Ethical dilemma

[hotflashion, BSN, RN]

I don't know if this is even appropriate for Allnurses, but here goes. I'm working in a one-doctor office. Though I am an RN, I was hired to fulfill a medical assistant role, which was ok with me as a means to an end beyond this particular job. I thought I'd work there for a year, learn what I could and then move on. I've come 2/3rds of the way.

Long story short, I am the only one left in the office besides the doc and because of this I have had to do the front office tasks, i.e., answer the phone, re/schedule patients, check in/out, take payments, all the administrative tasks associated with a doctor's office. Plus I room patients and do some minor documentation in the charts.

There is more work than I can do, and it is of such an intensity that I am exhausted. The doctor massively mismanages the business, and I regularly field calls from patients who do not get their tests or prescriptions called in as requested, who do not get test results once the tests are done, who are confused and angry because there is no follow up, or from creditors who shut off accounts for nonpayment. On top of this the paycheck does not come regularly: I am paid biweekly, am 1 paycheck behind, and the latest check is late.

The doctor was totally unprepared for ICD-10 adoption on October 1, and we are now unable to bill. It is a setting of utter chaos. I also happen to know that the doctor is now under warning from the local hospital professional organization for not paying dues and not charting within the required time frame.

I am currently training a medical receptionist. I'm very organized, have kept the front desk "together," and feel like a complete and utter fraud with this woman, a very nice woman who needs her paycheck to be regular. She likes me, and I evidently put on a good show of having it all under control. I am not telling her that she should run away now, though that is what I think she should do.

I got into this mess because I wanted the job, I wanted it for a year, and I was willing (and able) to put up with alot of nonsense. Then things happened and I ended up being the last employee on staff. I'm not sure what I'm going to do, but I'm miserable right now and having a tough time sleeping.

I'd love to read your thoughts. Opinions, please.

[Farawyn]

I clicked on this because of your name.

Quit. You are an RN and shouldn't be working (read: paid) as an MA.

Apply to everything. Work as an RN.

Good luck.

[RN403, BSN, RN]

If you feel like telling another employee to run away, I think it is time to start your job search. Not worth it.

[caliotter3]

I thrive in situations where the workload exceeds all resources, but I think even I would have to concede that this one is not for me. I would do the best you can until you have your new job lined up. That is probably more professional courtesy than is warranted. For day to day operations, I would prioritize and give each function only so much of your workday, no more, no less. If the doctor wants more, he can hire another employee.

[canigraduate]

Time to bail. Take the receptionist with you.

[ixchel]

Time to bail. Take the receptionist with you.

[klone, MSN, RN]

There is no dilemma there, whatsoever, in my opinion.

[hotflashion, BSN, RN]

Saying not to work below my level does not help. The fact is, I have almost no experience as an RN in the 6 years after graduation, and the experience I have had is piecemeal at places where you wouldn't want to work. The current job has just about served its function, which is springboard to my next endeavor, an independent RN-based endeavor in a specialty area of practice. This job provides money and relevant background experience, so it has been valuable. The ethical dissonance I feel is in not being upfront with the new employee. I feel like I am using her as a stepping stone out of the alligator-filled pond, all the while saying the alligators are rocks and logs and the water is just fine. I also don't like to run out on people, even when they do not uphold their end of the relationship. So, I have my issues in that regard.

[RNperdiem, RN]

Why be overworked and underpaid if you don't have to be? It sounds like this job is doing nothing to enhance your RN career and you are having to put up with issues that you shouldn't be.

Do you really owe a year? Did you sign a contract for a year?

No?

Then time for a job search. Leave on good terms, be professional and don't look back.

[klone, MSN, RN]

Quitting your job to take a different job is not running out on someone.

[imintrouble, BSN, RN]

You owe the new employee your honesty. Period.

I don't see how she wouldn't figure it out after a week or two anyway.

Since I'm being honest, after you give the new employee the cold hard facts, she's probably going to ask the MD if that's true. At least that's what new employees do in my experience.

They'll even say "Suzy said"....

It can make an unpleasant situation for you even worse.

Maybe I wouldn't volunteer all the ugly details unless I was asked.

I wouldn't hide my frustration with the paycheck situation.

I wouldn't pretend I was altogether, when I was obviously falling apart.

[canigraduate]

Sounds like you have issues with letting go and with valuing yourself.

You are worth more.

There is no need for you to be loyal to a train wreck. All that will happen is that you will get burned in the crash.