For the first 4 years of my practice as a nurse practitioner, I did all my charting through typing. I didn’t mind this because I’ve always thought of myself as a decently fast typist (69 words per minute isn’t terrible, right?).
Why use a dictation device
It wasn’t until I was introduced to Dragon, a dictation and speech-to-text software tool that completely changed my life (when it comes to charting, that is). I had no idea how much time I was wasting by typing all my notes by hand.
You might think you’re a fast typist but nothing, and I mean nothing, is faster than speaking. Charting is one of the most time-consuming aspects of our day. Using a tool to speed this up is game changing!
Your organization may not utilize Dragon (or other comparable speech-to-text software). If that’s the case, I recommend asking your employer if they will consider purchasing it. If your employer won’t purchase Dragon, I recommend you pay for it yourself. Dragon is so incredibly efficient and makes charting so much less painful; it’s a worthy investment.
After using Dragon for a week, I found myself wondering how I ever made it 4 years as an NP without using this incredible tool. What makes dictation tools so powerful is that it learns your speech, your articulations, and it autocorrects over time. It understands medical terms and learns your speaking pattern the more you use it.
You still want to review your notes when using Dragon or any dictation device, but it’s so incredibly efficient. I want every healthcare provider to know and use dictation tools!
How it works
Dragon is software that can be installed on any computer. You have a login and password. You then plug in your microphone (or use the built-in microphone on your computer) and that’s it. You click the green microphone on the screen, and it will turn green prompting you to speak.
Dictation tools are incredibly easy to learn to use and are an incredibly efficient way to chart.
Other dictation devices
I haven’t used any other dictation devices out there so I can’t speak to them, but I imagine they are all pretty comparable. Regardless of which one you use, the takeaway is that if you want to chart more efficiently, you NEED to be using dictation.
I had previously heard of physicians using this software but had never used it myself. In fact, it was a podiatrist who showed me this software and states he has been using it for years and would never consider charting any other way. I’m not sure why more providers don’t use it, but you absolutely need to look into using dictation.
Don’t wait the 4 years I did to add so much ease to your life!!
You can thank me later
Side note: I have no affiliates with Dragon or other dictation devices (i.e., M*Modal dictation). Again, likely any similar software will work! Happy charting!
The first few weeks and months in practice as a nurse practitioner are the toughest. The stress and doubt you might feel is common, normal, and overcome-able! Here are 7 top tips for reducing overwhelm in practice as a new nurse practitioner.
1. Ask for mentorship
Working with a seasoned provider, whether physician or nurse practitioner, is the single best way to grow your knowledge as a new NP. Mentorship is key to gaining clinical confidence and competence as a new NP. Use reference guides (see # 6) like UptoDate and Epocrates, but don’t underestimate the value of a mentor.
Ask one of the experienced NPs or physicians you work with to be your mentor and set up regular meetings to review complex patients. You can ask your mentor for feedback on how you are doing and areas for improvement. Private supervision, or consultation, on a regular basis, is the key to receiving the support you need early on in your career as an NP.
2. Research the most common conditions you will encounter
Another important way to reduce overwhelm as a new NP is to get a sense of the most common medical conditions you are likely to encounter in your practice.
How to know what the most common conditions are?
Look at your current caseload and keep track of the types of conditions patients are presenting with. Also, ask your experienced colleagues about the most common types of patients and conditions they see. Using this information, learn as much as you can about the diagnosis and treatment of these conditions.
For example, if you’re a primary care NP and most of the patients you’ll be seeing have diabetes, spend time learning more about the treatment of diabetic patients. If the second most common type of patient presenting has high cholesterol, learn about the treatment of hypercholesterolemia so that you become more prepared and comfortable seeing these types of patients.
3. Review your schedule and caseload
It’s important to review your schedule and caseload to help reduce overwhelm. Ideally, you got a sense of your caseload before you were hired during the interview process (when asking about how much time you would have for new patient visits and follow-up appointments as well as administrative time).
But, if you didn’t ask about this, or what you were told doesn’t match reality when you start practicing, don’t just accept your schedule for what it is. Ask your supervisor for a reduced schedule for a period of time as you gain experience.
4. Chart as you go
One of the most helpful tips to remember is to practice concurrent charting as you see patients throughout the day. Nothing, and I mean nothing, is more stressful or leads to burnout quicker than saving your charting for the end of the day to avoid keeping patients waiting for you. Yes, this may lead your patients to have to wait a few extra minutes while you finishing charting on your previous patient, but it is the most efficient want to stay on top of your work.
Also, read the documentation of more experienced providers to see how they chart. What do they include in their notes? What can you take away to implement in your notes to save time?
Remember that the goal of charting is to:
- document what occurred to provide safe, quality patient care
- document in such a way that another provider could read your note and know what’s going on
You don’t need to write an essay to have the world’s best note. The best note will be one where the events are clearly documented, and another clinician could clearly understand your plan of care.
5. Use dictation tools for charting
This tip took me YEARS to discover, but using a dictation tool, like Dragon, is a game-changer when it comes to quickly finish notes! Speaking is the fastest way to record information, I don’t care how fast you type. Nothing is faster than talking.
If your employer permits dictation software, ask to use it. If your employer doesn’t pay for dictation software, I highly recommend you make the investment. The investment will be worth all the time you save with charting efficiently (it might even save your hair…because it will all be intact from your stress-free days not playing catch up with your notes).
6. Utilize clinical references
It’s ok to look stuff up. You can’t memorize everything and besides, information is frequently changing and you need to be up to date with providing quality patient care. Use tools like UpToDate, Epocrates, Sanford Guide, and MD Calc.
7. Make cheat sheets and templates
Cheat sheets and templates are an awesome way to streamline charting. Side note: notice how important efficient charting is (several of these tips involve it!). If you’re a psych NP, check out the templates on my website to create beautifully clear, thorough but concise, initial psychiatric evaluations and follow-up notes.
Using these 7 tips will help you become a happier, less overwhelmed, NP in practice.