NP w/ Hospital Medicine

[ACNPC-AG]

What's your role as a night shift APP w/ HM? Do you admit only (if so, how many? Capped?) and/or cross-coverage & responding to rapids/codes? 

*New grad NP interviewing this week for nightshift, 7on/7off. 8 years ICU RN experience and final year of NP school was all ICU preceptorships. 

[Corey Narry, MSN, RN, NP]

I work in an in-patient Cardiology service where we are the primary team very similar to how a Hospital Medicine service runs. There are 3 NP teams under one Cardiologist attending. On day shift, our cap per NP is 8-10 patients. We currently do not have NP's covering our nights. When we leave after our shift ends, we sign out to a hospitalist physician who covers all the Cardiology teams at night (3 NP teams and 2 resident teams).

I think it can be rough for the hospitalist who may be covering up to 40+ patients but they pretty much just put out fires and admit (direct and from the ED). They do have back up from other hospitalists if they are swamped. Their admissions get redistributed and signed out to the daytime Cardiology teams. They respond to codes and rapids on their patients. We do get new hospitalists all the time (mostly new grads of IM programs waiting for a fellowship they like) and they do struggles sometimes. I think it would be a tough role for a new NP but would work if there is enough support, training, and guidance from a mentor.