NP leaving while short staffed

[rn_patrick, NP]

Hello Everyone:

I've been working as a NP for 5 years now.

I've been very successful in my current job which I have been at 3.5 years. My Manager is happy with the work I am doing. Three good performance reviews. I'm not super excited any more about being an RN or an NP. I do like the core of what I do which is patient care. I'm accepting of moving on to something else as well.

I'm fond of my manager. 3.5 years is my record for length of a job. If they opened a private practice I probably would ask to follow them.

The job overall like many NP jobs has picked up the pace in the last two years. We have many more Medicaid patients due to the expansion, and more local independent psychiatrists are choosing to not take insurance. So we are fully booked for about 2-3 months.

There is a management consultant coming in to look at our processes soon as well. So change was or is coming no matter what.

I've burned out twice in the last two years, I'm burned out now. I intended to give notice at the beginning of the year. Morale is really low, manager stated they are burned out also.

I plan on taking a month or two off (I have savings and low bills) and then decide what to do next. I travelled as an RN. I am considering locums. I need the 1000 hours in the next 5 years to keep the cert and then keep my licenses.

I also have a friend who has a progressive chronic illness and will be in a wheelchair soon. We wanted to do some travel together in the USA before they cannot walk. National Parks and things like that.

We have been working on minimal staffing, and this week someone resigned. My Manager sat me down the next day and told me my job was going to totally and completely change and I was to hand off all my patient panel to another APN and the one who is resigning. I would be assigned going forward to in-patient psych and floor consults. On a good day it's a 6 hour job, on a bad day it's a 10-12 hour job. Told Tuesday, put into effect Wednesday.

I have not made any major mistakes, or been sat down or written up. My manager has told me I did nothing wrong, we are going to have to change the schedules to survive at this time. I'm still on the group emails and I am still in the loop on the governance/leadership I do.

We get and I have read many posts around here of "I made a huge mistake and they put me in a holding pattern what should I do?" Which the answer is usually start looking ASAP and jump before they ask you to resign. If that was the case I would not be writing this right now I would be job hunting.

If my emails dropped to zero and they were keeping a close eye on me I would probably hope and pray to get to the first of the year.

Here is what I could really use some advice on from those of you with more experience:

1. I still want to leave. I'm still burned out. Am I horrible person for leaving?

2. Should I stay telling my manager "You have me until..." I probably can stretch and do this job until april. I need to keep my earnings down for ACA coverage (under 30K). I have about 5-7 years of living expenses in the bank.

3. Should I offer to do per diem for a while? Part time has no benefits under 32 hours starting in 2017. It might help them out, but then I get to see the other overworked co-workers of mine being annoyed at me instead of just leaving.

4. If my manager promises to "Turn it around" should I believe them? "Oh we are going to hire 4 new NP's and a Psychiatrist for 2017. I don't think this will heal how I feel.

If there is something else I am missing that you think of please let me know.

[CrunchRN, ADN, RN]

Leave graciously. Offer to help out "if you can".

[Jules A, MSN]

1. I still want to leave. I'm still burned out. Am I horrible person for leaving? Seriously? Its a job not your husband. Leave if you want to leave and rest assured if they didn't want your services they'd drop you like a hot potato, or shuffle you around to an area you have no interest working as it sounds they have already done.

2. Should I stay telling my manager "You have me until..." I probably can stretch and do this job until april. I need to keep my earnings down for ACA coverage (under 30K). I have about 5-7 years of living expenses in the bank. If you want to quit give a respectable amount of notice and move it along.

3. Should I offer to do per diem for a while? Part time has no benefits under 32 hours starting in 2017. It might help them out, but then I get to see the other overworked co-workers of mine being annoyed at me instead of just leaving. Do per diem if you need the money and its a good deal for you which should include an increased hourly rate due to the lack of fringe benefits. That whole self-righteous trap of "helping them out" will often leave one feeling even more bitter and used because trust me they will be more resentful than appreciative.

4. If my manager promises to "Turn it around" should I believe them? "Oh we are going to hire 4 new NP's and a Psychiatrist for 2017. I don't think this will heal how I feel. Yeah if you are buying that line I have some swamp land, uhhh I mean waterfront property for you. The truth is even if they truly intend this turn around in my experience things rarely do turn around and where the heck do you think they are going to find 5 new psych providers?

Best wishes with whatever you decide and I hope you are able to find the time to travel and do the bucket list with your dear friend.

[rn_patrick, NP]

Jules:

We may be from different regions. My Mother would say "If you believe that I have a bridge to sell you." Though the point is spot on. They are not going to hire 5 locums while they recruit, and it took them 5-6 months to recruit the last provider. You are right it's going to be a very ugly time, and I can be there burned out and making mistakes, and providing poor care or not.

My last job I gave them 5-6 weeks and they cut me off at 4. I have to give 4 here, which is my plan.

Also I agree with you and having read many other non-nursing career advice posts that if they needed to they would walk me out on a Friday afternoon with no regrets. I think we both have been nurses for a while and have seen that.

Part of the details above was that it does not look like they are setting me up for that. Pulling my long term patient panel with no warning, and giving me a job that I can just be sacked from without all the other chaos going on would have me scared about being set up to be fired.

I'm worried it looks like that to my old program that I worked in. Some of that is my projecting on them. They are seeing their program starting to be dismantled, and need the check and benefits. So they are looking at me sideways has less to do with me, and probably more that Counsellors are not as in demand as APN's.

I was thinking more resentment from my co-workers for walking, putting them on unpaid mandatory OT due to being salaried, and coming back in for a few months 1-2 days a week "Bless your little heart for coming in to help us out..." The rate would have to be spectacular for me to consider it.

I don't really need the money for now. On the finance boards we talked about the ACA and when it becomes TrumpCare or RyanCare if it happens at all. Starting next year I may have to jump into another job to get adequate insurance to protect my assets and my long term well being.

I'd rather do the bucket list items with my sick friend. Thanks for phrasing it that way.

[Psychcns]

I suggest putting your resume together and be ready to send it out. I have been doing locum tenens for several years and it is so much easier to work in 8-12 weeks blocks of time and just do clinical work within a constrained time period.

I would not tell them you are thinking of leaving until you are ready to give notice. As someone said to me once, "they start treating you like you already left."

You could call a couple of locums companies to see what is available. I got an email this morning from locumtenens.com that they have "hundreds of psych np jobs" in four of the states I have licenses. I work mainly with Staffcare-I give them my availability, and they try to match me. I usually go back to the same places because it is less stressful for me.

i would reread everything Jules said, start planning your trip with your friend, and start looking for other options

Best wishes