Work/Patient Ratio

Specialties NP

Published

I am taking my certification test in less than a month and was wondering what to expect (workload wise) once I enter the NP job market. Thanks

What state/city?

In what setting do you practice?

How many patient in how many hours do you see daily?

Im hoping to get at least 20 minutes per patient once i start working (for the first couple of months at least till I get more comfortable with the new role) but i know with how things are now a days that very unlikely to happen...

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Specializes in Adult Internal Medicine.
Im hoping to get at least 20 minutes per patient once i start working (for the first couple of months at least till I get more comfortable with the new role) but i know with how things are now a days that very unlikely to happen...

Ideally find a practice that let's you start with one patient an hour for a week, then two patients and hour for a week.

A slow ramp up will really help in the first few weeks.

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That would be awesome ... The problem is finding someone willing to do that. I guess its all in the negotiations at they beginning.... How should the pay be though? Should it be like the first two weeks no compensation? Or half compensation?

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Or maybe that could be part of the orientation with regular pay?

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Specializes in Adult Internal Medicine.
That would be awesome ... The problem is finding someone willing to do that. I guess its all in the negotiations at they beginning.... How should the pay be though? Should it be like the first two weeks no compensation? Or half compensation?

Practices that are interested in keeping you for the long term should be amenable to this. Or offer a structured orientation program.

You should be paid your full salary for it.

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Specializes in ICU, CV-Thoracic Sx, Internal Medicine.

What state/city? Austin, TX

In what setting do you practice? Family Practice

How many patient in how many hours do you see daily? 15-17 in a 7 hour day from day 1 (right out of school)

I had that type of patient load a few years back in an adult/geri clinic.

Loved it.

15-17/day is awesome.

Trauma, you are a machine! 42/day?

Jeez. My highest mark for daily encounters is 37. The other mid-level was out one day on a family emergency and I offered to pick up her inpatient load.

No one else was available to help that day, it was the perfect storm.

4 hospitals and 14 hours later I closed the note on my 37th encounter.

My brain was fried.

Not sure how you do that. But I guess we all have our strengths.

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I know this is an old post..but felt I needed to address the 20 minutes you noted for a Medicare AWV.

If you are getting these done in 20 minutes, it is not possible to be meeting all the Medicare requirements (which by the way are written into law, not just regulations)...unless of course, you are just seeing them to "finalize" the visit after a nurse has done all of the requirements. The Medicare Annual Wellness Visit should take at least 45 minutes the first time, and about 30 minutes for subsequent years.

Remember, the AWV is not a brief physical exam but an in-depth review of the patients entire medical history, surgical history, family history, recent hospitalizations, medication reconciliation, immunization review, creating a list of all the providers (docs, DME, pharmacists, chiropractors, dentists, home health, etc.), performing a health risk assessment that must include vitals, height/weight/BMI, sensory issues, fall risk, home safety, depression, cognition, alcohol, drug, tobacco use, and making recommendations/referrals where appropriate. ONce that is all done, you have to review all the preventive screenings Medicare offers and create a written schedule for when the patient is next eligible for all of those services, such as: immunizations, diabetic screenings, lipid tests, Low Dose Lung CT, AAA screen, colonoscopy, FOBT, HIV test, mammogram, prostate, bone density, PAP/cervical, HepC, and more. Then you must also do some basic patient education.

If you are really getting all of that done in 20 minutes, you are a miracle worker. This is why Medicare allows RNs to do the entire AWV instead of a provider. They recognize the time and expertise required are better handled by a nurse than a provider. The clinic I am working in will only allow RNs with at least 15 years of patient care experience to do the AWVs because they recognize that it is the foundation for all the preventive services in Medicare and it requires that level of knowledge for the AWV to be successful.

This website has some great information on the AWVs: e-AWV: FAQ | e-AWV®

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1. MN

2. Specialty, IP & Clinic

3. 4-7 patients in clinic, 4-6 patients IP depending on procedures

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1. MO

2. Outpatient specialty clinic

3. 1-2 patients per hour/10-12 per day

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