Ep #103: How to Save Time as a New Nurse Practitioner

Welcome to Becoming a Stress-Free Nurse Practitioner, a show for new NPs and students that want to pass their board exam the first time and make that transition from RN to NP as seamless as possible. I’m your host Sarah Michelle. Now, let’s dive into today’s episode.

Angela: Hi, this is Angela, one of Sarah’s podcast producers. Sarah asked our team to pick an episode to re-air this week that would be helpful as you balance seeing your friends and family with your work. 

This is a season where many nurse practitioners feel spread thin, so we thought this episode about time-saving hacks during the holidays was the perfect one to air. You’ll hear how to optimize your time so you don’t burn out and how to be your best self for those around you at home and at work. So without further ado, please enjoy this episode.

Hey, hey, my real deal NPs. In this holiday season, a time when we definitely want to be home with our friends and family as much as possible, I thought I would talk a little about how to save time as a new NP. And by saving time, I don’t mean rushing through your patients so that you can get back home to those Hallmark holiday movies, but just some things you can do to optimize your time.

I am huge on optimizing time at work so that I can be my best self for those around me, and then still be my best, most present self when I’m home. I hate to see messages and posts from new NPs who are staying hours and hours after their offices have closed or who are taking work home with them.

I love the dedication and I know that these NPs are doing it out of care and love for their patients. But leaving work at work and having a true break when you are at home and with your loved ones is so huge. It is also a key factor in avoiding burnout. So let’s go.

My first tip for new NPs getting used to a new office and possibly a new EMR is to use smart phrases. And what is a smart phrase? A smart phrase or sometimes called dot phrases are pre-programmed blockers of text, order sets, or patient instructions that you can have inserted wherever you need. This can be extremely helpful in saving time if you are typing the same instructions over and over again.

For example, especially during cold and flu season, if you find yourself writing out patient instructions to use a humidifier at night, be sure to wash their hands well, and staying home if they’re sick, you can make a dot phrase for this to avoid typing it out every single time. I like to have fun with my dot or smart phrases so I might name this one dot cold season or something of the like.

Other providers have entire order sets in a smart phrase. So say they want to do a lipid profile at their patient’s yearly physical, they simply type dot lipid, or whatever their smart phrase is, and the order set populates. You might be thinking that this is only a few seconds saved, but it really does add up. Additionally, many EMRs allow for sharing of smart phrases. So this can be a really great way to learn how other providers manage patient care and also a good way to help craft your own smart phrases.

I do want to be very clear here however, smart phrases are great, but they should not be used as blanket statements for all patients. Always be sure to tailor them to individual patient needs. Remember, anything you document can be used should you ever be sued. So you always want it to be reflective of exactly the care and education you provided. Next time you’re in your office, try out a smart phrase and let me know what you think.

Another way to save a lot of time, especially in this extremely busy cold and flu season, is to read through patient charts and start charting ahead of the visit. This may not always be feasible, but if it is, even just getting the chart opened and a chief complaint put in can really save time and allow you to give your undivided attention to your patient.

Now, sometimes the chief complaint listed in the chart may not be fully accurate, whether that’s due to patients not wanting to discuss their concerns with non-clinical team members, or even just misunderstandings. But usually the reason for being seen is accurate and can save you time if you know exactly what you are going in looking for.

I know so many of you are in and out of patient visits right now, so doing a little brief review of their chart can be super helpful to be able to flow through the visit. You don’t have to go super in depth, and this is even something you could do quickly in the morning before you start your day.

It can also be a good way to catch any patients who may be overdue for a physical, a pap smear, or even blood work. That way you can get them up to speed right in your office that day, or remind them to make an appointment on the way out for their routine care.

This can also be a good way to remind yourself if you have ever met this patient. I know nothing is more embarrassing than when you introduce yourself to a patient and they tell you you’ve already met them before. It would be virtually impossible to remember every single patient ever. But looking back through their chart and visits quickly to see if you’ve met them before, and if you did what you saw them for, can be a really great way to build patient trust and rapport.

Again, I know this is not always feasible, especially in a setting like urgent care. But if it is, I would definitely give it a try. What I caution you against, which I do see some providers do, is doing this at home. I want you to be able to unwind and give attention to your loved ones, not be on a deep dive into patient charts at home.

One of my biggest time-saving hacks is not even a hack at all, it is just to have clear, open, honest communication with those you work with. This was huge for me in my clinical practice, and especially now with my team at SMNP Reviews. No one can read your mind, so having open communication can save time and frustration.

In practice, for me, this meant always touching base with my RN or MA or whoever was working with me that day and just kind of going over the schedule, answering questions they may have and touching base.

This is a good way to say, hey, this patient is coming in, I would want a urine sample from them. Or, this one needs a pap, so can you ask them if they would want that done today, and if so, have them get undressed. Or even things like this patient appears to be having increasing trends of higher and higher blood pressure readings in the office, so let’s be sure to get a reading at the beginning and the end of the exam.

I had great RNs and MAs at my office, so most of them knew what I liked and the general flow I followed. But even so, I always made sure to touch base with them at the beginning of the day, and then also throughout. Having everybody on the same page of how you would like things done can be super time saving because you do not then have to go back and fix orders or chase down patients.

This is increasingly important as we are all stretched pretty thin right now and many NPs are seeing 20, 25, even 30 patients a day. So having the team on the same page can literally end up saving you hours.

A hack that a student actually told me they do, and I really love, is using good communication skills to keep the visit on track. This can be hard to navigate as a new grad and even as a veteran NP, but it is so essential to staying as on time as possible during your day, while still giving full attention to the patients.

This can be really hard to balance, especially with our lovely patients who chat it up with us. And trust me, I have a special place in my heart for those patients because I truly do care for them. But it is so, so important for us to be able to keep appointments on track so we do not start getting really far behind.

No one likes waiting, and while sometimes it is inevitable because urgent or delicate matters come up that we really do need to give extra time to, in general we should try to lead patient appointments in a way that patients feel cared for, not rushed, but that also we are not in the room for 45 minutes.

It would be so nice if we had this time for every patient, but we know that is sadly not the reality. So how might implementing this look? Well, when you first go into the room, introduce yourself. And I found it easiest to lead with, “And I see you’re here for,” fill in the blank today. If your patient says yes, great. If they say no, something else came up, definitely allow them to elaborate.

If it’s a complex or multifaceted concern, like they say, “Well, I have a cough, but I also hurt my toe and I should probably have my pap done while I’m here.” This is when you really need to use those good communication skills. I might say something like, “Well, I can definitely check out your cough and your toe today. And then let’s get your pap scheduled on your way out.” This way the patient hears you acknowledging their concerns and making a plan.

You might run into the patient who is less than happy to need to come back, but this is a time when I would just be honest with them. I found that telling patients I only allotted time for their urgent concerns, but would be more than happy to spend time with them for their other concerns at another appointment.

It can be tempting to give in to do everything for every patient, I know. But this often leads to us running behind and losing our precious free time at lunch or having us stay late to finish up. This is definitely a skill that takes time to perfect, so I don’t want you to feel discouraged if you are not great at keeping within appointment timeframes right off the bat. But practice makes perfect, and the better you get at communicating with patients, the easier it becomes.

One last time-saving hack that I think has become very useful, especially throughout the pandemic, is utilizing patient portals. I know it depends sometimes on your patient population, but the patient portal can save you hours of work and increase patient satisfaction all at the same time.

I have found that it is much quicker to chat with patients through the portal instead of playing phone tag. And as a bonus, a lot of times they can even send photos of concerns through the portal, which can really help guide your decision making for them. Portal messages are quick to send, and they save patients the frustration of trying to find a time to call the office.

Obviously, there are some things that are worthy of a same day appointment, and some things that are a little too urgent for patient portals. But for many things, especially like a quick prescription refill, patient portals can save us and save our patients time.

I hope you have found some of these time saving hacks helpful. The holiday season can be so jam packed, and on top of it we are now seeing so much sickness between flu, RSV, and COVID that office schedules are filling up. So try a few of these time-saving hacks and let me know any time-saving hacks of your own.

Until next time, friends. Happy holidays.

As an extra bonus, friends, if you’re looking for support no matter what phase of your nurse practitioner journey you’re currently in, I have communities available for both students and new nurse practitioners. In these communities, we work to uplift one another and grow this profession together every single day. Links to join will be included for you in the show notes. 

Thanks for listening to Becoming a Stress-Free Nurse Practitioner. If you want more information about the different types of support we offer to students and new NPs, visit npreviews.com/resources. See you next week.