What is acceptable?

[Panakee]

I am a fairly new NP floating through a small group of urgent care centers. I have been there for a few months and there have been some interesting practices.

1. Working without an MA. We had one of our MA's call in sick and because we're short I was expected to work without an MA. I had a front desk person to check in patients but that's all this person did. Luckily it wasn't too busy but was chaotic. I messaged my manager and explained why this arrangement was unsafe. I called the nursing board to ask if this was legal and was told it was up to me to determine what I felt safe with and if not advocate for myself and my patients. which I did... are there NPs who are practicing in an UC without MAs?

2. Recently, I received our February schedule and noticed I was short 19 hours. I am hourly. Before I was salary and would end up staying late for the same amount of money. Then I switched to hourly and was went down to 35.5 hours because when I was 40 hours I would always get scheduled over, not by much, but was not getting paid for this. This company doesn't pay OT so if you go over your hours you don't get paid time and a half let alone get paid for it at all. Anyways I reached out to the manager and was told that because I was behind on my charting that's why they cut my hours. I asked when this policy was implemented because it was done without warning and there is no written policy nor was it applied to the other providers that had 80-100 charts pending ranging from 2017 to present. Oh and by the way the most chart I had racked up was 50 and that was completed in 2 weeks- 1 month. For an hourly worker is this legal? Especially if the "policy" is not being applied to other providers within the company.

There is a lot of other sketchy things happening within this company this is the most recent.

[Spadeforce]

Start looking for a new job and tell the manage to stuff it when you leave.

[traumaRUs, MSN, APRN]

Totally unacceptable in my opinion for you not to have an MA. As to your hours, unsure about this as I'm salary. However, if I was hourly, I would want to get paid for my time. Thats being treated as a professional.

However, I think its unacceptable not to complete your charting either. The hospitals I'm credentialed at require charting to be completed within 48 hours. This is a reasonable expectation in that when our pts are referred out and the charting from the UC/ED is not complete, we (I now work in a specialty practice) have no clue the back-story nor the UC/ED providers notes. This delays pt care.

[djmatte, ADN, MSN, RN, NP]

I can't speak to not having a MA as being "unsafe". I can't think of a single task that an MA does that can't be done safely by a clinician. More like unprofessional, inefficient, or unsustainable would be my concern. Not to mention untenable as I hand in my resignation.

[Panakee]

The issue of untimely charting is pretty common. I think that employers in UC want numbers but don't stop to think how will they have time to chart this...esp when you have an employer who doesn't pay for time spent charting and wants you to chart at home as an hourly paid employee. I am far from the most behind within the company...I was shocked to see 150+ charts with at least 2 of our providers steming back to 2016. But then there are those who chart timely but put the bare minimum and you have no clue what is going on with the patient.

This company has a lot going on that is not right. I was asked to work after hours without pay...and was like no way. Or they expect their hourly providers to take call without pay...umm no. I wouldn't be surprised if they went down under in a few years.Definitely a stepping stone job to solidify the fundamental experience and transition to a practice where hopefully I would be valued a bit more. But when they started cutting my hours with that BS excuse that didn't apply to anyone else I was pretty frustrated. Ultimately I think they hired too many providers and didn't have a place to put me so rather than being transparent, they mayde up this b.s. excuse. they cut my hours and knew they did it unfairly because it should have been by seniority and I'm not the newest one there. I also think they are losing money and can't afford to have an additional provider those days when the pt inflow won't make it worth while. So I told them to go ahead an plug in PTO...if you're gonna cut my hours you'll still pay me for those days and I'll just enjoy the time. But also let them know I need this policy and all others in writing so I can refer to them in the future. But it was more insulting to be told that B.s. excuse. Thank you for your input.