Flexibility in NP Work Schedule

Question

I am certified as both an adult and an acute care nurse practitioner (NP). My current position is in occupational medicine and prior to that, emergency medicine. Because of childcare concerns, I will soon be unable to work the hours that these positions typically require, and I will need more flexibility in deciding my own schedule. Is there anything you could suggest that would provide that flexibility while also using my NP experience and training?

Response From the Expert

Marilyn W. Edmunds, MS, PhD, ANP, GNP
Adjunct Faculty, Johns Hopkins University School of Nursing, Baltimore, Maryland; Nurse Practitioner, NP Alternatives, Inc., Ellicott City, Maryland

In my opinion, you already have experience in some of the positions that offer the greatest schedule flexibility. Perhaps working in an emergency department or occupational health setting, but for a different employer who may bend a little in the job design, would allow you to gain some needed control over your schedule.

What you can do with the credentials that you have is clearly dictated by the state in which you practice, and regulations are increasingly restrictive.^[1] You don't actually say it, but it sounds like you may want to work fewer total hours. If so, you may consider linking up with a home health agency or hospice unit to provide home visits.^[2] These positions often allow you to contract for a certain number of patients, and when you make the visits and how long you stay would be determined by you and your patients. As someone with an acute care background, you may be able to negotiate with an agency to care for patients that would use your expertise with ventilators, dressings, or specific types of procedures or treatments.

Another employment option that you may consider that would give you more flexibility and fewer hours would be sharing a job position with another NP. Pregnancy, young children, going back to school, and reduced need to work are familiar reasons why an NP may want to work fewer hours. So, look around where you work now, and see whether there is someone like you who would like to have more control over his or her schedule or maybe work fewer hours. Sometimes splitting a position, with each of you determining when you will be on the job, can be an advantage to both you and the employer. The workplace benefits because they are able to retain 2 employees who are already oriented to the job and know the institution's policies. Employers are often willing to create a job-sharing position if both of you petition them and they realize that they may lose both of you if they cannot accommodate your schedules.

Editor's Note

Readers: If you have suggestions for modified work schedules for NPs, please share your thoughts in our online discussion (link provided in reference).^[3]