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You’re considering your first position of employment after graduation. You are so excited to finally be at this point, but you need to carefully consider the employment contract you may be offered. The future employer may have mentioned a contract. You may be uncertain as to whether one is needed or not. This is a different perspective than your first position as an RN. You may not be offered an employment contract if employed in a hospital system. What should you know or consider? Many states fall under “employment-at-will” provisions of law.1 This means that an employee may be terminated “at will” or without cause. It also means that you may terminate your employment without cause. The advantage of a good employment contract is that it can protect you from this occurring. An employment contract also affords you the opportunity to discuss issues that may be problematic before they occur. The first thing to know and remember is the employment contract you will be presented with will be developed by your employer or their legal counsel. This means that the employment contract will most likely be written to favor the employer. You will want to carefully review it, and even consider seeking your own legal expert to advise you prior to signing. Seeking legal advice on your contract is not considered an act of “non-trust.” The attorney you choose should be familiar with an NP’s scope of practice and job description. If you are unable to locate an attorney specifically familiar with NPs, one who handles employment law or contract negotiations would be appropriate. Three important clauses in an employment contract are related to bonus formulas, restrictive covenants, and termination clauses.2


Before we start discussing the employment contract, it is important to clarify the difference between an employment contract versus the collaborative practice agreement. Employment contracts are written (usually by the employer and reviewed by the NP who makes recommendations or suggests changes) and signed agreements between the NP and the employer.3 Although not required, an employment contract is a legally binding agreement that is signed by both parties. An employment contract is different than and does not replace a collaborative practice agreement. Not all employers will require an employment contract. If you practice in a state that requires a collaborative practice agreement you will have the collaborative practice agreement in addition to your contract.

Collaborative practice agreements are required in states in which NPs cannot practice independently.1 Collaborative practice agreements are also written and signed agreements between the NP and the collaborating physician(s). In states with Full Practice Authority, there is no requirement for a collaborative practice agreement. Therefore, not all states will require a collaborative practice agreement. Although some of the content of both agreements may be similar there are significant legal differences. Collaborative practice agreements are ...

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