Confused work ethics :-/

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I seem to be in a predicament and If anyone out there is reading this I would appreciate your feedback. Thank you!

I've been working as a Pediatric Nurse Practitioner for almost 3 years in July. Last year during my 2nd year evaluation, my boss approached me with a different kind of "raise". He said every 3 months I would meet with him and we could discuss my $3 raise based on the following stipulations. A) Our Human Resource recruiter would be calling a patient at random every week and rating me on various scales on my performance etc with their child during that visit B) The human resource recruiter would keep a journal jotting down my every move, for example "3:30 pm, the NP is sitting on her desk, or 4:00pm, the NP is talking to the medical assistants", all of this was done in hope that I would focus more on my work and do less talking/texting.

(side note: I see about 30 kids a day average, fluent in Spanish, and have great respect for my medical assistants, so yes I do talk to them and have developed a rapport, but never has it come in the way of seeing my patients for the day)

At the 1st 3 month evaluation I just did not feel right having someone watch my every move, and I realized now that it all seems subjective. I calculate medication dosages, check up on ICD 10 codes on an application, and constantly am using medscape, all of this which is done on my phone. So it seems like I'm being set up for failure, if, for my unlucky chance my HR sees me on my phone she is going to think I'm doing non-work related things. I'm coming up on my 2nd, three month evaluation and I want to bring this is up to my boss and tell him it needs to stop. I feel like I'm walking on eggshells at clinic that I consider my home after all these years.

This raise was never really a raise and more just a bonus that he gets to control, so I'm still getting paid the same hourly wage that a fresh NP with no Spanish skills is making. I just wanted to get advice on how to approach this to my boss and what to say without angering him. I don't want to loose my job, I love the kids I see daily at work and don't want to jeopardize anything but only I can fight for myself.

So please, if you have any tips, etc I would fully appreciate it, since I have to talk to him next Tuesday. *eek*

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Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.

BUMP! Well first lets get this moved to Nurse practitioner forum. Please ask mods to do this.

What is your annual salary? What other benefits (CME, days off for CME, who pays for DEA, nursing license, pharmacy license, malpractice, etc etc, vacation) You are hourly employee? not salaried? What state are you in? What is hourly or annual salary?

I use my iPhone to look up ICD10 codes to finish my superbly. Also checking stuff on up to date, prescribers reference as I am in urgent care. Is your boss aware of this? Are you the only NP? Is there only one physician?

As for having HR call one patient out of 150 each week? You could have patients fill out surveys and drop in a box. Those can be at the reception area. However, this really is not an evaluation of your skills as a NP, just if they "liked" you, or were happy, But what if they want an antibiotic and you did not order one? Most likely they will score your services low.

Also point out that being fluent in Spanish allows the MAs to continue to do other tasks such as med refills, or returning messages to patients. I a also speak Spanish as my first language (I get annoyed when job ads say: Spanish a Plus!, yeah for the employer but I am not compensated for it.

How did your first quarterly eval go? Wait, is he going to give you a $3.00 per hour raise every quarter if you meet the jumping hoops criteria?

Is any of this in writing?

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To me, this sounds more like the kind of reviews they do for being on probation rather than a raise. Were you getting a lot of complaints? Was the wait time very long? It's odd that they have enough staff to have an HR person watch and record your every move.

I would recommend seeing if you can move from an hourly raise to getting a certain percentage of your billing as a bonus without all of these stipulations attached to it. The criteria they are using right now is ridiculous to me and a little suspicious.

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Hello thank you for responding! I haven't posted in years so I have no clue what MODS is..

I work in Orange County, in California, the doctor owns 3 clinics, I work in the busiest one, where there are about 5 MD's, 1 PA, and 3 NP's depending on the days. I'm hourly pay, $53/hour and yes If i meet the criteria then I get that $3/hours worked only, every 3 months. It was all in writing. They only pay for my malpractice, and I have HMO insurance with them, and 10 days vacation paid. I have not told him I check my phone to look up medications, ICD's (that's my plan for Tuesday)

I think what brought this was that I had a friend who I asked to work with us and yes I tend to be a Chatty Cathy since I'm very social, so we spent time back and forth either talking about our patients or just catching up but never got in the way of seeing patients. When he made these stipulations in September he told me "well you are getting married and buying a house" so this should be more of a reason to want to meet this criteria. My friend ended up quitting 2 months later so when my first evaluation came it was all pretty much a notebook filled with "NP and other NP were in office chatting, NP is not where she was assigned for the day (there are 2 sides of the clinic but we can always go back and forth) that kind of thing, and then said "well since this former NP isn't here anymore then I have a feeling that your next evaluation will be much better than before since there is less talking".

You make a good point about the rating score, because if I didn't think the child needed abx but parents wanted it then of course they would rate me low, and not be happy with me, most of the complaints was that I went too fast, so I made more of an effort in these past 3 months to slow down, answer the parents concern and move on, but I brought up to him during the winter season that I felt bombarded with the 33-34 patients I was seeing while other providers were seeing 22, and how I didn't want this to reflect poorly on my next evaluation. I told him "you are expecting me to go slower but you are giving me more patients, how does this make sense?" Needless to say it didn't really make a difference, since I speak spanish and i'm known as the "fast one" I'm pretty much doomed.

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Please read the last comment I just posted to answer your question. I appreciate your feedback. Wait time was never long, we have patients booked every 15 minutes.

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Wow.. Sounds like they are micro-managing to the extreme. I wouldn't want to be watched every second. I would say that if this evaluation is better, perhaps you should extend the period to 6 months time. If that one is better than the next would be at 9 months.. you get the idea.

If not, perhaps they are gunning to get you out.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
BUMP! Well first lets get this moved to Nurse practitioner forum. Please ask mods to do this.
Done. Thank you for the suggestion, by the way.
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this tuesday will already be 6 months, and I have done everything they have asked, pretty much I isolate myself and try my best to not be a bother, which is unfortunate. I'm asking him this Tuesday to stop this because it just isn't right.

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Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.

Well time to refresh your resume and get it on indeed, nursing job cafe, etc etc. not saying it's time to go just time to start looking (I keep my resume updated and I have it on so many different websites that I get calls and emails every day like 15 of them I don't know what the salary is for NPs in California I know the cost of living is high because I pay RNs hi can you give me a ballpark I think you're being lowballed because I'm making close to what you're making and I'm in New Mexico in a small town. Also if this is a negotiation it's time for them to start paying for everything else your DEA I see Emmys the standard here is about 1500 with five days off to 10 I know that doesn't come out of your vacation or your sickleave which she didn't even mention so there's a lot more out there to be had good luck.

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I completely agree and am way ahead of you. I have put my resume on indeed. I need to stay part time and it's quite hard to find a full time primary care clinic in orange county. I have gone on interviews and have been offered $60 + because of the experience I have, but just part time. I'm staying hopeful and praying hard that a door opens up for me or that my boss has a heart and really listens to me and where I am coming from next Tuesday. Thank you for your input!!

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Sorry, but that type of monitoring sounds way over the top to me! There is more behind this than meets the eye!

Either he doesn't understand the process... that you are dealing with people, with all that that entails, not products.... or surmises for whatever reason that you are not pulling your weight! You have to honestly self examine and answer that question yourself. That's your call. I'd have my resume out there, because anyone who requires, and pays for, that rigid monitoring is either clueless, or is looking to document reasons to terminate/downsize employees. I, quite frankly, would not subject myself to constant monitoring...it's degrading and denotes lack of trust!

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Specializes in Outpatient Psychiatry.

You should be an autonomous professional. Find a new position, put in your notice, and leave.

You should be doing whatever the doctors are doing, and that's whatever the blank they want.

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