Through my work as The Burned-out Nurse Practitioner, I have found the #1 cause of nurse practitioner burnout is work-life imbalance.
And the #1 cause of nurse practitioner work-life imbalance is excessive charting!
Nurse practitioners are staying late at the office and bringing charts home! We spend more time charting and less time with family.
With so many nurse practitioners feeling burned-out from excessive charting, The Burned-out Nurse Practitioner compiled a Jump Start List of Smart/dot Phrases to help overwhelmed nurse practitioners save time charting!
What are smart phrases?
Smart phrases (also called dot phrases) are a block/combination of frequently used words that can be easily pasted into the chart note. Smart phrases are commonly repeated phrases, such as treatment plan for hypertension or discharge instructions following a laceration repair with sutures.
Smart phrases can be implemented into every single practice area, primary care, urgent care, hospitalist or acute care, emergency department, cardiology, pulmonology, women’s health, mental health, dermatology, endocrinology, orthopedics….. you get the point.
If you are a family nurse practitioner working in primary care and see a lot of Type 2 diabetes patients, you can easily use smart phrases! In general, the patient education and treatment plan will be similar for most patients with type 2 diabetes.
For example, you could use the following phrase in your discharge instructions:
“A1C at goal. Refills sent to pharmacy. Discussed medication desired effects, potential side effects, and how to administer the medication. Nonpharmacological interventions such as low carb diet, high in vegetables and fruit discussed. Educated on importance of physical activity. Discussed signs and symptoms of hypoglycemia and need to present to the ED. Patient verbalizes understanding regarding plan of care and all questions answered.“
If you are a family nurse practitioner or acute care nurse practitioner working in urgent care, you will see a lot of the same complaints again and again. You might find yourself documenting patient education for upper respiratory illness viral or allergic rhinitis all day, every day. Developing smart or dot phrases for each of these complaints will save you so much time as an APRN.
If you are an acute care nurse practitioner working in emergency medicine, you will begin to see the same types of patients. A work up of chest pain or shortness of breath can easily be created into smart phrases. A suture repair or abscess incision and drainage require the same steps. Save so much time by creating these commonly said statements into smart phrases.
Nurse practitioners can save so much time by creating smart/dot phrases for each of these. Here are a few tips for creating and implementing smart phrases into any APRN practice!
Smart Phrases for Nurse Practitioners consists of over 40 smart/dot phrases. These smart phrases are ready to use AND you can sign up to get access for free! Topics include: Review of systems, physical exam, acute medical visit, chronic medical visit, URI, rash, UTI, abdominal pain in the ED setting, HTN, a-fib, diabetes, COPD, anxiety, and much more! You can sign up here for a list of Smart/dot Phrases for Nurse Practitioners.
Here are 5 tips to using smart phrases in your nurse practitioner practice.
Make smart phrases specific.
Our documentation should reflect our practice area and be specific to our nurse practitioner specialty. The Jump Start List of Smart Phrases for Nurse Practitioners will get you started in your use of smart/dot phrases. Then nurse practitioners can adjust/add/delete any part of the smart phrase to reflect how they care for patients. The smart phrases should be the same as what you usually chart in the patient note.
Use smart ques you will remember.
Once you implement the list of smart/dot phrases for your nurse practitioner practice, create the (.) portion so that you will remember. Nurse practitioners can create a ton of smart phrases, but if it is something you forget about, the list is not that helpful. Determine the shortcut you will use to implement the smart phrase. For example .exam will pull a normal physical exam into your note. Pro tip: Create yourself a cheat sheet for quick reference!
Implement into your electronic medical record.
With so many different charting systems out there, it is hard to show nurse practitioners exactly how to add smart phrases. Ask the IT department for assistance. Discuss with a colleague who already uses smart phrases. Research tutorials on Google/YouTube. You can always save the smart/dot phrases into a Google doc and take with you wherever you go. That way, you can copy and paste phrases into the electronic medical record. This works great for locum work or if you are traveling to different sites.
Adjust smart phrases as needed.
If there is one thing certain in healthcare, it is that things are always changing. There may be a new clinical practice guideline. You may decide you want to add additional patient education/discharge instructions. You might be seeing different types of patients and need to create new smart/dot phrases. We should always be adjusting our documentation to fit our current practice. Update your list of smart phrases whenever needed!
See yourself save time with smart phrases.
Small changes lead to huge impact. See how saving one minute on each patient using smart phrases can add up. If you are seeing 30 patients a day times one minute saved, that equals 30 extra minutes a day! What would you do with that time? Maybe you could create a better work-life balance as a nurse practitioner. Maybe you could actually keep up with charting and learn to love your job again. Maybe you could actually overcome the nurse practitioner burnout.
Implementing smart phrases into your electronic medical record will take some up front work. But, if you use The Burned-out Nurse Practitioner’s jump start list, you will save so much stress in the long run!
For time management and charting tips, check out The Nurse Practitioner Charting School– The one stop for all documentation resources created specifically for nurse practitioners. Learn more at www.npchartingschool.com
**Full disclosure, this blog post may include affiliate links. I do receive a commission if any of the affiliate programs/services/supplies are purchased. This is at no extra cost to you but does allow me to continue to provide content as The Burned-out Nurse Practitioner! Thank you!