Term Paper: Business Management Plan

Pages: 10 (2870 words)  ·  Bibliography Sources: 6  ·  Level: Master's  ·  Topic: Healthcare  ·  Buy This Paper


[. . .] Failure to implement the new practice in the form of APN practice would result into lack of efficiency in the service delivery as well as increment in the cost of operations. The organization will continue to accumulate massive operational costs thus transferring the burden to the consumers or patients and their families. This is an indication of poor service delivery and planning for the achievement of the goals and objectives of the reformed health care systems in the modern society.

Negotiate essential elements of an employment contract for an advanced practice nurse in a selected care setting

Professional resume is vital in the preparation and submission during the interview process. Written employment contracts are essential in relation to provision of protection of the nurse and the employer. Before signing of a final agreement, it is ideal to integrate the services of an attorney with experience on the medial practitioner acts or contracts. There are various elements or factors essential in the development of the contracts for the advanced practice nurses (Adcock, 1995). The first element is nursing practice act. The first component is the examination of the state practice act through evaluation of parameters, collaboration, and regulations in accordance with the nursing practitioner practice (Adcock, 1995). The second element is practice setting. It is advisable to seek answers to the type of practice setting, family, specialty, and support towards the role of the nurse practitioner. The third element is the aspect of personal inventory with the aim of evaluating the needs and desire in the contractual or employment arrangement.

The fourth and fifth elements focus on the integration of negotiation tips and compensation thus examination and determination of the worth of service. It is also vital to incorporate benefits to the employees in the contractual or employment agreement for the purposes of motivation and transparency in striking the deal. An effective contractual agreement should also focus on the integration of restrictions in relation to competition and conflict of interest (Adcock, 1995). This is vital towards minimization of challenges and barriers with reference to the achievement of the goals and objectives of the reformed healthcare system.

Compare and contrast the legal and contractual considerations for APN as an employee and as a contractor

There are diverse considerations in relation to the employee or independent contractor in relation to legal and contractual considerations for advanced practice nurses. In the case of APNs as an employee, the employer is more likely to be liable for the acts of negligence with reference to the respondent superior as long as the acts of the employee are within the context of the employment. In this context, the employees have social security and Medicare taxes withheld from the paychecks. The employer is responsible for the payment of the unemployment taxes. It is also essential for the employer to offer W-2 statement illustrating the total amount of withheld taxes at the end of the year. Employee has the ability to deduct unreimbursed business expenses with reference to his or her tax returns. This is possible in case of itemization of the deductions totaling to more than two percent of the adjusted gross income of the employee (Henry 1995).

As an independent contractor, it is the organization that the independent contractor works to issue the 1099 form illustrating the total amount of money paid over the course of the year. The independent contractor has the obligation and responsibility of paying the income and self-employment taxes. It is also essential to note that under this consideration, business expenses are reported annually in relation to the income tax return. There is no specific amount or percentage of the independent contractor's adjusted gross income. Individuals do not have access to the benefits extended to the employees. Such contractors are also liable to financial benefits or profits and losses. Individuals are not reimbursed for some or all aspects of the business expenses (Henry 1995). There is significant or substantive investment by the contractor in the work or process of the health system. The independent contractor does not information on unfolding of events and activities despite the realization of less extensive instructions on what should be done.

Propose an employment contract

I would propose an employment contract relating to the APN as an employee rather than an independent contractor. This is because of the ability to understand what is to be done and aspects towards the achievement of the set goals and targets. Employment contract will also demonstrate benefits such as pension, motivational packages, ethical issues, and insurance coverage for the purposes of effectiveness and efficiency in service delivery. Employees under such contracts will have the ability to contribute to the development of the society through taxation systems and welfare contributions (Buppert 1997). The employment will focus on the demonstration of the aspects of the nursing practice act in accordance with the beliefs and doctrine of nursing in the context of the United States. This is vital for the promotion of an effective working environment and quality interaction among the APNs, organizations, and patients.

Outline ethical issues that may impact the APN

Ethical issues affect various complex issues outside of the philosophy of an individual. This indicates that ethics affect an individual socially, politically, economically, and legally. Some of the critical ethical issues affecting advanced practice nurses include autonomy, beneficence, justice, and non-maleficence (Bartter 2001). Autonomy focuses on the demonstration of sense of control in the healthcare by the patients. It is the responsibility of the advanced practice nurses to facilitate the empowerment thus realization of the sense of autonomy by the patients in their healthcare. Beneficence focuses on the demonstration of kindness and execution of good acts. In the context of healthcare programs, the balances between the actual patients benefit and betterment have massive influence in the decision-making process. This indicates that the employees or advanced practice nurses must demonstrate kindness and good act with the aim of avoiding harm to others especially the patients (Bartter 2001). APNs must focus on the examination of their actions to minimize or eliminate benefits and risks of an action. Justice is also an essential ethical issue in relation to the verification of the value system of the advanced practice nurses. This focuses on the examination or evaluation of the interests, morals, and values of the advanced practice nurses to avoid looming conflict with the rights, interests, and autonomy of the patients.

Examine insurance issues

The modern society is associated with rapid change and restructuring of the health care system delivery. This is an indication that advanced practice nurse face various new opportunities and challenge thus the need to understand the federal and state laws, regulations, and rules defining their scope of practice and prescriptive authority. It is also ideal for the APNs to familiarize themselves with Medicare and Medicaid payment policies and other aspects of the private policies. This is through learning the basic language in relation to the third-party payers thus getting to know the process of ensuring the rendering of reimbursement for the services. There is also need to keep in touch with the modern knowledge and technologies for the purposes of enhancing effectiveness and efficiency in the service delivery by the APNs (The American Association of Nurse Attorneys, 2005). Insurance issues should focus on the provision of coverage to the APNs in their contractual agreements, execution of duties, and interaction with the organization, employees, and patients. This is vital for effectiveness and efficiency in service delivery.


Adcock, G (1995). Negotiating an employment contract. Nurse Practitioner, 20(6), 22-23.

Bartter, K. (2001). Ethical issues in advanced nursing practice. Boston: Butterworth-


Buppert, C. (1997). Employment agreements: cause that can change an NP's life. The Nurse

Practitioner 22(8), 108-119.

Buppert, Carolyn. (2011). Nurse practitioner's business practice and legal guide Chapter 10

the Employed Nurse Practitioner, Chapter 10, 277-305.

Henry, P. (1995). The nurse practitioner's guide to practice agreements. Nurse Practitioner

Forum. Vol 6, No. 1, 4-5

Mullinex, C., & Bucholtz, D. (2009). Role and quality of nurse practitioner practice: A policy issue. Nursing Outlook, 57(2), 93 -- 98.

Sidani, S., Irvine, D., Porter, H., O'Brien-Pallas, L., Simpson, B., McGills-Hall, L., et al.

(2000). Practice patterns of acute care… [END OF PREVIEW]

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