The first few weeks and months in practice as a nurse practitioner are the toughest. The stress and doubt you might feel is common, normal, and overcome-able! Here are 7 top tips for reducing overwhelm in practice as a new nurse practitioner.
1. Ask for mentorship
Working with a seasoned provider, whether physician or nurse practitioner, is the single best way to grow your knowledge as a new NP. Mentorship is key to gaining clinical confidence and competence as a new NP. Use reference guides (see # 6) like UptoDate and Epocrates, but don’t underestimate the value of a mentor.
Ask one of the experienced NPs or physicians you work with to be your mentor and set up regular meetings to review complex patients. You can ask your mentor for feedback on how you are doing and areas for improvement. Private supervision, or consultation, on a regular basis, is the key to receiving the support you need early on in your career as an NP.
2. Research the most common conditions you will encounter
Another important way to reduce overwhelm as a new NP is to get a sense of the most common medical conditions you are likely to encounter in your practice.
How to know what the most common conditions are?
Look at your current caseload and keep track of the types of conditions patients are presenting with. Also, ask your experienced colleagues about the most common types of patients and conditions they see. Using this information, learn as much as you can about the diagnosis and treatment of these conditions.
For example, if you’re a primary care NP and most of the patients you’ll be seeing have diabetes, spend time learning more about the treatment of diabetic patients. If the second most common type of patient presenting has high cholesterol, learn about the treatment of hypercholesterolemia so that you become more prepared and comfortable seeing these types of patients.
3. Review your schedule and caseload
It’s important to review your schedule and caseload to help reduce overwhelm. Ideally, you got a sense of your caseload before you were hired during the interview process (when asking about how much time you would have for new patient visits and follow-up appointments as well as administrative time).
But, if you didn’t ask about this, or what you were told doesn’t match reality when you start practicing, don’t just accept your schedule for what it is. Ask your supervisor for a reduced schedule for a period of time as you gain experience.
4. Chart as you go
One of the most helpful tips to remember is to practice concurrent charting as you see patients throughout the day. Nothing, and I mean nothing, is more stressful or leads to burnout quicker than saving your charting for the end of the day to avoid keeping patients waiting for you. Yes, this may lead your patients to have to wait a few extra minutes while you finishing charting on your previous patient, but it is the most efficient want to stay on top of your work.
Also, read the documentation of more experienced providers to see how they chart. What do they include in their notes? What can you take away to implement in your notes to save time?
Remember that the goal of charting is to:
- document what occurred to provide safe, quality patient care
- document in such a way that another provider could read your note and know what’s going on
You don’t need to write an essay to have the world’s best note. The best note will be one where the events are clearly documented, and another clinician could clearly understand your plan of care.
5. Use dictation tools for charting
This tip took me YEARS to discover, but using a dictation tool, like Dragon, is a game-changer when it comes to quickly finish notes! Speaking is the fastest way to record information, I don’t care how fast you type. Nothing is faster than talking.
If your employer permits dictation software, ask to use it. If your employer doesn’t pay for dictation software, I highly recommend you make the investment. The investment will be worth all the time you save with charting efficiently (it might even save your hair…because it will all be intact from your stress-free days not playing catch up with your notes).
6. Utilize clinical references
It’s ok to look stuff up. You can’t memorize everything and besides, information is frequently changing and you need to be up to date with providing quality patient care. Use tools like UpToDate, Epocrates, Sanford Guide, and MD Calc.
7. Make cheat sheets and templates
Cheat sheets and templates are an awesome way to streamline charting. Side note: notice how important efficient charting is (several of these tips involve it!). If you’re a psych NP, check out the templates on my website to create beautifully clear, thorough but concise, initial psychiatric evaluations and follow-up notes.
Using these 7 tips will help you become a happier, less overwhelmed, NP in practice.
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