How to Make a Plan of Care as a New Nurse Practitioner

If you draw a blank when it comes to your a plan of care once you’ve got your differentials, you’re not alone.

I rely on step-by-step approaches to my care as an NP to keep me on track and make sure I’m not missing anything. 

In this video, I’ll share with you the approach I use and recommend for ANY patient, to give safe, high quality care and keep you from laying awake at night, worrying.

Plus, I’ll share 2 real world truths to help save you some frustration when it comes to making your plans.

Centor criteria link (this is the 5 point criteria, not the 4 I referenced)

Once you’ve watched, I’d love to hear from you.

Are there any steps here you can add to your plans of care?

Or, is there an approach that’s working for you that you can share with me and the other NPs watching?

Leave me a comment below. Be sure to share your thought directly in the comments, no links or videos as they may be removed.

Thanks so much for watching. Hang in there, and I’ll see you soon.

Liz

17 thoughts on “How to Make a Plan of Care as a New Nurse Practitioner”

  1. This video was super helpful. I have just started clinical rotations and I am feeling terrified of all the things I don’t know and what I might miss. This discussion definitely has added structure to how I will approach patient visits and case studies in my class this semester. Thank you Liz!

  2. This information was great !. I use the centurion criteria often and had used the positive, negative table while I was in school which was useful but I kind of forgot about it. Thank you for caring, you are highly appreciated and the support is needed.

  3. So nice to hear how to navigate the conversation about realistic and safe expectations when a patient presents with many concerns to be addressed in one visit. Taking care of yourself as an NP… I hadn’t heard that yet; thanks for the perspective and wonderful advice. ❤️

    1. I’m glad it was helpful! YES, it’s so important to take care of ourselves, I had to learn this the hard way! It’s hard not to want to do everything for everyone but is a relief to know that even if you tried to do that, it’s not as helpful as you think. ❤

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  6. I’m not a new NP but I have fallen into the laundry list trap and have become so overwhelmed that I ended up being sick. Thanks for the great tips.

    1. Oh Sharon, I’m so sorry to hear that. I got very sick my first year of practice from stress/overwhelm, it’s easy to get sucked into that place! I hope you can climb out of it, and hopefully this site can be helpful for you 🙏 It’s not easy to set limits, but it’s really, really good self-care for you, and it’s better care for your patients ❤

  7. I found your site on the NP networking group on Facebook. I really like your approach on the plan of care. I believe I work in a clinic similar to you. Often patients with chronic problems for more than 10 years. I tell them we are going to start on 1-2 problems and do frequent follow up until they feel the issues are addressed. Could you possibly speak to the issue of symptom complaints on Friday afternoons? I find this often changes my plan, knowing I will not be able to get results and we will not be open over the week-end for follow up if needed. Unfortunately, this frequently leads to other problems, such as insurance not wanting to cover a test that was ordered stat, but the patient does not want to go to the ER. How do you or other NPs handle that? I sometimes feel I am referring to often.

    1. Absolutely! Friday afternoon problems can be painful! I certainly run into that issue myself. I absolutely do what you do — and so do most other experienced clinicians. We try our best to help the patient, but ultimately it comes down to needing to go to the ER or an urgent care. We have a Saturday clinic and an on-call service, which helps — so any urgent lab results will get called to the on-call person, or they can come for symptom follow up on Saturday, but sometimes you get stuck!

      In terms of the feeling of referring too often — this is SO common. And likely, there will be more referring in the first years of practice than later in practice, BUT– this isn’t a bad thing. For example, someone with uncontrolled HTN that needs a secondary workup – you look at the first “primary care” level of things: OSA, renal artery stenosis, some basic labs, then you get to the “fancier” ones — if you don’t know how to interpret them, it’s doing more harm than good, you know? And once you’ve done that workup many times and had more time in practice, maybe you DO feel comfortable ordering and interpreting those labs. I could make a whole video about this topic! Moral of the story is that it’s safe care, and that’s most important. And over the course of your practice career you’ll gradually expand your comfort level of what more and more you can do. But you never want to cross over into unsafe care, ordering the wrong tests, etc. Hopefully that helps!

  8. Hi! Thank you so much for all your videos. They are very helpful as I am navigating my first few months as an NP in a family practice setting. I especially enjoyed this video as I feel it has helped me organize my thought process (through your suggested steps) in preparing a plan of care. Please keep up these fantastic videos!!

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