Latest Comments by SoundofMusic

SoundofMusic 12,622 Views

Joined: Apr 7, '07; Posts: 1,030 (56% Liked) ; Likes: 2,204

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  • 1
    wondern likes this.

    Have been working in a small mom and pop practice for about a year now -- no EMR -- all on paper. Doc is old school. Very busy and well loved practice with a large patient volume. I started there a year ago, with a few years of retail health experience, but not fully versed in primary care. The staff has all worked together for years, and we as NP's/PA's seem to march in and out of the practice, as no one ever stays too long.

    Have done well there and now am a fully fledged member of the provider staff, take call, and can stand on my own well - just need guidance now and then, which is appropriate, as I get any case handed to me.

    Still, one of the MA's there finds it in herself to be snappy and rude to me out of the blue. She's a rougher country gal, with a mouth, and I feel she gets an attitude about us as mid level providers, as many of us just get there, learn our stuff, then leave after 1-3 years. Or, it's just me ....I'm not sure.

    I hold off from just handing it back to her during the work day as I don't want to confront her, I'm not her boss, and I just don't have the time to duke it out with her in between my busy schedule. Also not sure what she'd do as she seems just slightly mentally unstable ....really don't want to get into a full on screaming match or worse with her in front of everyone.

    So, after the last episode, where she chided me for leaving the lid too loose on an FOBT sample (granted, yes, that could be a problem ....but it's also trivial and she could have just simply and kindly told me to make sure I tighten the lids before I leave them in the rooms, .....instead she ripped me over it rudely and nastily in my face) I decided to complain about her to the practice manager and have demanded a meeting between us all to address it with her.

    I feel wimpy, but it needs to be discussed. There are staff members in some places that often will treat the doctors with the utmost respect, yet feel they can be all out crappy to the mid levels. .... because they think they can I guess.

    The practice manager, though, seems to make excuses for her ...."well, that's just her" and "oh, she just does these things and thinks out loud, " etc, etc. I say BS to that ... .this gal knows exactly what she's doing and just wants to bully me around.

    So, hope I'm doing the right thing ....guess if it continues I'll leave ....but it makes me sick. Maybe it's my cue to leave ....

  • 0

    It's 2018 and I'm still reading your post. You have no idea how much this has helped me to hang on through a board complaint made against me by a former employer. I was also recently reprimanded and the entire experience was so hideously painful I cannot even describe it ..... but..... I survived it, and I'm still practicing well as an NP. I'm fearful now that the complaint may cross to the state I'm working in now .... which hopefully does not mean hiring more legal help ..... But, I know I will survive and it has made me stronger. At times the pressure seems so strong that I wish I could leave the profession all together .... and then I have days where my patients are complimenting me, or thanking me for helping them in some way and that they're so glad I'm their provider .... so, what can you do? Learn from it, I guess.... and move on. But be cautious .... every single day. But please know how this post in particular helped me on many days to just hang on and fight.

  • 0

    Any good and relatively inexpensive courses anyone could recommend? Or conferences?

    I've put this off and have until next July to get it done ....will pay more if it's worth it.

  • 1
    BCgradnurse likes this.

    Just started in a primary care office in Maryland. Often, patients under 18 are coming in without parents, and without any sort of parental consent form on the charts.

    Coming from the Minute Clinic environment, I always thought kids had to be accompanied by the parent. I realize this is not true for teenagers seeking birth control, pregnancy testing, STD testing, etc .....but for routine medical visits, shouldn't they be accompanied by a parent? We get a lot of the school physicals also being done without the parents of the older teenagers. To me this can be fraught with issues when kids are unreliable historians, uncooperative, clueless about their family history, etc.

    Looking at our state consent laws, it's very confusing.

    I'm finding lots of trouble with parents not present during these visits ...

  • 1
    Bumex likes this.

    Right -- I think that over time, as an NP you will catch up simply due to experience in practice, but it's very tough at first.

  • 1
    ICUman likes this.

    I don't know -- everyday I wonder if I should just hang it up ...I'm just four years into it, spent 3 in retail, and now during my first year in true primary care, I get easily overwhelmed and am often in a state of panic and/or sheer terror. However, it is pretty cool to write those orders and do that follow up, especially if your treatment helped that patient. Really nice when patients like you, want to come back to see YOU personally, and to see how much they believe in you.

    Also nice to have nurses to help you, especially if they know what they're doing. Nice to not have to do the grunt work anymore .... nice to get a smidgeon more respect from patients than you did back in the days of nursing. Nice to work with a great doctor, which I do work for, and to collaborate and/or discuss cases with him. Nice to have weekends off finally. I'm still balking at having to wear street clothes, however -- just wish they'd let me wear scrubs and a lab coat ....which they won't.

    And I guess the money is better ....but you sure work hard for it. I feel NP's should get paid far more, and I also think doctors, should also get paid far more than what THEY do. We're all so pitifully underpaid considering the work we do, and the responsibility we hold.

  • 2
    traumaRUs and espress099 like this.

    Oh gosh -- I'm relatively new in the field, but still have not really seen one who seemed to have the ability to effectively really manage, and who just did not seem untrustworthy and smarmy. The one I have now does a lot to make my job easy, but also CONSTANTLY cracks the whip on us in terms of patient volume and a host of other things. She just seems to always be lurking . .... right around the corner, ready to pounce if she sees something out of line. And it is tough at times taking orders from someone you KNOW has likely half or a third the education you do and truly has no understanding of how hard your job is. That said, yes, it's their job to keep the office running at a profit so we can all get paid ...

    The one I have now is already driving me crazy. She seems to draw you into her conflicts with others, which is ridiculous, because she doesn't seem to have the balls to stand up to the people whose behavior she wants to correct. She wants everyone to just keep their mouths shut, keep their heads down and do their job .... but it's just so unrealistic. There will always be a little bit of gossip in any office ...will always be a few moments here and there where people who are constantly hustling will sit back and slack a little. There will always be patients who take up a huge amount of time, and there will always be times where you just fail to perform perfectly. This one seems to look at us providers as if we are cattle ....she ALWAYS comes to talk to me during my lunch hour about SOMETHING ....which makes me mad ...I NEED A BREAK ...even just 15 mins to clear my head before the next session ... but she will never leave me alone during this time .... just wish they could view us providers as people/humans who need a little leeway ....but there is none. She's always digging and always saying things like, you need to remember who you work for .....ugh. (not necessarily to me, but says that about others ....actually, I think she's just a little off.) Also tough to see her relaxing, sitting at her desk with her manicured nails and cute outfits, all the while I'm sweaty, running from room to room, with my hands in various patient orifices, and me just trying to keep myself looking like an entirely disheveled mess.

    My dream would be to have my own practice where I as the provider ran things .... and eliminate the NEED for this type of person. But not sure that's entirely feasible

  • 7
    shingo333, Cococure, Zyprexa, and 4 others like this.

    I will honestly say, I strongly feel not all that much. I did 700 clinic hours, whereas my doc went to med school for 3 years, then did 3 years of solid residency ....that's what you NEED. I wish that's what I could have done. Now I'm out and expected to know and do what he does ...(well, not really), but sort of puts you in a perpetual state of intellectual disarray and discomfort/risk ... even the PA's I work with were far better prepared. Now that I'm here, I wish I'd gone to PA school. A nurse turned PA is a nice combo -- you've got the nursing background, but get the medical training to prepare you more thoroughly. Just my .02.

  • 0

    Oh I know .... I absolutely cannot and will not say much if anything at this point ... just trying to formulate a coping strategy for now.

  • 0

    Yep -- grates on me even more as I have to stand in a tiny room right right next to me While I chart ....

  • 1
    BSNbeauty likes this.

    Been working in primary care office for a while now and enjoying it -- for the most part. What's tough for me at times is working in close proximity with nurses with very foul mouths, loud voices, and just having to listen to the nasty talk, gossip and just non stop chattering while trying to work, chart, learn and THINK!! I'm also new amongst folks who have been working together for years. I'm no prude, but the non stop F-word all day also just grates on me after a while. How can I deal with this -- don't want to alienate anyone but almost not sure I can work in this office at times with it ... the doc here just seems to rise above it and doesn't seem bothered by it. They're all good nurses, but I don't understand how they can do this and not realize how disruptive it is... and here I used to be a nurse who also used to goof off big time in the nursing station!! 😂😂

  • 0

    It is 100 percent true -- follow the guidelines to the letter and you're fine -- problem is, patients sometimes want the same type of care they receive at their PCP -- I would explain to them that you are NOT their PCP, and you have to follow the guidelines of your employer -- 100 percent at all times.

  • 1
    traumaRUs likes this.

    Well, yes -- and I may add -- the board doesn't exist to protect nurses .... it exists to protect the general public! (From nurses and other healthcare professionals, and while some errors are more administrative, some are absolutely endangering and/or highly unethical) So, no -- they are definitely NOT there to do you any favors .... they are a disciplinary body.

  • 1
    traumaRUs likes this.

    I'm sorry -- can't share beyond what I already have.

    Having worked now, however, in a more traditional primary care office, I can say that the same situation definitely would not have likely even occurred. I do believe the risks in retail are very specific -- but there are also risks elsewhere. Again, just make sure your insurance is updated, anywhere you practice.

  • 4
    Joy16Sarah, Emergent, BCgradnurse, and 1 other like this.

    Thanks so much- it got me out of a bad job, that is for sure. I did get hired by a new employer and am doing fine!