Career advice- to leave or not to leave?

allnurses Guide · Jul 28, 2016

I would be very concerned about the high level of staff attrition. Why is that happening? First and foremost, you have to protect your license. If there are any questionable practices going on, I would start looking immediately.

For me, money is nice but it's not the be all, end all. I absolutely want to be paid fairly and well, But there isn't enough money in the world for me to stay at a practice where I'm overworked, not respected, and am just not happy with the environment.

I'd keep looking. Go interview at different practices closer to family and friends, and see what they have to offer. You have nothing to lose.

sadiemae1123 · Jul 28, 2016

If a lower salary is a big concern, you might want to look at your cost of living currently vs where you would like to be. You might be able to maintain the same quality of life with a lower salary if you aren't spending as much on rent, utilities, travel to see friends, etc.

It might also be worth a lower salary if the stressors at work and separation from family and friends is taking a toll on your mental and physical health.

Personally, if I have to choose between a high stress work environment with a salary at the top of the pay scale or one that offers a healthy work/life balance with a lower(but still reasonable) salary, I'll take the lower salary.

orangepink, NP · Jul 28, 2016

Usually pay raises are done in gradual increments. I wonder if the reason behind the significant (large) jump in your pay raise is to compensate for the cons especially the providers leaving consecutively?

If I were in your shoes, I'd leave given the cons alone. Unless they pay off my student loans then I'd stick around for that. But the huge pay raise and PTOs are not worth it to me if they double book you and dump so much on you anyway. After all you work more days than you are on vacation/leave.

amalay, MSN, RN · Jul 28, 2016

Many thanks for the reasonable and logical input. I can't comment on why other providers in the specialty practices are leaving but I know that our pediatricians are leaving because of a number of unfortunate events that occurred in the hospital.

The pediatricians were actually not paid for an entire month, then underpaid for 2-more months during a contract transition that we went through. A loophole had been used where because the old contract was nullified and the new contract wasn't signed into effect until a month later, they weren't paid. There is also a lot of politics and "he said/she said" within the hospital's quality committee, etc too.

I'm personally not affected by it since I don't take call in the hospital but just seeing as how they were treated leaves a bitter taste in my mouth. Sort of like - if they treat their MDs that way, what am I to them?

I did a little asking around, and one of the FQHC's close to the area I want to relocate does have reasonable pay; at about $50-52/hr which is around what I was making up until they gave me the raise 2 weeks ago anyway.

allnurses Guide · Jul 31, 2016

- Only NP in my office, little voice/representation for midlevels in the organizations as a whole
- No bonus/incentive structure for midlevels

If you do stay, you can start to improve that by calling us Advanced Practice Providers rather than "midlevels". Ugh sorry, hate that almost as much as "physician extender".

If you feel you are protecting your license, I'd stay where I am with regard to benefits etc for my family. However if you feel it's unsafe, move on.

amalay, MSN, RN · Jul 31, 2016

If you do stay, you can start to improve that by calling us Advanced Practice Providers rather than "midlevels". Ugh sorry, hate that almost as much as "physician extender".
If you feel you are protecting your license, I'd stay where I am with regard to benefits etc for my family. However if you feel it's unsafe, move on.

Totally agree--sorry, I have a bad habit of saying "midlevel" because that's what I'm called and what everyone uses most commonly where I work (in person, in contracts, etc).

I don't feel like my license is under threat per se, I'm feeling more uneasy that all the pediatricians are leaving so soon though. I keep getting this bad gut feeling that if they're all leaving I might be screwing myself over by staying??

allnurses Guide · Aug 3, 2016

It depends on your goals. If you would like to solidify your education with experience, just keep your head down and do your job, you should be fine. It may not be a longterm thing, but it looks better to have a reasonable length of time at a job.

amalay, MSN, RN · Aug 3, 2016

That's actually one of my questions too-- what would you consider a reasonable amount of time? I know my friends say that 2 years is enough, but they also work in tech where moving and turnover is a lot faster.

amalay, MSN, RN · Aug 4, 2016

I actually wanted to add in one more thing too: At my current job, since we are so low on providers in the office I'm often the only one left in the office and generally can't request many days off because the MDs schedules and day off requests almost always takes precedence over mine. Also, the MDs that I work with also tend to just randomly "call out sick" last minute, so I'm often surprisingly stuck on my own in the clinic at least once weekly for the past month or so.

My clinic has been "recruiting" for the past year or so and still haven't been able to find more providers for us (despite now losing more providers).

This has also been a dilemma of mine as well-- do I just tough it out for the salary/benefits and wait for them to get a new provider (which might not be until Fall 2017)? If I do leave soon and they don't recruit another person it feels like this clinic is just going to crumble and fall apart.

I'm wondering if any other NPs work on their own (as in the only one in the office that day) in a large clinic and how your experiences has been?