After 2 months, I have to leave my 1st FNP position

[jaznia15]

I never thought I would end up in this predicament, but I totally made the wrong choice in my first FNP position. If you have read my posts in the past around May/June, you know I was scrambling to find the right position with the right pay for myself. I agreed to take over a practice in which my supervising physician would only be available by phone. I love the practice but there are some very big issues and red flags that have led me to put in my 6 month notice (obligated by contract to be 6 months). The practice is a private practice that has been taken over by another physician who owns several practices around GA.

#1- My supervising physician did NOT tell her patients that she was leaving. She does come the 3rd Saturday of each month for 4 hours to see patients she felt would only see her. Many of the patients are skeptical of seeing me because they were never told of the change. I spend most of my patient visit proving myself to be knowledgeable and a good practitioner. I've won over almost all of the patients because I do take time to explain to them my plan of care and go over medications. Apparently my supervising physician made her visits quick.

#2- My staff consists of 2 CMAs, one manages the front desk and completes referrals. The other checks the patient in and obtains vital signs, UA, glucose, and labs if needed. The latter was given the "office manager" position, but no training as office manager. She has been in the practice for 2 years while the prior has only been there since mid-May. The office manager does not know her role and I really cannot tell her the expectations of the role because I am a new practitioner. So far I have had to handle issues by myself or call staff from the company who are hours away.

#3- I have been there a total of 3 pay periods and every pay period thus far has had issues with our checks. We were promised payment through direct deposit that first pay period. When the payday came that Friday, we were told our checks did not go through direct deposit and would be delivered by my supervising physician early Saturday morning. Saturday morning arrives and my supervising physician states she will bring the checks on Monday because she found out the amount of the checks later. Needless to say after telling her this was unacceptable because we were told we would receive our checks, she came down to the office. Unfortunately I was unable to even cash the check because they were given as a cashier's check and the banks were closed. She also shorted my check $300 stating this was taken out for taxes. Later I was told that our checks did not go through payroll so therefore the check should have been the full amount due. These last two pay periods, we were told the same thing about the checks going through direct deposit. Only on the day we were to be paid (Friday) do we ever find out that the checks did not go through as promised. Last pay period one of my staff had to drive 2 hours to Atlanta to get the check. We, then, discovered the checks were not signed and had to chase down the owning physician to get them signed. This past Friday we sat at the office for 5.5 hours waiting on our checks. We were told the physician would be there at 2pm ( we get off at 12pm on Fridays), he did not reach the office until 530pm. He sees patients for a pain clinic every other Friday so we could not leave the office because his many pain patients were sitting in the lobby (some since 3pm).

#4- The last straw was something I will have to look at the legality of. In my contract it states that I am paid an hourly rate. Sometimes I stay at the office late because of late patient appts that go past closing or charting. My previous check was for 82.7 hours. The owning physician told me this past Friday that although I am hourly, I am salaried as well. Meaning if I do not come to the office, I will not be paid but I also cannot get more than 80 hours. This was never in my contract and I also feel it is illegal to try to place someone under Salary and Hourly pay. ( Will research this)

#5- After putting in my notice on Friday, I called my credentialing/billing person who is also paid under our office account and had been having problems receiving her checks. She informs me that she was laid off that afternoon and told that our office was closed as of that day. This was obviously a bold faced lie and very unprofessional. I don't feel as if I have job security at this place and want to run as fast as I can.

There have been more issues, but if I went on anymore this post would be a novel. Please share concerns, opinions, and advice if you can. I'm scared because now I will have less than one year experience and do not really know if I will get a good reference while trying to find another position.

[TakeTwoAspirin, MSN, RN, APRN]

If they feel able to pick and choose what parts of the "contract" they wish to honor (i.e., hourly vs. salary) then I would suggest to you that they have voided their own contract and you are free to leave - a.s.a.p. There is no guarantee that even if you stay for 6 months they will give you a good reference.

[jaznia15]

If they feel able to pick and choose what parts of the "contract" they wish to honor (i.e., hourly vs. salary) then I would suggest to you that they have voided their own contract and you are free to leave - a.s.a.p. There is no guarantee that even if you stay for 6 months they will give you a good reference.

Definitely will be leaving. Called my supervising physician as professional courtesy to let her know I'd turned in my notice, she told me that basically the owning was talking about shutting down the practice anyway

[2015]

I would leave before the six months are up and look for a job to start afresh. Chances are, even if you work for six months, she will either lay you off or give you bad reference. You are not safe either way.

[jaznia15]

I'm looking into lawyers now to look at my contract to see if it can be voided based on breach of contract on their part. Speaking with recruiters now. I'm open to going ANYWHERE at this point, but would love to move towards Atlanta. I just want to make sure everything is lined up right when I leave so that there is no legal issues.

[TammyG]

An employment contract can never keep you from quitting -- that would be blatantly illegal. What it can do is subject you to termination clauses such as requiring you to repay the company for the education they gave you (an amount which must actually be attributable to education, not tasks performed), or prohibit you from stealing patients. These clauses must be very narrow. Courts frown on any type of termination clause that prohibits your ability to work. Anything else is usually illegal. So, you certainly can leave at any time.

As for the salaried/hourly issue, that depends on whether your position is exempt from the wage-hour laws or non-exempt. As an NP, especially one that supervises others, you are almost certainly exempt. That means that you do not need to be paid overtime but rather can be instead paid a salary (which indeed can be calculated per hour assuming a 37.5 or 40 hour week). What you describe is fairly typical for NPs, if not universal.

The other things you describe are unfortunately, but with the possible exception of the delayed paycheck, not illegal. You can check your state's department of labor to determine how often they must pay you and how many days they can make you wait for a paycheck. Usually these laws give broad discretion to employers, especially if they are exempt. Some states, for example, require an employer to pay you at least 2 x per month, and require that you be paid no later than 10 days after the end of the pay period. You could make a complaint to your state Department of Labor but, frankly, given the number of people who don't get paid at all from employers who close up shop or disappear, I don't think the state will be that concerned about your having to wait 5 hours for a check.

To be honest, you say you love the practice, and you knew when you took the job that the supervising physician would only be available by phone. I think lots of people reading this would be happy to be in your shoes. Is there something else that is making you want to leave?

[SIguy_RN]

Going to be honest here, Leave. Leave and get a free consult from a labor attorney, depending on how much you lose by the end of the 6 months. Then familiarize yourself with the laws governing your practice, contract negotiation, and liabilities, seriously. This type of activity deserves no place in family practice. This is what I would do 100%.

[jaznia15]

Well I received a warning call from supervising physician yesterday asking if I was willing to go part time. She states he's talking about only having the clinic open 2 days/week, of course I cannot afford that. Her feeling is that he is trying to let the practice go. She stated he had no idea that she was talking to me about it. I'm so tired of walking on eggshells and the lack of communication from his company. I spoke with the administrator today and you would think that everything was smooth sailing. She did not mention the possiblity of the clinic closing or going part time at all. She states she is coming on Monday simply to have me sign some needed paperwork for credentialling purposes. But of course this is the same person who fired her colleauge stating our practice was "closed" just to take over the billing.

Besides that information, I'm also starting to see that the MD is not an ethical person in the least bit. He runs a pain clinic in our office on fridays. Last friday he was extremely late to see his patients (as well as give our paycheck). One of his patients presented to the office on Monday saying she had missed her appt with him because he was late. She wanted to switch to another pain clinic. I told her I could not make the referral without a dismissal letter from him. When we called his staff, we were told that they would give the dismissal letter but could not make the referral. I work on the primary care side and therefore my patient would need a referral from us to even go to another pain clinic. That left such a bad taste in my mouth. We still have not resolved that situation and that alone makes me want to leave.