 Provided by Clinician 1
I think we as Nurse Practitioners and Physician Associates have a unique ability to adapt to change. We function in so many roles, adept at maneuvering through potential pitfalls and minefields in our day-to-day challenges. We learn to survive in adversity...and yes, even THRIVE in it.
Let’s face it...how many people can function in a role that was traditionally reserved for a physician, as little as a few decades ago? We have research that proves how wonderful a job we do...sometimes better than our physician cohorts. We may not have the “doctor” title—although many of us do, to the chagrin of some physicians—but we do the role well.
So let me put a few words down about the roles that we play: educator, facilitator, change-maker, psychologist/counselor, pharmacist, peace-keeper, task-master, director/boss. We may take on roles such as doing work as a front-office person, back-office medical assistant, LPN/RN, or office manager if that role is needed when someone is sick. We care for patients in hundreds of ways...as well as field phone calls from hospitals, nursing homes, pharmacies, insurance companies, and lawyers.
We complete mountains of paperwork from all of the above sources, not to mention patients who require information so that they can get lower-cost medications, disability payments, FMLA, or an excuse from jury duty. We get audited from insurance companies to make sure our care is appropriate...and that our coding is accurate.
We may participate in Patient-Centered Medical Home data collection, to show that our work is quality-driven, patient-centered, in the hopes that someday, we will receive money for it.
All of this...takes time, effort, paperwork...and hassle. Oh, and somewhere along the way, we need to see patients and try to stay profitable.
In the ensuing hospital buy-out and past year’s events, we are now down three full-time staff. I have TWO remaining staff members...a front-office coordinator and a back-office medical assistant, whom I love dearly. Without these two women, our office would fold. With the buy-out, our office manager left, as she was the wife of my collaborating physician. The hospital rule is that no spouses may continue to work in-office, as they see it as a conflict of interest. Although the hospital has put out notice for openings, we have not had any applicants at this point. The backlog of work is astounding. Initially the hospital gave us “float” staff to help out, but we have not had anyone this past week. Then my poor MA’s infant son got sick...she brought him to the office so she wouldn’t have to go home...so my doc and I roomed our own patients.
In addition to this, we are now using the hospital scheduling program, which has had multiple glitches. Patients are showing up for appointments...and are not on the schedule, even though they HAVE appointments. We are seeing about four extra people per day, on top of full schedules...and calming down irate patients to boot.
Couple this with our recent Medical Home collaborative meeting, when I was the sole attendant for our practice (party of one, please?), and we had wonderful discussions about all of the goals for the practices over the next four months. As the groups worked (me being solo), I sat there, lost in thought, wondering how in the world we would ever accomplish this. For the past 15 months, I have been the ONLY person in the practice collecting data and doing reports for diabetes, colo-rectal screening, and mammogram screening. It took months to set up a patient database and to get everything running smoothly.
It was during that meeting that I had an epiphany.
I cannot do this. Quietly, the voice whispered in my head. Slowly, it started to resonate louder. Finally, I put my pen down from the paper I was working on, pushed my chair back, and stopped working on the task we had been assigned. I am one person. We are down too many staff, having too many changes right now. Surely, someone is going to have to understand this.
So with the above all said, this week, I finally told my boss that I could not do anything else. I explained my thoughts. He was in complete agreement. Even better, he volunteered to speak to the Medical Home “powers that be” to discuss the situation. Just saying out loud that I cannot do everything was liberating.
Sometimes, even though we want to “do it all, be it all” for everyone, we need to stop, and realize that we, too, need to acknowledge our limits and just say, “Enough...is enough.”
Kim Spering is a family nurse practitioner who currently works at Brndjar Medical Associates, P.C., a family practice in Emmaus, PA. Her past experience includes the fields of medical/surgical ICU, open heart/trauma ICU, labor and delivery, nursing education, nursing supervision, and as a nurse practitioner in both family practice and OB/GYN settings. She currently serves as a NP preceptor for her graduate school alma mater, DeSales University, as well as for local baccalaureate programs. She is passionate about patient education and helping patients understand that they are ultimately responsible for their own health. She also firmly believes that the public needs to be educated on the value of NPs and PAs in meeting the health care needs of the next decade and beyond. In her free time, Kim enjoys family vacations with her optometrist husband, Mark, and her two sons, Matthew and Connor.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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