep track of any PNP job search expenses. Doing this weekly may save you time and effort at tax time.
Nurse Practitioner – Ambulatory Care Setting
Interested in a nurse practitioner (NP) role in an ambulatory care setting? Here are some ideas for getting your foot in the door.
Take advantage of the opportunity to sell yourself and to sell the NP role. Seek out practices or organizations that are hiring NPs, physicians or physician assistants. Start with the office manager, advanced practice provider or physician and ask if you can have a few minutes to talk with them. You may have the opportunity to create a role for yourself. Follow these steps:
1. Learn who is hiring
- Check internet job sites like NAPNAP’s Career Connection.
- Network with other NPs by attending NAPNAP chapter meetings or meetings of other NP or child health groups.
- Use your online networking connections.
- Use search firms and do not limit yourself to those specializing in NPs. Contact the ones specializing in recruiting physicians as well.
2. Talk to the right person
- This is usually not the receptionist.
- Leave a message for the hiring manager to call back. See if you can make an appointment to speak with the hiring manager in person. The hiring manager might be an advanced practice provider, physician or business manager. Depending on the person, a call or meeting is a good way to explain the advantages of NPs if they are not familiar. Be brief — do not take up more than 15 minutes.
- If dealing with a large company/hospital, make an appointment with the department chief or advanced practice manager/administrator. Do research to determine the best individual to target.
3. Know your stuff
- Be prepared to answer questions about scope of practice, patient satisfaction, cost effectiveness and job descriptions of NPs.
- Provide the hiring manager with handouts on NP education, training and collaborative agreement if required by the state. Check out our professional issue FAQs (requires logging in to access) and position on Post-Licensure Clinical Training.
- If you have an area of expertise (i.e., asthma, breastfeeding), let them know.
- Have a detailed curriculum vitae that outlines your accomplishments.
- Stress your NP training and experience.
- Use this as a perfect opportunity to educate a non-NP hiring manager on the role of a PNP — even if you don’t get the job.
4. “Manager of your Career”
- In your current work environment you can be the “manager of your career” by promoting NPs and educating physicians and staff about your role, responsibilities and capabilities. If you’re in a hospital ambulatory setting this can be through everyday contact or through committee membership. If you are in private practice, you can network with other practices through referrals and NAPNAP meetings.
- Anticipate participation in practice meetings and formal and informal education.
- Provide information to families about your training, education and experience.
- Visit referral offices to introduce yourself and encourage referrals to a PNP.
- Hand out business cards with appointment reminders.
- Add NP names to signage, letterhead and the website for practice.
- Track data that shows quality care markers.
- Determine and apply appropriate productivity tools.
- Ensure office voicemail contains names of all providers including NPs.
- Ensure office website contains names and biographies of all providers including NPs.
Nurse Practitioner – Hospital-based Setting
NP Need Evaluation
Establishing your presence as a nurse practitioner in a hospital-based setting involves careful evaluation of the needs of specific inpatient service. When developing a new role, consider the following questions:
- Is there a NP already on that service? What are their responsibilities?
- What is the composition of the inpatient team? Attending, fellow, residents, medical students? Of them, who would you work with the most? Who would you be learning from?
- Are the physicians on this service familiar with PNPs? Be prepared to educate other providers on NP scope of practice.
- Does the service interface with many areas of the hospital? If so, who are your key contacts in those areas? How would you be communicating with them?
- What does a typical day look like?
- How are/could the NP responsibilities be unique compared to the other APRNs, PAs, residents or physicians?
- Will the NP be billing for services?
- What are the potential opportunities for professional growth?
- Are there opportunities to participate in research activities?
- Are there opportunities to provide formal educational offerings within the division? (e.g. journal club)
- Talk with other NPs who work in a similar service in another hospital. What were their challenges? What would they recommend in starting a position?
Many inpatient services have NPs, but their roles greatly vary depending on the service. Although physicians who have worked with NPs previously may have a better idea of what they think the role should look like versus a specialty service that has never had an NP, you can take responsibility over the long term of your role as NP. The following are some basic responsibilities:
- Many times the NP is the continuity for the inpatient service. This is especially true for teaching hospitals with residents that rotate every 1-2 months. However, if a service also has a fellow, the NP and the fellow will most likely provide the continuity.
- There may be specific patient populations within the service that you will be responsible for (i.e. complex, chronic patients or discharges).
- Rounds are an important time to not only learn from the attendings but also to discuss plans of care with patients and families. Determine the structure of the team rounds and the best way for you to contribute to rounds.
- Discharging patients home from the hospital is a complex process. NPs are uniquely positioned to be instrumental in the patient discharge process. What is the discharge process? What are the expectations of the hospital for discharges? How is this communicated and documented to families? Who performs discharge documentation? Who makes the follow-up appointments/referrals? What are the available support services? Case management, social work, PT/OT, nutrition.
- With a busy inpatient service, there will be times where you need to communicate with the chief resident/fellow/attending. How is this best accomplished?
- Education of families is paramount to the NP role. This can be difficult for an NP in an inpatient service, so you want to know who to best delegate to and allow time for this.
- One of the biggest difficulties for an inpatient NP is clearly delineating your role from that of the intern. You don’t want to be considered a “permatern” where the team thinks you are just another resident. Clearly define your role and how that will differ from your peers.
- Will you be responsible for any procedures? How are you trained? How is this documented and how will procedural competence be maintained? How many procedures per year are required for competence? Who will oversee your procedures until you demonstrate competence?
Career growth is an important part of an inpatient NP role. Ask about opportunities to present at local and national conferences, participate in research and participate as a member on hospital-wide committees or the hospital advanced practice council.
Leadership in your role will always be important. Who will be your advocates? Is there an MD lead, lead NP, director of professional practice, director of advanced practice?
Some inpatient NPs may also have outpatient responsibilities such as running an NP clinic, triaging calls from outside providers or refilling prescriptions. It’s important to know how your time will be divided and if some of those responsibilities could be performed by a nurse or nurse coordinator.
Think in terms of team dynamics, does everyone on the team know your role? Do you take responsibility for communication to patients, families, physicians and nursing staff? What do you want to communicate, how do you communicate, are you professional, what should that look like? The more you own your career and thus what you communicate, the more others will respect you, recommend you, and think of you when they have a job or opportunity.
Once you have done your research and begin to have some of your questions answered, you will need to create a document outlining your roles and responsibilities. Shadow other NPs in as many areas of the hospital that you will interact with (e.g. radiology, emergency department) and learn from other inpatient NP’s. Keep a procedure log and continue to set up regular meetings with your physician supervisor to evaluate the role and discuss any needed changes.
Nurse Practitioner Independent Practice
Nurse practitioners considering establishing an entrepreneurial practice should first complete a community and feasibility assessment, then contact the Small Business Administration, (SBA). The SBA can provide information about financing programs that may be available. Developing a business plan and exploring options for practice types (e.g., partnership, professional corporation, non-profit 501 (c)(3)) are important next steps. Networking within a community before opening a practice will enable the PNP to have the best understanding of the environment in which they will work.
Another opportunity may be to work as a self-employed NP with a physician. The physician can pay a majority of the overhead, be in a separate office and consult as needed using free technology and you can enjoy the benefits of an independent practice.
Here are some additional considerations for entrepreneurs
Prepare to work long hours
Nurse practitioners who own their own practice devote six to seven days every week, and numerous evenings, to the development of their practice. It can take as long as five to seven years to see a financial return on the practice, so it is important to establish your practice in a community where you are planning to reside for several years. Carefully consider what is required prior to establishing an entrepreneurial practice as it takes ongoing commitment (Stevens, 2011).
Plan to care for underserved populations
NP-operated clinics frequently deliver comprehensive pediatric health care for people of diverse cultural groups who have historically not had access to medical services. More than 4 million children are living in the United States without health insurance; there is likely an opportunity, if not a need, for a clinic in many communities. Patients’ healthcare needs in these clinics may be different from what the NP is accustomed to seeing in traditional primary care settings.
The leading health problems in underserved population clinics may relate to poverty:
- otitis media, lead toxicity, anemia, scabies, lice, urinary tract infections;
- drug-dependent babies;
- mental health—depression and aggression;
- pregnancies, maternal wellness, and OB/GYN issues that are referred;
- asthma, bronchitis, viral infections and high fevers.
Less commonly sought reasons for health care in this population includes well-child care and immunizations.
Persistence and creativity are keys to success
Consider creative partnerships. It may be possible to partner with another advanced practice provider to open a family clinic, a dentist to provide more holistic care in one practice environment or another NP to pool resources.
Prior to opening the practice, obtaining an NPI number and registering with Medicaid for reimbursement are necessary. Seek out individuals and major foundations to support the practice to offset care costs for those who cannot pay for services.
Apply for grants and foundation funding to enable the practice to have foreign language interpreters. Reaching out to the United Way may be an additional funding source and may also be a resource to obtain health insurance benefits for providers in the practice.
Maintaining a relationship with key professionals outside of the healthcare field will support a private practice. Relationships with bankers, an attorney and an accountant will make financial dealing less complex. When setting up a practice location, a realtor, architect and designer can give you an advantage in drawing in new business and making the practice environment welcoming to the clients. Using a public relations firm and web designer can boost business as well. Seeking expertise outside of medicine adjuncts your professional knowledge as an NP.
There are many details for starting an independent practice. The necessary paperwork, a realistic timeline, business practice approach, marketing plan, legal issues, hiring the right staff, office location, purchasing for the office and affordability are all issues that must be considered. It’s a good idea to seek the experiences of other NPs who have developed independent practices.
Some entrepreneurial NAPNAP members work as child care consultants, own their own practices or are professional speakers and consultants. Some NAPNAP members have created products that appeal to other professionals and to families. Others have pursued a second profession, for example, as attorneys. The possibilities are endless. Having your own business has its challenges, but can be a very rewarding experience.
Tips for Completing Application Forms
Many employers, especially those in large organizations, require candidates to complete an application online. If the application is handwritten, fill out the application with neat handwriting and be accurate in completing the application. Remember that false information on an employment application is grounds for termination. Most pediatric nurse practitioner applications ask for the following:
- Position applied for: Employers want to know if you have the skills, experience and/or training to do the job for which you are applying.
- Wages/Salary: Do your previous wages or experience justify the salary you expect to make? If you can, leave this blank; try n/a. Then when you interview, if they ask you for your salary requirements, ask them to give the ranges they are willing to pay. That will give you a place to start negotiations.
- Employment History: Be prepared to talk about any employment gaps, job-hopping, layoffs, firings or extremely short periods of employment.
Tips for handling some common items found on a PNP application include:
- Salary requirements: It’s okay to write n/a or negotiable. If you are required to provide figures, it is better to provide a range to keep your negotiating options available. While you will want to have the figures for your salary history handy, try to defer discussion of salary issues to the interview if you can. We recommend that you check your state labor laws because some states prohibit employers from asking prospective employees about their salary history.
- Reason for leaving a job: Say something positive like “Seeking opportunity for growth.” You will want to intentionally avoid saying you left for negative reasons. If you were laid off or your job was terminated, don’t be afraid to say so.
- Names of managers and supervisors: If you are able to identify more than one person, pick those who would likely say favorable things about you. Again, it helps to write down their contact information beforehand so you have it to reference as you complete the application. Always check with your references before putting their names down.
Make sure you have a copy of your resume handy as you complete an application. Most applications ask for detailed information and trying to remember names, dates and salaries without a little help can be nerve-wracking.
Tips on Providing Pediatric Nurse Practitioner References
On your resume, you should state that your pediatric nurse practitioner (PNP) references are “available upon mutual consideration”. In other words, if an employer is considering you for a position, he or she generally will check your references only before making a final commitment. And, you should give them only if you are really interested in the position. Your references are an asset, use them carefully because they deplete with each use. Most employee reference checks are done by telephone but some are done online and require an email address. A hiring organization normally asks questions related to your character and reputation, procedural skills and experience, areas needing development, and leadership, attitude, reliability, and teamwork.
Employers want to hear from professional references. Professional references can be former supervisors, respected coworkers, physicians or preceptors. In creating your reference list, follow these steps:
- Identify at least two people who managed you at work; they can be nurse managers, physicians or preceptors.
- Identify two more people who are your peers at work.
- Ask them to serve as references and get permission to use their names. It’s important to keep your reference list current throughout your career including ongoing interactions with them over time. Maintain their information including their name, best phone number, email address, title, where and when you worked with them.
- Notify your references when you plan to give their information and send them a fresh copy of your resume.
It’s wise to carefully consider the individuals on your PNP reference list and what they may say to a potential employer. You may be asked if a future employer can speak with a former manager or physician as a reference. You may want to talk with them first about any areas you could work on for future development and your reason for leaving. It is optimal to have a conversation with all managers and physicians when you leave a position to create a lasting positive impression. These are areas of potential weakness that you should clarify and manage as your career develops. If there is a situation where you know you will not get a positive reference, then address it head-on and talk about what you learned and how you have made changes going forward. If you do not want your current workplace to know you are looking, consider past employers. If that is not a good option, let the hospital or clinic know that you will have to wait to get references until you have an offer to notify your place of employment that you are leaving and then to be a reference. This may be challenging for you. Discuss this with your potential future employer and find an agreeable solution.
Here are some typical questions former supervisors may be asked:
- Are there any technical skills that the candidate could improve?
- What are the candidate’s strengths?
- Are you aware of any problems that could affect his or her work?
- Would you rehire this candidate?
For each reference, you’ll want to list the following information:
- Proper name and job title
- Preferred daytime phone number
- Preferred mailing address (i.e., at home or at work)
- How many years you have known the person
Remember to be prepared with this information anytime you might be asked for references, but don’t submit it with a resume unless specifically requested. Keep your references advised of any interviews you schedule and stay in touch with them throughout the job search process. It is important to remain in touch, on occasion, even after you have secured a new position.
Tips for Pediatric Nurse Practitioner Cover Letters
Whenever you forward a resume to a colleague or referral within your network, you should include a cover letter. Cover letters highlight your strengths, (i.e. you can match your abilities to perform the work requirements listed in an ad) while pointing to the resume for more details. Pediatric nurse practitioner (PNP) cover letters should be approximately three paragraphs and should follow this format:
- First Paragraph: Grab attention. Briefly state how you can resolve the employer’s dilemma filling his/her open position. Create an attention-getting opening based on what you read in an ad or by mentioning a referral source.
- Second Paragraph: Create Interest. Mention your job objective and connect your key qualifications and experiences with the requirements of the position available.
- Third Paragraph: Close the “sale.” Establish a contact time when you will follow up with a phone call to arrange an interview.
Having a well-written PNP cover letter that you modify and personalize to suit any position will save you time. Save your cover letter on your computer to allow you to customize or update it anytime.
Here are some suggestions for writing cover letters:
- It is more effective to address your cover letter to a person. Make sure you spell the person’s name correctly and use his or her title. A phone call can ensure you have this information.
- Avoid starting sentences with a personal pronoun.
- Refer to an organization or facility as it rather than they. A business entity is a singular subject requiring a singular verb.
- Write in an active voice. Action verbs persuade.
- Proofread for grammar errors, such as subject and verb agreement, improper punctuation etc.
- Write in a direct manner. Avoid using wordy expressions or clichés (e.g., I am a highly motivated individual who enjoys working with people).
- Do not be afraid to suggest contributions you can make, such as establishing a Parent Education Program or organizing staff in-services.
- Keep the letter to one page, using three or four paragraphs.
- Project confidence – avoid phrases such as I hope you find and I think I would make.
- Print your letter and then proofread it. Relying on your Word processor’s spell-check alone can lead to mistakes.
- Many times you will submit an electronic resume, but when you are invited to an on-site interview, print with quality paper, white or cream-colored, for your letter (cover letter and resume should be printed on the same paper in the same font).
Always keep a list of employers to whom you send resumes and the dates that you sent them. Keep notes to track replies and follow-up activities.
Online and Offline PNP Job Leads
There are many sources for new pediatric nurse practitioner (PNP) jobs. You might begin by creating a list of potential employers. As you do your research, make notes of organization names, addresses and phone numbers and enter them in your tracking tool. Here are a few tips:
- Use the internet. There are many job search and nurse practitioner websites available to you, including NAPNAP’s Career Connection.
- Look at NAPNAP’s chapter websites and pediatric health publications.
- Subscribe to professional journals/newsletters, for example, Journal of Pediatric Health Care.
- Find directories of primary care or specialty care practices and facilities. Check your local or county library for resource materials.
- Check hospital staff directories and hospital websites for open positions.
- Search the internet for pediatric clinics and physicians.
Using Classified Advertisements
When using classified advertisements (ads) as a source for PNP job leads, don’t limit yourself to one publication. View as many online job boards and read as many newspapers and journals as you can. As you look for employment advertisements that reflect your skills and experience, don’t limit yourself to only one classified section — the job you want may appear under an unusual heading. Blind ads do not list the employer’s name and are often used by reputable organizations. If you pursue a blind ad and you are keeping your job search confidential, the newspaper staff will not tell you who a potential employer is, but may be willing to confirm if the ad was placed by your current employer.
When responding to online or classified job ads, note the following:
- Keep in mind that your reader is asking the question “What’s in this for me if I interview this person?”
- It is good if your qualifications meet at least 60 percent of the advertised PNP job’s requirements, but don’t let this limit yourself if you think the PNP job is a good fit for you.
- Develop a cover letter using the major requirements listed in the ad.
- Avoid providing a desired salary. If the ad requests salary requirements, state a broad range. Giving a range will allow for negotiation and you will not sell yourself short.
- For additional information on cover letters see the previous cover letter section.
- Keep in mind fraud protection. Do not send your social security number to anyone. Until you are offered and accept a job, there is no reason to give out that information.
Career Tip: It helps to make personal contact and follow up with a thank-you note.
Follow-up: Persistence can sometimes distinguish you as a candidate, so it is important to follow up on a letter of inquiry with a personal contact. Selling yourself on the telephone is very effective. Establish a time frame for following up on applications or inquiries. Add this to your tracking tool and follow up.
Employment/Search Firms: Employers often use search firms to recruit pediatric nurse practitioners. The firm partners with the employer and is paid on a contingency fee basis so there is no fee to you. Be wary of any employment firm that charges the job seeker a fee. However, most search firms are reliable and trustworthy, and hospitals and clinics count on them to fill their important positions.
Seeking Out of Town Pediatric Nurse Practitioner Job Opportunities
Your ideal pediatric nurse practitioner (PNP) job might be in another city or state. If you plan to look outside your home area for PNP jobs, the following suggestions might help:
- Seek interviews by using personal contacts, NAPNAP’s Career Connection site and other internet to generate leads.
- Visit the places where you would consider relocating. This will enable you to research the opportunities available, acquaint yourself with the area and expand your network contacts.
- Use the internet to find “salary converters” and city information. Examples of such sites include:
Every area is unique, and you will have to consider if it is right for you, especially if there is a cost of living difference in the new location that affects how you like to live. Make sure to ask potential employers about relocation allowances or reimbursement.
See the Get to Know Your State Board of Nursing’s Rules and Regulations section to begin your scope of practice search for a potential new state.