Career Advice needed. My position is being changed and not happy about it.

[Trueblood83]

Hi all,

So I took a job about a year and a half ago at a pain management center that did not do medication management. Its main goal was to manage pain through procedures. Medications were sometimes ordered for nerve pain such as Gabapentin or Lyrica. I was hired for a part time position and told that it would be around 20 hrs, sometime a little less and sometimes a little more. It would usually be 2 1/2 to 3 days a week. It would never be 5 days a week. I was told that I would be cross trained in both the procedure and clinic area with the intention that I would work in both areas. I was hired at the same time as another nurse. She was hired with the same purpose.

I started training first in the clinic and she started in the procedure area. I trained about 20 days and then we switched areas. The procedure area was working 3 to 4 days a week at this time with the clinic area being less hours/days. I was then told because the other nurse didn't want to work more hours (3-4 days/wk) because she had kids in childcare that I was going to be working all procedure days from then on and that I would not be working in the clinic. This was not what I had been told when I was hired, but I was fine with it and agreed. This has been over a year ago and I have been working only procedures. I have not been back to the clinic at all to work. I have been working anywhere from 3 to 5 days a week. The majority of the time it is 4 days a week.

We have had a lot of changes happen lately. This month alone our full time doctor left, and two more new full time doctors took his place. We also have two part time doctors. They have started doing medication management. Together they are only scheduling half the amount of procedures and seeing in the clinic half of that of our previous full time doctor did. Our manager just left, and we have a part time interim manager that was pulled from another area. The clinical coordinator is pretty much acting like our manager. He was "second in command" whenever our previous manager was not at work. He is full time. he does the sedation in the procedure area and on the days we don't have procedures he works in the clinic. he Does not like working in the clinic. Anyway, I was told that I am going to have to start working in the clinic because the other part time nurse that I was hired with is working more hours than she wants to and she doesn't want to be full time. I told clinical coordinator that I also do not want to be working full time. I also do not want to be moved from my area. However, it turns out this week one of the full time medical assistants/procedure tech and also the full time authorization nurse is also quitting. I have no desire to work in a clinic that is doing medication management. This week alone two of the nurses were yelled at by patients because they weren't being prescribed enough medication. I really don't want to deal with that. I also don't remember how to do most of the clinic stuff because I saw most of this stuff maybe once and some of it not at all. Plus the new doctors have been doing very different things. Sorry for such a long story!! But I was just curious if other people have been in a similar situation (maybe not in a pain management area but similar in that their position is changed) and how you handled it?

[caliotter3]

Sounds as if you are going to have to ride the storm while firmly asserting yourself, accept the changes and make the most of it, or make plans to move on. Only you know how much turmoil you are willing to accept in order to keep a job.

[HouTx, BSN, MSN, EdD]

First, I just want to say .... Danger Danger Danger!!! Pain management clinics in my area of the country are under enormous scrutiny due to the fact that so many have been found to be "pill mills". Be very careful that your employer is not on the verge of this slippery slope. If they end up on the receiving end of a legal action, everyone concerned with the business will be tainted with the accusations. Keep a sharp eye on the clinical process. If patients are just showing up for pills - without any effective treatment regimen, it's time to move to another job ASAP.

With your clinic experience, you undoubtedly have acquired both 'back office' and 'front office' competency. This is a valuable asset for ambulatory care jobs. Maybe it's time to check out the job market and see what's out there.