I work bedside in the NICU for about 8 months. I hate it. Management sucks, completely understaffed so I've found myself in unsafe situations and so, on. I have a contract with them that I knew I would break eventually because I knew I wouldn't end up there for even a year.
I applied to a plastic surgery clinic position (cosmetic - Brazilian butt lifts, breast implants, tummy tucks, etc.) This plastic surgery is all over TV in my city even though he's just starting practice and he's pretty popular on social media. I had to do an online test, a phone interview, interview with the doctor and manager and finally an interview with his business advisor today (which I've never heard of having to do before). They all absolutely loved me. However, are these red flags?
1)I would be the only registered nurse working in the entire clinic. Surgeries are Tuesdays and Fridays and the doctor would be in another clinic Mondays, Wednesdays and Fridays doing other surgeries. On M, W, F, I would be the one seeing every post-op patient from Tuesday and Friday by myself without having the doctor to consult. I would do patient education, dressing changes, and other stuff that for right now I don't know..
2) I would have to write his progress notes. They use Nextech, which I'm not familiar with but I'm really good with computers. However, writing his progress notes? That seems weird? He said it's because since he's only there Tuesdays and Thursdays, he wouldn't have a chance.
3) No insurance and no 401k. The business advisor told me they're in the process of getting it for the employees. My current job has both. Because of this, when we spoke about pay, I told them I would want the highest they're offering because it almost matches my current job. Surprisingly, they agreed and said I could be looking toward raises in the future.
4) They have another building they plan on moving to, that's bigger and owned since they're currently renting out. It's already built according to everyone, so the business advisor was trying to assure me that this is a real thing and that if I'm part of the team as they grow, it would be a huge learning experience for me. But how do I know that's really happening?
5) I would be with him Tuesdays and Thursdays as his scrub nurse I guess. He has 1 medical assistant currently and hiring 2 more. Do they help during procedures? What would be my role? I guess this isn't a red flag but I'm just confused.
6) He only wants a brand new RN. Isn't that weird for something so big like surgeries? He said he doesn't want nurses with bad habits and that he wants someone young because he's young and wants someone with him that's in the long-term. He told me his extremely strict, demanding but nice. He says he just wants his clients to get the best work, but how does he expect this with a brand new nurse?
7) Last but not least (sorry) - the staff briefly mentioned (like VERY briefly) that their only RN left. They have been in practice for less than a year, so I don't know what may have led her to leave beforehand? I might be looking into it too much but I feel like that's a major red flag?
Anyway, thanks so much guys. EVERY single comment means the world to me. My parents and other family members have been telling me I'm crazy for leaving my current job which has good pay, insurance, 401k and room for growth but I'm so depressed in that job. Breaking my contract is also something that will be big because of the money and the fact I'd be burning bridges with this hospital franchise but I don't mind, as long as I'm not making the wrong decision. But I'm not sure if I'm getting red flags. ?
So it sounds like he is fed up with the way his patients are treated at the other clinic and so wants to open his own. That isn't such a bad thing.
There are a lot of logistics involved in opening a surgical clinic. It will take him a while to figure it all out.
I ... don't think this is such a horrible option. Necessarily.
Check on what is going on with PACU.
Check on anesthesia.
Clarify who will be the author for the post op notes.
You'll need ACLS, which I'm sure you don't have as a NICU nurse unless you had it before you became a NICU nurse.
In other words, do your best to make sure he isn't cutting corners. From your last few posts though, he doesn't sound like someone who would put his patient's safety at risk. His talk about wanting to grow this practice with you sounds real, though a bit idealistic. Again, hiring a business manager is a good sign.
I'd investigate more, though. Just because he is acting above-board with respect to medical ethics does not mean that he understands nursing responsibilities.
Thank you for your response. Again, I appreciate everything.
meeting with his business advisor was unexpected to me but it was good insight, he had a lot of good things to say about him but he must be bias. I don’t know if I mentioned but he called me today and said he spoke to the doctor and they raised my pay to higher than I make now.
You need to know what your training will be and I would also try to ferret out why the other nurse left after less than a year. Not a true red flag just sorta pinkish.
One of the biggest red flags that stood out to me is the possibility of you writing notes for him. Did you ever clarify what that entails? Would he actually be signing his own name to your assessment and calling it his?
He has amazing reviews in his own clinic. The one where he would only do surgeries Tuesdays and Thursdays and the nurse would do the consults. He has over 500 reviews with images and everything, of everyone saying he has great bedside manner and that they love their results.
Then the other clinic that isn’t his has good reviews to but everyone talks bad about the office staff like the secretaries. There’s about three surgeons there and they all specifically mention mine and say he’s amazing though. Then I can easily Google his name and find so many great things about him, it’s crazy.
It looks like you are leaning towards taking the job. Well, the choice is ultimately yours.
However, I think many are reacting from the "prefers new grads" part as that can be a huge red flag but can also be code for "don't want to pay for experience."
Not really better, just a different way of expressing the low perceived value of the work required for the position. Also not a mindset I would appreciate as a patient. FWIW I agree with a lot of your other comments, especially pointing out the practices that may be acceptable with insurances out of the picture. I'm sure that was useful to the OP. There's a lot that goes on in r/t third party payers and many RNs have no experience outside of that world.
11 hours ago, Tegridy said:
I think he just wants a younger staff for aesthetic purposes. A lot of those body shops do. I’m not here to say if it’s right or wrong just a fact of life.
That part seems perfectly acceptable. His business revolves around selling physical beauty.
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he isn’t really wrong in saying he wants a newer nurse. Unless someone has worked in surgery before or in a very similar job situation experience probly won’t be helpful. The old myth that more experience is always better is just not true and especially not true for unrelated job descriptions.
Eh, your rationale doesn't support your statement tho. If we go with the idea that RN experience might not be particularly useful in this situation (which isn't a given just because it's a niche practice), that would just mean that the experienced nurse and the novice nurse would be equally desirable--which isnot what the guy said. I wouldn't have been ranting ? if he'd said he doesn't have a particular preference or he doesn't think that RN experience is going to be crucial for this position, or that he's willing to give a new nurse a chance. But none of that is what he said.
It sounds like he’s expecting you to work out of your scope of practice, doesn’t sound safe at all. By the sounds of it, he wants to hire cheap help to do his work. I’m not sure I’d take it if I were in your position. Good luck!
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
Even if everything is perfectly legit, etc etc...you only have months of training as a new grad in a NICU. I don’t think all of the responsibilities that will be expected of you are that feasible with your limited experience. And I think it is very likely you may be extremely overwhelmed and depressed in this position, too.
Specializes in Community Health, Med/Surg, ICU Stepdown.
I'm glad you were able to verify his credentials and find positive reviews about him. One other thing to consider is how you will feel working in this type of job. I worked briefly in pre-op/PACU for a plastic surgeon.
I saw depression and insecurity, body dysmorphia. An 18 year old girl who's mom pushed her into implants and lipo. Others who seemed to be trying to fix their problems by changing their appearance. Maybe it won't bother you, but I felt depressed and like I wasn't doing anything necessary or important since all of the work was cosmetic, and that there should have been some type of psychiatric clearance for these patients. (Not a dig at the mentally ill as I am part of that community!)
I feel especially bad that I didn't do more to stop the 18 yr old's surgery as it was clear she didn't want it. All I did was verify with her in pre-op that at 18 it is 100% her choice. But with her mom staring at her she signed the consent, and later I saw her crying in the PACU. It was terrible.
I'm not judging those who work in these environments, just good to consider if the job fits your values. Maybe there are people who wanted their surgeries and feel more confident after. I quickly returned to my county hospital, but it was a good learning experience. People at all income levels need an empathetic nurse, and if you take the job I'm sure you will do great!
Specializes in Community Health, Med/Surg, ICU Stepdown.
I'm really sorry if that post sounds judgemental, I hope it is clear that I want to be helpful! I know how it feels to be stuck in a job that is negatively affecting your mental health and to feel desperate to get out. But I have also made the mistake of jumping too quickly to the next thing that looked halfway decent just to end my current misery.
Easier said than done but it's good to take your time, think about all the aspects of the job and make sure you're not taking it just to get away from your current job. Even if the search takes longer it is worth it to find a job that's a good fit. But it seems like you are doing a lot of research and consideration, which is great!
I'm really sorry if that post sounds judgemental, I hope it is clear that I want to be helpful! I know how it feels to be stuck in a job that is negatively affecting your mental health and to feel desperate to get out. But I have also made the mistake of jumping too quickly to the next thing that looked halfway decent just to end my current misery.
Easier said than done but it's good to take your time, think about all the aspects of the job and make sure you're not taking it just to get away from your current job. Even if the search takes longer it is worth it to find a job that's a good fit. But it seems like you are doing a lot of research and consideration, which is great!
Don't have anything to add. Just want to say this and the post right before it gives a very thoughtful (different) perspective to think about. I also think @LibraNurse27 articulated it beautifully and respectfully. There are gray, and sometimes, messy ethical considerations in any healthcare business. It doesn't serve us to pretend that doesn't exist. Well said and something the OP should consider along with everything else.
Puppylover0213
11 Posts
Thank you for your response. Again, I appreciate everything.
meeting with his business advisor was unexpected to me but it was good insight, he had a lot of good things to say about him but he must be bias. I don’t know if I mentioned but he called me today and said he spoke to the doctor and they raised my pay to higher than I make now.