Inpatient BMT NP role

  • Inpatient BMT NP role

    Posted by Stacy Wolf on January 8, 2019 at 2:02 am

    I have been working primarily as an inpatient bone marrow transplant NP for the past year. I share the position (I rotate outpatient for 1 month every 3 months) with a long-time PA, who started when the program was established 18 years ago. The NP/PA inpatient role has always been one of primary management of the inpatient BMT patients – H&P,s daily rounding and progress notes, order writing, coordination of care, discharge summaries, med rec, etc. We have resident coverage overnight and on weekends.

    As of January 1st, we have been informed that the residents will now be the primary providers for our BMT patients, and that our role will now be more of “mentoring” the residents to address a “resident education gap”. We will no longer be able to write any aspect of the daily progress notes (they were previously “shared” notes), as the medical group would like 100% of the RVUs to go to the attending MD. If the NP/PA writes any portion of the note, it would be billed as a shared visit, with 60% going to the MD, and 40% to NP/PA. NPs are not assessed based on RVUs.

    Besides feeling disheartened and undervalued, I am also concerned about the likely impact to the continuity of care for my patients, as well as the abrupt change in the role I am now being asked to fill.

    For those of you working inpatient (hem, onc, BMT):
    – What are your daily responsibilities and work-flows?
    – How are your notes structured?
    – How is billing set up for inpatient NP care at your institutition?
    – Do you perform procedures? How do you document and bill for them?

    Thanks in advance for your responses!

    Stacy Wolf, CPNP-AC, CPON, RN
    San Francisco, CA
    United States

    Stacy Wolf replied 5 years, 3 months ago 1 Member · 0 Replies
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