I recently talked with a group of primary care nurse practitioners who expressed frustration about the amount of time they spend on work after the clinic doors close for the day. Working as a nurse practitioner means a lot more than interacting directly with patients. It means, well paperwork. From reviewing lab results to completing prior authorizations for medications, the behind the scenes activities of healthcare providers consume a lot of time. The NPs I talked with find themselves spending up to two hours every evening working on such tasks outside of normal hours.
The frustrations of these nurse practitioners are not uncommon. While there isn’t much data about the amount of time NPs spend on tasks outside of patient care, the issue has been looked at among physicians. Medscape’s 2016 Physician Compensation Report shows that over half of physicians spend at least 10 hours per week on paperwork. Given that nurse practitioners play a similar role to that of MDs, we can expect that the heavy paperwork load applies to advanced practice providers as well.
Clinics handle administrative responsibilities for providers in a few ways:
- Daily Administrative Time – Given that lab results, prior authorization requests, and even falling behind on charts can be a daily occurrence, some clinics allot each provider an hour or so of time dedicated to administrative tasks each day. This way, providers can keep up with their work taking less home with them and review lab and test results in a timely manner. The downside of this method is that late patient arrivals or running behind quickly eat into the dedicated time slot.
- Blocked Administrative Time – Other practices provide nurse practitioners a block of a few hours one day per week set aside for administrative tasks. The upside of this schedule is that administrative work may often be completed at home, making for a more flexible schedule and a mid-week ‘break’. It also allows for an uninterrupted time period for completing such tasks. The downside is that nurse practitioners will still need to address more urgent paperwork issues throughout the week in the midst of a packed appointment schedule.
- No Administrative Time – Many practices neglect to allot admin time to nurse practitioners. Rather, they expect charts, callbacks etc. to be completed before, after, or during the standard clinic day. Any work that must be done before or after traditional work hours is off the clock and expected as part of the nurse practitioner’s salaried position. This can be acceptable in practices that compensate on the higher end of the pay scale. Clinics that compensate NPs on an hourly basis pay an hourly rate for administrative time spent outside of work hours.
As a nurse practitioner, you must consider how administrative tasks are handled on the front-end of your employment. It’s always easier to negotiate for admin time in the beginning of the relationship rather than going back to ask for more admin time or higher compensation later.
How many admin hours do you have blocked in your schedule as a nurse practitioner? What does the arrangement look like?
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