I Resolved to Leave Work On Time...

…This is what I did to make it happen 

As a nurse practitioner who has worked in primary care, urgent care and emergency department settings, I can say there are a few challenges common to NPs across the board. Leaving work on time is one of them. Packed schedules have us scrambling from patient to patient with little time left for charting, reviewing lab results, and responding to questions. So, we tack these duties on to the end of our clinical day or bring them home with us. 

I am and always have been an hourly employee as an NP. So, taking my work home with me meant I was on the clock. My various employers have always encouraged providers to complete work during clinic hours in an effort to limit overtime. One day, both at my boss’ prompting and for my own sanity, I decided to make leaving on time happen. Here’s how I did it. 

I Didn’t Give Myself the Option of Working from Home

To kick off my resolution, I eliminated the option of working from home. Completing charts on my laptop squarely seated on my couch in front of a pile of snacks was needless to say, inefficient. The work I took home seemed to linger as I procrastinated from its completion. Thinking about what needed to be done ate up my evening or weekend. Not cool. Instead, if I was running behind in the clinic, I sat in my office after hours until my checklist was complete. This allowed my work to be done more efficiently and gave me permission to relax on the couch laptop-free later. 

I Charted After Every Patient

The habit of charting after each patient I see (with an occasional exception) makes my workday significantly more efficient. It eliminates the need to re-familiarize myself with the encounter when documenting at a later time. It also ensures that my charts are more complete as the patient’s visit is fresh on my mind. Whether waiting for lab results, or for a new patient to check in, I redirect downtime in my practice to wrap up charts STAT. And, if my charts are complete at the end of the day, there’s far less to do after hours. 

I Stopped Seeing Patients in Order

Okay, okay, I usually see patients in order. However, if I notice a patient with a chef complaint that’s pretty straightforward in the waiting room or on my schedule, I ask for that patient to be brought back to an exam room right when they arrive. An encounter for otitis media, for example, won’t take a full appointment slot. By expediting the process of seeing this patient and getting them back out the door, I’ve given myself a cushion in my schedule. Saving a few minutes here and there adds up!

I Ordered Fewer Diagnostic Tests

Sometimes diagnostic testing is warranted, and sometimes it’s really not necessary. Making sure that each and every test I order for a patient has a purpose maximizes my time. Patients presenting with strep, for example, may often be diagnosed clinically. Doing so eliminates the process of ordering a strep swab, collecting the sample and waiting on results. Limiting diagnostic testing to that which would have an impact on my clinical decision making or ultimate course of action saves precious time. And, my patients are thrilled with their speedy care. 

Overall, efficiency came with time for me as a nurse practitioner. In my new grad years while I was still building my clinical foundation, focusing on strategies to maximize my time seemed overwhelming. But, as I’ve progressed in my career, I’ve identified a few ways to help maximize my time at work so I’m not taking my job home. 

What strategies do you use to leave work on time?

 

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Comments

All good ideas.
Nurses with clinical and management experience as a RN, prior to entering a FNP program ,usually do not have time management issues. RN experience is a major advantage for the FNP; RN experience (at least two years) prior to acceptance into a FNP program should be required.

Bill

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