I just got hired in a plastic surgery clinic. Are these red flags?

Nurses General Nursing

Updated:   Published

Hi everyone!

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. ?

Specializes in Endoscopy/Gastroenterology, General Surgery.
On 2/26/2020 at 10:03 PM, Puppylover0213 said:

write his progress notes

and

On 2/26/2020 at 10:03 PM, Puppylover0213 said:

the one seeing every post-op patient from Tuesday and Friday by myself without having the doctor to consult.

These two are HUGE red flags. Remember, you have your license to protect. Any post-op complications will be ON you.

Remember, charting is a legal documentation. Any things go wrong, your boss could have just blame it ALL on you.

On 2/26/2020 at 11:35 PM, 3000series said:

Trust your gut.

Like everyone said, trust your gut. The last thing you want is no job AND no license!

Specializes in Endoscopy/Gastroenterology, General Surgery.
On 2/26/2020 at 11:57 PM, TriciaJ said:

Wants a brand new nurse "with no bad habits"?

I felt like he just wants to hire a brand new nurse because new grads usually don't know stuff like writing out progress note might be wrong and will just listen to the Dr blindly.

Specializes in Geriatrics, Dialysis.

I'm a little late to this party. No update from OP? Wondering if she took the job or not.

Specializes in 20.
Specializes in ED, ICU, PSYCH, PP, CEN.

I only read the first page, so I bet this has been covered, but you writing his notes is not legal. and the first time a case goes bad he is going to say you wrote his notes without his permission and you are going to prison for fraud and more.

have considered working for plastic surgery myself, except that it is potentially so high risk. Everyone gets sued if the patient doesn't like the result. Do not believe you can create a note for anyone but yourself, but contact the ANA or your state's nursing association, or state board. (as an example, is the intention to use you to duplicate physician services and commit fraud through documentation? Physician services are sometimes paid by the note.) And if you are to be involved in finding surgical codes to charge for services provided, make sure you are well trained, or once again, another fraud charge could follow if the diagnosis / service had expanded the service to a higher charge than merited.

The new nurse / new attitude idea has been used a lot to signify that the employer does not wish a nurse who is grounded in their practice, and savvy to the wiles of employers. How long in practice.... less than a year? Is it dressing changes, or do you do some of the cosmetic work itself, to include injections? Is there a procedural book for your work, which you can copy (take a copy home, because if there is trouble, it will disappear) and use to justify your services? My sister got fillers once for her smile lines, and the fillers wound up drifting so that it enhanced the frown/smile lines, and otherwise the job was perfect. She could have sued. Just went to another practitioner. Anne,RN in Texas

Specializes in Med Surg, Tele, PH, CM.

Run...as fast as you can. The interview with the business manager should have been a big clue....

I really, really hope the OP did not take the job because if she did I'm betting she's unemployed again.

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