Not at same site as supervising md

nomadcrna, DNP, CRNA, NP · May 23, 2011

Thankfully, I don't have nor is it required to have a supervisor. :)

pedspnp · May 23, 2011

I am required to have a collaborative md. But there is a nurse who questions me about it, tells me she thinks I need to be on site with my md, told me she thought I did not have enough experience to be on my own.but taking it with a grain of salt I asked her give a kiddo 30 mg iof prednisone and she said she never given it before and was not familiar with the drug

Trauma Columnist · May 23, 2011

I am not on site with any of my collaborating MDs. I do have phone contact with them when needed and/or texting/email but nope, I rarely see an MD.

BTW IL has the collaborative agreement bill before the legislature yet again this year.

zenman · May 24, 2011

I'm not required to have a supervisor as such, but do have a supervisor who is over the clinic, but many states away. We meet an hour every two weeks via telemed.

mammac5 · May 24, 2011

Just from reading some of your previous posts, I'm thinking it may be necessary for you to limit your conversations with this nurse or medical assistant. For some reason you're in a position where you seem to answer to her and she seems to feel free to criticize you, question your authority, and second-guess your treatment/orders.

It also sounds like the physicians you work with are not really very helpful in backing you up or in supporting you in a position of authority. Sounds discouraging, bordering on legally risky for you. Are you looking for a better opportunity elsewhere?

pedspnp · May 24, 2011

well we had a big meeting last week, the nurse was told that if she had any questions about why i was doing what i was doing I would be more than happy to show her the guidelines and have her read them, then we could discuss it if it did not make sense to her, her comment was well I am just not used to pediatrics and think too many tests are ordered. I told her I would be more than happy to show her the guidelines. End of conversation, actually my supervising md and the pa at the other site are great always helpful, the dr at my site is known to be difficult to get along with and has been read the riot act over his behavior they have given a no nonsense warning that if his behavior does not improve there will be consequences. I just have to learn to some back bone and not be buddy buddy with these people, I need to be polite but i dont need to be thier best buddy

mammac5 · May 24, 2011

well we had a big meeting last week, the nurse was told that if she had any questions about why i was doing what i was doing I would be more than happy to show her the guidelines and have her read them, then we could discuss it if it did not make sense to her, her comment was well I am just not used to pediatrics and think too many tests are ordered. I told her I would be more than happy to show her the guidelines. End of conversation, actually my supervising md and the pa at the other site are great always helpful, the dr at my site is known to be difficult to get along with and has been read the riot act over his behavior they have given a no nonsense warning that if his behavior does not improve there will be consequences. I just have to learn to some back bone and not be buddy buddy with these people, I need to be polite but i dont need to be thier best buddy

Absolutely agree about not being "buddy, buddy" with these people. They are coworkers and support staff...for YOU. I like to limit conversations at work to things like what the kids did over the weekend, where are you planning to go for vacation, sports, television shows. Really, there's not much more that is healthy for me to know about coworkers. And I certainly don't want them knowing about my personal life!! It's cordial, it's warm, it's surface-y.

pedspnp · May 25, 2011

The past two days have gone great after the nurses were sat and told expectations of them things have run much better, neither one has worked with a np before me, and when they have a question they know they can come to me and say whatever and I will explain why I am doing what I don't mind and after today when I ordered a hgb on a teenager and explained the rationale they were like wow a teaching moment. Both nurses thanked me but are now wondering why it was never done before by the md

Floridanurse · Jun 21, 2011

I think you need to take her questioning graciously as you may make a mistake sometime as you are human. I know as a RN, I frequently question doctors and NP's and often find they were not aware of something that imacts the order they were giving.

pedspnp · Jun 22, 2011

I think you need to take her questioning graciously as you may make a mistake sometime as you are human. I know as a RN, I frequently question doctors and NP's and often find they were not aware of something that imacts the order they were giving.

I do take her questions graciously, we are human and make mistakes. But this same nurse did not know what prednisone was or what the indications were or side effects, basic pharm 101, so you can see where I also take her with a grain of salt

carachel2 · Jun 22, 2011

Absolutely agree about not being "buddy, buddy" with these people. They are coworkers and support staff...for YOU. I like to limit conversations at work to things like what the kids did over the weekend, where are you planning to go for vacation, sports, television shows. Really, there's not much more that is healthy for me to know about coworkers. And I certainly don't want them knowing about my personal life!! It's cordial, it's warm, it's surface-y.

I came to the NP role in my 40's. SOOO glad it was not in my 20's and my 30's. I have BTDT getting too wrapped up with coworkers and the such. One 10 year plus workplace got to be SO insane with how we knew each others business. Friendships became hard alliances, to the point where it impeded true workplace growth and undervalued new management.

Now as an NP, I just want to get in to work and get out. I don't care about who is arguing with their kids, who is friends with whom. Just do my work and get out. I am nice. I am cordial. I will ask politely about weekend or vacation plans but beyond that I am thankful I have OTHER friends.

Also, I really can't imagine an office world where you have to justify everything you do to the MA or the nurse. They are there to do what needs to be done. I will order what needs to be done. I like to teach as much as the next person and sometimes I will point things out and we will talk, but in the heat of the moment if I want a strep test and the MA doesn't think the patient has strep I REALLY don't want to explain WHY I am doing it ! I don't feel like I should have to stop what am I doing and justify it with them!!