How Many Patients Should FNPs Expect to Treat per Hour?
Nurse practitioner students and practicing nurse practitioners alike often wonder what the standard is when it comes to how many patients NPs should be expected to treat per hour. New grad FNPs want to know what to expect as they apply for positions. Practicing nurse practitioners want to be sure they are keeping up with expectations but aren't being overworked by an employer. So, is there a magic number when it comes to the standard patient load for family nurse practitioners?
The number of patients nurse practitioners are expected to treat per hour varies depending on the practice setting and type of patients most commonly treated in the practice. For the sake of this article, we will look at the most common settings for family nurse practitioners, primary care clinics and urgent care/walk-in settings.
Primary Care Nurse Practitioners
Most commonly, primary care clinics schedule patients at 15 minute intervals for episodic and follow-up visits. Complete physical exams, well child visits and new patient appointments are typically allotted a longer, 30 minute visit. So, based on this scheduling schema, family nurse practitioners working in the primary care setting can expect to treat about four patients per hour or fewer depending on the classification of the patient's appointment.
While 15 minute time slots are cited as the norm in the primary care setting, other factors affect nurse practitioners' patient load. Clinics that are not busy may have open appointments throughout the day, leaving the FNP's schedule less taxing. Other clinics treat patients with more complex medical illnesses and multiple comorbidities. These clinics may adopt the standard of setting longer appointments, perhaps requiring nurse practitioners to treat patients in 20 minute increments.
Urgent Care Nurse Practitioners
Urgent care and walk-in clinics don't always have the luxury of scheduling patients evenly throughout the day. Nurse practitioners may find themselves treating six patients per hour in the mornings and evenings when the clinic is busy and few patients in the mid-afternoon. Alternately, a busy urgent care clinic may not experience downtime. The NP may treat four or more patients per hour throughout the entire work day.
In most urgent care clinics, the expectation is that the nurse practitioner be able to handle a patient volume of about four patients per hour similarly to the primary care setting. Urgent care and walk-in clinics with very high volumes may advertise their workload expectation in a job posting. For example, some clinics expect FNPs to be able to keep up with treating at least five patients per hour. Clarifying these expectations in a job interview is perfectly acceptable. You want to set yourself up for success rather than accepting a position that's not the right fit for your experience and personality.
New Graduate Considerations
New graduate nurse practitioners often expect that they will be slowly onboarded into a new practice or expected to manage a reduced patient load. This isn't always the case. Practices that have not hired new graduates in the past or that are strapped for providers expect new nurse practitioners to hit the ground running. Feel out the company culture in your job interview to see if a gradual intro into a full patient load is the norm for the practice. If not, think through the implications of jumping into a full patient load immediately after graduation.
Polling by the American Association of Nurse Practitioners indicates that 69.5% of nurse practitioners see three or more patients per hour. So, family nurse practitioners should anticipate that this will be the case in their own practice. There is no 'magic' number when it comes to the workload nurse practitioners should anticipate but, four patients per hour or one appointment every 15 minutes, is a good reference point to start from.
How many patients do you treat per hour in your practice?
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I've been practicing as a family NP for about 6 years and have come to realize just how seriously broken the healthcare system in this country truly is. Average work day is 8-5pm, plus after hours documentation, call backs and paperwork. I work full time, 5 days a wk with alternating Saturday hours. I am also scheduled throughout lunch each day and do not get a break. This is insane. Sure, it might be do able on a short term basis, but long term, this is burnout city for even the most high energy workaholic. Many practices operate under the mentality of hiring NPs for "cheap" labor (comparable to a MDs salary). Work the NPs as hard as possible, with same expectations as MDs in regards to scope of practice. When NP burns out, get rid of them and hire fresh blood. Wash, rinse, repeat. I love what I do, but I hate the what healthcare system has become. Ultimately, I would never have become a NP if I knew then what I know now.
I work in the Federal Healthcare system and see patients with multiple complexeties and diagnosis. I see 12-16 patients per day and stay after most evening for 2 hours on average doing callbacks, prescriptions, etc. I get 30 for routine; however, we have additional requirements or clinical reminders completed by nursing first-typically I get 15 minutes if the patient is on time, 45 minutes for new patient including full panel of labs, records request, etc and 1 hour if I am doing complete gynecological exam and addressing any routine concerns.
I work part time in addition to full time at another healthcare organizations immediate care centers where I average of 3-4 per hour-36-50 in a 12 hour shift.
I work in a pediatric practice, and have been an FNP for 2 years. I do all 30 minute visits, acutes included. the only exception is for ear infections- I will see those for 15 minutes. We are a newer practice, but our organization is supportive of our dictating 30 minutes.
I expect to see enough patients to cover my salary and overhead, plus some profit for my employer. 30 patients a day is a very realistic expectation. I have an assistant to put my pts in the room, assist with procedures, and documenting. I also have my assistant do call backs and schedule. She also brings important labs and questions right to me. My day is 8.5 to 9 hours long, and I take 45 min to an hour for lunch. I don't need 30 min to Complete a physical. If you are slotted for every 15 min, 8 hours gives you 32 patients, so that's 30 min to finish charting/answer questions, 30min-1 hour for breaks.
I have been an FNP for 20 years, and have worked primarily in IM for the past 9. I am very fortunate that the internist I work with is independent and will not schedule our (complex) patients for less than 30 minutes, so I am scheduled with the same guidelines. I have seen as many as 19 patients in a day because of acute care add-ons, and this is doable. But I have noticed a real difference in productivity since the introduction of electronic medical records. When I was a new practitioner working in a rural family medical clinic 15-20 years ago, the documentation requirements were much less demanding. I could see up to 36 patients a day, and while challenging, it was still possible without excessive OT because I could still finish my hand-written patient charts in 1 hour. I can't imagine doing that in this day and age. Today, with some acute care visits, it takes me longer to complete the progress note than to see the patient!
I work in a freestanding ER and see all levels of acuity and average 1.5 pts per hour. This includes procedures, admissions
Wow... these are rough schedules. I see on average 10 to 14 hours patients a day. I am on a 20/40 template. 40 minutes is not only for physicals but pts that indicate more than one issue when scheduling.
I am a new graduate NP and I recently started a position in a private practice in Harlem, NY. They expect me to see an average of 30 patients during an 8 hour period. This is insane. They double/triple book me, and I have no lunch break scheduled. For example, on some days I will have three new patient physicals all scheduled for 9:o0 am. Moreover, they will guilt me into seeing walk-ins on top of the patient load I already have. It's a family-owned practice, and the physicians (owners) will dump their patients onto the NPs.
Most of the patients are Spanish-speaking (I don't speak Spanish) and chronically-ill with uncontrolled HTN, DM, etc. I see many complicated cases...getting 5-10 minutes for a patient like this is asinine. Then I'm left to answering phone calls, returning phone calls, sending rx refills, answering emails, preparing FMLA and disability requests, etc. I have no time to chart therefore I go to work early/stay late in a poor attempt to catch-up. The high turn over rate with NPs/PAs and Medical Assistants speak for itself. Since the turnover rate is so high, I don't have a steady medical assistant, so I waste even more time giving and charting vaccines, etc. I will be submitting my 2 week resignation letter very soon. I love my patients, but this private practice is obviously more interested in $ and not quality of care.
I am a new grad with approx 7 months experience working in a very busy pediatric clinic. I see approx 25 patients a day from 8:30-5, as well as do call backs, review labs, etc. I am given 10 mintues for sick visit and 20 minutes for well checks. I am typically double and even triple booked most days. As an example I will have two sick visits schedule at 8:30, a well check scheduled at 8:40, and two more sick visits scheduled at 8:50, etc. It's insane. There was one day last week I saw 12 patients in the morning and 18 in the afternoon. I feel like I am always rushed then I have lots of charting in the evening to complete. I believe this is the future of healthcare. I am just a pinball in a machine and am expected to bounce from room to room making sure I don't kill anyone in the process. It's only about money. I hate my job, but I love my patients.
I am a new grad working in a clinic with a physician. He has allowed me to schedule at 16-20 per day. I usually put in 8-9 hrs per day and get all my phone calls, labs, and paperwork done during the time after clinic and I come in one hour before I start to see patients. It's very nice to have a job where I like what I do.