New NP

  1. 0 Hello Everyone,
    I am a new NP and struggling to say the very least. the days go by fast I am there 1-2 hours late. I am not sure how providers see pt in 15 min and are finished - completely.

    Everyday is something new. I have epocrates essentials, books but it never seems enough and doesn't always allow me quick answers especially since I am the one that is 2hours behind.

    Also, am I the only one that feels this way?

    What are good websites to find answers to questions that you would ask a provider about a pt but can't because they are too busy- I need help!

    Thanks Sam
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  3. Visit  SAM49 profile page

    About SAM49

    Joined May '08; Posts: 18.

    12 Comments so far...

  4. Visit  ms_orion profile page
    0
    I am not a NP but...you are correct..."How do you really, really see a patient in 15 minutes"? It is a disgrace that healthcare has become an 'assembly' line. How often do you get checked out in a grocery store in 15 minutes? I have worked mainly in primary care clinics. EVERY provider was behind! Schedulers MUST take into account the problem (as well as the pt) when scheduling a visit. 15 minutes for an earache, acne whatever...and BEING A NEW PROVIDER, they should be allotting extra time for you until you get into a routine. You are new and need the extra time to get to know your clients as well. A good nurse should also be helping you. Type out your expectations. Talk to management. It doesn't mean your a 'loser'..it means you KNOW your limitations and need to be respected. Hang in there. I don't know where you work, but stand up for yourself. Wishing you the best of luck in your profession.
  5. Visit  Boonce1 profile page
    0
    I agree with the above post I would personally prefer a provider taking his/her time. Hang in there taking your time is not a bad thing. A lot of providers take short cuts in health care maybe it is best not to become one of them. A lot of providers that have more experiance have a routine that keeps them on track. I worked in dr office and I know for a fact if you have a good nursing staff you can see a lot of pateint quickly we would do all the vitals, take history, a minnie assessment, and report our findings so all the dr. had to do was evaluate and write a prescription. You should have a good relationship with your nursing staff they should be your right hand. They should no what you need before you need it. Hope this helps. I am a RN with years of experiance working in a health center and I am currently in FNP school. Hope this advise may help
  6. Visit  tonet0908 profile page
    0
    I have been working as an FNP now, first job out of Grad school. It is a single physician Family Practice. I was shocked and horrified to see what he does. He schedules 3 patients for the same 15 minute slots, no matter what they're coming in for, lab results, sick visits, physicals, newborns or new patients, doesn't matter, 3 patients for the same 15 minute slots. Then, he has 5 exam rooms and 2 Medical Assistants. He expects me to run through these patients and order all the diagnostics I can on these patients. In my opinion, it's all a money making thing.

    My first week in the practice he was mad at me because I wasn't seeing the patients fast enough. I have basically learned how to survive by being extremely respectful and kind to the MAs because they have been with him for yrs so they know the patients and how he functions, what diagnostics and labs he normally orders so they will either tell me what to order or they will do them for me before I even enter the room. I'm getting more proficient I guess because he is starting to leave me alone in the office while he goes to the hospital and Rehab to see patients. Yesterday he left me alone while he was at a conference and I saw 42 patients in 10 hrs.

    I also learned to jot down the important info while in the room with the patient, the info that you know you won't remember and then you can fill in the other info at another time. My NPPR helps me out alot too, that has become my Bible. You have to work smart, not hard. And as I said before, make friends with the other associates, no matter who they are, you can learn from anyone.
  7. Visit  traumaRUs profile page
    0
    Uptodate is our gold standard. Pricey, $450 yr but my practice pays for it.
  8. Visit  tonet0908 profile page
    0
    Quote from traumaRUs
    Uptodate is our gold standard. Pricey, $450 yr but my practice pays for it.
    I've never heard of Uptodate but I know if I decided to use it I would be paying for it just like I paid for my malpractice insurance and DEA number. NPPR is way less inexpensive.
  9. Visit  traumaRUs profile page
    0
    Yeah but uptpodate is just that: very current.

    Why are you paying for everything? They are making a profit from you.
  10. Visit  tonet0908 profile page
    0
    Quote from traumaRUs
    Yeah but uptpodate is just that: very current.

    Why are you paying for everything? They are making a profit from you.
    I paid for everything because my employer owns his own practice. He does not have the money that a coorporation has. He even started me at a low rate because he said he did not have the finances. He recently gave me a $5/hr raise which puts me higher than what most of my classmates are receiving. Also, I didn't mind paying for those things because I was very greatful to him for hiring me. I had been on about 3 interviews and noone hired me, some didn't even have the courtesy to tell me they hired someone else. Now, with him, I have more freedom and independence. He leaves me to run the office by myself. If I need him, he's only a phone call away.

    I'm learning alot at his practice and that's exactly what I'm using it for, experience, so hopefully in a few yrs I can go to a bigger institution where they will pay for my malpractice insurance and DEA number. So, if he's making a profit off me, it's all good because everyone makes something off everyone.
  11. Visit  tonet0908 profile page
    0
    Quote from traumaRUs
    Yeah but uptpodate is just that: very current.

    Why are you paying for everything? They are making a profit from you.
    Also, NPPR is current as well, they send you a new manual quarterly as well as weekly emails with updates. You can also go on their website to look meds up. I've been using it since grad school when one of the professors suggested it and I don't feel like I'm any less proficient in looking up and prescribing meds.
  12. Visit  traumaRUs profile page
    0
    But NPPR is just that: meds and prescribing. Uptodate is so much more: treatment options, tests to order, how to interpret the tests once you get the results, etc.

    Uptodate is updated DAILY with the latest info.

    I've been an APN for 5 years now and just subscribed to NPPR - haven't gotten my first edition yet.

    At any rate, its whatever your practice/MD wants you to use in the end.

    I do agree that this arrangement sounds like its mutually beneficial.
  13. Visit  tonet0908 profile page
    0
    Quote from traumaRUs
    But NPPR is just that: meds and prescribing. Uptodate is so much more: treatment options, tests to order, how to interpret the tests once you get the results, etc.

    Uptodate is updated DAILY with the latest info.

    I've been an APN for 5 years now and just subscribed to NPPR - haven't gotten my first edition yet.

    At any rate, its whatever your practice/MD wants you to use in the end.

    I do agree that this arrangement sounds like its mutually beneficial.
    LOL, for $450/yr it better be that good. The NPPR takes a while a while for you to recieve it because it is released quarterly. So it depends on when you ordered it.
  14. Visit  FLoat RN profile page
    1
    I'm in ARNP school right now. I have shadowed a Primary Doctor in the Past. One thing I noticed is he did move very fast and efficiently because he was only addressing one problem and he knew what the diagnosis and treatments were immediately. He would go to each room very quickly order labs or simple point of care test, then go to the next patient while the blood was being draw or test being run. Yes you have to be fast yet attentive to the patient and their needs. It's a business and the physician may not be reimbursed as much as he/she charges. If the patient bring up another problem then they need to set another appointment.
    canchaser likes this.
  15. Visit  PerrelliFNP profile page
    0
    Float RN is absolutely right...I am a FNP in a primary care clinic. I've been out of school for one year. You will get faster, I am slower than most but I don't care. Be patient, the first 6 months out of being a NP are 1000x harder than becoming a RN. I use epocrates on my iphone and love it, the premium package. It will give you everything you need. Never forget Dr. Google for unusual s/s, icd9 codes etc...Your best friend is in your pocket - a smart phone. Trust your gut instincts and practice safely! I worked as a self employed NP in 9 nursing homes/AL for my first year- it's a great setting to start a NP career. You have TIME!!!!


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