I'm new here..this is my first post. I really don't know where else to turn, so I found all nurses and thought I'd give it a try.
I have been working as an FNP in a rural clinic. From day one I was on my own. If I ask a question, he will say, "If you don't know you shouldn't have ordered the test" or "give me a medical reason you're concerned about this" in a condescending way. He has laughed at me for things I've said or questions I've asked, and trust me, I don't ask him things often.
Is this even remotely usual? I'm terrified to look for another job, thinking ALL collaborators will be like this!
He is the only physician in the office and I'm the only NP, but he will tell me "all the physicians I've talked to agree you give steroids too frequently". I'm pretty conservative on steroid use, so I'm just left wondering what is going on?
I'm a she. Anyway I feel some type of residency would be preferable. I was always in the top of my class, but there are situations we just couldn't cover. For example, I recently found a urachal remnant on a guy. A what!? Was my first thought. I was looking for kidney stones. So, should I not have ordered the test because I didn't know what that finding meant? Well, that was my answer from the good doc. So I called a urologist who kindly filled me in. Good thing, because this guy had a malignant tumor. Its not that I won't do my research or make my calls. I just thought a collaborator was someone to guide you with those oddities.[/quote']
Honestly it sounds like your collaborating doc didn't know what it was either and was trying to cover up that fact he didn't know.
It was an ancillary finding, and a lucky catch.
The way you handled it is great evidence of how competent you are in practice. You did the right thing and you got the dx. Great work.
I have to say that I have developed a relationship with the local radiologists. I drop in and see them and discuss cases with them when I am at the hospital. I call them from clinic which questions. It is a great help for me as they will make suggestions and if you give them some history in the patient they will re-read the image and give you a more focused report.
Please don't feel you are alone. It does sound like you need to be looking for a more supportive environment.
I've been an APN for 7+ yrs and nurse for 20 + yrs and I still ask questions of my docs (17 of them). They all have very different personalities, styles of practice, etc.. They, without exception provide me with solid answers, great advice,respect and great collaboration.
They do question me sometimes but again, not in a demeaning way.
I work in nephrology and had no experience with this type of pt so I received a total of 5 months orientation. Three months of shadowing and side by side mentoring and the last two months of frequent calls. Most of my orientation was with other APNs and PAs. We had 5 mid level providers at that time. It took 5 months to get all the credentialling done at all the hospitals anyway.
Nowadays I have very little interaction with MDs but still feel vey comfortable calling them when I need to.
I've been independent from my very 1st day of practice. No one (other than myself) assumed any responsibility for me in any way. To assert, as a previous poster did, that it is some enormous burden to work with a APRN is ridiculous and offensive, and I don't blame BostonFNP for calling them on it. I have had respectful conversations with many other providers about a variety of topics, but no one has ever insulted me that way.
Blue devil, thanks. I learned through the grapevine I'm going to be given a PIP this coming week, which means 1st step to getting fired. He's had 3 different NPs in the past, each staying around 2 years. Why do companies put up with docs who can't keep an NP? its rural clinic so he has to have one. He's even had a doc there for 2-3 years. He's like this to anyone who tries to work there besides Hus own nurse, who acknowledges he hates NPs.
Is there some remedy for this? If I get fired, would there be any way to report his behavior? I hate to think this way, but it is just not right!
I just want to add, as if it isn't obvious, that I am just in a panic now. I don't want to go into the clinic this week knowing that Friday my doc and the om will hit me with this PIP that SOMEHOW others knew about before I did.
I'm back to thinking, am I really that awful to have occasioned this subversive treatment? What should I say at the meeting? That my nurse happened to overhear the receptionist and docs nurse talking about it? How unprofessional!
Should I preemptively request a transfer before the meeting occurs?
Finally, I am terrified now to work with a new doc. If I transfer, how can I be sure my record will be OK? I can't. Oy.
I think the job is not a good fit for you-this is a neutral way to describe the situation. See what else is available if you can transfer. You need an atmosphere of mutual respect where you can get more experience in a more supportive work situation.
Oh my goodness! Go ahead and just QUIT before this guy can even try to fire you!!!!
My collaborating physician is NOTHING like this...always treats me as a colleague and is very very helpful when I ask questions! You do NOT deserve to be treated this way. Get out before your hiring record reflects anything different.
I just graduated and passed my boards but i have been working with the physician who will be my collaborating for nearly 10 years. He encouraged me for 4-5 years to go back to school for my np before i finally decided to do it. Very respectful and kind. As were the numerous doctors i worked with and around during my education. Your's is the exception. I would put in for the transfer asap. Keep us posted.
Once again, thanks for the overwhelming support and the vignettes. Its nice to know what its like for other people. I'm over the panic again and called my on and told her I'm going to apply for a transfer. she said I'm so sorry to hear it but I'd do the same thing. I talked to my dad..so embarrassed about failing in my first job, and he said don't worry, but you can't live with a target on your back. Sound advice.
Its scary to hit the pavement again, but I'm going to have to see it as a welcome opportunity! So, no more panic, just business. I'll let you know what happens!
I'm sorry your first job has gone so poorly. He sounds like a terrible person to work with and I think you'll be much happier in a supportive environment. I hope you find something else very soon.
I hope you find a new job that is positive, where you will feel supported and treated like a team player. It is crucial to be in an environment that one is allowed to ask questions! I was expected to be independent from day one. I was ready to practice from my many clinical hours and beyond difficult classroom hours. My supervising physician is helpful if I have a question. We communicate by text, phone and occasionally in person. He never makes me feel bad. A new NP needs to know when to ask a question or refer to a specialist. If not, now that is dangerous practice.
I am not a FNP as of yet but my advice is based on personal experience in the past. If you have feelings that a job is not working out, chances are the employer feels the same. I was at a job position as an RN where the vibe was way off. One day I came in and the pushover manager has removed me from the schedule. She came to the job apologizing over and over not realizing I'd been scheduled to work that night. She proceeds to tell me that the night shift crew was very cliquish and I just wasn't fitting in. I never received a write up or complaint from a charge nurse or MD. I'd started having a bad feeling about the place but put it off as me missing my old hospital. Needless to say the rural hospital was operated by a national company and because I was let go before my 90 days, I'm not eligible for hire at other hospitals associated with the company. If I'd been smart I would've fought the termination but had at that time just started a full time FNP program and was able to obtain my current job a week later (pushover ex boss gave good recommendation). My philosophy now is that you should leave before they fire you especially if its your only or first job in the profession. Get the physicians you have consulted with to write recommendation letters especially if you don't think this MD will give a good reference. Dont allow them to tarnish your job record. My 2 cents.
BostonFNP, APRN
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