Sigh...the dreaded day...advice needed

PinkPinkster · Feb 5, 2013

Greetings all,

I barely have had time to breathe it seems these last several days because of my prior obligations with my work as well as my continued job searching and 2nd interview I just had. I was so determined to secure a nursing position that I had already provided notice to my Regional Director that I would potentially be leaving two months back as a way to motivate myself to actually follow through this time. I am extremely comfortable in my present position so I needed to light a fire so to speak underneath my bottom to get going. Now that she is aware that I have already started the interview process of my job search we have finally announced my decision to the staff since we had decided to withhold that information in case something changed. I will stay to help screen new applicants for our company until a new Manager has been selected. So to sum this paragraph up...IM ACTUALLY GOING FORWARD WITH THIS TRANSITION!!! HOLY COW!! :)

With that said I met the clinic staff today whom I found to all be extremely pleasant and nice. I have never wanted to work somewhere so intensely before today. I bonded immediately with the Doctors wife and she seems really enthusiastic about the prospect of me joining their small team which is a relief on so many levels. The doctor requested that I come in Saturday and Sunday when it doesnt conflict with my current work schedule to observe how the clinic functioned and of course to shadow. He didnt state that I would be seeing patients during this time and I didnt have the courage to ask him, all he said was to "shadow and observe clinic flow". I did reach out to one of my friends whom I hadnt spoken much to since we were batchmates and she stated that most likely he would be observing me as I seen a few patients to assess my knoweledge and work ethic. Does anyone know what is standard when a potential provider is observing? He said he would like to "hammer out the fine details" and finalize things by next week which I hope means he's leaning in the direction of taking a chance and hiring me.

Also, he did mention that he was interested in potentially expanding clinic hours which I found to contradict his previous statement of wanting to have more time off. Of course its not a big deal as I am just happy to even be considered for this position. He also asked me if I would mind working the evenings and weekends which I told him "of course not" despite the voice in the back of my head that was screaming "yes you do!". Also, I am slightly concerned when considering the fact that I would be assuming the role of the Office Manager as well as working a dual role as a provider and expected to work at nights and the weekends when typically an onsite manager is generally needed during the day time. It is apparent now that the Doctor is not exactly sure in what capacity he will utilize me or what the responsibilities of this job will exactly entail for that matter. Its definitely obvious that this position I will be assuming if I am offered the job will be created and defined as time goes on...the doctor is absolutely playing it by ear much more than I realized. Nonetheless I am convincing myself that I am capable and up to this exciting new challenge and this opportunity is worth the risk.

Thanks to everyones immense support and advice. I look forward to it.

Respectfully,

PinkPinkster

roser13, ASN, RN · Feb 5, 2013

I feel compelled to point out just a couple of warning signs that I see in your post:

First, be very cautious about a clinic that is run by a husband/wife team. That combination can work very well or it can be truly lethal. Be very observant of the interactions between wife-husband and wife-staff.

Secondly, if you really DO mind working nights and week-ends, you need to be up front about it from the beginning. I'm not saying to refuse, but negotiate a schedule that you can live with. You DO have negotiating power and you WILL be an asset to the clinic.

Please don't sell yourself short in these preliminary negotiations. Obviously, the MD isn't quite sure yet what the parameters of the position will be, and you need to participate in forming them into a position that is workable for you both. It's very easy under the circumstances to lose sight of the fact that as much as you might want a particular position, an Employer also finds much desirable about you.

allnurses Guide · Feb 5, 2013

You really want to avoid situations where you are the sole provider on site at a given time, unless you are very confident in your practice and comfortable on the phone with colleagues.

netglow, ASN, RN · Feb 5, 2013

Sounds like just why an MD would want an NP. You are to become an integral part of his practice. Now with two providers it is assumed that more patients would be seen and should be assumed that changes will take place, such as extended hours. Sure he might want to see how you seem around patients. He's hiring an NP to bring in business not scare it away. Remember, he's probably got someone else in the wings too for the position, so you need to show him you are the right person for the job. This is a big economic decision for him. Soon you will need to be as much part of the income of this practice as he is, or, he'd not be hiring an NP. He did say he wanted some time for his family. Other hours are part of the job of an independent provider, I am sure you will share call.

Just remember, that for most professional people life fits around work. Not too many have the luxury of fitting work around life, at least until you are well established and have found some niche or other source of income. He's gonna feel that he's spent years building the practice, now in hiring you, you're gonna have to put in some elbow grease to help it grow.

allnurses Guide · Feb 5, 2013

I would be prepared to see patients or at least participate in visits while shadowing. Should be similar to your preceptorship placements.

CrunchRN, ADN, RN · Feb 5, 2013

Sounds like just why an MD would want an NP. You are to become an integral part of his practice. Now with two providers it is assumed that more patients would be seen and should be assumed that changes will take place, such as extended hours. Sure he might want to see how you seem around patients. He's hiring an NP to bring in business not scare it away. Remember, he's probably got someone else in the wings too for the position, so you need to show him you are the right person for the job. This is a big economic decision for him. Soon you will need to be as much part of the income of this practice as he is, or, he'd not be hiring an NP. He did say he wanted some time for his family. Other hours are part of the job of an independent provider, I am sure you will share call.
Just remember, that for most professional people life fits around work. Not too many have the luxury of fitting work around life, at least until you are well established and have found some niche or other source of income. He's gonna feel that he's spent years building the practice, now in hiring you, you're gonna have to put in some elbow grease to help it grow.

Great advice. If things work out down the road you can re-negotiate the hours, but for the 1st year I would be prepared to suck it up until I have proven my value.

chrisrn24 · Feb 5, 2013

Extended hours because you'll be there to cover it.

Nicody · Feb 6, 2013

Well, I was going to say that I think it's a good idea to get some experience at the bedside prior to pursuing an advanced practice position; however, I see that it's a moot point. Congratulations on your potential job.

chrisrn24 · Feb 18, 2013

OP you got any news?

PinkPinkster · Apr 8, 2013

Hello Everybody,

I figured that I would provide a brief update regarding my employment since I have not really utilized my account since starting my first day at work.

Things have gone relatively smoothly and I for the most part have settled in to my dual role as a Provider as well as the Practice Manager. My anxiety has not been as big of a hinderance as I previously had feared and aside from a couple of "moments" where I had to consciously "check" myself, everything has been peachy with no major "events". I admit the first two weeks on the job I had a difficult time transitioning into the provider role and I utilize our physician's immense knowledge routinely for guidance, but overall I feel I become a better provider everyday with each new patient encounter. I am sincere when I say that I look forward to my continued growth and for the first time am excited for what is to come in my nursing career.

With that said, the only issues which have arisen has been with our physician's wife. We started out relatively close but now our relationship is strained. She seems to have more of an active role in the practice than what I had imagined despite her not even being an employee. Although it is in my job description to essentially handle all aspects of personnel management, she seems to feel it is her role to be involved as well. She does this in a rather unprofessional manner and I have since had to speak one on one with our physician as I believed her behavior was unacceptable and was inhibiting me from performing my job properly and efficiently. He spoke with his wife which for the most part stopped her...brusque behavior towards the staff...but now has placed a target on me. She went so far as telling one of the Medical Assistants who worked for our practice she was being terminated which was effective immediately. I found her crying in the parking lot and I had to take her back into the office and tell her to resume her work as I was the Practice Manager and as far as I was concerned she had did nothing worth reprimanding let alone to be terminated.

So essentially me and this women go back and forth daily. I find that she spends more time at this practice than at her own place of employment. But I am remaining positive and focusing on my patients and providing quality patient care. My extensive background in personnel management and office administration has really aided me in remaining calm and collective while dealing with her but I am afraid that at any moment her bias towards me may rub off on the physician which may complicate things. Im grateful for his objectiveness throughout this. If anyone would like to provide me with advice regarding this situation it would be appreciated.

Again thanks to all who initially provided me with encouragement and advice.

Respectfully,

PinkPinkster