The Primary Care Nurse Practitioner: How to stay on schedule

 I get 15 min per patient for the most part, which includes the check in process, the MA rooming the patient, me actually seeing the patient, AND any testing/referrals/prescribing/everything else. So how do you stay on time? Believe it or not, I rarely run behind and get my charts done before I leave the office every day. If I can do it, so can you. But how? Streamline the process. Train your MA to the process. I made my MA a guide to follow and she loves it. 

TIP #1

I look at my schedule the day prior. I get an idea of what we are going to go over for my chronic care patients that are coming in for follow ups and medication management visits. Example: For my dietetic patients I will review the last A1c, any changes we made based on labs, if they are due for a foot exam or fundoscopy, etc. If they are new to me, I try to look up their relevant medical history. 

TIP #2

I also got in the habit of updating my problem list. I keep all active problems so at a glance I can see their current active conditions that I need to consider (HTN, DM type 2, hyperlipidemia). I put a note in the problem list if they see a specialist (ex. If they follow a cardiologist I put a note beside the problem A-fib that says managed by cardiology so I remember next time). 

Tip #3

Do not be afraid to tell the patient we are going to focus on your top 2-3 complaints today. I will say something like "I want to make sure we thoroughly address your concerns so let's focus on your main concern today and start there." If they come in for a follow up but they are sick and request a strep swab, I will switch that to an acute visit and tell them to reschedule for their chronic care follow up. YOU are in control of your schedule. Obviously, do it kindly and respectfully but you have to have boundaries. 

 Remember 

Primary care for the nurse practitioner is A LOT. It’s busy, stressful, and sometime feels like a revolving door of patients. Everyone feels overwhelmed at one point or another. Give yourself some grace and let me know if I can help you. I have a whole session with resources and processes I use that we can tailor to your setting and preferences.