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by Power2020 Power2020 (Member) Member Nurse

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Hello fellow NP's 

 

So little about me- worked in family practice for 1.4 years- got laid off because of financial issues with office. now am in urgent care- and basically the staff - MA'S are horrible. there was a ma who had what i felt an allergic reaction so I gave her a decadron injection iM and told her to go the ER 

 

5 days later I get written up. 

the way the company is structured is medical assistants are managed by managers of whom back up the mA's. 

the NPs are managed by medical director (who is a very nice person...) 

 

anyway the OTHER np I WORK WITH is very lienient in his care (nothing wrong) just different. I am  a structured individual -like things orderly (to a certian extent) so I correct staff where need be. Staff like the other NP because he is not a rule follower- like doesn't check in some patients and refers them to ER without being triaged properly etc.

so staff are gossiping about me -and the MA I gave the injection to got me "trouble" for helping her. 

 

so now I feel like i walk on egg shells- like im watched on my every move if i make a mistake boom i will get written up. 

 

what am i to do? any tips will help thank you 

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traumaRUs has 27 years experience as a MSN, APRN, CNS and specializes in Nephrology, Cardiology, ER, ICU.

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Hmmm...yeah maybe time to move on. 

1. In the future, don't treat ANYONE unless you have a pt/provider relationship, meaning there is charting to back you up. In IL, this would be a BON issue. 

2. I like things organized too but being flexible especially in urgent care is probably necessary. I've never worked urgent care but have worked ED as  an APRN and flexibility there is definitely key.

3. What is it you want from the MA? More organization, faster check ins or ? 

4. As to the other NP - what do you mean "lenient?" Is your urgent care in an ED? I mean if at the triage desk, a 50 y/o male presents with crushing chest pain, diaphoretic and clutching his chest - is it easy just to wheel them down the hallway to the ED? Or are you free-standing? If that is the case, I certainly would fully triage and then decide to refer or not. 

 

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4 Followers; 1,480 Posts; 7,353 Profile Views

You don't say specifically what you were written up for, or who did the write up. Was it your supervisor?

One is always taking a chance treating a fellow employee in this type of situation.

I probably would have talked to the MD first to see how they wanted the situation handled.

Now work is suddenly very uncomfortable. It may blow over, it may not.

The other NP has a different style from your's.

I would discuss these things with the medical director, if you have a decent relationship with that person.

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66 Posts; 764 Profile Views

 

I got written up  by the medical director for treating the employee w/o checking them in- no chart. and telling them to go the emergency room- we still had 2 more hours on the shift- and so no medical assistant last 2 hours 

 

the medical assistants have attitude - one doesn't speak with me because she feels she is the provider and when initially i was working she would literally argue with me in regards to who should be seen or not......

 

so she wont speak- so i cant ask her to do anything as she wont communicate (typically this does not make a huge difference but it doesn't FEEL good working with staff like this) especially considering they themselves got me written up.

 

I spoke with the medical director and he said please do not worry about it. he said it's something "he had to do". 

 

 

other nP- ok...so we are supposed to check in every patient... he isn't comfortable seeing young kids- so I was told there was a 8 week old that came in and they referred him to the ER WITHOUT checking him in.....so the staff won't "tell " on him for doing this.....as they feel they have autonomy 

 

the other NP sent in amoxicillin for the MAs daughter WITHOUT CHECKING HER IN -NO CHART...but he doesn't get written up ...staff has his back 

our is urgent care is stand alone- no ER connected. so a patient with chest pain would be fully triaged- then referred

 

the problem is this company's management is seperate meaning the medical director manages the medical staff- which is FNPS, DOCS ETC and the other management is over the medical assistants. SO the manager over the medial assistants has their back- avoids getting them in trouble- i KNOW THIS bevause we have a medial assistant that has missed about 10 days of work and is still employed......if I were do to this...obviously I would be fired. 

 

I just feel very uncomfortable at work. I can feel the tension and I am already tense working in a "urgent" type of environment. 

I don't know what to do, how do I move forward? 

 

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ArmaniX has 5 years experience as a MSN, APRN and specializes in Surgical Critical Care.

286 Posts; 6,515 Profile Views

4 hours ago, Power2020 said:

 

I don't know what to do, how do I move forward? 

 

Jeez. Just get a new job, start applying. If you are unhappy with your current situation then why stay or seek approval from anonymous individuals online to tell you how to live your life? 
 

Your work environment sounds very high school. Have you brought your concerns about the medical assistant’s behavior to anyone? Document their behavior, email chain, get your manager and their manager on the same page. Sounds like they are acting in such a way that detracts from a “patient first” environment .. learn your key words. Be willing to walk if changes are not seen. I trust it is much easier to replace a medical assistant then a provider, recognize that.

On the same page - don’t worry yourself about what the other provider is doing or the care they provide. Worry about your behavior and how you present yourself. 

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4 Followers; 1,480 Posts; 7,353 Profile Views

Just don't rx for an employee or a friend/acquaintance

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4 Followers; 1,480 Posts; 7,353 Profile Views

I worry and wonder about people who have studied a whole bunch of bull fees nursing theory, but don't know you can't just hand out prescriptions to anybody.

This is not to denigrate the OP, an NP friend of mine fell into the same pit.

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11 Followers; 3,605 Posts; 26,495 Profile Views

On 10/13/2019 at 10:41 PM, Power2020 said:

I am  a structured individual -like things orderly (to a certian extent) so I correct staff where need be. Staff like the other NP because he is not a rule follower- like doesn't check in some patients and refers them to ER without being triaged properly etc.

There is some kind of disconnect going on here...Why did you do what you don't appreciate others doing?

It almost sounds like they got tired of your corrections and set you up.

It sounds very junior high-ish and it also sounds like you are right in the middle of it.

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66 Posts; 764 Profile Views

thank you for the input. armanix I have attempted to verbally tell the clinic manager about the ma attitude...and looks like what happened is she refuses to work with me therefore is not scheduled with me any longer... fine by me 🙂

 

I cannot formally complain and send to chain of command as the main manager backs these MAs....

 

and what would I complain about? that they don't listen to me? for the most part they do...but give me attitude along the way.... they go sit in the front when discharge paperwork is printed for patient I have to go find them and get it to the patient...

 

so if i formally complain- i bELIEVE they will silently retaliate...somehow. so is it worth it to complain or just quit? 

only reason I was considering the other NP behavior is I am very different from him so staff get tense as they have less autonomy in the clinic with me so therefore this causes an issue when I work. 

 

jkl33

yes I am in the middle I feel like i walk on eggshells at work daily. I feel anything I do can be complained of and I cannot relax. and the person who I gave the injection to could have set me up- did not think of that- she looked as if she was maybe having an allergic reaction- gave decadron. 

anyway....I really am confused at to how to move forward from this...we are in a saturated market. there is a job potentially in family practice opening althouhg I know grass isn't always greener on the other side 😞

this job has a LOT of perks- multiple days off- high pay... but I am now unhappy and don't know how long I will feel like this. 

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7 hours ago, Power2020 said:

thank you for the input. armanix I have attempted to verbally tell the clinic manager about the ma attitude...and looks like what happened is she refuses to work with me therefore is not scheduled with me any longer... fine by me 🙂

 

I cannot formally complain and send to chain of command as the main manager backs these MAs....

 

and what would I complain about? that they don't listen to me? for the most part they do...but give me attitude along the way.... they go sit in the front when discharge paperwork is printed for patient I have to go find them and get it to the patient...

 

so if i formally complain- i bELIEVE they will silently retaliate...somehow. so is it worth it to complain or just quit? 

only reason I was considering the other NP behavior is I am very different from him so staff get tense as they have less autonomy in the clinic with me so therefore this causes an issue when I work. 

 

jkl33

yes I am in the middle I feel like i walk on eggshells at work daily. I feel anything I do can be complained of and I cannot relax. and the person who I gave the injection to could have set me up- did not think of that- she looked as if she was maybe having an allergic reaction- gave decadron. 

anyway....I really am confused at to how to move forward from this...we are in a saturated market. there is a job potentially in family practice opening althouhg I know grass isn't always greener on the other side 😞

this job has a LOT of perks- multiple days off- high pay... but I am now unhappy and don't know how long I will feel like this. 

I wish you well, but your comments suggest that you have not learned your lesson about handing out prescriptions to acquaintances and/or co-workers. And you barely even know these people.

Most NP programs are extremely lax about the laws governing our practice.

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66 Posts; 764 Profile Views

oldmahubbard

thank you for your post. I want to understand where your perspective is coming from. Do you believe I dont understand what ive done should never been repeated? Trust when I say I definitely will never do anything like this again. My apologies for not mentioning that directly. 

 

I guess I am worried because lets say at work I miss something?  Will these MAs report me ? 

 

Thank you again. 

 

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ArmaniX has 5 years experience as a MSN, APRN and specializes in Surgical Critical Care.

286 Posts; 6,515 Profile Views

11 hours ago, Power2020 said:

I guess I am worried because lets say at work I miss something?  Will these MAs report me ?

Why work in an environment that lets you be worried about such trivial matters? I work with a lot of sensitive “write up happy” sallies. Never once have I worried about the chance of being reported. 

I said as much before, but your choices are to continue to work in this environment (which you don’t seem happy in..), try to change the environment and demand the respect ✊, or call it a wash and find new employment and discover new challenges there. 

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