Charting Tips for Primary Care: Lori, NP, Reclaimed Her Time!

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Lori, a seasoned nurse practitioner in primary care, knew this feeling all too well.

What started as a few late nights quickly became a daily routine — logging off hours after the clinic closed, only to continue charting at home, constantly exhausted and overwhelmed.

She loved her patients and believed in providing excellent care. But her personal life was suffering. Family dinners were missed. Evenings were filled with EMR screens instead of connection and rest. Her boss was becoming frustrated at the open chart notes.

She thought it was just part of the job — until she realized it didn’t have to be.

Lori made a shift. She got honest with herself, changed her approach, and implemented sustainable charting strategies. Today, she finishes her notes during her workday and hasn’t brought charts home in over six months.

Here’s Lori’s story — and the charting tips for primary care that helped her finally reclaim her personal time.

Lori’s Breaking Point: Spending Hours Charting at Home

Lori had been in practice for fifteen years. She didn’t always struggle with charting but a few staffing changes and pressure to see more patients tipped her over the edge.

At first, she assumed she just needed to move faster. She tried arriving early, staying late, even skipping lunch. But the charting never seemed to end.

She found herself writing 25–30-minute notes for 15-minute visits. Lab results, patient messages, prior authorizations — it all added up. At night, she sat at her kitchen table trying to catch up, while her husband ate dinner without her. She knew she couldn’t keep going like this.

She is a dang good nurse practitioner, holding some of the highest patient satisfaction scores and key quality metrics in the primary care clinic setting. But the charting got the best of her.

Her employer was constantly following up, wondering why she wasn’t able to get the chart notes signed, when her colleagues had completed the documentation. She was on the brink of needing to take a sabbatical to mange the nurse practitioner burnout that arose.

Accountability First: Lori Had to Get Honest

Lori’s real turning point came during a conversation with her 10-year-old daughter, who asked, “Are you working again tonight? Why don’t you ever spend time with me?”

That hit hard. She realized that while her charting problem was complex, part of it came down to a lack of boundaries and systems — and some patterns she was responsible for changing.

She stopped blaming the EMR or the patient load. Instead, she asked herself, What am I doing that’s making this harder than it needs to be? What charting tips for primary care do I need to implement?

It wasn’t about working harder — it was about working smarter. It was about implementing the charting tips for primary care that would actually make a difference in her practice.

Charting Tips for Primary Care

Here are a few of the charting tips for primary care I helped Lori implement into her practice.

Charting Tip #1: Stop Letting Perfectionism Take Over

I helped Lori identify that her notes were long — way too long. She was including information “just in case,” crafting full paragraphs when a single line would do, and trying to write the perfect SOAP note every time.

One of the most effective charting tips for primary care is to embrace the idea that your notes should be billable, accurate, and defensible — not perfect.

She began using this internal checklist before moving on from each chart:

• Did I meet the documentation requirements for billing?
• Does the note clearly reflect medical decision-making?
• Would another provider understand the care plan?

That’s it. No fluff. No over-documenting. No essays.

For example, instead of writing:
“The patient reports an ongoing, persistent dry cough that has been present for approximately 6 weeks. She states it tends to worsen at night, occasionally disturbing sleep, and is sometimes triggered by strong smells or talking for prolonged periods.”

She simplified it to:
“6-week dry cough, worse at night, triggered by odors/talking. Affecting sleep. No SOB, fever, or chest pain.”

Concise. Clear. Done.

Soooo many nurse practitioners tend to over chart. In fact, it is the #1 charting mistake nurse practitioners make.

That is why I created 5 Minute Chart Notes. A course designed to help nurse practitioners to get rid of the note bloat and create problem-focused chart notes that take less than 5 minutes to sign (One of the best charting tips for primary care). 

If you’re spending wayyyy too much time writing chart notes, you need to take this course! That way you can spend LESS time charting and MORE time with your family!

Charting Tip #2: Chart in Real-Time (Yes, Even During the Visit)

Lori knew one of the first charting tips for primary care to implement was the use of the EHR features.

She updated her charting templates and smart/dot phrases for her most common complaints:

• Annual physicals
• Hypertension follow-ups
• Diabetes visits
• Medication refills
• UTI symptoms

With utilizing templates and smart phrases, her average note time dropped from 20 minutes to under 10.

This allowed her to sign chart notes off right after a patient visit. **This is one of my favorite charting tips because it is sooo powerful.

When nurse practitioners can sign a chart note off after the patient visit, they can clear it from their mind (and their task list). That way the APRN can focus on the next patient and not feel the mental fatigue or brain fog from having sooo many tasks to do.

Signing the chart note off right after the patient visit, is one of the most powerful charting tips for primary care.

Charting Tip #3: Set Boundaries with Patient’s During the Visit

Lori also realized she was letting patient care spill far outside of visit times (allowing 15 minute appointments to roll into 30 minute appointments) and also through the patient portal.

She felt obligated to answer every message the moment it came in. But this constant interruption made it hard to focus on charting or even take a breath.

So she implemented some boundaries (one of the charting tips for primary care that is vital (pun intended)):

• She scheduled two 15-minute blocks per day to respond to patient messages, instead of checking the inbox after every patient.
• She trained her support staff to flag urgent messages and batch routine ones for those blocks.
• During visits, she became comfortable saying, “Let’s schedule a follow-up to talk more about chief complaint so I can give it the proper time and attention,” if the conversation went off-track.

Setting these boundaries didn’t harm patient satisfaction — it improved it. Her patients got quicker responses, and she was more present during visits. Plus Lori got her charting done faster and actually had time in the evenings to rest and recharge.

Charting Tip #4: Use Freed AI Medical Scribe

One of the most game-changing charting tips for primary care allowed Lori to leverage technology to work for her — not against her.

She started using Freed AI Medical Scribe, an intelligent medical scribe tool that transcribes and summarizes her patient encounters in real time. Instead of manually typing every detail during the visit or struggling to remember everything after, she now speaks naturally with her patients while Freed AI captures the conversation and drafts a note.

“It felt like I suddenly had a second set of hands,” Lori said. “I was still in control of the note, but I wasn’t starting from scratch anymore.”

With Freed AI Medical Scribe doing the heavy lifting, Lori could quickly review, edit, and finalize the documentation — often within minutes. This not only sped up her workflow, but also reduced cognitive fatigue at the end of a long day.

In addition to using Freed AI, I showed Lori how to create a library of customizable templates (click here to see a video tutorial) for her most common visit types. These included:

• Annual wellness visits
• Chronic care follow-ups (e.g., diabetes, hypertension)
• Acute complaints like sore throat, UTI, and rashes
• Medication refills and transitions of care

She took the time to build out a solid foundation for each template, keeping them structured but flexible. With just a few clicks and tweaks, she could complete a well-organized note that met all documentation requirements — without reinventing the wheel.

This combination of AI-powered scribing and tailored templates helped Lori move through her day with more ease and consistency. She no longer dreaded charting — she had a system that worked.

Using Freed AI Medical Scribe is one of my top charting tips for primary care.

In fact, I love Freed AI so much that I have partnered with them! Try Freed AI Medical Scribe for FREE for 7 days! When you’re ready to subscribe, use my coupon code: NPCHARTING for $50 off your first month!

Lori’s Results: More Time, Less Stress, and a Life Outside of Work

After just a few months of working with Erica D the NP Charting Coach in a 1 to 1 setting and applying these charting tips for primary care, Lori saw dramatic changes:

• She consistently finished charting during the workday
• She hadn’t brought her laptop home in over six months
• Her evenings were her own again — family dinner, walks with her dog, even time for hobbies

Most importantly, she felt like herself again.

“I didn’t become a nurse practitioner to write notes all night,” Lori said. “Now I actually feel like I’m doing the job I trained for — without sacrificing my life in the process.”

Lori’s story is powerful because it’s not about shortcuts — it’s about strategy. She didn’t find a magic solution. She took ownership, shifted her mindset, and built habits that worked in the real world of primary care.

You can do the same.

If you’re overwhelmed, burned out, or spending too many evenings catching up on documentation, it’s time to take back control.

Start with these four core charting tips for primary care:

1. Let go of perfectionism and write only what’s needed.
2. Sign chart notes off right after the patient visit.
3. Set clear boundaries with patients and your own time.
4. Use Freed AI Medical Scribe to write your chart notes for you.

Want help making these changes stick? My STOP Charting at Home in 90 Days Program is designed just for nurse practitioners in primary care. You’ll learn how to implement these strategies step by step — and finally stop bringing charts home.

You deserve your time back. Let’s make it happen — starting now.

But burnout is not a badge of honor — and working late every night doesn’t make you a better provider.

You deserve time to rest. To be present with your family. To have a life outside of your EMR.

Ready to get started? Explore our step-by-step course designed to learn more charting tips for primary care finally stop bringing work home:
STOP Charting at Home in 90 Days!

***Full disclosure: This post contains affiliate links. I receive a small commission if you subscribe to Freed AI Medical Scribe. This is at no extra cost to you, but does help me continue to run the NP Charting School. Thank you for your support!

The post Charting Tips for Primary Care: Lori, NP, Reclaimed Her Time! appeared first on The Nurse Practitioner Charting School.

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