Setting yourself up for success in practice

Alright, here’s the reality. As a nurse practitioner, particularly if you’re a new grad, you’re going to have a lot, and I mean a lot, of questions on the job. You probably won’t practice as efficiently as your employer would like you to. You’re under significant pressure to increase productivity. You’re trying the hardest you can and still falling short. This is a scenario I hear all too often from the nurse practitioners I talk with – I’ve been there, too. 

So, what’s a nurse practitioner to do when you’re not meeting expectations? Ask for help…the right way. 

While employers may be in an authoritative position over us as NPs, this doesn’t mean they always do things correctly. One thing employers often get wrong is sharing negative feedback, suggestions, constructive criticism and the like. For example, you asa nurse practitioner might ask “What do you need me to do better in my job?” and your employer might respond “Increase productivity”. You’re motivated to crush it at work. You want to be good at your job. So you start working harder and faster to succeed. The problem is that you’re just working harder at your already ineffective systems.

The key, I’ve discovered, to success and meeting employers’ demands is to seek the how behind the expectation. “Increase productivity” is a pretty non-non-specific request. It generally means increase patient volumes and therefore increase billing. However, it doesn’t give really give the actions or speak to the result-getting behaviors required to actually increase productivity.

Played out in practice, the results of such conversations can be devastating. For example, I practiced with an NP colleague who was told to increase productivity. So, she worked harder at her already inefficient patient care system. Several months later, she hadn’t improved her productivity metrics and was let go from the practice group. 

When your productivity is called into question, get the how behind the ask. Is your productivity suffering because you document inefficiently? Can you cut time when it comes to other admin tasks by organizing them more differently? Is the problem simply that you’re a new grad who must look things up during patient visits? If so, maybe your path to productivity is simply experience – share this with your employer. Ask your mentor, supervisor or collaborating physician to take one or two hours of their time to shadow your patient visits. This is nerve-racking but professionally mature step. Ask this individual to critique how you spend your time. Are you over-documenting? Are you neglecting to delegate inappropriately? Find the how behind increasing your productivity in practice.  

Overall, when you receive any kind of negative feedback, constructive criticism or concerns about performance at work, your follow-up question should be “Thanks for letting me know, can we spend some time talking about how I can achieve this?”. 

Do you struggle with meeting employers’ expectations? 


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