Any NP's working as Hospitalist?

[kathrn]

Hello, I am a new graduate since May. My first job as an NP is at a fairly large community hospital as a hospitalist NP. I was there my last two semesters of school so, therefore knew what to expect but it is really hard getting a job right out of school. The use of NP's is new for this group and they are still trying to figure out the best way to "use" us. Currently we do the admissions all day long. Then the next day if there is time, we round on the ones we admitted. There's usually very little time for that, especially since it takes me 2-3 hours to do an admission. I just don't want to miss anything important. I feel as though I slow them down by being so slow. But, I still have to ask a lot of questions on how to put orders in the computer. I didn't do anything as a student but write the H&P minus the assessment and plan. I didn't even discuss with the MD after seeing the patient.

We are expected to call the doctors after every encounter with a patient. They give us the assessment and plan along with orders to enter. There's not much autonomy there. What do the NP's do at most hospitalist positions?

[IBSavn]

I have worked in a facility that utilized NPs. Both as hospitalist and in specialties. First off, I hope you are ready for the long haul. It takes any facility or group of physicians a long time to accept NPs as providers and to adapt to the learning curve. They find it really hard to hand over the responsibility and a lot of them like the idea of, "you have to answer to me."

Our NP hospitalist use to take turns with everyone else. Everyone rotated between covering the ER (admissions) and rounding on the floor. The NPs saw patients, wrote orders, performed procedures, and did whatever else that patient needed--just like the physicians. Only if the NP needed help was the physician consulted--they did not have to check in after every patient. ICU patients required that the physician be notified immediately of admission and a physician had to "lay eyes" on the patient within 2 hours of admission.

The state I'm speaking of is Virginia. Here, NPs don't have to have direct supervision but are supposed to have collaborative agreements with a physician. However, in the hospital setting, NPs are treated synonymous with PAs to make everyone's life a little bit easier.

[sauce]

Where I work we do everything except intubated or do central lines. But the Gen med docs don't do that either here. So pretty much no difference. We cover nights. Full autonomy. No calling for orders or anything like that. I mean calling for orders is what an rn does lol