How EverCare nurse practitioners spend their time

OBJECTIVES: To describe how nurse practitioners (NPs) employed by EverCare, a Medicare HMO serving exclusively nursing home residents, spend their working days. DESIGN: A descriptive study based on structured self-reports. SETTING: Nursing homes. PARTICIPANTS: Seventeen NPs employed by EverCare in five sites. MEASUREMENTS: Self-reports of time spent over a 2-week period and specific reports of how time was spent on selected cases. RESULTS: NPs spend about 35% of their working day on direct patient care and another 26% in indirect care activities. Of the latter, 46% of the time was spent interacting with nursing home staff, 26% with family, and 15% with the physicians. The mean time spent on a given patient per day was 42 minutes (median 30); of this time 20 minutes was direct care (median 15). CONCLUSIONS: NPs' activities are varied. Much of their time is spent communicating with vital parties, an important function that supports the physicians' primary care role and should enhance families' satisfaction with care.