The NP who can't function in the role

  1. I have heard of this a few times over the last 20 years. People who graduate with their NP degree, and never have the confidence to function in the role.

    Right now I know of two people, an NP and a PA who are not functioning in their role. Neither are new grads, both have several years of experience, at least on the books.

    One has already given notice, and the other is waiting for the ax, because she doesn't meet minimal productivity standards.

    It could be that LTC work is not their niche, but the work is at one's own pace, unlike a clinic, and the expectations for productivity are quite reasonable.

    If you cannot see 12 patients a day as an NP, and keep up with the associated documentation, I am not sure where you can work. You are probably unemployable in the field.

    I haven't analyzed either of these individual's work habits in depth, but I have observed they often get bogged down in details, and misunderstand their role in the LTC setting.

    It isn't like previous nursing jobs, where the pay comes by sitting in a chair for 8 hours. The pay only comes from billing.

    The NP must shift into a mindset where they focus on providing good care, and billing for it. A boring meeting is an opportunity to pick up referrals. And bill.

    Well, this is my rant for the evening.
  2. 6 Comments

  3. by   caliotter3
    I once read of a PA who was laid off and could not find new employment after more than two years. However, nothing was said about the individual's work performance. One does wonder.
  4. by   heron
    Totallly OT, but LTC nurses do not sit in a chair for 8 hours. Just thought I would clarify that.
  5. by   Oldmahubbard
    Ha ha, so true. I am always comparing everything to state jobs.
  6. by   FullGlass
    Wow! One of my best preceptors is an NP at a nice LTC. It was one of those humongous campuses with independent, assisted, and then full care of various sorts. Every day she had a list of patients that needed acute care (cold, flu, new complaints, etc) along with a list of patients that needed routine checks. Boy, did we do a lot of walking! LOL However, I thought she had a great job - she just had to see the patients on the list and deal with any new problems, but other than that had total autonomy. She was out the door at 5 pm every day because she was very organized and completed charting as she went. it's a shame the folks you wrote about couldn't make it work.
  7. by   Oldmahubbard
    Well, yes, I don't get it. I keep my own list for the follow ups, but I get additional referrals for mental health symptoms. I am in an independent state, have autonomy and move along at my own pace.
    I am usually done by 1 or 2 pm, and have to do an hour of paperwork at home.
    I don't get why people are getting so hung up.
  8. by   heron
    Quote from Oldmahubbard
    Ha ha, so true. I am always comparing everything to state jobs.
    I worked at a state hospital for 11 years (the only dedicated AIDS unit in New England through the height of the epidemic). My colleagues and I didn't sit much then, either. But I understand your point so I'll stop with the de-railing. Carry on ...