Published Mar 18, 2014
URGR8T
20 Posts
So I am a fairly new grad (graduated Sept 2013). I am working in a clinic where I see newborns to advanced age. The majority are pediatric (about 80%). Today we had a "meeting" where I was told that I need to increase the amount of patients I see per day. I am seeing around 25 pts/day. I often have to work through lunch to catch up and I come in early to stay on top of all the extra's. I feel maxed. I was told that many providers are seeing up to 50 pts/day! I said I can't do it, and I would end up compromising patient safety if I even attempted that.
So I would love to hear how many patients you see a day, and what your thoughts are about this issue. Is this a reasonable expectation?
BostonFNP, APRN
2 Articles; 5,582 Posts
A patient every 20 mins is more than you should be expected to handle for the first six months.
allennp
103 Posts
It's a bit of balance with acuity. I am in a UC and see 2-5 a hr, I have CT/US with RN staff and the workups can get occasionally a bit complex and with arranging follow up. I have fellow providers who may hammer thru 35 pts in a ten hr shift and they get complaints from families and staff. I ......humbly do not ....I say it's the nurse in me that takes the time to explain it them what the heck is going on.
My system sort of initially gave me a small amount of conversation about my speed but after my patient satisfaction scores were all the highest in the system and my true numbers over the long term were only like 5 percent off they no longer do and say all is good....
We have 1 MA for the clinic, so I do all of my own referrals, immunizations, etc.. They even told me I should be helping check people in! If all I had was otitis and URIs then I could see more of course, but I may have a 2 day old with jaundice, then a well woman with pap, an uncontrolled DM, then suturing a minor laceration. That's a typical day, and I feel strapped for time already! I feel I'm not only advocating for me but the patients as well. I refuse to compromise safety, and I'm pretty sure they aren't going to back me up if I hurt someone. So far I have great patient satisfaction scores so they can't complain about that one.
BostonRN13
184 Posts
50 a day?!! Whaaat? That isn't even mathematically possible even if you aren't taking a lunch break and seeing a new patient every 15 minutes from 8am-5pm..
AnnaN5
429 Posts
I would say that is crazy & not even logistically possible! Will your pay increase if your patient volume increases?
phillycpnp-pc, MSN, RN, NP
286 Posts
I'm a new grad and have been working for a little over a month. I am seeing only a partial patient load right now, but i am expected to see about 25 per day in long run. Some of the MDs i work with do see 40-50 patients! Its crazy and i know i will never reach that nor do i want to.
Well I see a similar issue in my practice. I think a bit of it is experience, also though in a way I think it might reflect somewhat the difference between the medical model and nursing model that as a RN for so long I still retain. I know docs that will go in and in 3 min listen, look and discharge some simple otitis. Sure I can do that but I spend a min sitting down, establishing contact, and will spend a extra....sometimes regrettably min asking .....is there anything else......it's called health care...... Right! HA!
No, it's a practice style and some systems do not care about quality as much as others, also you learn as to where to spend those extra minutes you save from the 5 min visit. It sounds like you wrk though in a system tat might not be the best fit for your style, just hone your skills and keep your eyes open for a different position.
JeanettePNP, MSN, RN, NP
1 Article; 1,863 Posts
How do you fit charting into your day if you're seeing 4-5 patients an hour? I see far fewer than that and I'm always playing catch-up.
Charting question to me?
I use templates (otitis is a good example, fairly basic similar exam), in Epic, also use dragon voice dictation which helps, always.....almost knock out at least my HPI may defer my medical decision making note till later, though in a bow to my group I am paid for charting time after my shift as long as it is not excessive. I tend to have to do some...charting after if I see over 25-30 patients in 10 hours. But it depends on acuity issues.
carachel2
1,116 Posts
Wow. I'm four years out and no one has ever talked to me about my requirement. My schedules usually settles in at 16-18 a day andd I like it like that. Sometimes 20 during the peak of flu season. I work old fashioned, one provider owned family practice.
uronurse1
75 Posts
6 months out and seeing 25 pts per day? Thats outstanding. Im a new provider in urology but have 10+ years experience in this area and just now seeing 20-25 per day. My employer realizes that 30 will be my max because its important that i spend enough time with my pts. Id say you probably need to look for a new job, where you will be appreciated. 50 per day in that setting seems crazy to me!