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CMA playing "Nurse Manager?" CMA boundaries? NPD?

Nurses   (2,523 Views | 60 Replies)

RenaissanceNurse specializes in Med-Surg, L&D, NB-100+ (home care & office).

110 Profile Views; 33 Posts

**I mean no disrespect to CMAs, and would really appreciate your input.

I recently interviewed at a Peds office I worked at from mid-90s to early-00's. Many changes,¬†but 3-4¬†providers + 3-4 remaining staff greeted me with big hugs and "great-to-see-you's." It was so heart-warmingūüėćespecially¬†after a few¬†several (personal¬†&¬†professional) life-changing punches to the throat!

My experience and 2 thumbs up from nearly a third of the staff make me pretty confident I'm a shoo-in. Especially since they've been "urgently hiring," for 2 openings, for a few weeks.

I was so excited at the thought of working with people that I knew wouldn't plunge a knife in my back or mess with my head. BTW: I'm not paranoid, I'm very self aware and honest...a painfully earned "gift" that few people are comfortable with, and definitely don't want to talk about. 

Niggles:

"Office Manager"/MHA believes in full transparency, so he mentions some turn-over issues they're working through, then says "so-n-so is a CMA...my right hand...but only makes the schedule...are you OK with that?" I wanted to say "I was until you asked." In hindsight I recognize his attempts to describe a CMA with some great attributes that helps with scheduling/ordering/admin stuff, but it didn't/doesn't make sense. At some point he said something like "she's great, I don't know how I'd do it without her."

A fleeting sense of being gas-lit, almost like being sized up for a fresh target, came and went.

We talked about all kinds of stuff, he would ask my opinion or invite me to share my thoughts...I kept thinking too much, too much...then I remembered reading something about people pumping others for information, not because they care about you or your opinion...they stockpile, and use it as ammunition.

Then he said something about discipline, or maybe current problems they're having. I was mostly paying attention until he said "....me or 'Right Hand'." 

THAT got my full attention, as I was getting the distinct impression that "Right Hand" had more of a managerial role, than was being let on.

Or maybe I wasn't "catching on" quick enough, because as I was preparing to leave he texted "Right Hand," so we could meet. Thank goodness she didn't respond, as I likely would have stood there, dumbstruck.

It was so strange to hear a grown man with a Master's Degree, speak so highly of a CMA, referring to her as his "Right Hand," almost as his "professional" equal. Maybe you had to be there...?

I can't judge her, and really not even him, but my lower jaw started tingling as we were saying good-bye. I met a lot of people -- old and new -- when we did the tour, but if they weren't at their desk, we just kept going. We didn't even wait or look around for the Dr who's kids I used to babysit.

Only "Right Hand" -- the CMA that makes the schedule, which he and I had already discussed, in detail -- was summoned, "to meet me." 

My "BS radar" -- free, with a painfully earned ArmChair degree in Psychology, specializing in NPD -- suggests they came as a "set" or just happened to make a "perfect match." And has me wondering if all the employee turnover/discord is all due to lazy, complacent CMAs with attendance issues...? 

What are a CMA's limits/scope/role? In the real-world, preferably...like what's acceptable vs what's no-way-in-h*ll?

I can't judge any who think I'm off-my-rocker, but hand-to-heart, I'll follow up, whether I'm right or wrong...

But based on everything, I smell a[n] [ove]RAT[ed], manager wannabe...that's very likely a narcissist...with a weird relationship, but I don't suspect sexual, with her boss. 

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30 Posts; 208 Profile Views

That's a lot to unpack. Can you please explain what you mean by "She makes the schedule."

It kinda sounds like you are judging a book only by it's cover...just my opinion.

Edited by sam619

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3 Followers; 37,063 Posts; 98,483 Profile Views

Something tells me your radar is giving you a message. I did not finish your description before I started to sense something that I think you need to pay attention to. If it were me I would look for a different new place of employment. This one seems to have gone beyond its prime.

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RenaissanceNurse specializes in Med-Surg, L&D, NB-100+ (home care & office).

33 Posts; 110 Profile Views

6 hours ago, sam619 said:

Can you please explain what you mean by "She makes the schedule."ÔĽŅÔĽŅ

She creates the document, indicating the hours -- those without a set schedule -- will be working.

I genuinely mean no sarcasm, but I suggest choosing your words more carefully and taking your own advice. Especially when sharing your thoughts with someone that's obviously a bit rattled, distressed, unsure...and fully understands they might be jumping-the-gun. 

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Been there,done that has 33 years experience as a ASN, RN.

4 Followers; 6,237 Posts; 69,572 Profile Views

Office manager has come to rely on the CMA  for issues with the staff.

CMA will be your immediate manager, I would run.

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LibraSunCNM has 10 years experience as a MSN and specializes in OB.

1,348 Posts; 25,451 Profile Views

I agree, your post is a lot to unpack.  One the one hand, what you've described does make you sound a little paranoid, I'll be honest.  I'm not sure how the OM telling you that a CMA makes the schedule equates to being gaslit.  On the other hand, I wasn't there and I know how poorly run so many outpatient practices are, with little cliques and power wars and people who shouldn't be managing HCPs doing so. At the end of the day I would follow your gut instinct and pass.

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Rose_Queen is a BSN, MSN, RN and specializes in OR, education.

6 Followers; 4 Articles; 9,010 Posts; 105,360 Profile Views

A CMA cannot clinically supervise a nurse, but can do so administratively. This would include making the schedule or following the established disciplinary process when warranted. However, if the CMA in question doesn't have an actual managerial role, then being responsible for disciplinary processes is out of line. Depending on staffing bylaws/procedures/whatever they may be called, scheduling may be done by a committee- and if she's the only committee member because no one else is interested, then she'd be the only one making the schedule.

Main impression from what you posted: Shady stuff. Don't take the position, but keep an open mind when interviewing elsewhere about the exact management/scheduling structure.

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RenaissanceNurse specializes in Med-Surg, L&D, NB-100+ (home care & office).

33 Posts; 110 Profile Views

I know, I'm so torn. I'm doing my best to be positive, and not judge, but it's hard when the niggles start to pile up.

I think the challenge might be as "simple" (HA!) as setting the same I-am-a-nurse-hence-you-are-not-my-supervisor boundary, my former co-worker mentioned.

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RenaissanceNurse specializes in Med-Surg, L&D, NB-100+ (home care & office).

33 Posts; 110 Profile Views

4 minutes ago, LibraSunCNM said:

what you've described does make you sound a little paranoid

I don't blame you in the least. If I hadn't personally experienced the past 5 years of my life, I would have a hard time believing it, too.

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Rose_Queen is a BSN, MSN, RN and specializes in OR, education.

6 Followers; 4 Articles; 9,010 Posts; 105,360 Profile Views

3 minutes ago, RenaissanceNurse said:

I-am-a-nurse-hence-you-are-not-my-supervisor boundary

Be careful with this- again, administratively you can be supervised by a non-licensed person. You need to be sure of the management structure before you automatically assume someone who is indeed in a management position isn't your supervisor just because they aren't a nurse. Working in the OR, we have unlicensed personnel who are surgical technologists. They are qualified to become service line coordinators, who are similar to an assistant nurse manager. They are assigned staff to their team and function as the direct manager for those staff, which does indeed include licensed RNs. Their management role is primarily attendance and disciplinary concerns. They do not clinically supervise the RNs but do indeed have an administrative management role in their employment.

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LibraSunCNM has 10 years experience as a MSN and specializes in OB.

1,348 Posts; 25,451 Profile Views

39 minutes ago, RenaissanceNurse said:

I don't blame you in the least. If I hadn't personally experienced the past 5 years of my life, I would have a hard time believing it, too.

Well, then I wish you a more drama-free workplace in the future.

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RenaissanceNurse specializes in Med-Surg, L&D, NB-100+ (home care & office).

33 Posts; 110 Profile Views

4 minutes ago, Rose_Queen said:

Be careful with this- again, administratively you can be supervised by a non-licensed person. You need to be sure of the management structure before you automatically assume someone who is indeed in a management position isn't your supervisor just because they aren't a nurse. Working in the OR, we have unlicensed personnel who are surgical technologists. They are qualified to become service line coordinators, who are similar to an assistant nurse manager. They are assigned staff to their team and function as the direct manager for those staff, which does indeed include licensed RNs. Their management role is primarily attendance and disciplinary concerns. They do not clinically supervise the RNs but do indeed have an administrative management role in their employment.

That makes sense, and if it had been relayed that way, I wouldn't have a problem. But the way he described her role initially was CMA in charge of making the schedule, which I didn't have an issue with in the least, until he started making comments about transparency, and asking if I'd have a problem with that. What would the problem be?

And even if she is some kind of administrative assistant, all is legit, and she stays within her scope, why not just say so from the get-go.

I'm tellin' ya, it was weird. I walked in and she was the schedule-maker (that often works the floor, d/t constant shortage) on my way out the door, she was his "Right Hand" that he wanted me to meet, before I left.

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