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

[RenaissanceNurse]

**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-warming?especially 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.

[RenaissanceNurse]

5 hours ago, klone said:

Dude. I don't even know what to say to that. Your OP, and your subsequent posts, do seem like a teapot. Yes, you do sound paranoid.

Also, your attitude, that because manager has an MHA, he can't take advice and rely on a lowly MA to help run the clinic, is quite distasteful.

I think you're being incredibly unfair, and ascribing ulterior, malevolent motives to this MA based on....I'm not really sure what. I find the idea that you've already diagnosed this person with narcissistic personality disorder infuriating.

I agree with the others that you shouldn't take this job, but only because you've already made up your mind on how this is going to play out, and I think it would be unfair to the employees at the clinic, as I could easily see you bringing a level of toxicity to the workplace dynamics.

Noted.

[RenaissanceNurse]

9 hours ago, Rose_Queen said:

Once you've put it out there for comment, you have no control over the responses, whether you agree with them or not. I hadn't previously read your last line and agree with the poster you quoted- that was a very judgemental opinion of someone you only met for a few minutes.

Noted.

[RenaissanceNurse]

5 hours ago, Jory said:

An OB office we work with has a CMA as their "head clinician". Not even kidding, they have her bossing LPNs around. She has an ego the size of a Mac truck. They have an Uro/GYN that we have to sometimes refer to and more than once, this CMA has dismissed the urgency that some patients need to be seen when we send them over, even failing to pass on important information to the physician if we have to speak with her by phone...even information we have told her is important.

I refuse to deal with her anymore. When I call I ask to speak to either the physician if he is available or the nurse..

THANK YOU!! I appreciate your input and understanding.

[RenaissanceNurse]

9 hours ago, KatieMI said:

I worked for a few years with RMA managing very large and busy private practice. Nobody cared for her medical knowledge, everybody knew she was a multitasker and organizer of the level 80.0100/Goddess Assoluta with a big warm heart and an ocean of common sense.

Also saw a few SNF heads/leads with degrees in "LTC administration" who were honest, hard-working, dedicated and eager to learn, and a few DONs who were doing nursing longer than I am alive and whom I had to report to State as they actively harmed helpless human beings they were supposed to take care for.

If someone knows for real how to do the job, the letters behing the last name can be considered as secondary factor under usual circumstances. RMA cannot prescribe meds or do surgeries, that's correct. But administrative duties and scheduling - even if it is not written somewhere, they can do it, and those of them who do this gloomy and thankless job well deserve our endless gratitude.

Noted.

[RenaissanceNurse]

I might struggle and have my vulnerabilties, but I'm very good at recognizing and staving off the online nonsense. Attempts to get under my skin do nothing but empower and strenghten me.

For those so emboldened by their snarky comments and words, I have to ask "which, or who's, yardstick do you use, to measure another's sins?"

I can't make anyone believe me, but I AM an exceptionally forgiving person, and willing to help or listen to those that many might think don't deserve it.

Anyway, rest well my fellow nurses, and thank you for the input thus far. Good, bad or just-plain-mean, I will note it accordingly, and do my very best not to judge.

[kp2016]

“Especially since they've been "urgently hiring," for 2 openings, for a few weeks.“

“Then he said something about discipline,or maybe current problems they're having”

Moving on from all the previous comments I have to say these two quotes really caught my attention.

It’s fairly obvious you have been through a really rough time professionally and or personally and are looking from a fresh positive new start. Sadly as much as you would like it to be this clinic where you know people and have some sense of being welcomed home the things you have written lead me to think it would be a really bad idea. I really don’t wish to pile onto the previous comments, other than to say I think you should turn down this opportunity and keeping looking for something that might be a better fit.

Best of luck!

[JKL33]

I have to say that in picturing the conversation you've reported, it seems possible for it to have come off as singing this MA's praises a little too much, rendering the same effect as "doth protest too much." I would find that behavior (as well as things like asking if a random potential hire is okay with the way the office is run) somewhat suspicious for manipulative tendency/pandering and the like. IRL it isn't too difficult to discern this kind of thing. He also might have given the overall impression that he is a little unsure of himself, which is an easy enough situation for others to take advantage of and yes it's possible that the MA has found a way to do just that.

But....you would need more information than a somewhat-awkward interview in order to know.

I would ask to shadow if you can keep an open mind about it.

[Horseshoe, BSN, RN]

19 hours ago, RenaissanceNurse said:

When commenting on my post, please do so using effective communication and active listening, essential skills for any and all in the medical field.

“Most people do not listen with the intent to understand; they listen with the intent to reply.” – Stephen Covey

There was nothing wrong with that poster's communication skills.

Come on, be honest: you came here for validation, not for honest opinions.

Your "gut" has told you a whole lot of things about this job and the person as yet unseen (amazing that you can diagnose someone with a personality disorder without even meeting them-must be some really great psychology credentials you've got there) who may be in a position to impact your experience.

You've got it all figured out, so best to trust your instincts and run-not walk-away.

[ruby_jane, BSN, RN]

On 1/14/2020 at 3:53 AM, RenaissanceNurse said:

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 would check that out with the entity that licenses CMAs in your state but it has been my lived experience that they can accept a doctor's delegation as long as the doc deems them competent to do the task.

Also lived experience: There may be nothing wrong here. But we had a boss at my last district who was definitely emeshed with his right-hand CMA. And when the CMA had a problem with an RN it immediately became a problem for the boss as well.

[Cowboyardee]

If the person interviewing you hadn't made such a big deal out of it, I would say that you are making too many assumptions about the CMA and also putting far too much weight on her education level and how you think that should determine her status rather than her skill set, work ethic, and ability to navigate power hierarchies in the real world, which don't stack up nicely according to how impressive one's education and resume might look on paper. (In fairness, you might be making this error anyway).

But your interviewer did go out of his way to belabor this particular point, and that would raise my eyebrows too. If the arrangement wasn't already a source of contention, he probably wouldn't have bothered.

Ask for a day or two shadowing on the job before making a decision. Try your best to see and evaluate this new workplace on its own terms and as it is, its own unique (and possibly disasterous) environment, rather than as a retread of your past.

Best wishes.

[BostonFNP, APRN]

I am lost with that the particular concern is here?

Administrators don't need any specific degree, a private practice care hire whomever they want to fill a role. If this woman is going to be your immediate superior or assistant manager or assistant to the manager it doesn't matter what her degree is in (or what certification she holds). The owners/management put her in that role because they feel that is best for the practice.

Is it worse that she is a CMA with experience in private practice vs a new graduate MBA that's never worked a job in healthcare?

[TriciaJ, RN]

I'm smelling a rat, too. I had no trouble with a CMA doing the scheduling and handling administrative scut work. But is this person actually going to be disciplining nurses? No dice.

Nothing wrong with having a right hand person, but I'm getting that the boss was making way too much of it. That is a red flag. And by the way, I do think they're sleeping together. Call me jaded but there it is.

I agree with previous advice to shadow. Have lunch with some of your former coworkers. Get the real story before you sign on the dotted line.