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This is a discussion on Need advice in Nurse Practitioners (NP), part of Advanced Practice Nursing ... I am an OP NP.I have been in my current practice for over a year.I like what I do but the office is...by AutumnBreeze Jan 5I am an OP NP.I have been in my current practice for over a year.I like what I do but the office is really getting to me. The MAs are allowed to be rude to staff and patients. They use foul language.The staff complains to me daily about at least one of them. I made a list and submitted it to the office manager several months ago.She also has talked to the patients who complained.On the surface, she agrees that these staff need to be written up, at the least. However, our physician likes these people and doesn't see the problems. He is in his office with the door closed. I hear it constantly. I feel so frustrated and wonder if I should be looking elsewhere.The job market here is tight and there are good things about this job but this situation is really getting to me.I plan to talk to the office manager again next week, but I'm not sure what I am going to say.
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- Jan 5 by traumaRUsI personally wouldnt tolerate it. I work in a large nephrology practice but dont work in the office. I have been there almost 7 years. I had an occasion to call the office recently and the receptionist was quite rude to me. After she found out that I was an APN who worked there, her tune changed quickly. However, I was concerned about who else she was rude to so I did discuss it with her. Didnt report her or go anywhere else with it but she knows it wont be tolerated. Pts have a choice too and pts are who pays our salaries so it behooves us to work in a practice that has standards and sticks to them. I would bet it is far easier to replace an MA then an APN.
- Jan 5 by AutumnBreezeI did tell the office manager before Thanksgiving that I was prepared to leave. The problem seems to be that the doc doesn't want these people disciplined. That's the real problem.
- Jan 5 by AutumnBreezeI have also talked with the MAs personally, and they take no responsibility for their actions. Someone else is always wrong in their eyes. And since the providers aren't really their supervisors,they don't much care what I say. I think I need to talk to the doc, but that was useless in the past.
- Jan 5 by traumaRUsI would use this time to polish my resume and move on.
- Jan 5 by LobstrosityI'm not sure what your experience was as an RN, but that kind of environment can exist just about everywhere. I worked in the largest ICU in my region for several years and our floor was known throughout the hospital as being by far the most hostile. Complaining (not meant in a negative way) only gets you so far, regardless of who you complain to. You've already confronted the MA apparently, which in my opinion is the best way to handle the situation. Next, maybe you should try something different:
1. If you hear a complaint from a patient, hand them a piece of paper with the MA's boss's contact information on it and urge them to bring it to that person's attention.
2. Pull the MA into their boss's office and the 3 of you have a talk. Go in prepared with a list of specific examples, keep your cool, and provide not only criticism but suggestions on how to correct the problem other than firing the MA. This shows that you value the MA and want to help rather than simply eliminate a problem.
3. It sounds like you're part of a large organization. Find your code of conduct and pick out specific spots where it's being violated. This was the thing that finally worked for me. There was an RN on our floor who constantly harassed me until I'd finally had enough. I pulled out my union handbook (I'm so not "that guy") and showed my manager, in front of the offending RN, the parts of the policy that she had violated by treating me the way she had; I gave specific examples of each violation.
Like TraumaRUs points out though... if this is an obvious problem and nobody wants to do anything about it, I wouldn’t want anything to do with that kind of management.
- Jan 6 by AutumnBreezeI spent 20 years as an RN and did see this situation occ. but it rersolved usually. I have been an NP for 10 years and this is my second position.Ours is a private practice . I really do not want to leave and there aren't that many jobs here. I just want something to be done about it.I do tend to feel responsible to fix it when pts/staff complain to me, However, I have also talked to our CEO, who instructed the office manager to fire the MAs. The office mgr told me that herself. But as long as the doc is happy, nothing changes.Is leaving the only way ?
- Jan 6 by traumaRUsThe only solution I see is that you talk frankly to your doc: Hey there doc, these MAs reflect poorly on our practice. I want to provide great service to our patients but they are a hindrance. Heres what I propose: we have a meeting with the MAs, we make them fully aware, in great detail, what the issue is and how it will be resolved. We put them all (the offensive ones) on a one month probation period. If, at the end of that month, there performance/behavior has improved, that is great. If, however, at the end of the one month period, there is no improvement, I see no alternative but to leave the practice.......................................... ............this sets the stage for the doc to realize how serious you are, that you are willing to leave over this issue as it reflects negatively on your professionally too. Then, use the one month time frame to network with your states APN organization, local hospitals, etc., and get some resumes sent out.
- Jan 6 by mammac5I agree with what's been advised so far. You can't make the doc understand that these MAs are making the entire practice look bad, but you can darn well make sure he/she HEARS about it, loud and clear.
I was an MA for many years and if there is one thing I know, it's that I had the power to make the doc I worked with look great, smart, caring, thorough, and responsive to requests...even when he/she was NONE of those things. The opposite is also true - they can make the practice look horrible and they could become a legal/financial liability when they insult or offend the wrong person.
- Jan 8 by AutumnBreezeThank you all for your responses. I finally got 5 minutes with our office mgr today. She informed me that the CEO had talked with the doc and since the doc sees no problem, they are not going to intervene. I am so mad I could spit right now. I am going to have a little chat with the doc tomorrow.It seems obvious to me at this time how little they value me.