The recession has brought about the interesting, but not surprising, trend of retired NPs wishing to re-enter the workforce. Not a bad idea in theory, if your retirement savings are down and you have loads of experience to offer, one would expect you would be welcomed back into the workplace with open arms.  

Unfortunately, you would be incorrect. In an ironic twist of fate, employers are not so quick to jump on the "unretirement" bandwagon. In fact, they are not only passing up the returning retiree, but are often choosing instead to go with a new graduate. Why?

Try to see it from the employers' perspective. In their eyes an ideal candidate is one who will be with them for the long run and potentially stay in the job for several years. By sharp contrast, when they see a retired NP seeking work it practically screams "seeking short-term employment."

Of course, no one openly declares on their resume their intention to re-retire as soon as the economy recovers, but you WILL have to explain why you haven't been working at all for the past couple years. I don't think you need to be Einstein to figure out when an applicant is coming out of retirement due to a bad economy that once the recession ends a resignation letter is bound to not be very far behind.

Just as NPs have readjusted their priorities and goals with the recession, so have employers. In the current job market, more value is now placed on assuring a return on investment. Budgets are decreased and hiring costs money, so no employer wants to repeat the hiring process again anytime soon. Patient satisfaction is also at risk -- when providers leave a practice, sometimes the patients do, too.  

Not the best news if you are a retiree looking for work, you may have to consider looking at temporary or locum positions, or maybe even doing some nonclinical work.

If you are toying with the idea of retiring and have been telling yourself you can easily come out of retirement if your finances run short, you may wish to rethink that strategy and hang in there for the time being.

So how it is that employment can decrease? It seems counterintuitive since the number of patients certainly has not seemed to decrease. I mean, someone has to take care of them, right?

So where DO the jobs go? Well, it's sort of like asking that old question we have here in the north about where the "white" goes when the snow melts. (Yes, we are weather obsessed up here, thanks for asking). The answer is not that it disappears, but rather that it changes forms. The same holds true for jobs.

When the economy falters and unemployment goes up, people get nervous. Part-time workers look to increase their hours. This fills some employment needs in a win-win situation for both parties. Employers get their hours filled without hiring new personnel, and employees increase their income.

This scenario is most evident in the temporary or locums market. A job that might have been sent off to a recruiter to find a temporary employee is filled internally by folks looking to pick up more income. This is an across-the-board phenomenon -- I am told by fellow recruiters that travel nursing is down almost 50% as well.

Nervousness about the economy and the future is also causing some NPs to delay or rethink retirement. People who a year ago may have felt ready to retire are feeling much less secure about their finances after seeing the bottom drop out of their 401K over the last few months. Not only are they not retiring, but they are also not cutting back hours in preparation for retirement. It's human nature to delay changes when faced with the unknown. Another trend is NPs coming OUT of retirement.

If that is an idea you are kicking around, please don't miss my next blog post.

I just can't say enough about the importance of a good resume. It's critical to landing the interview. And since you only get one shot at it, the resume you submit better be good.

Unfortunately, no one really teaches NPs how to write a good resume. Occasionally as a student we will get some advice, usually from well meaning "career placement" folks who are really not familiar with the style and content that potential employers are expecting from NP candidates. We also get some guidance from NP faculty members, which can be helpful in a general sense. But unless your professors have been out job hunting lately, or in a position of reviewing resumes for the purpose of hiring, they can be somewhat out of touch with resume trends as well.

I turned next to the Internet and looked up how to write a resume for an NP. The examples were disappointing to say the least. Most were formatted in a manner that I would highly discourage using if you wish to be taken seriously. And to make matters worse, most of the services on the Internet would charge you a tidy sum to use their format or to have them write it for you. If you chose to go that route not only would you be unlikely to get the interview, you would also be out quite a few of your hard earned dollars.

So where does an NP turn to for resume advice? Recruiters can be fairly good judges, although many of the larger firms will use a software program to distill your information automatically into a standardized format for their clients so your typical recruiter may not necessarily be able to give you specifics either. They also may not be inclined to offer you much help if you are not using their services.

The best advice probably comes from hiring managers, not the HR folks but those who are actually doing the hiring.  They go through large volumes of resumes when they are conducting a job search and will be able to tell you some very specific dos and don'ts. If you know anyone who is in the position of hiring NPs, I suggest you take them to lunch and pick their brain. Get the advice straight from the folks that matter when it comes to hiring.

Or you can ask me, your friendly career coach .

Over the last few months I have watched the job market for NPs shrink steadily, each week I see fewer and fewer ads. The Sunday "healthcare" job section has gone from several pages in length to just a few columns, and typically only 1-2 of all the ads are looking for advanced practice nurses. Wages appear to be flat lining as well, it's been a long time since I have seen employers touting big sign on bonuses or relocation incentives. And when it comes to layoff and cutbacks, NP's no longer feel immune in this new economy. I hear stories daily from colleagues who have experienced - or are expecting - a decrease in hours and/or salary.

My late father, who was a young man during the great depression, always used to say to me "Never depend on someone else, you need to be able to take care of yourself." Folks like my father, who have lived through tough economic times, never really feel secure again. They know the value of a backup plan, no matter how sound or stable they may view their current situation.

I encourage you as an NP not to keep all your eggs in one basket. I am probably starting to sound like a broken record, but try to expand outside the clinical box. As NPs we are among the fortunate, as our background and education will allow us always have a "back-up" plan if we keep an open mind and do a little planning.

Do you have an expertise in a specific clinical area or heath topic? Consider teaching or writing continuing education programs. Local colleges and NP organizations are often looking for presenters, especially for local conferences.  Don't forget nursing conferences, as an NP you are the "expert" and will be welcomed at their educational events.

Do you like to write? Contact your local health publications or community newspapers that run short health related articles and editorials and find out how you can become a contributor. There are also Internet sites like www.ehow.com where authors can publish and sell articles on topics of their choice.

Look into guest lecturing or even teaching a class at a local community college. Many have undergraduate programs in nursing and are looking for part time instructors.

Oh yeah, and don't forget blogging!

In the course of my career I have been part of many different groups and organizations, some medically related and some not. I have joined well-established groups and been part of groups that are young and growing. I have served on a board of directors, and I have helped to organize conferences. I now know Robert's Rules of Order. Sometimes I served in the lead role, sometimes as part of special committee or task force, and sometimes just as an observer. I have met incredible NP and non-NP leaders on both national and local levels. I have also become well acquainted with both my state senator and my state representative. There is only one constant, I am always the learner.

Don't underestimate the value of nonclinical experiences. Employers (current and future) will be impressed, and your patients will see a difference, too. Serving on committees or boards will increase your communication skills and give you a broader perspective in general. You will learn how to get things done and how to navigate the political waters. At the very least, you'll get to hang out with some really smart people.

Previously we've discussed many aspects of the job search and interview process. What should happen after you receive that phone call or e-mail informing you that you've been hired? Employers should follow up with details in writing, and because you are a savvy job seeker, you'll request it in writing if it's presented verbally! Miscommunications readily occur, and having everything written down can save you heartache later.

Your offer should clearly state the compensation. Your base compensation should be stated along with any other bonuses, profit sharing, etc. You should know what it takes for you to reach the goals established for production.

Benefits vary from employer to employer but generally include health, dental, and disability insurance. Make sure you know what portion you pay and what the employer is responsible for as well as how the health plan works.

Although you'll love your new job, you may want a day off occasionally. Paid Time Off is simply what it implies. More companies today roll both sick time and vacation time into one category rather than keep them separate. Be sure you know how many and which days are considered vacation days and how comp time is taken if the clinic is open on a holiday.

Continuing Medical Education (CME) should be separate from paid time off and will usually include a number of paid educational days and a lump sum of money to be used for conferences, etc.

There are many different types of retirement plans, and planning ahead is essential. Be sure it's recorded if your employer is contributing to your plan and what that looks like. Most often we see a match up to a certain percentage of the employee's salary.

Make sure you haven't left out the basics such as who you report to and what your hours will be. It should be noted when the first and last patients of the day are scheduled and when there is a break for lunch or catch-up.

If you are completely satisfied with all of the details in the offer, go ahead and sign on the dotted line and good luck with your new position!

Lynn Schiff, NP, is the owner of Advanced Practice Solutions, a recruiting firm specializing in permanent and temporary nurse practitioner placements.  Reach her through the Web site www.advancedpracticesolutions.com.

As is typical of a union, there are specifics issues and causes they tend to rally around. Concerns such as safe staffing, patient handling, layoffs, mandatory overtime and on-the-job injuries. These issues are high priority mainly for RNs, but not so much (at least not directly) for NPs.  

I confess I am no longer a member of the state nursing association; in fact, most of the advanced practice nurses in the state do not belong. This is by choice, as I mentioned earlier the association is really a union and therefore its members are primarily employed in hospital settings or government facilities. Since the majority of NPs work in ambulatory and private practices, not many of us see much merit in joining.

The state association, of course, would beg to differ. They are quick to point out that it was THEIR efforts and THEIR lobbyists that ultimately won NPs in our state the right to independent practice. True enough, and while we don't wish to sound ungrateful, we argue that since we comprise such a small percentage of their membership it's not very often they take up NP causes. At least not often enough for us to fork over 40+ bucks a month.

The union also feels that we owe them a debt of gratitude for increasing our wages. They claim we benefit indirectly from their negotiation of RN wage contracts across the state. Sort of a rising tide lifts all boats scenario. Maybe. Personally I think it is the retail health phenomenon that helped to drive up NP wages.

So I pose this question to you: SHOULD we be more active in our state nursing associations? After all, their infrastructure is in place, and they already have the ear of the state legislature. If we joined in greater numbers we could demand a bigger share of lobbyist time. What if your state association is a union? Does that fit with who we are as NPs and what we want our image to be? What are the pros and cons?

Naturally, I am a "fan" of Advance for NPs on Facebook and this week I noticed Jill wrote a post about "call" compensation. Now today I see another blog post about an "on call fiasco." So if you can stand one more post about call this week, I will try to demystify call and give you some tips to avoid "call" remorse.

Jill is right, call can indeed be mysterious. Not only is the method of compensation tough to pin down, but sometimes the structure of call is also murky.

Before you can begin to calculate compensation, you have to first define the call and the potential impact on your life:

Will the call be purely "phone" call, or will it require you to actually go in to work in response to a call? Don't underestimate the disruption to your life either way. Even phone consultations can seriously cut into what you do and where you go while you are on call. I don't care what the Verizon guy says, there are some places where even he and all his "network" buddies are not going to help him get decent cell reception.

How frequently will you be asked to take call? Once a month, every other week? One day a week, an entire week straight?

Is a call day the entire 24 hours? (i.e., will your phone ring at 2 a.m.?) How does this fit into your family life? One of my physician colleagues actually left a practice due to late night calls wreaking havoc with a family member's sleep disorder.

What is the volume of call? Does it matter? This is a red herring in my opinion, regardless of the call volume, you still have to be available and will have to restrict yourself to cell reception-friendly activities. Yes, that does mean no Merlot. And while we are on the subject of volume, will you be required to keep a log or chart later on the calls you take? It all takes time to do.

Will a phone be provided for you, or do you have to use your own? Call can eat up your cell minutes very quickly, so factor that in to your compensation.

There is no one universal "call" compensation structure, but these points may help you to determine what your time is worth. And as always, get it in writing, and set aside a date to revisit and revise.

I was thinking about how important good structure and foundation plants are for a successful garden, and I began thinking about the new NP students who are getting ready to start their foundation work. The process is not unlike the labor of love a garden requires.

I remember how challenging juggling a career, family and school could be at times. Success comes, and graduation will happen despite the occasional weeds that pop up. Visualizing the big picture and celebrating small successes will help you grow into your new role as an NP.

Like a mature garden this will take time and patience. Great mentors and preceptors are like the sun and rain. Soak up all you can from them. As you learn new skills you'll become stronger and more confident each day. You will begin to find your niche, your own special way of practicing. Before you realize it, you'll be ready for your boards and then your first job. You'll continue to grow and change just like our gardens do.

Sometimes trying something new is in order, and sometimes the familiar seems just right. Look forward to the end result of all your hard work, but don't forget to step back and enjoy the process and revel in how far you've come.

Lynn Schiff, NP, is the owner of Advanced Practice Solutions, a recruiting firm specializing in permanent and temporary nurse practitioner placements. www.advancedpracticesolutions.com

Although it is possible to have a great interview and still not get the job, the opposite pretty much never happens. It is virtually impossible to perform poorly in an interview and still get the job.

To do well in an interview you must be prepared, and in order to be prepared you first must understand the purpose of an interview. I know that sounds rather elementary, but before you read further, see if you can sum up in one sentence what you believe to be the purpose of an interview.

If you said something along the lines of "to learn more about the applicant" you would be only half right. You must add "what can this applicant do for our organization?" in order to get full credit.

Failing to recognize that the question "Tell me about yourself" actually means "Tell me what you bring to the table and how it will be a benefit to us" can be a fatal error. One of my biggest pet peeves when I am interviewing candidates is being treated to a litany of reasons of why my job would be good for them, rather than the other way around. I have had candidates tell me everything from wanting a better schedule, a shorter commute, solving daycare problems, gaining new skills or just assuring me that getting this job will help them to fulfill their "dreams."

Now I am not so naïve as to believe people don't have personal reasons for seeking a new job; it's just that sharing those reasons is not a great marketing technique. How would you react if someone tried to sell you their services by informing you of what the sale would mean to them rather than what the service they provide will do for you?

I'm not recommending that you don't take the opportunity to "blow your own horn" during an interview. By all means, blow it loud and clear! Sharing accomplishments are different from sharing needs. Be vocal about what skills you bring to the table, but be clear how you can use those skills to benefit the employer.

Keep in mind that if you want to land the job, it ultimately boils down to what they need, not what you want.

• Am I protected individually under the policy? (i.e., am I specifically named as an insured?)
• Does my insurance include license protection to help defend me in an administrative or disciplinary situation?
• If I leave my employer, will its policy cover me for an incident that occurred while I was still employed? (i.e., is my employer's policy "Occurrence"?)
• Do I have my own individual limits of liability?
• What level of coverage do I have?
• May I see the policy?
• Do I have coverage 24 hours a day?
• What is my employer's insurance company's stability rating?

The most common mistake I see is not clarifying whether coverage is "occurrence" or "claims made." Occurrence coverage affords protection to the insured against any event described in the policy that occurred during the policy period, regardless of how long after expiration of the policy period the claim may arise.

Under a claims-made policy, the event that triggers the insurer's duty is the reporting of a claim within the policy period arising from an occurrence within the same policy period.  While the cost of a claims-made policy is often less, enabling the professional to carry some type of protection, the coverage is also less, since the annual payment bought protection for only 1 year, not for eternity.

What should you look for if your employer-to-be has a claims-made policy? The key question is to determine who covers the tail coverage if you leave or if the practice closes and what the associated costs are. If you do have a claims-made policy without tail coverage don't forget to ask your new employer about prior-acts coverage. It either includes the retroactive date established under the earlier policy, or provides coverage for claims arising out of prior acts without any specific time limitation in the past. The latter coverage is commonly referred to as "full prior acts" coverage. Determining how well (or not) you are covered is one part of interview you don't want to forget!

Lynn Schiff, NP, is the owner of Advanced Practice Solutions, a recruiting firm specializing in permanent and temporary nurse practitioner placements. http://www.advancedpracticesolutions.com

That's not to say that it's always the younger folks that master the tech toys. I consider myself to be very computer literate and would be lost without my "gadgets." However, among those of us who are *ahem* "of a certain age," there does seem to be greater resistance (or maybe suspicion?) when it comes to embracing all things digital. Are you one of these people?

Take an honest look at yourself, because if you are slow to climb aboard the digital bandwagon it could be hurting your career. NPs who are less than proficient with their computer skills are risking losing their competitive edge. Whether we like it or not, EMRs are here to stay. We are living in the information age, resources are now either online or in a handheld PDA rather than on a bookshelf. Radiology now sends x-rays to me in a digital format ONLY. The provider who can quickly access and manage information digitally is going to be perceived as more valuable to the team.  

Don't be that person who stresses the support staff because you are not independent or confident in your computer skills. Take a class (online or locally), get some training CDs or DVDs, and learn all you can about SEVERAL types of computer programs. Push your limits but don't forget to learn the standards like Word and Excel. Understand the lingo, know the difference between a .doc and a .pdf. Get comfortable with Google and the other search engines.

You can do it! We're smart people, after all we wrote a THESIS, we have a master's degree and we once had to memorize the Krebs cycle. In comparison this should be a walk in the park.

Your cover letter and resume were spell checked and polished, your attire was professional and you clicked with your potential employer. A second interview is sometimes the next step in the process, but what always follows is a reference check.

1. Don't wait until after the interview to begin thinking about potential references. Professional references are contacts that can speak with regard to your clinical and interpersonal skills and will do so in a positive manner. They should have a good overall view of who you are and what you bring to a practice. They are often a current NP or PA colleague, a previous supervisor, a clinic manager or perhaps an MD you worked with. New grads may want to include academic advisors or clinical instructors on their list. Employers generally request a minimum of 3 references. It's often a good idea to include an alternative reference or two in the event one of your references does not respond, is on vacation, or has moved.

2. Make sure you have contacted your references ahead of time so they know they can expect a call, fax, or form letter from the potential employer.

3. Phrase the question so that you can be assured of a positive reference. Ask a question such as, "Do you know my skill set well enough to write me a good recommendation letter or to give me a good reference? Remember the key words here are good.

4. Ask for a letter of recommendation when leaving any future position so you can build a portfolio of strong written recommendations.

5. Bring your list of references complete with all contact information to your interview or have them easily retrievable to simply e-mail at their request.

Once your references are complete you one step nearer to successful employment!

Lynn Schiff, NP, is the owner of Advanced Practice Solutions, a recruiting firm specializing in permanent and temporary nurse practitioner placements. www.advancedpracticesolutions.com 

A typical scam scenario goes like this: A "recruiter" contacts a job seeker claiming to have seen their resume online. (Hmmm, does this sound familiar?) The scammer informs the job seeker they have a great job that matches their resume and all the unwitting applicant needs to do is provide their social security number in order to submit an application. The request is usually made via e-mail, and the applicant is asked either to reply to the sender or they are directed to a sham Web site to apply. Quite often a sense of urgency is implied. It only goes downhill from there.

Because almost all job searching and applying takes place online these days, it doesn't seem odd to be contacted by e-mail or be directed to apply on a Web site. However, no legitimate recruiter or job ad should ever ask you to furnish them with your social security number or any license number during their first contact with you and/or prior to an actual interview. If a "recruiter" cannot give you any real details about the position or uses high pressure techniques to get you to apply, it should raise red flags.

Good jobs aren't fire sales and shouldn't require you to "act fast" before they are gone. Take the time to verify who you are dealing with and who they are representing. You should NEVER, EVER put your social security number, license number or DEA registration number on your resume, and under no circumstances should you enter this information when filling out online initial applications.

We see many baby boomers caring for elderly parents and relative, or perhaps they themselves are dealing with an extended illness or injury. Many of our candidates are raising young families and want time off for maternity leaves and childrearing responsibilities. Some fortunate candidates are able to take extended time off between jobs to volunteer or take a much needed break to vacation and relax when their families are grown and raised.

We always recommend explaining the gap factually but briefly. Candidates should leave out details that may make them seem unsuitable for the position or that might raise red flags with an employer. Some applicants have learned new skills during the leave of absence that are applicable to this position, and it may be appropriate to share these with the employer.

Another common reason for a lapse in employment is that an unexpected termination occurred and it has taken some time to find suitable employment. Job seekers need to explain in simple terms what happened and what can be learned from the experience. Under no circumstances should applicants speak negatively about a previous employer or employment situation. Omitting a job from the resume because of a termination may backfire and may be considered lying about one's background.

Employers want to be 100% sure they are making a good choice and need to cover all their bases by asking difficult questions. By showing them there is nothing to hide, job applicants will have a better chance at landing their dream position.

Lynn Schiff, NP, is the owner of Advanced Practice Solutions, a recruiting firm specializing in permanent and temporary nurse practitioner placements. Reach her at http://www.advancedpracticesolutions.com/