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EMNP

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  1. Good morning everyone- I will be starting to precept a new NP student, I work Internal Medicine, this is first rotation for the student as well as me. For those who have experience precepting students, what is your approach to make the best experience both for me and the student? What is the best approach to prevent getting behind and overwhelmed? What do you usually do on the first day and thereafter (other days)? Thanks in a lot for your support.
  2. Good morning- I started working at an IM outpatient place a few months ago 2-3 times a week. All my previous hx is inpatient. Things in general are going great, the only issue is my charting. I find myself charting at home sometimes because I have a hard time structuring patient time when going into the room. Acute visits are pretty good, the issue is with follow ups as patients talk about many other things and drift off a lot from the pertinent things we are following up.. It is difficult to chart some in the room due to the same issue. I don't want to come off as rude, so I need some help. As my number of patients keeps increasing, I keep finding this more difficult at times. I am seeing around 20-22 patients a day, but at times it can be around 25. 1- What is the average time you spend with a follow up patient? DM/HTN/Hyperlipidemia, etc.. 2- What is your routine when you go into the room. 3- What is the average time you spend in the room for an acute vs a follow up visit? 4- What techniques do you have/use to keep patients on topic and have the pertinent conversation/exam and then get out of the room? Any other advice/input is greatly appreciated.
  3. I just started an outpatient IM gig; have been there for a month; it’s part time. All of my career had been inpatient, so transitioning to this has been a learning curve in regards to patient flow and timing; very different than inpatient. i have been there a month and currently am seeing 14 patients, it’s been slowly moving up since 10 when I started. I am sure the increase will continue and this is where I need your help: I get a mix of everything, physicals, AWVs, follow ups, new patients, Acute visits. My biggest issue is keeping the appointment focused to the CC/reason as patients like to wonder into other things or simply start taking about other things. I feel bad cutting them off; not sure what approach to use in regards to this as I don’t want patients complaining because of this. I feel that if I can keep them focused into their reason for the appointment this can make a huge difference with my documenting. How do you guys approach this? i have tried to do some charting in the room, but I feel uncomfortable as I feel the patient may feel ignored, how do you guys do this? How long do your usual/average yearly physicals, AWVs and follow ups take? What is an appropriate number of patients for me to see in an outpatient IM practice? I work 8 hr days twice a week; I am the only other provider apart from him. Thanks in advance!
  4. Hello everyone! Just started an outpatient IM PT job where DrChrono is what we use for charting; never used this program before. Any one have experience with this and had tips/tricks on how to move faster through charting to balance time between documenting and patient? Any input is greatly appreciated!
  5. First of all I want to thank you all for the numerous times you guys have offered insight and advice to my questions; thank you for that. I am asking the following question for a friend whom is feeling pretty “shi**y” to say it in an honest way. He completed a Nurse Practitioner program back in 2016 and started working right after as a hospice NP with no other forms of experience. Because of all these pandemic he has been dealing with a lot of end of life issues and it’s gotten to a point where he says it’s affecting him emotionally. He wants to start looking for new opportunities doing “real medicine/management” like he said but feels that because his only experience has been in hospice he will have a difficult time being considered for family practice, internal medicine, ER/UC, or hospital medicine. His second concern is that he feels “everything” that he learned he forgot because he has just been focusing on hospice care. This situation has him all bummed out and feeling hopeless and asked me for advice. I honestly felt that I had no good advice/guidance and asked him if he was ok exposing his situation here and go from here. what do you guys he should do to regain some Confidence in his knowledge given his background? Should he study any specific books, online review? What would be the best approach from your experience and perspective? Thanks in advance and wishing you all a good new year!
  6. I am in California, Central area and is internal medicine (outpatient). The dollar amount I said is just figurative with the range of $20, example $20-40. Let’s change this number to 50-70 and me currently making 55 as an example. Sent from my iPhone using Tapatalk
  7. Hi everyone- I need your advice/perspective. I received a call today for a job I had applied for and the physician is offering the position. We talked about a few things briefly over the phone and conversation came about salary. He mentioned that he was looking to pay $20-$40 per hour (just using numbers, not actual pay lol ). On the original job position it said 10-40 per hour. He asked how much I was making at my current hourly pay and I mentioned $25 and that was that and continued staring to talk about other things. He then asked when I would be able to start etc and how him and his team were looking forward to my addition. He said that they interviewed several candidates but that I really stood out. He said they were going to start working at n a contract and he would then send it to me and see what I thought about it. I am going to email him in the next two days to let him know of a couple things we talked about. These are my questions: Should I mention to him that I am looking to get paid between $30-$40 per hour or should I wait to see what the contract says? At my current job I am due for my annual review in the next couple days which will bring my salary up from what I told him, so Gould I mention in this email that I am looking to get paid in the 30-40 range as I will received an increase in my annual review? Or should I simply wait and see how much he offers in the contract and then mention if they can increase the hourly pay if it’s not what I am looking for? I also am bilingual (Spanish) and it would be a benefit for the practice. Thanks in advance for your advice! Sent from my iPhone using Tapatalk
  8. A friend of mine will be starting working for a general Surgery group, mostly following post surgical patients inpatient and outpatient; not first assist. His experience is 3 years of psych so a bootcamp like program or anything you guys may recommend could help him prep for this. Thanks for recommendations. Sent from my iPhone using Tapatalk
  9. Any of you have favorite apps/pocket books that you use in UC or EM that help you with a quick look/assurance with dosing, treatment guidelines etc. Thanks! Sent from my iPhone using Tapatalk
  10. Thank you for such insightful advice, I appreciate it. Sent from my iPhone using Tapatalk
  11. Hello everyone- How would you respond via email after an interview for X organization where a job was offered in Y specialty but you feel this specialty is not a good fit for you, but you love the organization and the APP director and CMO and you want to be considered for other positions within the organization? That’s the honest truth, I don’t feel this epically would be a good fit, but I would love to be considered for other positions within the organization. How would I word something like this to not burn Bridgestone keep doors open? I am just being honest and will email them in the next couple days. Thanks! Sent from my iPhone using Tapatalk
  12. Anyone? Sent from my iPhone using Tapatalk
  13. Bump.... Sent from my iPhone using Tapatalk
  14. Hi everyone, I was wondering if any of you would feel comfortable enough to share a template of your resume/cover letter. I feel like mine are very old and not up to date and just trying to obtain some ideas on how to best design/prepare and update my resume/cover letter. Some examples I have seen are colored as opposed to just black and white, some contain a personal picture. Thanks in advance, Sent from my iPhone using Tapatalk
  15. Do you guys have any recommendations on any emergency medicine books I can purchase to study? As mentioned in earlier posts; I am interested in working at an UC or ER. My background is inpatient cardiology and inpatient palliative medicine. Thanks in advance! Sent from my iPhone using Tapatalk
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