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Maybe a less popular option...is 2nd/3rd shift hospital position an option?  Not necessarily ER but on the floor(or specialty hospital)?  I'm just thinking you'd have less interaction with angry docs and night shift folks tend to be a little less high strung.  Would help keep the income at least. 

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look into making the most of the degrees and interests you have. sounds like you don't want to work with patients or supervising physicians any more(or not much). that leaves some options without goin

You're in New York. I would eat a .40 cal round within 3 months if I had to live in NYC.   Move. Tomorrow. Most of America is still full of nice, respectful, hard working people. Find a rural FP

I think a lot of people go into medicine assuming it is populated by kind, caring people and then get very disillusioned to find it is populated by the same aholes that infest every other profession.

Maybe a less popular option...is 2nd/3rd shift hospital position an option?  Not necessarily ER but on the floor(or specialty hospital)?  I'm just thinking you'd have less interaction with angry docs and night shift folks tend to be a little less high strung.  Would help keep the income at least. 

 

my first job was 3-12s nights/weekends. it worked ok (except for the circadian rhythm disruption).

 

I'd work 2nd shift in a heartbeat, but being divorced now with a 15 year old...well, I'd never see her.

 

it is def an option on my horizen, when she gets older.

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Internet advice of this magnitude is intimidating to me. 

 

It's akin to, "I don't like my arm.  Should I cut it off?"  It's a hard call to make and I don't envy you in your position. 

 

From reading your posts and the background on you that you've given, you seem to be a passionate person who is trying to fit her square self into a round hole because of your title.  You have certain training, you have been given the privilege to care for other human beings and the responsibility of doing so and you don't feel that you can betray that honor.  But you work to live, not live to work and often in medicine the two don't mesh. 

 

My gut instinct is to say that you should not abandon being a practicing PA (I'm biased because I love my job and can't imaging doing anything else).  You, like all of us, worked hella hard to get here.  You succeeded where others have failed.  You are among a little over 100,000 other Americans who do this job.  The top 0.0003% of the population, as I like to say (tongue in cheek, of course).  So my gut says stay the course, but find out what compromises you can make that still make you happy. 

 

For example, I used to work 8 hrs in wound care, then 3 11s in urgent care, then 4 hrs in wound care again.  Then alternating weekends for the urgent care gig.  I hated my life.  Too busy, too many hours, too many people making demands of me.  So, I dropped 4 hrs of wound care and now I have 3 day weekends most of the time.  It was like a weight was lifted.  Now, this is not to say that my solution was what you need, but the question I have is this: What can you do in your current position that would make you happy? 

 

We need type B people in medicine. 

 

Hoping this gets you at least a half step toward what you seek. 

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Maybe a less popular option...is 2nd/3rd shift hospital position an option?  Not necessarily ER but on the floor(or specialty hospital)?  I'm just thinking you'd have less interaction with angry docs and night shift folks tend to be a little less high strung.  Would help keep the income at least. 

night shift rules are awesome...no admin folks around to tell you not to have coffee at your desk or nitpit BS stuff.

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If TV news is not your bag, and you've got experience with producing and editing, I'm seeing a really good option here: Podcast.

 

Or even better, once you've got 10 or 12 episodes of a podcast in the bag, see if your local NPR station wants to get behind some medical reporting/ storytelling. What was that one last year about the criminal case, where they interviewed everybody years after the fact and uncovered new stuff? Everybody was going nuts about the twists and turns. If you can present the info well, nothing is as dry as it might seem, even (or especially) complex stuff like law or medicine.

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Look.  Others have given you a lot of good suggestions.  Some are realistic (commute to a semi-rural practice, move to a different specialty where your state of mind might be more appreciated such as palliative care of integrative medicine, or to a low pressure area of medicine such as weight loss medicine) and others are less so.

 

However, based on your reply, and I sincerely do not mean to hurt your feelings but rather give you advice that will be applicable in your real life: I do not think finding a different job is going to do you much good.  I think the problem is you.  To be fired from 5/7 jobs, and your current job being on the fence in one way or another, then the problem is you.  It is not the boss, the patients, the atmosphere.  It is your own, personal issue.  Maybe medicine is not for you, or maybe you would be having these same struggles in any career path.  I wanted to be a writer too, and to some extent I can write a good H&P but I made a career decision similar to you: if I went into writing I would write on topics I did not enjoy, and I would grow to hate writing; thus, better to go into medicine and keep writing as a hobby.

 

I think you need to make a decision because honestly, I don't know how practical the advice given to you is or if you will follow it.  I was raised by a single parent who returned to school when I was around your kid's age and it only had positive impacts on me.  If you are so miserable, make the change.  I am willing to bet your child, later in life, if stuck in a job she hates, would look to you as a role model.  If this were your kid in a job she hated with a child (ie your grandchild), what would you tell her to do?  That is a good way to assess things, and then take your own advice.

 

If you decide that is not the best thing for you and/or your family, I do not think you will find your answer at a new job.  Where that the case, I think out of 7 jobs you would have found and stuck to one by now.  I am not trying to offend you, you are probably a great parent and PA.  But here is my advice, should you choose to stay in medicine: stop blaming others, stop complaining, stop blaming outside / external forces for your downfall.  Look at your own personal self.  Look at where you can improve, not where you can complain.  Find the silver lining.  Force yourself to find the good in your job.  Instead of complaining and expecting others to sort out your issues, find what YOU can do, on a day to day basis, to make your own life and work environment better.  Stop stirring up conflict and choose your battles more wisely in the future.  I sincerely hope this advice is helpful and not hurtful for you.  Just my two cents.

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this is something I'd really like to do. I was looking into it for awhile, but it seemed EPIC only trains people who are sent from a health care facility. I'll have to revisit it. and I have not heard of T-systems but will look into that too.

I have a buddy working for EPIC I could reach out to him...

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I have a buddy working for EPIC I could reach out to him...

That would be awesome - could you please do that and PM me? I was told by the CIO when I supported his hospital GoLive that was exactly the right kind of person with the right kind of mind for this. I did contact EPIC and rhey confirmed what I thought - they train only people who are sent by one their clients. I think I contacted them about same last year...and got the same answer; that's why I thought you couldn't just go there as an interested student and get trained.

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If TV news is not your bag, and you've got experience with producing and editing, I'm seeing a really good option here: Podcast.

 

Or even better, once you've got 10 or 12 episodes of a podcast in the bag, see if your local NPR station wants to get behind some medical reporting/ storytelling. What was that one last year about the criminal case, where they interviewed everybody years after the fact and uncovered new stuff? Everybody was going nuts about the twists and turns. If you can present the info well, nothing is as dry as it might seem, even (or especially) complex stuff like law or medicine.

I love that idea. I'll look into that too thanks!

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Problem child I've responded to a number of your posts and I see a recurring theme here---you keep landing in bad environments.

 

First, surgery. Second, surgical personalities and the gopher role of PAs in surgery. Third, NYC?!? GTFO of there.

 

I know moving is easier said than done. Interstate relocation is a HUGE undertaking especially when you have a family. But it may be the answer to finding a tolerable niche in this profession.

 

I was also about ready to throw in the towel a year ago because of a number of factors. I hated my job, I worked in a somewhat toxic an unprofessional environment, and i had bad experiences pretty much right out of the gates as a PA.

 

It turns out I had seen nothing but crap so I had no healthy frame of reference. There is tremendous variation in the day-to-day life of PAs. I've noticed my professional happiness depends directly on 3 things: 1. The amount of autonomy I have, 2. The volume of patients I am seeing per week, and 3. The type of patients I am dealing with each week.

 

If you have an interest in medical science and like to help people out, you can find a good niche as a provider.

 

Also, You may have already done this, but if you have been let go from 5 jobs, there has to be a common denominator here. It could be your attitude because you hated it so bad. I've lost jobs for that reason. But you have to nail down the pattern before you move on.

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Problem child I've responded to a number of your posts and I see a recurring theme here---you keep landing in bad environments.

 

First, surgery. Second, surgical personalities and the gopher role of PAs in surgery. Third, NYC?!? GTFO of there.

 

I know moving is easier said than done. Interstate relocation is a HUGE undertaking especially when you have a family. But it may be the answer to finding a tolerable niche in this profession.

 

I was also about ready to throw in the towel a year ago because of a number of factors. I hated my job, I worked in a somewhat toxic an unprofessional environment, and i had bad experiences pretty much right out of the gates as a PA.

 

It turns out I had seen nothing but crap so I had no healthy frame of reference. There is tremendous variation in the day-to-day life of PAs. I've noticed my professional happiness depends directly on 3 things: 1. The amount of autonomy I have, 2. The volume of patients I am seeing per week, and 3. The type of patients I am dealing with each week.

 

If you have an interest in medical science and like to help people out, you can find a good niche as a provider.

 

Also, You may have already done this, but if you have been let go from 5 jobs, there has to be a common denominator here. It could be your attitude because you hated it so bad. I've lost jobs for that reason. But you have to nail down the pattern before you move on.

 

I'm not so sure if it's my attitude as it is speaking up when I'm being beat up for no reason by nasty moonlighters who just want to pull rank, or attendings for same. They probably see that as an attitude. And while I'm not insubordinate in terms of medicine/medical care rank-and-file; I will speak up if I'm being over-used/abused. I am not disrespectful. I start every job cheerful, helpful, friendly, and optimistic. But I am not a submissive person, and when I am treated like sh&t just bc I am independent, or bc I expect to be treated as a colleague and with respect, I will speak up. it s invariably my downfall, as retribution snowballs and lands smack on me.

 

so in a sense, it is me. but that's what I mean when I say I may not be cut out for this profession. I just don't get it: like when to speak up, when to shut up, when to push back, when to crack a joke, and when to bust my butt to get something done. well, actually, I am usually busting my butt to get stuff done. then I just reach a breaking point.

 

I just don't know how to navigate the culture so I can function, have some boundaries, be treated with respect, and save my sense of self-worth.

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But I am not a submissive person, and when I am treated like sh&t just bc I am independent, or bc I expect to be treated as a colleague and with respect, I will speak up. it s invariably my downfall, as retribution snowballs and lands smack on me.....I just don't know how to navigate the culture so I can function, have some boundaries, be treated with respect, and save my sense of self-worth.

You are working in a specialty known for being run by douches.  Of course I am over-generalizing, but surgery is the LAST place where a PA expects to be treated as a colleague and with respect.  

 

You are also working in an environment run by douches.  Boston?  I am, again, over-generalizing, but Boston is a major epicenter of ultra-rich "DO YOU KNOW WHO I AM" snobs who look down on the rest of us.  

 

Add the two together and they don't bode well for a type B personality.

 

I've lived/worked in Boston and in San Francisco, small towns on both coasts, and a major city in the midwest.  I have been to NYC too many times to care for, and I choose to work in rural America because the people (and the docs) are much much better people.  

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Long story short Problem Child:  I'm becoming knowledgeable in legalese because of a bad experience with a bad doc.  The doc was unethical so I resigned.  Upon doing so, the boss was upset and kept my sick/vacation pay.  The medical board was notified of the unethical behaviors and thus an investigator was assigned to the case.  Being disillusioned, I thought of a career change into law - medical law.  Then I looked into the investigation part and found many cool things about it.  So, look around in your state for such a position where you can work independently but can use your medical understanding of the career.  And then go after those bad docs that are unethical - it makes me feel good thinking about it already.  

 

You say: "so in a sense, it is me. but that's what I mean when I say I may not be cut out for this profession. I just don't get it: like when to speak up, when to shut up, when to push back, when to crack a joke, and when to bust my butt to get something done. well, actually, I am usually busting my butt to get stuff done. then I just reach a breaking point."        

 

I totally get it - I have a very strong personality outside of work but am learning slowly and through mistakes when to push and when to walk away.  I still struggle with learning how to be professionally assertive - hard as heck as I don't want to really show them my aggressive side as I don't want to get fired (bills, etc).  My Mom said "Be a good Asian and sit still and clasp your hands and don't ever complain." But damn it, I don't want to shut up.  But I don't want to get fired either.  I feel your struggle.

 

When I lamented my situation to a NP friend, she said "It's funny - we (the medical folks) grow up simply thinking 'I want to help people.' But have you ever thought about what TYPE of people you want to help?"  Mind blown.  If I wasn't so old/lazy, I would go back to studying for law so I can help put people behind bars.  That's how I want to help people now - jaded, I know.  

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Sorry guys I was just joking ... I know some people in the medical community who are Type B's as well. In fact did you all know that their are four major categories that are used to assess personality type? (Something I learned while obtaining my BS psychology degree. At least it was good for something after all these years.). The two which we all know are: type A, B, but there is actually a Type C and Type D personalities.  Bear in mind, that no individual is just a single type but a mixture of other types, however one may prevail. 

 

  • Type A  –  competitive, over achiever, things done on time
  • Type B  –  calm, relaxed, laid back, flexible, analytical
  • Type C  –  detail oriented, not assertive, suppress wants, needs and desires
  • Type D  –  negative outlook on life, fear of rejection, prone to depression 
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funny thing is, I think people can be all of these at different times.

I think with work & school I am an A, but at home (alone) I am a B, but when dealing with the family I am a C (their needs come first, etc).

Never a D

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