By: Betsy Finkelmeier, MBA
Hospitals are hiring an increasing number of mid-level providers to fill the void created by strict guidelines governing resident work hours and an exodus of primary care physicians from inpatient management. Physician recruiters often are asked to assume recruitment responsibilities for this emerging generation of providers. Just as a descriptive position assessment is an essential preparatory tool to guide the targeting of optimal physician candidates, defining positional characteristics for mid-level provider (MLP) roles is equally important but may be less familiar. When preparing an MLP position assessment, the unique features of advanced practice should be considered and the assessment adapted to accommodate these differences.
A first objective is determining the specific type of advanced practice role that is best suited to meet the clinical need. In most specialties, the advanced practice role is filled by either a nurse practitioner (NP) or a physician assistant (PA). Clinical departments with a team of advanced practitioners typically have a blend of NPs and PAs working collaboratively and interchangeably to perform the same MLP responsibilities. The unique training programs for each may offer specific advantages for particular roles. For example, a PA is more likely to have the surgical training required for a position with intraoperative first assistant responsibilities; a nurse practitioner may provide a better fit for a role that requires significant multi-disciplinary care coordination.
While nurse practitioner certification is the most common nursing preparation allowing practice as an advanced practice registered nurse (APRN), three other APRN categories may be targeted in searches for specific clinical settings: certified registered nurse anesthetist (CRNA), certified nurse midwife (CNM) and/or clinical nurse specialist (CNS) for an advanced practice role.
In addition to the type of MLP, the position assessment should delineate whether or not a position is appropriate for a newly graduated advanced practitioner. Most often, the clinical team will seek experienced MLPs. However, new graduates may be appropriate candidates if experienced mentors are available and the candidate has relevant clinical experience, e.g., as a registered nurse or emergency medical technician.
The position assessment will also define primary responsibilities of the position. For advanced practice roles, specific information should be included regarding guidelines for MLP scope of practice and relationships with supervising physicians. The position description should accurately convey how the role provides both the autonomy associated with advanced practice and also sufficient physician mentoring and consultation. Because many advanced practice roles are designed to provide 24/7 coverage of hospitalized patients, scheduled work hours often include weekend/night rotations and/or call coverage duties. The position assessment must clearly delineate specific requirements so that candidates can accurately assess work/life balance afforded by the position. Expectations or options for working additional hours should be clearly defined, including associated compensation.
The preparatory time to craft a thoughtfully detailed position assessment is well worth the effort and will enhance the recruiter’s ability to optimally target and attract candidates best suited to fill advanced practice positions.