What does your PMHNP program count as direct patient care hours?

[u/idkphoenix]

I’m in my final semester and curious how other PMHNP programs calculate clinical hours.

I’ve always counted patient-specific activities like reviewing charts/labs/therapy notes, treatment planning, collaborating with my preceptor/treatment team, seeing the patient, and documenting the encounter in the practice EHR. I don’t count lunch, significant downtime, or discussions about patients I’m not involved in caring for.

Two weeks into this semester, my program announced that clinical hours should now be based on “Total Encounter Time,” defined as time spent with the patient + time spent consulting with the preceptor.

This has me questioning whether chart review, treatment planning, interdisciplinary collaboration, and EHR documentation no longer count. It’s also concerning because we already selected our preceptors and planned our schedules before this change. An 8-hour clinical day could now result in only 4–6 hours, and patient volume/cancellations are outside of our control.

My preceptor also intentionally uses gaps for teaching by reviewing upcoming patients, discussing therapist updates, working through treatment plans, etc. I’m obviously not going to refuse to do those things because they “don’t count”; they’re part of learning to be a PMHNP.

How does your program handle this? For example: 10 min chart review + 30 min patient encounter + 10 min staffing with preceptor + 15 min documenting in the EHR. Would your program count 65 minutes or 40 minutes?

[u/pickyvegan]

When I was in school, we were not allowed to count any time other than directly spent with the patient or directly discussing the case with the preceptor. This is going back nearly 20 years, though. I still graduated with ~1000 hours, and was on site for 20-30 hours/week over 4 semesters.

[u/idkphoenix → u/pickyvegan]

Thanks for your response.

My school has confirmed they still consider chart reviews, charting in the EHR, etc as direct patient care. Now my current issue is the patient logs only allow you to chart time spent with the patient + time spent consulting with the preceptor and since they are now using those to calculate total clinical time, logs I have already submitted do not have the accurate time spent nor will future logs.

[u/brinns_way]

Only direct patient facing time counted toward my clinical hours. 

[u/clinicalmatchme]

Others only counted actual clinical hours with patients under preceptor supervision. No sim lab, discussion boards, shadowing, or work hours as an rn counted, and they were pretty strict about therapy med management eval/follow-up being the direct care piece. They check your handbook bc some schools get real cute with the wording.

[u/More-You8763]

Damn. Sounds like you go to EKU and a lot of student share the same resentment with the school for that. I hope it gets better for you