lizchao74 Posted September 18, 2014 Share Posted September 18, 2014 I have worked for a medium-sized hospital organization in General Surgery for the last year, been a PA for 9 years. From day 1 the chief has been abusive and frequently volatile, and the remaining surgeons have been condescending and uninterested in my offering important details about patient care, because they prefer to socialize with each other during rounds and dump all the work on me and the other NP I work with (e.g., they show up to round for the first time around 4pm every day). They don't even submit their own billing charges when they see consults, we have to do it all for them. Despite busting my ass regularly, staying late, producing detailed, quality documentation and being communicative with all the surgeons regularly and trying to be a team player, my 6 month evaluation was "you are adequate enough to stay." The chief's work wife, a.k.a. an RN (and now dept manager) who has worked with him for 30 years, who came with him to this hospital 2 years ago, and who is unreasonably & ferociously loyal to him, has harassed me, denigrated me and is openly hostile to me on a regular basis, and both she and chief regularly show preferential treatment to the other NP who also came with them from their other hospital. This woman forced a confrontation where I finally asked her why she speaks to me abrasively and unprofessionally; the reasons she offered included how I expressed concern about one surgeon having us regularly prescribe abundant quantities of Percocet (50-60 pills) on discharge for patients who have had relatively minor procedures (i.e., lap appy), who says she doesn't care if patients sell it (and I quote), especially in our community where there is a LOT of drug abuse. Other complaints from this work wife RN have included my inquiries about proper billing practices to Risk Management("throwing colleagues under the bus" when I was looking for verification upon my NP colleague informing me that we submit level 5 billing charges for "everything," when it is clearly level 1 or 2 work and dictate notes that are 3 or 4 lines long. I am regularly turned down when I offer to scrub cases with any of the surgeons and they instead continue to use RNFAs (rather than bill for me, with 9 years of surgical experience), while the chief routinely books the NP for his cases (who just finished RNFA training and has minimal OR experience); I did my first case last Thursday in 2 months. Needless to say, I am miserable here, and these are miserable people. I have actually heard one of the surgeons say he "doesn't care if this woman lives or dies," when referring to one of our patients. I finally had it, and recently decided to start looking for a job elsewhere. The hospital is building its Ortho practice from scratch (after a mosaic of other practices fell apart and/or left), and the new Ortho chief actively recruited me, pleasantly asking me to "come over to the dark side." I have heard from many sources that he is a good guy, friendly, down to earth, not condescending even under pressure in the OR. He proposed to me a position with the new hand surgery group which was in the process of being created, with lots of autonomy, where I would practice very independently and generate real revenue. Ortho as a group required that I be the one to discuss my intent to transfer with my current chief (rather than give outside references), because they want to play nice with my current department. Therefore, I met with my current awful chief in late July about it, and he surprisingly said he would support my transfer and put in a good word for me when the chief-to-chief discussion takes place (not sure if he's just trying to get rid of me). Current chief was very seemingly supportive and would update me whenever he spoke with someone else in administration such as the physician in chief about supporting my job transfer. At that time, he talked about meeting with administration regarding hiring more PAs which he feels the department needs, and that he planned to ask about this especially in light of additional new surgeons being hired and my impending departure. During the very bureaucratic process that finally resulted in the position being approved, I was frequently keeping the chief apprised of any new development, and mention was made on several occasions about the hospital's policy of only holding employees for a maximum of 30 days prior to a transfer, and that Ortho was looking at a start date after 10/1 (new fiscal year). The position was approved and offered/accepted on 9/7, and I accepted and gave verbal notice to my current chief on Friday 9/8, wherein I also asked to be the one to share the news of my transfer myself with the rest of the team. As directed by Ortho, I also asked about establishing a start date (and reiterated the plan for an on-or-around 10/1 start date, as well as my plans to take a trip to Florida to visit my family in between the 2 jobs). Chief then asked me to not say anything to the existing dept, that he was meeting with administration the following Monday about how he needs more midlevels because of the imbalance in staffing between the 3 campuses, how our surgeons will start doing cases at another campus that only has 1 hospital-employed PA supporting a competing practice. Said that he wants to be able to announce my departure with "a plan," not just say I'm leaving because the other surgeons will be upset that there will be less coverage. He launched into a lengthy discussion about the politics of that competing group and their negotiations to have them join our group, and repeatedly "jokingly" said, "not like I'm trying to hold you hostage, but..." At the end of our conversation, when I told him I would be emailing him with written confirmation of the verbal notice I just gave of my intent to transfer, he asked me not to, and asked me to give him until Monday. I called HR to clarify when those 30 days start "ticking," and was given the advice to send the chief the written notice regardless but to do this on Monday so as to make it seem to him that I was complying with his request. On Monday, by 5pm, I didn't hear from him, so I composed an email saying that HR had clarified that written notice needs to coincide with verbal notice, and that I would be sending that email today, but to rest assured that I would not discuss my departure with anyone in the dept until he had had a chance to synthesize a plan with administration regarding further staffing needs. I added that I thought submission of my written notice would expedite posting the position and thus, a replacement. After I sent him a heads up text message to please check his email, he called me immediately. I was unable to come to the phone, and texted that I would call him in 30 minutes, and he replied deferring the conversation until the following morning. He called the next morning and briefly said that the result of the meeting was that I have to stay until they find a replacement, and that this was supposedly coming from the physician in chief, not him, and asked if I could refer any potential candidates his way. I said very little but politely agreed, but I was LIVID. I immediately called HR, and they said they would kick it up to their director, and agreed this was unreasonable. I reminded HR that even if they started interviewing TODAY, it can take up to 4 months to get a replacement in given the interview process, and subsequent lengthy credentialing process. Ortho has said it will take up to 3 months for me to be up and running with them, so that's more than half of the fiscal year where no revenue is generated, and, when the hell am I going to get out of here????? Later that day, I fortuitously met one of the administrative people involved in this decision to hold me hostage, who asked me to "be patient," and told me she would be posting my job that day (this was on 9/9). Here is the content of the governing policy: "When an employee is selected to fill a position vacancy, the appropriate site's Human Resources Department will coordinate all details incidental to the offer, including the coordination of an equitable transfer date. Transfer dates should normally be within a four (4) week period. An exception may be allowed to retain the employee in the current position longer than 4 weeks, from the date the position was filled, as determined by the needs of the current department, subject to review by the Director of Human Resources and involved department director. Should irreconcilable differences arise in determining the transfer date, the Director of Human Resources will resolve the situation." As of today (9/18), it has now been almost 2 weeks since my verbal notice, 10 days since my written notice, and about 2 MONTHS since I first expressed my intent to the chief to pursue another opportunity. The position has STILL not been posted (10 days since the admin lady said she would be posting it, I've been checking every day). HR is still waiting on "connecting" with this same admin lady, who is "probably busy finalizing the budget for the next fiscal year" which starts Oct 1, which made it sound to me like they were possibly considering NOT filling the position, but HR guy said that is not the case, that they don't plan on revoking any positions. NO news as to what the HR director has to say. I have heard NOTHING from my current chief as to whether I should say anything to anyone in the dept, although my inclination is to say nothing to avoid drama or weird attitudes from these already toxic personalities about my departure. Frankly, I can barely look at him because I am so enraged by this decision to keep me indefinitely until a replacement is found. Ortho is tiptoeing around this so as to not offend my current chief, but they too believe this is completely unreasonable, as this is losing money for them and also losing opportunities to capture business, build the service, etc. (Our dept isn't even that busy, but the Gen Surg chief wants to make it look like it is, despite my not generating any charges and seeing almost exclusively global/postop patients). Ortho admin guy said that *I* should set up a meeting with my chief and the physician in chief, which I think would get me nowhere as they would steamroll right over me. Ortho chief said this past Friday (almost 1 wk ago) that HE would talk with them and insist on getting me over to them asap. Meanwhile, I can't plan my vacation, buy plane tickets or plan my life because of this political drama. If I were taking a job outside of the system, I could have been long gone by now or at least have a set date to be out of there and no longer in a job in which I am miserable (which is known to HR and Ortho; I contacted HR about the situation re: the abusive chief months ago but then put a stop to the process because I feared retaliation). I am losing my patience playing nice, and am completely outraged. Any input and advice would be appreciated. Thanks and sorry for the long post. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 18, 2014 Moderator Share Posted September 18, 2014 give them an ultimatum date and leave. Link to comment Share on other sites More sharing options...
lizchao74 Posted September 18, 2014 Author Share Posted September 18, 2014 Are you suggesting the ultimatum be that I leave my current position to go to the other position, or that I will leave the organization altogether? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 18, 2014 Moderator Share Posted September 18, 2014 if you can transfer to a dept that is run better where you will be happy and not have to interact with your prior sps within the same organization do that asap. if not, leave asap. you have given your notice. get another job and leave. no reason to stick around for more abuse. Link to comment Share on other sites More sharing options...
Derbingle Posted September 18, 2014 Share Posted September 18, 2014 That is very well written, and I cant believe how some groups are abusing PAs. Disgusting that they simply consider no one else. Makes me feel very lucky at my job. Im surprised you are staying in the same hospital. Those surgeons can still make it so hard for you. If it were me, i do t think anything would make me stay in the vicinity. Nothing is worth being treated like that. If anything, sometimes you have to stand your ground and do what is right for you, vs tyring to figure out how to keep a house, your kids in same school, etc. you are working. An anchor. Self respect is so key. In other words, I would say, good luck finding an NP to do this job, bye bye. They dont own you. Human resources cant simply ignore your plans and agreements. Especially when theyve made no effort to facilitate things as far as new hire, for the group you are leaving. Good luck. Link to comment Share on other sites More sharing options...
KMD16 Posted September 18, 2014 Share Posted September 18, 2014 A very disturbing read. I will find another job ASAP! Link to comment Share on other sites More sharing options...
JFarnsworth Posted September 18, 2014 Share Posted September 18, 2014 I feel your pain, I really do, and I'm sorry that you are being treated this way. So many docs, nurses, NPs, and others still think PAs are the universal kicking boys (or girls)... I transferred from one surgical service to another and it did not go down well despite the surgeons always telling me what a mediocre job I was doing. They held me for the 30 days and I was free. Can your soon to be SP throw his/her weight around, kick up a fuss, and say that his/her department needs you, too? Usually admins will listen when there is a threat to potential revenue; some surgeons play hardball and threaten to utilize a facility less if they don't get the support they need. I will say this: of course I don't believe that any one should stay in a position like the one you're in. But to get the job you want, you may have to suck it up for a bit. Or, can you quit your job and then apply for the new position as an external candidate? The goal here is to get out of your current (sucky) job and start in that new (promising) job. Having a light at the end of your tunnel may also make it easier to deal with all the horse sh*t you have been enduring. I'd probably respond to each snarky remark or criticism with, "oh well, lucky for you I'm leaving soon!" Best of luck. Link to comment Share on other sites More sharing options...
gbrothers98 Posted September 18, 2014 Share Posted September 18, 2014 I think if you have to write a novella to describe how much your current job sucks and part of this story is that the whole environment sucks then it is clear what you should do. Then it is a matter of doing it. Good luck. G Brothers PA-C Link to comment Share on other sites More sharing options...
winterallsummer Posted September 18, 2014 Share Posted September 18, 2014 My question for you and others who write these types of posts: why the hell are you staying? You are experienced and you are miserable there. Am I missing something? Life is too short for this crap. You are a PA and a human. You should leave. I would tell them if you are not transferred in thirty or whatever days you will be leaving. Sounds like this group isn't going to be useful for a reference anyway. And if HR can't help you then you can try to help yourself and if it doesn't work out I'm sure there are PLENTY of ortho and surg groups that would be happy to have you and give you the respect you deserve. Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 18, 2014 Moderator Share Posted September 18, 2014 welcome to turf wars in hospital systems what I have found from being in one for a mere 2 years - no one looks out for you but you! Figure out what the regulations are - then use them to your advantage - along with the help of HR (who should be very interested in you staying with in the system) But yes this does mean laying the law down - 'giving notice' of one job and accepting the other - hopefully all together - - only when you finally professionally, and politely clearly state your needs and intention will you be taken seriously - just make sure you are not jumping from the frying pan into the fire...... HR should be your helper in this - as you want to stay in the same system.... Link to comment Share on other sites More sharing options...
Guest JMPA Posted September 18, 2014 Share Posted September 18, 2014 Are you suggesting the ultimatum be that I leave my current position to go to the other position, or that I will leave the organization altogether? are you a NP or PA? This can make a difference in your options. I get the impression that you are being toyed with. I would leave the entire facility immediately. there is no benefit of staying. Transferring to another dept will not help your situation. you have already been labled and probably blacklisted. start fresh at another place and leave the garbage behind. they do not deserve you. Link to comment Share on other sites More sharing options...
FBIDoc Posted September 18, 2014 Share Posted September 18, 2014 This seems to be a recurring theme on this forum...my advice, and advice I've used to my advantage, is to find another job while you have that crappy one. Play nice in the sandbox and then GTFO...let them wallow in the revolving door of mediocrity and do what's best for you and your family. If that means moving to a new position in the city or across country, makes no difference...I've hauled my fam across the country twice for this very reason. People forget that when you are interviewing for a job you're on your A game...but so is the prospective employer. There's always something going on behind the curtain that you won't finds out about until you take the plunge. Eventually you'll land on the greener side of the grass...I did. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted September 18, 2014 Share Posted September 18, 2014 ^^ Unless the prospective employer is the VA. I don't know if they have an A" game at present time. B? C? Link to comment Share on other sites More sharing options...
Incognito Posted September 19, 2014 Share Posted September 19, 2014 I wrote a long novella a week or so ago. The reason we write these things is that it is cathartic and can actually help us focus and write down exactly what the issues are. My little (long) novella crystalized my thoughts better and hopefully will help in my contract negotiation coming up on Monday. Also, will help me to focus on my upcoming interview for another job in October. Anyway, I lend my support to the OP of this novella. I get it! Keep your eyes open for other opportunities. Link to comment Share on other sites More sharing options...
lizchao74 Posted September 23, 2014 Author Share Posted September 23, 2014 Thanks to all of you for your posts. I emailed the director of HR with a very clear but polite message calling out my SP and laying out all of my grievances. The following morning the recruiter had my transfer date, and the HR guy and the director both emailed me back first thing in the AM letting me know this had been handled as of the previous afternoon. My future chief duked it out with the current chief, and apparently must have egg on his face now, because they gave me a transfer date that is exactly 4 weeks from when I gave my notice, no slack being given to him at all. My start date is October 6th! I had been planning that trip to Florida and had emailed the previous week that I would be postponing my trip to likely the following week (of the 29th), and took advantage of that to email my department confirming my vacation plans. Official email went out 1 hour later to all parties about my start date, so now it's just 1 more week with these clowns, then a week of vacation before I start! Feels good to have a chief that is supportive, and feels even better knowing that these awful people no longer have any power over me. Again, thanks to all of you for your input. And yes, these looong emails are in fact cathartic, and because our respective clinical environments are so particular and laden with details that matter, despite the tedium to the reader it can be therapeutic for the writer of the post. Some of us are more verbose than others, but thank goodness for the patient audience you all provide! Peace, Lissette Link to comment Share on other sites More sharing options...
JFarnsworth Posted September 23, 2014 Share Posted September 23, 2014 Good for you and congrats! It's always nice when your SP goes to bat for you. It speaks volumes. Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 23, 2014 Moderator Share Posted September 23, 2014 Thanks to all of you for your posts. I emailed the director of HR with a very clear but polite message calling out my SP and laying out all of my grievances. The following morning the recruiter had my transfer date, and the HR guy and the director both emailed me back first thing in the AM letting me know this had been handled as of the previous afternoon. My future chief duked it out with the current chief, and apparently must have egg on his face now, because they gave me a transfer date that is exactly 4 weeks from when I gave my notice, no slack being given to him at all. My start date is October 6th! I had been planning that trip to Florida and had emailed the previous week that I would be postponing my trip to likely the following week (of the 29th), and took advantage of that to email my department confirming my vacation plans. Official email went out 1 hour later to all parties about my start date, so now it's just 1 more week with these clowns, then a week of vacation before I start! Feels good to have a chief that is supportive, and feels even better knowing that these awful people no longer have any power over me. Again, thanks to all of you for your input. And yes, these looong emails are in fact cathartic, and because our respective clinical environments are so particular and laden with details that matter, despite the tedium to the reader it can be therapeutic for the writer of the post. Some of us are more verbose than others, but thank goodness for the patient audience you all provide! Peace, Lissette great job! This happens more then you can imagine in big systems...... still doc centered - but with being clear, concise and knowing what the 'rules' are means you can advocate for yourself and everyone else just has to go along. Typically HR will only step in when things are going poorly and you are about to quit....... Link to comment Share on other sites More sharing options...
winterallsummer Posted September 23, 2014 Share Posted September 23, 2014 Glad to hear that you advocated for yourself. And also that it worked out. Way to stand up for yourself! Link to comment Share on other sites More sharing options...
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