FNP- Did I make the wrong decision at this job.

Specialties NP

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I am a new grad FNP. This is my first NP job. I have caught on pretty quick, however it is becoming unbearable. I currently work as a medical hospitalist in a psychiatric facility. It is a 56 bed facility and there are 3 psychiatric physicians and 2 psychiatric NP and then myself the medical NP. As the medical NP in this 56 bed facility I have to do all the admission within 24 hours (normally 4 to 10 admissions daily). I have to do all the medical discharges that leave the building and also see the medical patients daily. I also constantly get interrupted by the nurses for things dealing with there patients and acute issues. The company I am with we are contractors in this facility. I don't have no MA or any type of assistance. Oh by the way this facility is all PAPER CHARTING. I have to share charts with the psych physicians, make my own copies and make copies of the vital signs and look for my own blood sugar readings. So in a nutshell I do all my own administrative work as well as try to care of the patients. I can't use the secretary really because we are a contractor in this facility for medical only. My collaborative physician comes in the building daily anywhere from 30 minutes to 1 hour. She sees 25 patients in this timeframe and she goes home and dictate. She will only see the Geriatric patients. I basically see all the patients because she is only in the building for a short period of time. She states it shouldn't take me no longer than 15 min. to do a complete history and physical?????? She want me to see atleast 20 patients a day. I informed her that I need some assistance in the building it is way to much for one NP. I have been working 10 hour days and 9 to 10 hours on Saturdays. To try to get as much done as I can. She is totally not concerned about how many hours I am working. She constantly talk about numbers and money to be able to see a profit. I am feeling burnt out and I don't think she really care. My contract states an average of 40 hours in one week I am working between 52 and 60 hours weekly. I am feeling discouraged because I have learned a lot, however I am getting way to stressed out with no help. NOT sure what to do?????

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Specializes in Ortho.

Find a new job, you're being taken advantage of

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Find a new job, you're being taken advantage of

I agree. had a similar situation during my first job. I basically had 3 roles and travelling more than an hour and a half one way. I know that you do have to make revenue with private practice but the main thing I realized for myself what I was looking for is a work and life balance. Anyway, everybody has their story of why they quit their first job and at some point you will work over time 50-60 hours a week but just make sure you are being compensated for the extra work that you are doing.

If I were you I would find another job, it sounds like its not worth the headache even if my boss gives me a pay raise. Long story short, I ended up being a travel nurse practitioner after 10 months of my first NP job (I've been an NP for only 16 months) and its been really awesome!

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I have found that many physicians see NPs as simply a way for them to make more money. The provider probably isn't providing the quality of care that you are. That being said...interruptions from the nurses? Stop them now. I would create a sign in sheet. If it isn't urgent (i.e. coding) then they write down the patient and concern and you deal with it when you get a chance. 20 a day isn't unrealistic, but you need to find ways to make it flow smoother. If she isn't willing to help you with that then you need to find a new job.

When I was struggling with time management and what I felt were unrealistic demands, one of the partners came on his day off and shadowed me around a facility. He made notes on what worked and what didn't work. He gave me a lot of good tips. If your boss can't do that, then run.

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Specializes in Outpatient Psychiatry.

Yeah that's how it goes for medical folks at a lot of psych hospitals. You could probably implement some things to make the job easier, but...walk. Your boss is riding your back. Most docs do a H&P really fast. NPs are generally slow in effort to be thorough. But again...walk. It won't get better.

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

I work a couple weekends per month at in patient psych doing H&Ps on new admits. Can take from 20 min for adolescent up to one hour for adult with comorbid diseases. I've had as many as 17 in one day but I get paid per patient as 1099 contractor. We do paper charting which is faster to me then most EMRs. Yeah time to look for new job since your boss does not care. 25 visits is one hour? I also do medical consults as pp suggested those are called in to one unit and addressed next day. Most consults can wait since this is not Acute care medical.

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Thanks everyone for your comments on my situation. My collaborator informed me she knows I need help but she will not pay for a NP, LPN or a MA right know but she will hire a medical secretary for me to do the administrative work I do. However, she is not understanding the workload within itself is to much for one NP. The place where I am working they stated they always had 2 NP's this is the first time they have only had one at this facility. I do understand that she is a seasoned physician however how does she possibly see 22 patients in 1 hour??? Well these same patients she states she see, I end up having to treat them through out the day for something she should have caught if she was really see the patients for follow up. I believe I am about burnt out know and I have actively been looking for a new job. I have tried to incorporate things like a communication book however it was shot down by the facility. I had no input on who will work with me throughout the day at all her (my collaborator) and the office manager made the decision on the secretary I get. I am not feeling like my collaborator even is considering how I feel about anything especially since I am in that environment all day by myself 9-11 hours daily. Yes, I was trying to make it to 6 months but I don't think its gonna happen.

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seeing 20 patients a day is realistic but in addition to 4 or more admissions in the same day....not so much.

If the patients are complex admissions ....not very realistic at all!

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How long have you been at this job? Polish up your resume and get busy sending emails and making calls. Leave this gig off the resume. If asked about the time gap simply say that you haven't been able to find the right position since NP school.

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