In the midst of my New Years resolution making and general getting my life together madness, I picked up a book that proved to be quite helpful in my endeavors. Eat That Frog! 21 Great Ways to Stop Procrastinating and Get More Done in Less Time by Brian Tracy is the perfect gut check to help you uncover the reasons you aren’t getting $&*(^ done and taking a no excuses approach to life and particularly your job.
While I gained several insights and motivational nuggets from Tracy’s book, one in particular stuck with me. Tracy suggests asking yourself one question to increase productivity at work: “Why am I on the payroll?”. Tracy points out that focusing on the right things at work (i.e. the main reason you’re on the payroll) is the key to being effective in your job and therefore higher compensation. Avoid distractions. Stop spending time on things that aren’t key components of your role or that someone else can do.
I talk with a number of nurse practitioners who are frustrated or disillusioned with their employers. I’ve been there, too. Given the pressures they face from government regulations and insurance companies, employer policies may prevent you from practicing in the manner you would like. To keep up with these pressures and run a financially sustainable practice, employers demand that you as a nurse practitioner meet certain metrics (like these 4 ways your boss is measuring your performance). Or, you just might be frustrated with your employer’s management style. Your compensation might not be what you think you deserve or you may be pushed to practice at a pace beyond which you’re comfortable and/or don’t receive the support you need in your role.
If you’re frustrated about your employment situation and/or lacking direction, part of solving the problem and succeeding in your role as a nurse practitioner means asking the question “Why am I on the payroll?”. For most NPs the answer is easy – to see patients efficiently in order to generate revenue for the practice. And, yes, to do so in a safe, quality manner.
This may not be the answer you want to hear, but in every case I can think of, that’s why your employer hired you. As nurse practitioners, we are one of the few employees in the healthcare facility that actually generates revenue for our employer. We (or our employer on our behalf) bill directly for the services we provide. What does this mean for your job? It means that you should be delegating anything that can be done by a support staff member with a lesser scope of practice. Even though you may know how to do nursing duties and prefer assisting with them to your role as a nurse practitioner, they aren’t why your employer hired you. You might like coaching patients on healthy eating, but if your employer staffs a dietician, this should be delegated to free up your time for higher level patient care activities or so that you can fit in more visits.
Asking yourself why you’re on the payroll helps prioritize your time in a way that allows you to practice more efficiently and effectively making you a more valuable member of the healthcare team as a whole.
Sure, no nurse practitioner wants to see themselves as a pawn in a revenue-generating machine, but from an employer standpoint our practice are not viable without dollars flowing through the door. Efficient patient care can still be provided in a quality, mission-driven manner. But, you may need to be willing to delegate and prioritize in some ways that may not personally be your first preference. Your employer will notice (and maybe even offer you a raise in your next performance review).
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