American Academy of Nurse Entrepreneurs

This is When Nurse Owners Should Create Policies and Procedures…And in Which Order

Policies and procedures. Many nurse owners believe they need an entire laundry list of what to do when such-and-such situation happens. Having wall-to-wall policies and procedures is a nice goal, but it’s also a huge undertaking – especially when you’re just starting out.

This is my stance on policies and procedures: Besides basic emergencies, there are no set rules you need to follow for YOUR practice’s policies and procedures. You can build your policies as procedures *as you need them*.

The True Purpose of Policies and Procedures

The whole point of policies and procedures is to scale. You have policies and procedures as a way to make the protocols and how-tos of your business easily accessible and known by your team. If, right now, your practice is just you, then there’s really not yet a need for policies and procedures. 

Once you’ve got your marketing squared away and patients coming in, you should dedicate time to methodically building your policies and procedures. It will make it easier to standardize your practice and, eventually, you can use them for your onboarding and training materials for new hires. 

If you don’t have policies and procedures in motion once you start hiring, important things won’t get done, or they’ll get done in a subpar way that doesn’t meet your standards. Policies and procedures should make your life easier because they should become the guidebook for your staff, meaning they don’t have to call you every time they need something.

The Simpler, The Better

When it’s time to start writing, it’s easy to feel intimidated by the style policies and procedures are typically written in google results. But you know what? It doesn’t have to be that complicated. In fact, some policies and procedures can be in the form of a simple checklist. 

You want your policies and procedures to be accessible to everyone on your team. The simpler, the better.

How to Get Started in Creating Your Policies and Procedures

If you’ve started your practice, but haven’t yet hired anyone, then you have some time to slowly build your policies and procedures. And if you have already hired people, the process is the same; you’ll just prioritize the policies and procedures for the roles you’ve already hired. 

Start by thinking about what you do every day in your business. What are your recurring tasks? Create a list of all of those activities. Really spend a week or two just on this step.

Then, choose one recurring task and write out how you do what you’re doing. Even write down the steps while you do those tasks or right after you finish them. Then, “field test” it by spending the next few days using it as your guide for that task. Anything missing?  

Continue this process for the next few weeks/months, depending on how many moving parts there are to your business. 

Which Policies and Procedures Should You Create First?

Ultimately, you want to have policies and procedures for all areas of your business. But where should you start? Your best option is likely in the administrative category. Typically, those are the tasks that you want to hand off early; they’re the things that you don’t want to waste your time doing when you could be seeing patients. 

Administrative policies and procedures include:

  • New patient appointments/onboarding
  • Reconciling lab invoices
  • Taking care of patient no-shows
  • Schedule management/review
    • Confirming patient appointments the day before/the process if they haven’t confirmed

After administrative policies and procedures are handled, it’s a good idea to build up your clinical policies and procedures. Those include:

  • The clinical aspects of what happens in a new patient appointment
  • How to handle bloodborne pathogen exposure
  • How to handle sharps and biohazardous waste
  • Basic exam protocol
    • For example, in my practice we don’t do any intimate exams during first appointments.
    • Or perhaps you’ll decide you always want a chaperone when doing intimate exams in your practice. 
  • Inviting the patient to download a communication app during their appointment
  • How many prescription refills are to be given to a patient
    • For example, it’s our policy to prescribe enough to hold them over until their next appointment; when they’re in need of a refill, it means they need to schedule a follow-up appointment.

Then, you want to round everything out with policies and procedures for incidents, such as:

  • What to do if a patient has an anaphylactic reaction
  • What to do is a patient comes in with chest pain
  • Other urgent/emergent conditions

Resources, Resources, Resources

If getting these policies and procedures down on paper is still intimidating, just remember that you don’t have to reinvent the wheel. There are plenty of books out there, and we’ve included many resources within AANE as well – like our employee handbook. There’s no need to start completely from scratch.

The Living Process

You can create all the policies that you need, by just understanding one thing: It’s an organic process. When a member of your staff reaches out to you with a question that isn’t covered within your procedures, that’s your clue to add something. 

There will be a learning curve; when you first start out. When those first hires start coming in, there will be growing pains. But if you stay mindful of your policies and procedures, you can save yourself so much time and avoid so many headaches in the future and as you expand further. 

AANE for Nurse Entrepreneurs

We help APNs start, grow & scale their practices with online resources, classes, community & mentorship.

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