There are 30 seconds on the clock, you are trying to see one patient every 15 minutes, but it is not working out as per usual. You are already 45 minutes behind, and it is only 10 am. And the constant interruptions by the staff regarding non-emergent requests are fraying your nerves. As though that was not enough, you are backed up on charting, and it feels as though you will never catch up. “Pop quiz, hotshot. What do you do? What do you do?” (For some reason, a Speed reference comes to mind).
1. Breathe.
It seems obvious and simple; however, it is often overlooked as a vital part of self-care that requires conscience effort.
When you have down time in the evening while venting to your significant other about your day, practice breathing exercises to help prevent burnout. For a few moments, think of nothing else except the act of breathing. Concentrate on the way air feels as it passes over your membranes, through your nose or mouth and the movements your accessory muscles and diaphragm make throughout inhalation and exhalation. Do this several times a day until it becomes an automatic response during or shortly after stressful situations.
2. Be prepared for each patient encounter.
Preparedness leads to improved job satisfaction which is a crucial part of preventing burnout. First, be thoroughly familiar with the EMR system at your clinic. Make sure you get the full orientation and know where information is located so it can be quickly accessed before the encounter. Second, glance at critical information before entering the patient’s room. Hopefully, your EMR allows you to do this with ease. Information such as: the reason for the visit, vitals, pertinent diagnoses, medications, information discussed at the last office visit and any recent plan of care from specialists. Use this information to formulate leading questions, which will allow you to conduct a timely and productive interview. The patient will be impressed by your preparedness, which is a great first step in building trust. And it is imperative for preventing burnout.
3. Minimize interruptions during clinic.
Constant interruptions detract from patient care and can damage the relationships you are trying to build. Even though interruptions are inevitable in medicine, you can drastically reduce them by educating your staff.
Keep in mind that some of your staff may not have a medical background so do not assume they have the knowledge to make those calls regarding prioritization of patient needs. To them, everything may seem like a priority, but as the saying goes, “if everything is a priority than nothing is a priority”. Educate your staff regarding prioritizing appropriately, but also make it clear that if they have doubts about the urgency of a particular situation then of course ‘er on the side of caution’ and interrupt. They will learn from that experience and become more efficient and capable team members. Building a stronger team will alleviate some of your day-to-day frustrations which will help prevent burnout.
4. Documentation (possibly the #1 cause of burnout).
Most nurses are exceptionally good at time management, but we tend to prioritize patients over documentation. I know, I have the same thought, “aren’t we supposed to prioritize patients over documentation?” My answer is, “Of course”.
Documentation is my least favorite part of being a nurse practitioner, unfortunately, it is also an extremely important part. The most efficient way to chart is during the encounter when the information is most fresh, but that is not always possible. Especially, since most of us prefer to maintain eye contact with the patient during the interview process.
Some nurse practitioners do have administrative time which does relieve some of the stress of documenting in a timely manner, but not all have that “luxury”. And even for the providers who do, saving all the documentation until then is still extremely daunting. Therefore, I would suggest documenting as much as possible as you go, even if that means you will run behind. Also, utilize templates to cut down on the amount of ‘clicks’ required to personalize a chart. It is much easier adding abnormal findings rather than building the note from scratch. Lastly, use every minute of down time during clinic (if there is any), by dictating on one or more charts during ‘no shows’, while the medical assistant is rooming a patient or when there are problematic insurance delays during patient intake.
You may prefer to use that down time to go through emails or correspondence, however, my preference is to do those quickly in the morning before clinic starts and while my first patient is getting prepped. I prefer to get the tedious work of documenting done while my memory is fresh, during or shortly after seeing the patient. This way, I do not have to waste time having to “jog” my memory by re-reviewing the chart.
5. Take a break.
Do not sacrifice your lunch to get “caught up”. You will need that energy boost to remain sharp and productive for the remainder of the day. Besides, when it comes to your career, you need to think long term and though getting caught up may feel good in the moment, the relief will be fleeting. Continuing to skip breaks will lead to exhaustion and burnout may be a consequence.
Not only use that time for nourishment but use it to decompress. Have positive conversations with friends and acquaintances about trivial things or if you prefer solitary activities, read a book, or listen to your favorite podcast. Do not gossip or become bogged down in office politics for that will only lead to negative feelings about team members, career choices or both. If there are problems with the company where you work use appropriate times and speak to the appropriate people to enact change.
6. Be good to team members.
Remember, support staff members are there to make your job easier, but they also make your job possible. I am not saying that you should take sole responsibility for your staff in the facility where you work. However, you should do your part. A simple smile and greeting goes a long way in building trust and positive relationships between you and team members. Other things you can do may include reserving complaints for management, being consistent with expectations, and intervening when other team members are struggling. If you help create a positive work environment, your staff will be able to convey that positivity to patients. And if the patients are happy, that is less time you will need to troubleshoot problems and complaints. You will be able to focus on patient care which is why you became a nurse practitioner in the first place.
Hope this helps!
Comments