Should and do fnp's room their pt's

[ozarkstumpjump]

I am shocked what I just found out. I need input to see what is happening in rest of the US. I was told that most orginizations are having their FNP's room their own pt. They are saying that a nurse is not assigned until they see enough pt's to justify a nurse. Is this true? I have been an FNP for 16 years and I was always ( and I expected) allowed to hire/interview a nurse prior to starting my job. I believe it is demeaning for them to expect us to room a pt routinely. Am I off base? Am i not keeping up with the times? Physicians at our organization are not required to room their own pt's - Why should we? A NP we just hired at at our cloinic was tols she would have to see 12-16 pt's a day before she could have a nurse. Is this what others are seeing? Please let me know. I believe we should stand up against this - but I could be wrong. Thanks for any input.

[Here.I.Stand, BSN, RN]

Oh, wait, scratch that. I was roomed by the RN in the rural family practice clinic of my adolescence (hometown of about 500; clinic in the next town over of about 1300.) The *entire* practice was 1 MD, 1 PA, 2 RNs (one of whom was the MD's wife), and receptionist.

[1endogirl]

A FNP, though advanced, is still not a physician and doesn't normally have the exact same privileges as such.

[traumaRUs, MSN, APRN]

I work in a very large 19 MD, 6 NP/PA specialty practice. We all work in and out of the office at times (we have multiple offices).

When I see pts in the office, the MA rooms the pts, does vitals, a med rec and obtains urine and labs (all labs are ordered prior to visit especially for the first visit)

When I see pts in dialysis units, I am running by myself - I must look up labs, do the med rec, any paperwork needed (including the ever present prior authorizations that must be done for every stinking med (or so it seems)). When I see dialysis pts I see between 15-70 pts per day and I travel between 50-200miles per day, average 130miles per day.

[Libby1987]

70? Is that a typo? Or is it just for brief oversight?

[Jules A, MSN]

A FNP, though advanced, is still not a physician and doesn't normally have the exact same privileges as such.

I have the exact same hospital privileges so I absolutely do expect the same treatment. Thankfully I have rarely felt slighted because I'm a NP not a MD and it has never been from staff on my unit.

[BostonFNP, APRN]

A FNP, though advanced, is still not a physician and doesn't normally have the exact same privileges as such.

I have the exact same privileges, requirements, and I am held to the same standards as my physician counterparts. NPs aren't physicians. They are better.

I think the OP meant demeaning to the NP to be treated as less of a provider rather than demeaning to have to take your own vitals.

Sent from my iPhone.

[BostonFNP, APRN]

I room my own patients when my medical assistant is busy with other tasks; I would not take a job where you have no ancillary support. I would rather spend the extra five minutes with a patient that needs provider-level attention rather than taking a temp on a patient.

Sent from my iPhone.

[sadiemae1123]

Is it just rooming the patients? Or, are you also going to be expected to do other tasks usually delegated to ancillary staff like fielding patient phone calls, sending out lab letters, and dealing with referrals, etc?

I understand that they don't want you to just be sitting around, but I question why they are hiring someone if they haven't budgeted for both the NP and ancillary staff.

[honeykrown, MSN, NP]

Well if I had to do vitals, immunization a, get UA, run it to lab and then do all the other stuff I don't think I will be able to see more than 12 a day. If the MDs are given a nurse then I expect to be treated equally. I have roomed pts before but only those who have been triaged already

[sadiemae1123]

What they're asking doesn't make a lot of sense to me. They should already be aware of how many patients are being turned away for same day visits, new patients being scheduled several weeks out, how difficult it is to schedule follow ups, and how overworked they are at the moment.

It's not about it being demeaning to room your own patients; everyone should be willing to help out. But, if you're expected to have a full practice they need to show they're willing to support that.

It almost sounds like they just want you there to pick up their slack, not act as a practitioner in your own right. I would be worried that I would end up having patients that no one else wants foisted on me and no opportunity to take on new patients.

[rnsrgr8t]

I work in a Urology practice and have my own clinic. We have MA's that room the patients, do VS, do dipsticks, take specimens to the lab etc. They do the same for me as they do for my MD counterparts. Of course, when they are busy (our clinics can be crazy busy) I will room a patient or two myself to help with flow, do my own dipstick etc if I am not busy and waiting to see a patient. I think that is teamwork and we should all do it (and to be fair, MD's should do it to).

I do not think that was what the OP was talking about. Sounds to me that the plan is for her to NOT have support staff and in that case, I would NOT do that and do not think it is fair. The amount of patients she sees should not be a factor in the decision. They should know the need and the volume of their practice and if they have enough patients to justify adding another NP. In the beginning, she is going to be getting oriented, getting used to the EMR, finding her resources etc so 12 patients may take her longer than it would someone who is established at the practice. That is what she should be doing with her "free time" early on. If they do not know if there are a enough patients for her to see to justify the support staff...why are they hiring her? When I interviewed for jobs, I had an ENT practice that told me the MA was for the doctor...not for me and I was going to be expected to do everything myself. No thank you.

We all should be team players and be willing to step outside our credentials to help with patient flow and care but to not be given the appropriate support staff.... I have a problem with that. Although we are not MD's, we are providers and all providers in a practice (irregardless of their degrees) should have the same quantity of support staff.

[MikeFNPC, MSN]

I'm about to start my first NP job so the only experience I can share is what my preceptors did. Out of 6 sites, 2 of them roomed their own patients. And at both of those sites all providers did it; MD, NP, and PA all roomed their own patients. As previously stated, we observed functional status, endurance limitations, gait, and mentation. Some of the patients commented that it made them feel special or that the provider went the extra yard.