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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

Specializes in Nephrology, Cardiology, ER, ICU.

After reading all the more recent comments I'm going to change my advice.

Expecting a work family is not what being an APRN is all about. Its nice if you all get along but not necessary. The MAs need to do their job and you do yours.

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On 10/19/2019 at 10:44 PM, Power2020 said:

egg122

very interesting gender point. I do believe that is true.

kooky korky

thank you for the response. Yes you are right it is a hard situation to report or not- considering the main manager has their back.

easy to say report little things sure....but silent retaliation does exist. in medicine it is easy to have upset patients or make an error (something small like forgetting to send in the prescription...) and if staff don't have your back it makes your job difficult.

workitinurfava

I do agree that upper management (medical director) is completely aware and does not want to be involved with fighting with the manager too much. great point.

problem is I went in all energetic and excited i guess with a expectation of work family? that crashed and burned fast and now I can't really get my mind off my work when I'm off.

A similar thing happened to me but with time the assistants got used to me and showed respect because I can handle situations but I also let them give me their suggestions to show them that we are a team when it is appropriate.

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Just a question - you stated something earlier about having to go and get the discharge paperwork, etc. I have learned one thing dealing with MAs that have been around longer than me and being a newer provider. If it is their job, you MUST let them do it. They may drag their feet, take too much time, fiddle around and essentially wait on you to do their job. I have found with some people who aren't "go-getters" they will see exactly how much you will do so that they don't have to do it. Boundaries have to be drawn. Know your role, know their role and stick to it. If patients aren't being discharged and you have done your part, let them sit in rooms. If patients need labs, let them sit until they are drawn. This is the only way respect is given, it has to be earned. It cannot be verbally demanded.

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On 10/16/2019 at 2:31 PM, AtomicWoman said:

"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......" I would be out of there like yesterday. That sort of situation is intolerable, IMO.

I agree. I am also surprised that the urgent care tolerates this since sending patients away is lost revenue.

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trauma

yes great point - I had an expectation and that's why I have been contemplating so much about this....but in reality from an outside perspective bottom line everyone needs to do their job. period.

HHNurse NP I never though about it like this....you are absolutely right. I get anxious when patients are waiting and I try to help as much as I can....and this maybe sending wrong signals and people do take advantage.

The other day I had 16 patients show up within a 2 -hour time frame...it was very busy and I triaged a patient or two and am not familiar with the med reconcilation screens, so I asked the MA I need your help how do I enter these meds, and then I called again as I did not know how to edit allergies, etc. and this MA is kind of sarcastic overall agreat worker and she said "you are so needy"

I mean I know she didn't mean it maliciously...but WOW I am helping you guys out...as much as I can ? and you say im' needy???!!?!?

As far as attitude and how the urgent care tolerates it- yes they will.....because the main manager has their back---it's basically a culture of MA aganist provider ... (this is not an assumption, it is been proven) and if I keep complaining what is going to happen? fire all the MAs? they change ? sure maybe but for sure will have an attitude.

I know I can't expect a work family I GET THAT but having a 40 hour work week with people like this is draining. I feel I am a bit insecure myself with my skills/etc. as I am working with more peds (haven't done that much) so people can sense this vulernabilty and take advantage.

Now, to change jobs is something I am considering.

thank you for all the input.

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On 11/5/2019 at 2:37 PM, Power2020 said:

trauma

yes great point - I had an expectation and that's why I have been contemplating so much about this....but in reality from an outside perspective bottom line everyone needs to do their job. period.

HHNurse NP I never though about it like this....you are absolutely right. I get anxious when patients are waiting and I try to help as much as I can....and this maybe sending wrong signals and people do take advantage.

The other day I had 16 patients show up within a 2 -hour time frame...it was very busy and I triaged a patient or two and am not familiar with the med reconcilation screens, so I asked the MA I need your help how do I enter these meds, and then I called again as I did not know how to edit allergies, etc. and this MA is kind of sarcastic overall agreat worker and she said "you are so needy"

I mean I know she didn't mean it maliciously...but WOW I am helping you guys out...as much as I can ? and you say im' needy???!!?!?

As far as attitude and how the urgent care tolerates it- yes they will.....because the main manager has their back---it's basically a culture of MA aganist provider ... (this is not an assumption, it is been proven) and if I keep complaining what is going to happen? fire all the MAs? they change ? sure maybe but for sure will have an attitude.

I know I can't expect a work family I GET THAT but having a 40 hour work week with people like this is draining. I feel I am a bit insecure myself with my skills/etc. as I am working with more peds (haven't done that much) so people can sense this vulernabilty and take advantage.

Now, to change jobs is something I am considering.

thank you for all the input.

A sarcastic person that says I'm needy would not make me think twice. I would just say "I know, right? thank goodness you're here to help" I once was sitting in my office and one of the nurses was talking about how when she rooms for me she is always shocked about the absolute mess I leave the room in. I leaned around the corner and was like "right? you should see my house" Her eyes went big because she didn't know I could hear and They all burst out laughing and we are all good. I get your feeling stressed and overwhelmed......but I'm a big believer in the Q-TIp (Quit taking it personally) philosophy . Also if you aren't efficient with your EMR ......get on top of that. That is worth putting in a few hours off the clock to build you skill base because if you are feeling rushed and behind that is going to great a stressful work environment for you regardless of the people you work with.

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Surely you have moved from one job to another before during your career. The job market was saturated when you got this job. If you are going to continue putting up excuses not to leave, then get used to the idea of putting up with, and dealing with, this situation. Look closely at your own behavior while seeking ways to change what you don’t like about how the MA’s act. You have a part in this, even if it is a very small one.

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On 10/16/2019 at 10:39 PM, Power2020 said:

mike fNP thanks for the reply.

I like your concrete perspective. makes me feel better. I know now never to treat anyone without a chart.

egg 122- I felt she was potentially having a allergic reaction yes. and I just acted quickly i guess out of more care- this person was friendly with me, always needing someone to hear out her personal issues... she's missed about 10 days of work...and still doesn't get fired...one day we even had to shut down because she didn't show up to work. it's all taken lightly.

Anyway, I will never attempt to help someone in this way again. I now know it is very wrong, yes puts company up for liability.

I just go to work quietly sit down- and I avoid conversation with staff all together. I know not everyone is bad in the world (esp this medical director ? ) but these people I work with are not good people. I used to buy donuts/bring food, etc. now I've stopped being friendly.

My previous jobs everyone was literally like family....I have never experienced a hostile work environment as this- I can just feel it and I KNOW it's because staff want autonomy.

EGG112:

what do you mean by male/female ? I am a female-all staff are female and the other provider is a male.

For your consideration:

All of this sounds very insecure to me. You can be both friendly and kind while not compromising over important matters or when you know you shouldn't.

Alternately, you can try to get into others' good graces by compromising yourself in attempt to make them like you -- which will always, always be a superficial "like" when you go about it this way -- it's over as soon as you are not of some kind of use to them or as soon as they can use your compromised position for their own benefit.

If you can't kindly maintain professional and interpersonal boundaries when it matters, you inform people that you are a compromiser, which is something generally taken as a weakness, even by those people who superficially benefit from your compromise. For example: This woman who needs you to hear out all her life's troubles does know that neither of you are getting any work done during these times. She knows she is occupying your time when you are supposed to be doing something else--which could be phrased a different way that is more to the point: She learns that she can commandeer your time, and that even though patient care is stalled and your productivity is affected, you won't do anything about it.

*I'm not saying there is never a place to be a listening ear or to help a coworker, but these people are taking advantage of you and then despising you for it! This is borne out again through your example of them mocking you/complaining at the very instant you tried to help with a small portion of their work.

It's easily possibly to try too hard or try the wrong things to make people like/accept you. Those things are nearly guaranteed to have the opposite effect; they will tell people they can use you. Genuine acceptance often isn't instantaneous, and it often involves being steady, doing the right thing, gaining people's trust, as well as basic kindness (not "niceness" - read about the difference if you don't know; there are some very good articles online).

^ That is the bigger picture to this mess. You can't win people over with donuts and inappropriate compromises. They won't tell you this, but all it will do is make them despise, pity, and disrespect you.

You can be professional and kind and accepted. ??

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You need to think about your self. Time to move on because staff will get you in trouble. Would you like to loose you NP license ? I do not think so. It is not good place to work

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